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

The authors reported an extremely rare case of ruptured aneurysm associated with persistent primitive trigeminal artery (PTA) and persistent metopic suture (metopism). A 46-year-old female suffered sudden onset of a severe headache with nausea and vomiting on February 24, 1991. She was transferred to Kagoshima Prefectural Oshima hospital from the other clinic on the next day. She complained only of severe headache on admission, and neurological examination revealed no abnormal findings. Plain craniograms disclosed a persistent metopic suture extending from the bregma to the midportion of the frontal bone. Computed tomography demonstrated a mild subarachnoid hemorrhage. The right internal carotid angiograms showed a ruptured aneurysm in the middle cerebral artery. These angiograms also demonstrated PTA originating from the cavernous portion of the internal carotid artery and ending at the mid-portion of the basilar artery. The frequency of angiographic demonstration of persistent primitive trigeminal artery is 0.1 to 0.3%. It is well recognized that approximately 14% of patients with PTA also have intracranial aneurysm. The incidence of persistent metopic suture in adults is 1-10%. After an extensive review of the literature we have concluded that there has been no case report of a ruptured aneurysm associated with PTA and metopism. The authors think that, in this case, the coexistence may be only incidental.
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PMID:[A case of ruptured aneurysm associated with persistent primitive trigeminal artery and metopism]. 807 97

The period of time between clinical manifestations and admission of 18 patients with pituitary apoplexy (PA) was of a mean of 6 days with the exception of two cases. Distribution by age and sex, absence of previous endocrinal clinical manifestations in 38.8% of the patients was similar to that of larger series described. Headache constituted an almost constant symptom. The most affected cranial pairs were II (12 patients), III and IV, both in 8 cases. Following decompression surgery, great improvement was observed in visual acuteness in 5 of these patients, and in the ophthalmoplexy in 8. Alterations in the level of consciousness is less and less frequent in the context of PA thanks to the diagnosis of less severe clinical episodes. Similarly, a high rate of clinical suspicion and the use of new imaging techniques (NMR) have contributed notably with the most outstanding findings being resumed. Moreover, a case of PA with associated intracranial aneurysm verified by carotid angiography is described.
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PMID:[Hypophyseal apoplexy: clinico-radiologic analysis and clinical course in 18 patients]. 844 94

A 54-year-old female presented with acute subdural hematoma secondary to rupture of an intracranial aneurysm. She was admitted with acute onset of severe headache, nausea, and vomiting. There was no past history of head trauma. Computed tomography demonstrated a left subdural hematoma with extension along the tentorium in the absence of subarachnoid or intraparenchymal hemorrhage. Angiography revealed an aneurysm of the internal carotid-posterior communicating artery which was oriented posterolaterally. Uneventful clipping was performed and the patient was discharged from hospital without neurological deficits. The possibility of aneurysmal subdural hematoma should be considered in the absence of trauma.
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PMID:Acute subdural hematoma without subarachnoid hemorrhage due to ruptured intracranial aneurysm--case report. 925 52

The occurrence of a subdural hematoma caused by the rupture of an intracranial aneurysm is rare. In our case, the patient is a 43-year-old woman who suffered from sudden onset of severe headache. Computed tomographic (CT) scan disclosed a subdural hematoma associated with subarachnoid hemorrhage. CT angiography and digital subtraction angiography revealed an elongated aneurysm adhering to the dura in the left Sylvian fissure. The subdural hematoma was evacuated and the aneurysm clipped. The patient made a full recovery.
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PMID:Acute subdural hematoma with subarachnoid hemorrhage caused by an intracranial aneurysm: a case report. 968 13

An unusual presentation of a giant intracranial aneurysm is demonstrated. The patient was a 58-year-old woman who developed sudden onset of headache followed by generalized seizures. CT scan showed a high-density lesion in the middle cranial fossa with extensive vasogenic edema. Possible mechanisms for the edema are discussed.
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PMID:Cerebral giant aneurysm with extensive vasogenic edema. 981 28

Three women, aged 54, 69 and 73 years, respectively, developed diplopia together with ptosis of an upper eyelid during light exercise or fatigue or continuous; in one patient the diplopia was followed by headache and vomiting. The diagnoses made were 'intracranial aneurysm', 'myasthenia gravis' and 'temporal arteritis'. Diplopia may be a symptom of a disorder timely diagnosis and treatment of which may prevent serious consequences.
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PMID:[Double vision as a symptom of a serious disorder]. 986 44

