Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cilostazol (6-[4-(1-cyclohexyl-1H-tetrazol-5-yl)butoxy]-3,4-dihydro-2 (1H)-quinolinone, OPC-13013) is an anti-platelet aggregating and vasodilating drug. But cilostazol is known to have a tendency to cause headache, which is thought to be due to the dilatation of the external carotid artery. In the present study the effect of cilostazol on the blood flow in the carotid arteries was established by the Doppler ultrasound technique. Twelve patients with cerebral infarction (mean age 66.3 years) were divided into two groups consisting of 9 patients (Group 1) who did not have headache during treatment with cilostazol and 3 patients (Group II) who complained of headache. The systolic peak frequency (PEAK) of the common and external carotid arteries was measured using a Doppler ultrasound device. The PEAK of the common and external carotid arteries were examined before and 4 weeks after oral administration of 200 mg/d, 100 mg twice a day, cilostazol. In Group I, the PEAK in bilateral common carotid arteries increased significantly after treatment with cilostazol, but the PEAK in bilateral external carotid arteries showed no significant change. In Group II, the PEAK in both common carotid arteries showed no significant change after treatment with cilostazol, but the PEAK in the right external carotid artery increased significantly.
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PMID:Increased external carotid artery blood flow in headache patients induced by cilostazol. Preliminary communication. 238 1

Segmental arterial narrowing has rarely been angiographically demonstrated in patients with migraine. One new case is reported and 12 previous cases are reviewed. Though often referred to as vasospasm, arteriographic stenosis may result from edema of the vessel wall, arterial dissection, the effects of puerperium or arteritis. A biphasic course of spasm, similar to the pattern noted with subarachnoid hemorrhage, has been recorded in some migraineurs. The current neurogenic and biochemical concepts of "spasm" developed for subarachnoid hemorrhage are reviewed. Arterial narrowing may be important in several phenomena associated with migraine. It may account for migrainous cerebral infarction or hemorrhage. Vasoconstriction has also been invoked to explain the aura and other features of migraine. But the site of stenosis does not always correlate with the headache or focal neurologic features in location or timing. The angiographic changes are probably an epiphenomena rather than a primary mechanism of migraine. These changes may result from altered sympathetic neuronal activity; factors supporting that concept are reviewed.
Headache 1990 Jan
PMID:Arterial stenosis in migraine: spasm or arteriopathy? 240 21

Of the patients who underwent surgical treatment for the respiratory system at our hospital over the past 9 years, 6 were postoperatively complicated with chylothorax, 1 with liquorrhea and the other one with paraplegia. Chylothorax occurred after mediastinal lymph node dissection which was carried out for the treatment of malignant tumors. In five cases, it occurred on the left side, and in the sixth case, it occurred on the right side. In 2 patients who received conservative treatment, there was no reduction in chyle outflow, and they died of cerebral infarction and sepsis. The other 4 cases were surgically treated. In 3 of them, the impaired site of the thoracic duct was confirmed by administration of Sudan III before surgery. We confirmed that early reoperation for the chylothorax after lung resection should be performed. Liquorrhea occurred from the 5th costvertebral joint which had been directly infiltrated by lung carcinoma. Fortunately, the postoperative course was uneventful, though the patient complained of dizziness and headache until 14 postoperative days. The case of paraplegia was caused by oxydized cellulose cotton that entered the epidural space via the intervertebral foramen. It was used for hemostasis in the 5th costvertebral joint. This case indicates that oxydized cellulose cotton, which swells when it absorbs water, should be carefully used for hemostasis around the nerves.
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PMID:[Complication related to operative procedure in lung cancer and mediastinal malignancy--report of 6 cases]. 258 77

Sixty-one consecutive patients, less than or equal to 40 years old, were hospitalized for cerebral infarction between 1977 and 1985. Evaluation included computed tomographic brain scan, arteriography, echocardiography, and blood tests. A probable migrainous infarction was diagnosed in six patients (10%) (all women with a history of migraine) who survived the initial stroke and were followed-up for an average of four years. In five patients the stroke occurred during a common migraine attack and in one patient during a classic migraine attack. The site of infarction was invariably the occipital lobe. During the follow-up, no subject had a further stroke. All six women had a permanent hemianopic deficit.
Cephalalgia 1989 Dec
PMID:Ischemic stroke in young adults: the relevance of migrainous infarction. 261 82

