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)

Five adults with primary intraventricular hemorrhage are described. The presenting features included headache, confusion and drowsiness. Focal neurological signs were minimal or absent. All five had a history of hypertension, three patients had bilateral internal carotid occlusion at its origin, one had unilateral occlusion of the left internal carotid artery with severe stenosis of the contralateral siphon. Unilateral occlusion of the middle cerebral artery were present in the fifth patient. Pathological examination of the brain from one patient showed the presence of severe hemorrhagic "lacunar" infarcts adjacent to the left lateral ventricle, one showing direct continuity of blood in the lacune with the massive intraventricular hematoma. We hypothesize that such a finding illustrates one possible mechanism for this unusual type of hemorrhage. Patients with longstanding hypertension and severe occlusive disease of the internal carotid arteries may be predisposed to this unusual complication.
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PMID:Primary intraventricular hemorrhage in adults. 376 57

Seventy nine cases of sporadic, community acquired legionnaires' disease have been reviewed. Annual and seasonal variation in incidence was noted. The mean age of the patients was 53 years and 50 (63%) were male. Pre-existing chronic diseases were present in only 23 (29%), including two patients receiving immunosuppressive treatment. Common symptoms included unproductive cough, dyspnoea, chest pain, headache, confusion, nausea, vomiting, and diarrhoea. Respiratory symptoms were absent, however, in 17 (22%). Localising chest signs were present in 74 (95%) cases. Frequent laboratory findings included lymphopenia, high erythrocyte sedimentation rate, hyponatraemia, raised urea and creatinine concentrations, abnormal liver function, hypophosphataemia, hypoalbuminaemia, proteinuria, and haematuria. Thirteen patients died (16%), including nine of 20 who received assisted ventilation. The mortality rate in patients treated with erythromycin (11%) was lower than in those who received other antibiotics (23%), but this difference was not statistically significant. Of the features noted on admission, only a high plasma urea concentration was significantly associated with death. Sporadic community acquired legionnaires' disease is a not uncommon disorder, which with appropriate treatment has a prognosis similar to that of other forms of community acquired pneumonia.
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PMID:Legionnaires' disease: a review of 79 community acquired cases in Nottingham. 378 45

Two cases of acute blindness due to quinine poisoning are presented. In both cases, the diagnosis was initially unsuspected. In addition, tinnitus, decreased hearing, vomiting, abdominal pain, and confusion were noted in one patient, and the other experienced decreased hearing, headache, confusion, tachycardia, later bradycardia, and first-degree atrioventricular block. The onset of blindness was delayed more than 12 hours after ingestion in both cases. Quinine levels of 13.6 micrograms/mL and 18.6 micrograms/mL were demonstrated (therapeutic = 1 to 3 micrograms/mL). One patient developed marked constriction of visual fields and some residual decreased acuity, while the other regained normal visual acuity.
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PMID:Acute toxic blindness: unrecognized quinine poisoning. 380 84

Twelve patients with advanced malignant disease were entered onto a Phase I study of escalating doses of beta-interferon serine given by 4-h i.v. infusion twice a wk. Three patients each were entered at starting doses of 0.01, 1, 10, and 30 million units (MU)/m2. Doses escalation within individual patients was allowed to a maximum dose of 400 MU/m2. Fever, chills, fatigue, and acral cyanosis were commonly seen and increased in frequency at higher doses. Myalgia, nausea, diarrhea, headache, and confusion were seen at lesser frequencies. Mild leukopenia, paresthesia, infusion site erythema, and hypotension were each seen in one patient. No conventional maximal tolerated dose could be defined, since several patients underwent escalation to the highest allowable dose and seemed to develop tolerance to acute toxicities. However, a maximal starting dose of 10 MU/m2 was identified, such that those begun at this level or below tolerated semiweekly dose escalation, while those begun at 30 MU/m2 could not tolerate continued therapy. Detectable serum interferon levels were noted during treatment at 10 and 30 MU/m2, the levels at which significant toxicity also first appeared. A maximal starting dose of 10 MU/m2, with gradual escalation as tolerance to side effects develops, is suggested if therapy with high-dose beta-interferon serine is given by 4-h infusion.
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PMID:Phase I study of recombinant beta-interferon given by four-hour infusion. 380 98

Thirty-six colloid cysts were treated from 1949 to 1983. There were 26 male and 10 female patients, ranging in age from 12 to 65 years old, 60% between 31 and 40 years. Headache or disturbed mental function was the most frequent complaint, papilloedema the most frequent sign. The patients were classified into 3 groups by symptoms and signs; Group I (17 patients): Headache, papilloedema and no neurological signs. Group II (6 patients): Fluctuating or progressive dementia. Group III: Twelve cases with "classical" features, episodic headache and drop attacks. One patient could not be classified in any of these groups. Seventeen of 36 patients were diagnosed by ventriculography, 19 patients were diagnosed by CT scan. CT scan was the most reliable diagnostic study, but was unavailable in the earlier part of the series. All patients have been operated by transventricular exposure of the right foramen of Munro with incision of the middle frontal gyrus in an antero-posterior linear manner. Twenty-five of 36 patients showed an excellent operative result, and nine had a good result, one of the 9 patients dying of an unrelated intracerebral haemorrhage 4 years after operation. Two patients had a poor result, characterized by memory loss and confusion. One of these died of an unknown cause 5 years after operation.
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PMID:Colloid cysts of the third ventricle. A review of 36 cases. 387 15

