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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A man of 35 years, who had had three attacks of subarachnoid hemorrhage in the previous 3 years, was admitted to hospital with complaints of headache and priapism. There had been intermittent priapism with abnormal acceleration of sexual desire since the first attack, and erection of the penis had persisted with intolerable pain after the last attack of subarachnoid hemorrhage. A carotid angiogram revealed an aneurysm at the junction of the left internal carotid and posterior communicating arteries. Clipping of the aneurysmal neck was successfully performed. However, priapism continued for 22 days after the operation and resulted in sexual impotence. The neurological problems of priapism are discussed with special reference to a hypothalamic lesion caused by the ruptured intracranial aneurysm in this report.
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PMID:A case of priapism with ruptured intracranial aneurysm. 9 54

Extravasation of contrast media through ruptured intracranial aneurysm has been reported as an unusual case. Among the reported cases, a ventricular opacification is very rare, and in such cases, the prognosis is worst. In this paper, two cases with an aneurysm bleeding into the ventricular system were reported. Case 1. A 37-year-old woman was admitted because of severe headache and disturbance of consciousness. On admission, she was deeply comatose with decerebrate rigidity. Carotid angiogram taken 2 hours and 30 minutes after the attack revealed an aneurysm of the anterior communicating artery and an extravasation of contrast media into the lateral ventricle. Although a continuous ventricular drainage was instituted immediately, the patient died after five days. Case 2. A 33-year-old man suddenly developed severe headache with subsequent loss of consciousness. Two hours after the onset, the patient was admitted in comatose state. Angiography taken 3 hours after the attack demonstrated an aneurysm of the anterior communicating artery. The posterior horns of the lateral ventricles were opacificated. The patient died after 24 hours. In case 1, it was interesting that a remarkable stenosis of the cisternal portion of the internal carotid artery was demonstrated at the 2nd carotid angiography (lateral view), but the third carotid angiography taken after the continuous ventricular drainage showed a complete recovery from the stenosis. This stenosis was supposed to be caused by a compression of the internal carotid artery against the interclinoid ligamentum. Moreover, a rapid enlargement of the aneurysm was noticed by repeated angiography.
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PMID:[Intraventricular extravasation of contrast media through ruptured intracranial aneurysm--report of two cases (author's transl)]. 31 82

In a group of 281 cases of subarachnoid haemorrhages including 105 cases of intracranial aneurysms confirmed on autopsy or by angiography the authors analyse the symptoms preceding subarachnoid haemorrhage and suggesting presence of aneurysm. The most frequent symptom suggesting presence of intracranial aneurysm were headaches, especially associated with other symptoms such as dizziness, nausea, paraesthesiae of extremities, visual disturbances. A careful analysis of these symptoms and early radiological examination may help in establishing the diagnosis of aneurysm before its rupture.
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PMID:[Symptoms preceding rupture of subarachnoid aneurysms: an analysis]. 68 25

The hematomas occupied between the inner surface of skull and brain surface are well known and the majority of these intracranial hematomas are elicited by head injury. On the other hand, the intracerebral hematomas formed in the brain tissue are produced by the various causative diseases and the majority of these cause are cerebrovascular disease. The causative diseases of intracerebral hematomas were cerebrovascular diseases like hypertension, intracranial aneurysm and cerebral arteriovenous malformation in 65.7% and head injury in 32.4%. The cause of two cases were bleeding from asymptomatic brain tumors and formation of intracerebral hematoma produced initial clinical symptom of these cases. Age distribution of intracerebral hematoma has peculiarity in each causative disease. Hypertensive intracerebral hematomas occurred in patients over 30 years old and intracerebral hematoma due to bleeding from cerebral arteriovenous malformation was not observed in patient over 50 years old. The frequency of consciousness change as initial symptom of traumatic intracerebral hematome, hypertensive intracerebral hematome, intracerebral hematoma caused by bleeding from cerebral arteriovenous malformation and bleeding from intracranial aneurysm and spontane intracerebral hematome are 79.4%, 57.1%, 57.1%, 40.0% and 25.0% respectively. Headache as initial symptom are conspicuous in patients of intracerebral hematoma caused by bleeding from intracranial aneurysm and arteriovenous malformation, and each frequency were 86.7% and 71.4%. The frequency of motor disturbance as initial symptom was highest in patients of hypertensive intracerebral hematoma and its frequency was 50.0%. Clinical symptoms observed at admission were as follows: Consciousness change in patients of hypertensive intracerebral hematoma and traumatic intracerebral hematoma were 100% but in patients of cerebral arteriovenous malformation and intracranial aneurysm were 64.3% and 60.0%. Consciousness change in patients of spontane intracerebral hematoma were only 50.0%. Motor disturbance as clinical symptom were 85.0% in hypertensive intracerebral hematoma and this frequency was highest in all causative diseases. The frequency of coincidence between the side of dilated pupil under anisocoria and the side of hematoma was less than 50.0% in average and this frequency was marked lower by compared with the frequency in patients of hematome formed between the skull and brain surface.
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PMID:[On the intracerebral hematoma --clinical analysis of 105 operated cases-- (author's transl)]. 124 Aug 45