Utilizing data from seven independent double-blind controlled trials for cerebrovascular diseases (CVD) in chronic stages, a study was performed to describe the short-term prognosis of cognitive impairment with CVD patients and to identify correlating factors. 943 patients out of 2,818 with CVD (cerebral infarction, cerebral hemorrhage and brain arteriosclerosis) were selected. The subjects had more than moderate intellectual deterioration, i.e., less than 21.5 points on Hasegawa's dementia scale (HDS) at the baseline of the trials. The improvement rate was estimated at 11% (102/943) with more than a 10 point change on HDS in 8 weeks and 34% (322/943) with more than a 5 point change. Long duration of illness, old age, severe initial global severity rating and severe initial cognitive impairment were correlated significantly with aggravation of cognitive impairment. However, sex, type of CVD, complication and rehabilitation were not markedly related with aggravation. In addition, it appeared clear that there was a tendency of improving cognitive impairment on patients with severe subjective symptoms (vertigo, headache, dull headache, feeling of congestion), anxiety, irritability in consequence of the covariance analysis of adjusting for duration of illness, age, global severity and initial cognitive impairment. On the other hand, incontinence, impairment of activities of daily living (excretion), motor weakness and low total protein correlated significantly with aggravation. These findings might be explained on the basis of changes in stages from reversible to irreversible with cognitive impairment, the contribution of aging and the influence of peripheral symptoms.
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PMID:[Short-term therapeutic prognosis of cognitive impairment with cerebrovascular diseases in chronic stages]. 261 1

The MR scans of seven patients with intracranial carotid occlusion (five proved, two presumed) were reviewed to evaluate the MR signal characteristics seen in this disorder. Five patients had clinical signs of cerebral infarction. Of the remaining two patients, one was asymptomatic and the other had a long-standing occlusion and headaches. We correlated the MR findings with cerebral angiography in five patients and with CT scans in six patients. All occluded vessels demonstrated MR signal predominantly isointense to brain on proton-density- T1- and T2-weighted images. Since there is an absence of flow, the MR signal is based on the intrinsic properties of the arterial thrombus and possibly on the chronicity of the occlusion. The pathogenesis and histopathology of intravascular thrombus differ significantly from extravascular hematoma, which accounts for the differences in their MR signal characteristics. The demonstration of occluded intracranial vessels may solidify the diagnosis of stroke in cases in which clinical and/or CT findings are equivocal. In patients presenting with infarction, an occluded carotid artery by MR may obviate the need for angiography; however, the demonstration of a patent carotid in conjunction with infarction suggests the possibility of an embolus, which may require angiography. We believe that MR is a valuable adjunct to CT in evaluating patients with cerebrovascular infarction.
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PMID:MR imaging of intracranial carotid occlusion. 271 64

Deferoxamine (DFO) has been widely used in the treatment of aluminum toxicity in patients on chronic dialysis. Mucormycosis is an opportunistic infection caused by fungi of the Mucorales order and some reports suggested a role for DFO in the precipitation of this infection. A 50-year-old man had been on hemodialysis for 16 years. 6 weeks before admission, he was begun on DFO because of aluminum toxicity. 2 weeks before admission, general fatigue and fever developed and followed by headache and loss of vision. He was admitted to this hospital with disturbed consciousness. His clinical course and a CT scan of the head suggested cerebral infarction. Within 24 hours he required ventilatory support and died 5 days after the admission. On autopsy, rhino-cerebral mucormycosis was demonstrated with a mycotic thrombus involving the left middle cerebral artery. Dialysis-related mucormycosis has recently appeared in the literature. We feel that hemodialysis patients on DFO may be at risk for potentially fatal mucormycosis infections. With a possible relationship between DFO treatment and this fatal opportunistic infection, caution should be given before using this drug and the indications should be definitive.
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PMID:[A case report of rhinocerebral mucormycosis in hemodialysis patient receiving deferoxamine]. 274 4