The effect of propofol, in the emulsion formulation, on post-anaesthetic recovery was studied in 80 patients anaesthetized using one of three different techniques. Propofol was administered to 20 day case patients for induction of anaesthesia, to 20 patients for induction and maintenance by intermittent bolus injection to supplement spinal blockade, and to 40 patients for induction and maintenance by continuous infusion with spontaneous ventilation. Its effects were compared with those of methohexitone (all three techniques) and thiopentone (day case study only). The assessment of post-operative recovery included measurement of the speed of immediate recovery, psychometric testing comprising choice reaction time and critical flicker fusion threshold and the incidence of post-operative sequelae. In all three techniques, propofol was associated with rapid and symptom-free recovery from anaesthesia. With the day case and infusion techniques immediate recovery was more rapid after propofol than after methohexitone and thiopentone. Recovery of psychomotor function was more rapid after propofol in the day case study. The frequency of sequelae such as nausea and vomiting (5% of cases), headache (1%) and confusion/restlessness (2.5%) was considerably lower overall after propofol and in each individual study than with the other agents.
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PMID:Recovery following propofol ('Diprivan') anaesthesia--a review of three different anaesthetic techniques. 387 81

Diagnostic quality and adverse reactions associated with metrizamide and iohexol as contrast agents for lumbar myelography were compared in a prospective randomized double-blind study in 350 patients at seven centers. Both contrast media were administered in comparable volumes at a concentration of 180 mg I/ml. Overall quality of radiographic visualization was graded as "good" or "excellent" in 95% of 175 metrizamide studies and in 98% of 175 iohexol myelograms. Ninety-three patients examined with metrizamide (53%) and 130 patients studied with iohexol (74%) experienced no discomfort during or after myelography. The incidence of postmyelographic headache was 38% with metrizamide and 21% with iohexol. Nausea and vomiting were also more common with metrizamide. Five patients examined with metrizamide (3%) experienced transient confusion and disorientation after lumbar myelography. No such reactions were observed after iohexol myelography.
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PMID:Lumbar myelography with iohexol and metrizamide. A comparative multicenter prospective study. 388 14

L-Deprenyl, a specific monoamine oxidase subtype B inhibitor, has been reported a valuable adjunct to conventional treatment of Parkinsonism. A double-blind cross-over controlled study was performed in 19 parkinsonian patients with on-off type problems. Five mg L-Deprenyl per day reduced the number of on-off episodes. Side effects such as hyperkinesias, vivid dreams, dizziness with diaphoresis were frequent. Severe side effects such as nightmares, postural hypotension, confusion, and dizziness with headaches necessitated discontinuation of the drug in 4 patients. L-Deprenyl was of limited value in this group of patients with longstanding Parkinsonism.
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PMID:The effect of L-Deprenyl on on-off phenomena in Parkinson's disease. 392 50

We reviewed the clinical, neuroradiological, and serological findings in 27 patients with cerebral toxoplasmosis complicating the acquired immune deficiency syndrome, 19 of whom were also analyzed neuropathologically. The clinical manifestations of this disorder varied, ranging from headache and fever to coma. However, the characteristic presentation included focal neurological symptoms and signs, usually of subacute onset. In addition, two-thirds of the patients exhibited more generalized cerebral dysfunction with confusion and lethargy. The computed tomographic (CT) scan most commonly revealed ring contrast enhancement, which appeared to correlate best with the histological presence of vascular proliferation and inflammation surrounding the abscesses. However, in 5 patients the CT scan revealed either homogeneous enhancement or no enhancement, and in 3 patients the scans were negative. In general, CT scans underrepresented the number of lesions eventually documented pathologically. Double-dose contrast administration and preliminary experience with magnetic resonance imaging suggested that these techniques were superior to standard CT scanning in detecting Toxoplasma lesions. All patients were seropositive for IgG antibody against Toxoplasma gondii in blood, both before the onset of illness and at the time of presentation, although titers in some patients were as low as 1:8 and most patients did not exhibit rising titers. Prompt therapy resulted in rapid clinical improvement, documented by CT scan, associated with the development of an organizing tissue response in the host and elimination of free organisms. Response to treatment was sufficiently rapid in most patients to allow a trial of therapy as the favored approach to diagnosis.
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PMID:Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. 396 67

The records of 16 consecutive patients with proven cryptococcosis, admitted to the two referral hospitals in Harare over a 15-year period, were reviewed. 15 were cases of meningitis, one with spinal cord granuloma, and the 16th was an orbital osteomyelitis. There were eight children and eight adults with a marked male preponderance. There was an absence of any predisposing conditions. The common clinical signs and symptoms were headache, neck stiffness, fever, confusion or drowsiness, cranial nerve lesions and long tract signs. The diagnosis was rarely suspected on admission but was discovered during life in 15 patients, in 12 by finding the organism in the (CSF) cerebrospinal fluid, and in three by biopsy of affected tissue. 50% of patients presented with a predominance of polymorphs in the CSF. The mortality rate was very high (57%) but most died before adequate treatment could be given.
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PMID:Cryptococcosis in Zimbabwe. 399 44


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