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

The here presented case concerns a 74-year-old woman treated for many years with steroids and immunosuppressive drugs during pancytopenia. Seven days before her death she developed severe headaches and visual disorders, rapidly increasing disturbances of consciousness and a temperature of 40 degrees C. The course of the disease was violent with meningeal syndrome and cerebral coma. The cerebrospinal fluid was purulent, pleocytosis 1235/ml, with prevalence of polymorphonuclear leucocytes (88%) and an protein level increased to 210 mg%. In autopsy no mycotic changes were found in the internal organs whereas in microscopic examination of the brain the dominant finding was the presence of numerous filamentous bodies with septa characteristic of aspergillus which were visible both in microthrombi in the lumen of meningeal and interstitial vessels and in the areas of extensive necroses in both cerebral hemispheres and the brain stem as well as within granulomas occurring on the edges of necrotic foci and in the inflammatory infiltration of the brain base meninges. The presence of aspergillus hyphae was usually associated with a severe inflammatory reaction of polymorphonuclear leucocytes, acidophilic and plasmatic cells in microabscesses and in the inflammatory infiltration of meninges or in the form of granulomas composed mainly of multinucleated giant cells of Langhans or of foreign body type and mononuclear cells. The etiopathogenesis of these changes is discussed. The role of the facilitating factor could have been played by protracted therapy with steroids and immunosuppressive drugs and/or by pancytopenia itself which is probably associated with abnormal immunological response. Noteworthy is the fact that the seldom described mycotic changes caused by aspergillus concerned in the present case the central nervous system exclusively.
 ...
PMID:[Aspergillosis of the brain in a patient with pancytopenia]. 262 81

Thirteen cases of pneumoencephalos attended at our hospital in a four-year period are reported. All the cases were men; mean age was 47.2 years. The most frequent cause was injury (seven cases) followed by surgical procedures (five cases); in one case, pneumoencephalos was secondary to barotrauma. In the initial period, the most frequent clinical features were impairment of level of consciousness and psychomotor agitation (84%), whereas in the established period, deep coma (Glasgow scale less than or equal to 7) predominated in 69% of patients. Only 16% of patients complained of headache. The most frequent localization of gas was in subdural space (54% of cases) followed by subarachnoid space (23% of cases). Twenty-three percent of patients presented tension pneumoencephalos. With respect to distribution of gas, 53% of patients presented pneumatocele, 38% of patients had pneumoencephalos, and 15% presented a laminar distribution of the gas. Pneumoencephalos is usually associated to a high mortality rate; 53% of our patients died. In the postsurgical group, mortality rate was 60% and in the posttraumatic group, mortality rate was 43%.
 ...
PMID:[Pneumoencephalos: etiology, pathologic significance and diagnosis. Apropos of 13 observations]. 263 1

This article reported a familial occurrence of intracerebral cavernous angioma in four members of one generation diagnosed by X-ray CT, MRI or operative specimen. Case 1, a 34-year-old female, was examined just after an episode of sudden convulsive seizure. On examination, she had a cutaneous angioma without any neurological deficit. X-ray CT revealed a high density mass lesion in the left frontal lobe, and MRI demonstrated a mass lesion in the chronic stage with an old hematoma circumscribed by hypointensity ring indicating peripheral hemosiderosis. Complete excision was carried out and a diagnosis of cavernous angioma was made after histological examination. Case 2, the 37-year-old brother of Case 1, suddenly developed left hemiparesis and hypesthesia with severe headache. X-ray CT revealed a high density mass in the right parietal lobe and two other calcifications. The right parietal lesion was excised and a histopathological diagnosis of cavernous angioma with intracerebral hematoma was made. Case 3, the 49-year-old sister of Case 1, suddenly fell into a coma and was admitted immediately. X-ray CT revealed a large pontine hemorrhage. She died on the 4th day of hospitalization without operative treatment. Necropsy was not carried out. Case 4, the 39-year-old sister of Case 1, was asymptomatic, however, she was examined on the supposition of a familial occurrence of intracerebral cavernous angioma. On examination, it was found she had multiple cavernous angioma without any neurological deficit. X-ray CT revealed parietal intracerebral calcification. MRI demonstrated a mass lesion with peripheral hypointensity ring in the right parietal lobe, and another small lesion in the pons.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Familial occurrence of intracerebral cavernous angioma]. 265 57

