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

Experience at University Hospitals of Cleveland with 71 cases of Gardner and Diamond's syndrome of autoerythrocyte sensitization is reviewed. Gardner and Diamond attributed the pathogenesis of the inflammatory bruises typical of this syndrome to sensitization to the stroma of the patients' own erythrocytes, as demonstrated by reproduction of the lesion on intracutaneous injection of erythrocytic stroma. Nearly all the cases my colleagues and I have seen were in adult women, in whom the onset of inflammatory bruising could often be precisely dated, frequently some weeks after an injury or surgical procedure or, more often, severe emotional stress. Bouts of bruising were often preceded by sensations localized to the affected site. Cutaneous responses to the injection of erythrocytes were erratic. The patients described a wide range of both hemorrhagic and nonhemorrhagic complaints, including, among others, severe headaches, paresthesias, repeated syncope, diplopia (sometimes monocular), and "nervousness." Psychiatric studies indicated that patients had overt depression, sexual problems, feelings of hostility, and obsessive-compulsive behavior. The patients had traits that can be described as typical of a hysterical character disorder. Therapy of autoerythrocyte sensitization--that is, psychogenic purpura--has been difficult; in younger individuals, psychiatric therapy has appeared to be beneficial.
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PMID:Psychogenic purpura (autoerythrocyte sensitization): an unsolved dilemma. 248 28

Brain stem glioma is the third most common childhood brain tumor, comprising 10-15% of this group of neoplasms. Typical presenting symptoms include ataxia, diplopia and headache, while signs of increased intracranial pressure occur later in the clinical course. Although prolonged failure to thrive, characterized by cachexia and vomiting are rare manifestations of brain stem lesions, in this study we report a 9.5-year-old boy with failure to thrive since infancy which remitted after excision of a brain stem astrocytoma.
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PMID:Chronic dysphagia, vomiting and gastroesophageal reflux as manifestations of a brain stem glioma: a case report. 248 55

The antiepileptic effect of lamotrigine (LTG) was assessed in a double-blind, placebo-controlled crossover trial in 24 adult patients with refractory partial seizures. LTG or placebo was added to existing antiepileptic drugs (AEDs). The dose of LTG varied from 75 to 400 mg daily. Three patients did not complete the trial. One was withdrawn from the trial with ataxia, tiredness, dyspnea, and diplopia while receiving LTG and died 18 days later of invasive carcinoma involving the liver. A second patient was withdrawn during baseline for contravening admission criteria, and a third received LTG in error during both treatment periods. Twenty-one patients (12 men and 9 women) completed the trial. An analysis of seizure counts in the 12-week treatment period with LTG showed a statistically significant reduction in seizures as compared with placebo for total seizures (p less than 0.002), partial seizures (p less than 0.002), and secondarily generalized seizures (p less than 0.05). The analysis of total seizure days showed a significant reduction during LTG treatment (p less than 0.002). There were no statistically significant changes in plasma concentrations of phenytoin (PHT), carbamazepine (CBZ), primidone (PRM), or phenobarbital (PB) between the two treatment periods. The most common adverse events reported during the trial were diplopia, drowsiness, tiredness, ataxia, and headache, but although these were more frequent during LTG treatment, the differences from placebo were not statistically significant. No hematological or biochemical changes were noted.
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PMID:Controlled trial of lamotrigine (Lamictal) for refractory partial seizures. 249 73

The authors describe the case of a 37-year-old patient, who, after a minor craniocerebral trauma suffered in 1970, was admitted to hospital because of progressive headache, unsteady gait and balance disturbances, deglutition disorders and diplopia. Computed tomography (CT) scan showed a large median hyperdense tumour of posterior fossa with the fourth ventricle involvement. Operation under microscope was performed to remove a considerably large cystic tumour, occupying the fourth ventricle and cisterna magna, displacing the cerebellar lobes and pushing the vermis upward. The tumour was waxy and grey, whereas the cystic liquid had the colour and consistency of oily fluid. The capsule was occluded with the CO2 laser. Postoperative course was good.
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PMID:Dermoid tumour of the fourth ventricle with hyperdense aspect demonstrated on CT scan. Case report. 258 31

Ocular complications occurring in temporal arteritis are of different severities. These manifestations of the disease occurred in a population of 57 patients with diagnosis of temporal arteritis, in 16 of them (28%). The diagnosis was suggested by finding an inflammatory syndrome (high erythrocyte sedimentation rate) and confirmed by temporal artery biopsy. In making this diagnosis, it was helpful to find a history of characteristic temporal headaches, neckache, jaw claudication, fever and malaise or weight loss in addition to polymyalgia and polyarthralgia. 6 patients presented with diplopia and different ocular muscle or nerve palsies. The 10 others came for sudden loss of vision due to ischemic anterior or posterior neuropathy and in one case, central artery obliteration. Prompt treatment with steroids gave good results on oculomotor troubles and in preventing the risk of involvement of the fellow eye. But loss of vision did not regress with this treatment. That means the importance in making this diagnosis and starting very promptly this treatment.
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PMID:[Eye manifestations of Horton's disease]. 259 Sep 88