Thirty outpatients with unruptured cerebral aneurysms screened by computed angiotomography have been analysed and followed up in our clinic since 1979. Seventeen were men and the age range was 41 to 74 years old (mean 57.7 years). Patients had no or only mild neurological symptoms, such as headache, sensorimotor or speech impairment and others, which were scarcely related to the unruptured aneurysms themselves. It is important to realize that these first aneurysms which remain unruptured, have a primary significance to the individual in the protective aspect of an initial subarachnoid haemorrhage. Operation was successfully performed in fifteen patients. Transient aggravation of previous diseases, e.g. cerebral infarction, occurred in three after operation. Follow-up studies of fifteen patients without operation revealed no change in eight and some worsening or death due to other or previous diseases in six. One died of aneurysmal rupture in the 5th month after its detection. Because of the low operative risk, we advocate the operative treatment of unruptured aneurysms, following careful selection of the indicated patients.
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PMID:Screening and treatment of unruptured cerebral aneurysms. 287 10

Isolated angiitis of the central nervous system (IAC) is usually a fatal inflammatory disease with a predilection for small blood vessels. Recurrent cerebral infarction leading to death within a few years is the usual course, but this may be significantly altered by aggressive immunosuppressive therapy with prednisone and cyclophosphamide. Other diseases may, however, present with similar clinical and angiographic features. Because antemortem diagnosis suggests a therapy, establishing the criteria for diagnosis is important. This report describes clinical, angiographic, and biopsy features, and therapy of five successfully treated patients with IAC. The following specific criteria are recommended for establishing an antemortem diagnosis of IAC: (1) clinical pattern of headaches and multifocal neurologic deficits present for at least 6 months, unless the deficits are severe at onset or rapidly progressive; (2) cerebral angiography demonstrating segmental arterial narrowing; (3) exclusion of systemic inflammation or infection; and (4) leptomeningeal/parenchymal biopsy demonstrating vascular inflammation or exclusion of alternate diagnoses. Based upon the successful management of these five previously unreported patients, as well as others in the literature, the following treatment regimens are recommended for the initial 6 weeks of therapy: (1) prednisone 40 to 60 mg/day, and (2) cyclophosphamide 100 mg/day.
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PMID:Diagnosis and management of isolated angiitis of the central nervous system. 258 87

This review of the effects of sex steroids and oral contraceptives (OCs) on neurologic function in health and disease covers the following: sex steroids and their interaction with neural tissues; the human menstrual cycle and OCs; and sex hormones and OCs in human neurologic disease, i.e., stroke (thromboembolic cerebral infarction, subarachnoid hemorrhage, vascular malformations, and cerebral venous thrombosis), migraine, movement disorders, nervous system neoplasm, and the peripheral nerve. The various sex hormones may exert their effects on the nervous system directly or undergo conversion to more active metabolites. Interactions of sex hormones with neural substrates subserve numerous activities essential to both the well-being and perpetuation of the individual and the species. These interactions are key to the sexual differentiation of the brain, control of the brain-pituitary-gonad axis, and to the establishment of normal patterns of sexual and aggressive behavior in both sexes. Additionally, they play a role in temperature regulation (progesterone), caloric homeostasis (estrogen), and possibly sensory discrimination. The potent influences exerted by sex steroids on catecholamine and indoleamine turnover and the colocalization of labeled E2 within catecholamine and luteinizing hormone-releasing hormone (LHRH) positive perikarya suggest that many of the physiologic effects of sex steroids are mediated by modulation of specific monoaminergic and peptidergic pathways. Estrogens and aromatizable androgens also induce irreversible structural alterations in the rodent hypothalamus during the neonatal and peripubertal periods that are predominantly synaptogenic. In adult mammals, estrogens induce pathologic changes in the hypophysiotropic hypothalamus that may contribute to reproductive senescence in some species. Data from a series of retrospective and prospective studies have implicated OC use as an independent risk factor for the development of hemorrhagic and nonhemorrhagic stroke. Hormonal changes accompanying the pregnant state and the estrogen (and possibly progestogen) content of OCs may be predisposing factors in thromboembolic cerebral infarction, subarachnoid hemorrhage, cerebral venous thrombosis, and bleeding from intracranial and spinal vascular malformations. There are well-documented temporal associations of migrainous headache with specific phases of the menstrual cycle and the modifying influences of pregnancy, the menopause, and OC use. Also well established are relationships between endogenous and exogenous sex hormones and chorea. Fluctuating sex steroids also influence neuropsychiatric states, such depression and neuroendocrine disorders.
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PMID:Neurology of sex steroids and oral contraceptives. 302 81


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