A case of essential thrombocythemia (ET) associated with subdural hematoma and postoperative intracerebral hemorrhage was reported. A 57-year-old man had complained headache in the morning. Six hours later he was found unconsciousness and soon he was brought to our hospital. On admission he was comatose. There was no evidences of head injury and the X-rays were normal. A computed tomography (CT) scan revealed an acute subdural hematoma over the left temporoparietal region. Laboratory data revealed thrombocytosis of 85.7 x 10(4)/mm3 with increased red and white blood cell counts. Emergent right craniotomy was performed and a subdural clot was evacuated. Neither cortical damage nor vascular malformations were seen on the cortical surface. But a spurting cortical artery with a pin-hole could be seen. A postoperative CT scan revealed an intracerebral hemorrhage deep in the right hemisphere. Cerebral angiograms revealed no vascular anomalies. Postoperatively, the platelet count remained high and laboratory data including bone marrow finding, neutrophil alkali-phosphatase score and chromosome analysis were consistent with the diagnosis of essential thrombocythemia. The mechanisms of subdural hematoma formation and postoperative intracerebral hemorrhage associated with essential thrombocythemia were discussed.
 ...
PMID:[Essential thrombocythemia associated with subdural hematoma and postoperative intracerebral hemorrhage--a case report]. 271 68

A case of an acute intracranial subdural haematoma occurring shortly after spinal anaesthesia is reported. A 67 year old poorly controlled hypertensive man, ASA II, underwent removal of a prostatic adenoma under spinal anaesthesia. He complained of postural headache on the third day after surgery. Unresponsive to the usual analgesics, his headache became severe, persistent and non postural on the fifth day. Twenty-four hours later, he suddenly presented with a left hemiplegia and became comatose. Computed axial tomography showed a large left-sided subdural haematoma, lying over the left hemisphere. During the immediate surgical removal, a pulsatile arterial bleeding originating from a small cortical artery was discovered, and stopped. The patient slowly recovered consciousness, but the hemiplegia remained. He finally died six months later of bronchopneumonia. The link between the haematoma and the spinal anaesthetic is not proven; the possible relationship between the two is discussed.
 ...
PMID:[Acute intracranial subdural hematoma of arterial origin after spinal anesthesia]. 273 74

Carbon monoxide poisoning causes tissue hypoxia because of reduced transfer and altered release of oxygen by hemoglobin. Considering many case histories, we realized that symptoms and clinical signs of acute poisoning are mostly neurologic: coma, headache, dizziness, vomiting. On the contrary, it seems that myocardium, the other organ which mostly requires O2, is attacked in a "silent way". ECG in 5 patients with accidental carbon monoxide poisoning underlined that cardiac rate increased (3 of them presented tachyarrhythmias by atrial fibrillation) and the presence of more or less important alteration of ventricular repolarization like "subendocardial lesion". Simple hyperbaric oxygen treatment determined the regression of the rhythm disorder and of the abnormalities of ventricular repolarization. The only patient who had not the restoration of sinus rhythm had chronic atrial fibrillation.
 ...
PMID:[Cardiologic aspects of carbon monoxide poisoning]. 275 46

D-Lactate-associated encephalopathy is a rare clinical syndrome characterized by dizziness, ataxia, confusion, headaches, memory loss, lethargy, and aggressiveness which may progress to frank but reversible coma. It occurs in patients with profound dysfunction of the short-bowel syndrome and is believed to result from massive carbohydrate malabsorption with resultant over-production of D-lactate and other organic anions by the colonic flora. Extremely elevated serum levels of D-lactate (but not L-lactate) confirm the diagnosis, but currently D-lactate is not clearly established as the putative neurotoxin. We describe a patient who repeatedly developed D-lactate encephalopathy after surgical removal of nearly the entire jejunum and ileum. Markedly elevated D-lactate serum levels were documented during an encephalopathic episode. Potential pathophysiologic mechanisms and the treatment rationale are discussed.
 ...
PMID:D-lactate-associated encephalopathy after massive small-bowel resection. 276 Apr 34