The elderly as a whole suffer fewer headaches than the young. For the majority headache will represent a minor annoyance to be endured or treated with any available drug in the medicine chest. For some, migraine headaches or tension-type headaches become entwined with every daily activity. With the advent of modern pharmacology, headache can often be treated successfully. Trigeminal neuralgia is a source of particularly high morbidity among the elderly, but may be treated very satisfactorily with carbamazepine or baclofen. Paroxysmal hemicrania is exquisitely sensitive to indomethacin, while cluster headache patients receive relief from oxygen inhalation, corticosteroids or lithium. Headache may be the signature of the disease which leads to serious morbidity and mortality. The 'sentinel' headache of subarachnoid haemorrhage is evaluated by a physician in 15% of patients who will eventually rupture an intracranial aneurysm. Morning headache with nausea and vomiting may represent increased intracranial pressure caused by a tumour, haematoma or abscess. The elderly patient with a new headache needs emergency evaluation for temporal arteritis and rapid corticosteroid treatment if the diagnosis is confirmed, to prevent blindness. The broad spectrum of headache, at times a benign aggravation, while at others the harbinger of death, makes the careful evaluation of each headache imperative. This article attempts to make the difficult evaluation of head pain a little easier.
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PMID:Treatment of the elderly patient with headache or trigeminal neuralgia. 179 4

A case of systemic lupus erythematosus (SLE) with subarachnoid hemorrhage due to a ruptured intracranial aneurysm is reported. A 31-year-old woman who had been treated with steroid for SLE was admitted to our department with severe headache, and nausea. CT scan showed subarachnoid hemorrhage and the left carotid angiogram revealed a small aneurysm at the supraclinoid portion of the left internal carotid artery. She had no neurological deficit. Hematological examination on admission showed disseminated intravascular coagulation (DIC), therefore, we decided to perform an intentionally delayed operation. In the meantime we treated the patient for DIC with FOY and methylprednisolone. The operation was performed after two weeks, when DIC had been eliminated completely. Postoperative hematological examination showed severe thrombocytopenia. We considered that SLE had come to the fore again, so we used Danazol in company with FOY and steroid. It seemed that Danazol was very effective for her. She was discharged about two months after admission with no problem. Cerebral apoplexy, such as cerebral infarction and cerebral hemorrhage, has often been seen in SLE, but subarachnoid hemorrhage due to a ruptured aneurysm is very rare. We could find only five reports of this phenomenon. Their prognoses were all, unfortunately, poor. It should be born in mind for therapy that a patient in SLE has a tendency to bleed. It seems that repeated hematological examinations and quick and proper management are important. We think that the aneurysmal formation in SLE is due to lupus vasculitis or the fragility of blood vessels due to a long use of Steroid.
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PMID:[A case of systemic lupus erythematosus with subarachnoid hemorrhage due to ruptured aneurysm]. 220 86