A 45-year-old Japanese man, who had had bilateral visual disturbance due to Vogt-Koyanagi-Harada (VKH) disease 17 years before entry, was admitted to this hospital because of headache, vertigo and vomiting. On examination at entry, no abnormalities except for poliosis, patches of vitiligo on his left shin, sunset glow fundus, and positional nystagmus with Frenzel glasses were found. Laboratory data other than leukocytosis and elevated level of gamma-GTP were normal and the results of brain CT scan were within normal limits. On the following day, diplopia was developed and the neurological symptoms including loss of bilateral visual acuity, Horner's syndrome on the right side, right facial palsy, bilateral sensorineural hearing disturbance, palsy of the soft palate on the right side with swallowing difficulty, and dissociated sensory disturbance on the right face and the upper and lower extremities on the left side appeared with a few days. He couldn't get up. The cerebrospinal fluid (CSF) was clear and had pleocytosis with normal sugar content. The protein, immunoglobulin G and myelin basic protein (MBP) were elevated but the tests for oligoclonal band and antiviral antibodies were negative. Brain CT scan showed low density areas in right cerebellar hemisphere and in left putamen without abnormality with contrast material and evoked potentials were normal. Prednisolone was prescribed and his symptoms were subsided but his gait remained ataxic. Magnetic resonance imaging (MRI) 4 months later showed an atrophy of the lower half of bilateral cerebellar hemisphere supplied by posterior inferior cerebellar artery, suggesting cerebellar infarction, and high intensity areas on T2 image in bilateral cerebral white matters, basal ganglia, and left cerebral peduncle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Wallenberg's syndrome in a case of Vogt-Koyanagi-Harada disease]. 261 5

21 patients, who fulfilled the clinical and angiographic criteria of a spontaneous carotid cavernous fistula (CCF), were studied at the Alfried Krupp Hospital, Essen, Germany, between 1980 and 1988. Of these patients, 4 had direct shunts between the internal carotid artery and the cavernous sinus and 17 patients had unilateral or bilateral dural shunts between meningeal branches of the internal and/or external carotid artery and the cavernous sinus. The most common initial symptoms were eye redness, bruit and headache. 6 of 12 patients with double vision had mechanical disorders of eye movement. A rapid irreversible loss of vision occurred in 2 patients. In 9 of 21 patients either progressive visual deterioration, proptosis or severe orbital pain necessitated prompt institution of treatment. All direct fistulas could be occluded by the use of the detachable balloon technique. 5 patients with dural CCF were successfully treated with particle embolization of the external carotid artery blood supply. In dural CCF not requiring emergent treatment, combined carotid artery and jugular vein compression was preferred and resulted in complete cure or sufficient improvement in all but one patient. We recommend this method as the first stage of treatment in dural CCF with uncomplicated course.
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PMID:[Clinical aspects and treatment of spontaneous carotid artery-cavernous sinus fistula]. 261 55

Cryptococcal meningitis is the most frequent fungal infection of the central nervous system, known readily to complicate with immuno-compromised patients. There are only a few cases of primary infection in healthy non-immuno-compromised patients. Amphotericin-B (AMPH-B) and 5-Fluorocytosine (5-FC) are effective agents against Cryptococcal meningitis, although, their toxicity and drug resistance are limiting factors. However, in recent years Miconazole has been widely used against fungal infections and it's effectiveness has been reported. This is a 68 y.o. male who was admitted to Toyohashi Municipal Hospital on March 15, 1987 because of headache, vomiting, diplopia and gait disturbance. Continuous lumbar drainage was performed since lumbar puncture revealed surprisingly high cerebrospinal fluid (CSF) pressure and presence of many Cryptococcus neoformans, i.v. AMPH-B and p.o. 5-FC was also administrated. A 7 day course of i.v. AMPH-B and p.o. 5-FC showed no improvement with side effects of macrohematuria and anorexia. Then Miconazole was administrated i.v. and intrathecal (i.t.). The clinical signs and CSF laboratory data improved after a 90 day course of Miconazole therapy and the patient was discharged on August 24. But the patient was readmitted from March 10 to April 30, 1988, because of a slight increase of C. neoformans in CSF (17/mm3) and improved by i.v. and i.t. Miconazole. The total Miconazole dosage was 90.6 g (i.t.: 505 mg) at the first admission and 36 g (i.t.: 50 mg) at the second admission, but no side effect was seen. The reduction of elevated CSF pressure with continuous CSF drainage was also important for the treatment of such cases with increased intracranial pressure.
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PMID:[A case of cryptococcal meningitis successfully treated with miconazole and CSF drainage]. 261 99

A 36 years-old man was admitted in September 1987. For 5 years he suffered from 4 recurrent episodes of throbbing headache, tinnitus, nausea, diplopia and divergent strabismus to which a facial palsy was recently added. In all episodes, the symptoms disappeared spontaneously and completely. A neuro-ophthalmological examination at admission disclosed an exotropia of the right eye, gaze paralysis to the left, paralysis of adduction of the left eye and preserved right eye abduction which triggered a rhythmic horizontal nystagmus. The upward and downward gazes and the convergence were well preserved. Moreover, there was a left peripheral facial palsy, and Babinski sign at the right side. Auditory evoked potentials were slowed at the mesencephalopontine transition. CT scan showed a low-density area with no contrast enhancement at the left pontine tegmentum and a left anterolateral atrophy of the pons. CSF examination showed increase in protein content and increase in the IgG content. Additional investigation included a dopplerometry of the cervical arteries, a panangiography and a bidimensional echocardiography which were normal. Diagnosis of one-and-a-half syndrome was made, possibly secondary to multiple sclerosis, and immunossuppressive therapy was initiated.
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PMID:[One-and-a-half syndrome: anatomo-clinical considerations apropos of a case]. 261 17

The authors present a case of a ruptured aneurysm of the anterior inferior cerebellar artery at the right internal auditory meatus, of which incidence is thought to be very rare. The patient experienced a sudden onset of headache, vomiting and tinnitus in the right side. Moderate peripheral facial palsy and hearing disturbance in the right appeared 2 weeks after the onset with diplopia. These symptoms improved to some extent after the successful neck clipping of this aneurysm.
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PMID:Aneurysm of the anterior inferior cerebellar artery at the internal auditory meatus: case report and review of the literature. 266 61


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