Angiomatous malformations of the central nervous system are relatively rare and have a serious prognosis. Clinical manifestations of such lesions of the spine include back pain associated with motor and sensory weakness, progressing to complete paraplegia. In angiomatous involvement of the brain, the symptoms may progress from headaches to coma and death. Computerized tomography and magnetic resonance imaging are new noninvasive modalities used in the diagnosis of such malformation, but they have not replaced myelography and angiography. Up to the past decade, the management of angiomatous lesions of the CNS was only surgical. Angiographic embolization is now widely accepted as an alternate method of management. Experience with embolic treatment of 3 cases is reported. In a 15-year-old boy with two adjacent thoracic vertebral hemangiomas (D7 and D8) compressing the spinal cord, embolization was used before surgery. A 23-year-old man with acute myelopathy due to extraretro-medullary arteriovenous malformations of the spinal cord (D9-D11) was successfully treated by selective embolization via catheter of the right 10th intercostal feeding vessel. An 82-year-old man had proptosis, bruit and pulsation in the right eyeball and loss of vision. Arteriovenous malformation of the dura of the anterior cranial fossa was demonstrated and was completely cured by bilateral selective embolization of the feeding branches of the internal maxillary arteries.
 ...
PMID:[Angiographic management of angiomatous malformations in the central nervous system]. 279 43

Headaches, vomiting, and altered sensorium can be seen in patients with shunt malfunction as well as in those with migraines. We report five cases in which children with hydrocephalus and CSF shunts presented with a variety of recurring symptoms, including headache, vomiting, impairment of consciousness to the point of coma, and, in one patient, decerebrate posturing. Various diagnoses were entertained: shunt malfunction, slit ventricle syndrome, and low pressure (overshunting). Repeated procedures were carried out in all patients, including shunt taps, multiple shunt revisions, and a subtemporal decompression. When the diagnosis of migraine was considered, four patients improved on propranolol therapy; one failed this therapy but responded to verapamil. We conclude that in patients with hydrocephalus and repeated bouts of symptoms such as headaches, vomiting, and impairment of consciousness and in the case of documented, adequate shunt function, the diagnosis of migraine be entertained before further operative intervention is undertaken.
 ...
PMID:Migraine headaches in hydrocephalic children: a diagnostic dilemma. 280 2

Metastasis of hepatoma to the central nervous system is rare, although hepatoma is a relatively common malignant tumor in Japan. Much rarer is metastatic hepatoma presenting as intracranial hemorrhage and there have been only 4 cases reported in the past. Here, we report two such rare cases with a literature review. Case 1 was a 26 years-old female with a history of 60% hepatic resection in the diagnosis of hepatocellular carcinoma. Later, she developed bilateral lung metastasis. She was admitted with complaints of headache, nausea and vomiting. Neurological findings were clear consciousness, right homonymous hemianopsia and bilateral papilledema. CT showed high-density mass in the left occipital lobe. Evacuation of hematoma and removal of tumor were performed. Pathological diagnosis was hepatocellular carcinoma of clear cell type. Later, two other hemorrhage occurred from different metastatic lesions in the left occipital lobe and the right occipital lobe, and the patient underwent two more surgeries. The patient died of lung metastasis, three months from neurological onset. Case 2 was a 42 years-old male who developed an intracranial tumor adjacent to the right temporal bone without a history of hepatoma. The tumor was removed, which turned out to be hepatocellular carcinoma pathologically. Three months later, on admission, the patient showed sudden neurological deterioration into deep coma. CT showed an irregular high-density mass in the right temporal lobe and evacuation of hematoma coupled with tumor removal was performed. Pathology was of trabecular type. Later, intracranial recurrence and bony metastasis to C5, L3 and the left iliac bone appeared.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Metastatic hepatoma presenting as intracranial hemorrhage: report of two cases]. 284 59


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>