We successfully performed craniotomy and mitral valve replacement on a patient with bacterial endocarditis and ruptured intracranial aneurysm. A 15-year-old woman with fever and heart murmur was admitted to another hospital. Infective endocarditis and mitral valve regurgitation was diagnosed and treated with antibiotics. About one month after admission the patient suddenly showed severe headache and hemiparesis. Brain CT demonstrated intracerebral and subarachnoidal hemorrhage. The patient was unconscious when transferred to Mitsui Memorial Hospital where cerebral angiography showed anterior cerebral aneurysm and echocardiography showed mitral valve vegetation. We judged the necessary mitral valve replacement could be delayed until the aneurysm had been stabilized. We therefore began treatment using a different antibiotic but, in spite of this, 10 days later the aneurysm had enlarged dramatically. As conservative treatment was ineffective, a clipping operation was done to prevent re-rupture at the time of mitral valve replacement which could not be delayed much longer. 10 days later, cerebral 4 vessel study was done which showed no abnormality. Mitral valve replacement was then done and the patient was discharged in good health 64 days after the valve replacement.
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PMID:[Valve replacement in infective endocarditis with mycotic aneurysm]. 226 95

Two cases of ruptured intracranial aneurysm with severe DIC were reported. One case recovered due to early treatment. A 65-year-old man was admitted to our hospital in June, 1987 because he was suffering from sudden severe headache and nausea. On admission, CT-scan angiograms disclosed moderate subarachnoid hemorrhage (SAH) and probable ruptured anterior communicating aneurysm. However definitive diagnosis was not made at that time. On the 15th day after SAH, he had high fever and low blood arterial pressure. His laboratory findings were consistent with DIC, and therapy of FOY was then started with transfusion of fresh blood two days after. His laboratory findings and clinical status improved gradually and he underwent uneventful operation of the aneurysm on the 42nd day after SAH. Another case concerns a 71-year-old woman who was admitted to our hospital in June, 1988 because she had lost consciousness. On admission, CT-scan disclosed severe SAH and next day an operation was performed. On the 6th day after SAH, she showed clinical and laboratory evidence of severe DIC and died two days later. The association between DIC and ruptured intracranial aneurysms have been rarely mentioned in past reports. But the association might occur more frequently than we have supposed, and so more immediate and careful diagnosis and proper treatment for DIC should be given.
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PMID:[Studies of two cases of ruptured intracranial aneurysm with disseminated intravascular coagulation]. 251 15

Recently it was contended that it is bloodstained cerebrospinal fluid (CSF) that is important in the diagnosis of subarachnoid haemorrhage (SAH) and not xanthochromia, and also that a normal CT scan and the absence of xanthochromia in the CSF do not exclude a ruptured intracranial aneurysm. The CSF findings were therefore reviewed of 111 patients with a proven SAH. All patients had xanthochromia of the CSF. Lumbar punctures were performed between 12 hours and one week after the ictus. Xanthochromia was still present in all (41) patients after 1 week, in all (32) patients after 2 weeks, in 20 of 22 patients after three weeks and in 10 of 14 patients after four weeks. In six years we identified only 12 patients with sudden headache, normal CT, bloodstained CSF, and no xanthochromia. Angiography was carried out in three and was negative. All 12 patients survived without disability and were not re-admitted with a SAH (mean follow up 4 years). It is concluded that it is still xanthochromia that is important in the diagnosis of SAH and not bloodstained CSF. Furthermore a normal CT scan and the absence of xanthochromia do exclude a ruptured aneurysm, provided xanthochromia is investigated by spectrophotometry and lumbar puncture is carried out between 12 hours and 2 weeks after the ictus.
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PMID:Xanthochromia after subarachnoid haemorrhage needs no revisitation. 232 63

Intracranial aneurysms arising in the region of the cavernous carotid artery are difficult to manage surgically because of the surrounding cavernous sinus. With recent advances in microballoon technology and permanent solidification agents, it is now possible to treat certain intracranial aneurysms by detachable balloons and preserve the parent vessel. A patient with Marfan's syndrome presented with severe retroorbital pain, ophthalmoplegia, and headaches. Cerebral angiography demonstrated a large cavernous carotid artery aneurysm measuring 17 X 9 X 6 mm. This was successfully treated by placing three detachable balloons within the aneurysm and preserving the carotid artery via a transvascular approach. Intravascular detachable balloon embolization may offer a form of alternative therapy for the management of surgically difficult aneurysms.
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PMID:Cavernous carotid artery aneurysm associated with Marfan's syndrome: treatment by balloon embolization therapy. 335 78


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