Intracranial aneurysms associated with moyamoya disease are often reviewed. Aneurysms not around the circle of Willis but on the collateral vessels are rare. A 71-year-old woman presented with sudden onset of severe headache and vomiting. CT scan showed an intraventricular hemorrhage from bilateral lateral ventricle to fourth ventricle. Cerebral angiography showed the occlusion of the terminal portion of the bilateral internal carotid artery with moyamoya vessels and three aneurysms at the distal portion of the left lateral posterior choroidal artery. Clinical symptoms improved day by day, but 17 days later, due to rebleeding of the aneurysms the patient fell into coma. The day after rebleeding, endovascular embolization was performed using liquid particle, and the left lateral posterior choroidal artery and the aneurysm were occluded. Brain infarction with massive brain edema of the left cerebral hemisphere resulted in the patient's death. The management of the aneurysms in the basal ganglia and on the collateral vessels associated with moyamoya disease is controversial. We suggest positive intervention during the acute stage for the peripheral artery aneurysms taking endovascular embolization into consideration to prevent rupture or rebleeding.
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PMID:[Moyamoya disease with intraventricular hemorrhage due to rupture of lateral posterior choroidal artery aneurysm: case report]. 1056 52

The present review focuses on subarachnoid haemorrhage (SAH) secondary to the rupture of an intracranial aneurysm, a condition with a high case fatality rate. Additionally, many of the surviving patients are left with significant disabilities. Risk factors for aneurysmal SAH include both genetic and acquired conditions. The most common presenting symptom is sudden onset of severe headache. Since headache is very common in the general population, it is not unusual that SAH is misdiagnosed at its onset with often catastrophic consequences. Unlike other acute neurological disorders such as brain injury, in which patient outcome is closely related to the extent of the injury occurring at the time of the trauma, patients with aneurysmal SAH are at risk of subsequent deterioration from 'avoidable' complications such as rebleed, vasospasm, hydrocephalus, and several other non-neurological general medical complications. Thus, the critical care management of the patient with SAH is of utmost importance in order to maximise the chances of satisfactory recovery. Although surgical clipping of the ruptured aneurysm remains the gold standard therapy, with the continuing refinement of endovascular techniques, a new, 'less invasive' option is now available, especially for patients considered poor surgical candidates.
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PMID:Subarachnoid haemorrhage: epidemiology, risk factors, and treatment options. 1104 18

Branchio-oto-dysplasia is characterized by abnormalities of embryonic branchial arch system and deafness inherited as autosomal dominant with variable gene expression. We present a rare case of multiple intracranial aneurysms associated with branchio-oto-dysplasia. A 40-yr-old man with severe headache presented as spontaneous subarachnoid hemorrhage on brain computed tomographic scan. The patient also manifested clinical features of branchio-oto-dysplasia and right hemifacial hypoplasia. Carotid angiogram confirmed an aneurysm in the anterior communicating artery. Intraoperative findings demonstrated multiple aneurysms in the anterior communicating artery and in the left posterior communicating artery, which were clipped successfully. Postoperative course was uneventful. This condition has not been reported previously. We also reviewed literatures to discuss whether the intracranial aneurysm was as a coincidental finding or a part of this malformation.
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PMID:Multiple intracranial aneurysms associated with branchio-oto-dysplasia. 1130 57

A case of persistent primitive proatlantal intersegmental artery (PPPIA) associated with a ruptured basilar bifurcation aneurysm was reported. A 44-year-old male with sudden headache was admitted to our hospital. CT scan revealed subarachnoid hemorrhage. Cerebral angiography revealed anomalous anastomosis between the internal carotid artery and the vertebral artery at the proatlantal region. This anastomosis branched off from the left internal carotid artery at the C4 level and joined the horizontal portion of the left vertebral artery. It was thought to be PPPIA. Angiography also revealed an aneurysm of the basilar bifurcation which was responsible for the patient's subarachnoid hemorrhage. The aneurysm was successfully treated by endovascular embolization with Guglielmi detachable coils in an acute stage, and resulted in good outcome. PPPIA with basilar bifurcation aneurysm has not been presented or reported in the literature to date. To our knowledge, this is the first report of such an association of vascular anomalies. The frequency of PPPIA combined with the intracranial aneurysm is relatively high, whereas the occurrence of PPPIA is extremely rare. Therefore, it was suggested that some congenital and/or hemodynamic factors changed by PPPIA may affect the pathogenesis of intracranial aneurysms.
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PMID:[A case of a persistent primitive proatlantal intersegmental artery with a ruptured basilar bifurcation aneurysm]. 1155 97


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