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

Three cases of brain abscess following an occlusion of the internal carotid artery were reported. Case 1: A 6-year-old girl with congenital heart disease was admitted with headache, disturbance of consciousness and left hemiparesis. Right carotid angiography revealed an occlusion of the right internal carotid artery. After 6 months, she was readmitted with high fever. CT scan revealed a low density area and a ring-like shadow at the same site of cerebral infarction. Case 2: A 69-year-old man was admitted in semicoma and with right hemiplegia. Left angiography revealed an occlusion of the left internal carotid artery. After 2 months, a brain abscess was noted in the infarcted area. Case 3: A 20-year-old man with congenital heart disease, was admitted due to headache, vomiting and high fever. CT scan revealed a brain abscess in the right frontal lobe. Carotid angiography showed bilateral internal carotid artery occlusion. We concluded that diminution of cerebral oxygen and encephalomalacia are predisposing factors to the evolution of brain abscess.
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PMID:[Brain abscess (Part 5)--Brain abscess following internal carotid occlusion (author's transl)]. 49 56

The authors describe the use of MR in a patient who underwent prefrontal sonic treatment for relief of intractable headaches. MR demonstrated well-demarcated regions of encephalomalacia within the white matter of the frontal lobe (with relative sparing of cortex) in a characteristic conical volume that corresponded to the insonified regions.
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PMID:Prefrontal sonic treatment: MR findings. 141 48

Mitochondrial myopathy, encephalopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is one of the mitochondrial encephalomyopathies that has distinct clinical features including stroke-like episodes with migraine-like headache, nausea, vomiting, encephalopathy and lactic acidosis. We report a 27-year-old woman who presented with partial seizure, stroke-like episodes including hemiparesis, hemianopia and hemihypethesia, sensorineural hearing loss, migraine-like headache, and lactic acidosis. Brain computed tomographic scan showed encephalomalacia in the right parieto-occipital area and recent hypodensity in the left temporoparieto-occipital area with cortical atrophy. Muscle biopsy revealed ragged-red fibers and paracrystaline inclusions in the mitochondria. Genetic study revealed an A to G point mutation at nucleotide position (np) 3243 of mitochondrial DNA. External ophthalmoplegia and ptosis were also found during two exaggerated episodes in this patient. Therefore, the overlapping syndrome of chronic progressive external ophthalmoplegia in the MELAS syndrome is considered in this case. Furthermore, we also found carnitine deficiency in this patient and she was responsive well to steroid therapy. Muscle biopsy also revealed excessive lipid droplets deposits. Therefore, the carnitine deficiency may occur in MELAS syndrome with the A to G point mutation at np 3243. We recommend the steroid or carnitine supplement therapy be applied to the MELAS syndrome with carnitine deficiency.
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PMID:CPEO and carnitine deficiency overlapping in MELAS syndrome. 748 81

A 19-year-old woman with congenital cyanotic heart disease (Epstein anomaly and ventricular septal defect) had persistent headaches and intermittent fever for five weeks. Physical examination revealed central cyanosis, finger clubbing and fever. The leucocyte count was elevated. Cerebral MR imaging showed the characteristic features of brain abscesses in the right frontal lobe, including multiloculation with adjacent satellite lesions, ring enhancement, T1-hyperintense and T2-hypointense signal areas within the abscess rim, as well as hypointense internal concentric rings on T2-weighted images. The diagnosis of brain abscesses was confirmed by craniotomy and pus drainage. She made a good recovery with a combination of antibiotics and surgery. Follow-up CT scans showed only changes of encephalomalacia at the healed abscess site. The aetiology, clinical features, and the role of CT and MR imaging in the diagnosis and management of brain abscess are discussed.
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PMID:Clinics in diagnostic imaging (51). Multiloculated cerebral abscesses due to paradoxical cardiac emboli. 1102 6

A 36-year-old homosexual man with 6 months of visual symptoms and headaches had right homonymous hemianopia, mild new learning impairment, and alexia with agraphia. The initial brain magnetic resonance imaging (MRI) scan was reported consistent with left occipital infarction. Subsequent MRI demonstrated abnormal demyelination in subcortical white matter and deep parieto-occipital white matter bilaterally, but primarily left. Human immunodeficiency virus testing and cerebrospinal fluid polymerase chain reaction for JC virus DNA were both positive, consistent with progressive multifocal leukoencephalopathy (PML) with AIDS. His clinical status steadily deteriorated, and MRI white matter abnormalities worsened despite high-dose antiretroviral therapy. After the antiretroviral regimen was intensified by the addition of a protease inhibitor, rapid clinical and radiographic improvement occurred with subsequent MRI studies revealing only residual left parieto-occipital encephalomalacia. PML in AIDS patients has been associated with a nearly uniformly poor prognosis until recent reports of improved outcomes after highly active antiretroviral therapy. This patient with PML and AIDS similarly showed a robust clinical and MRI response to intensive antiretroviral combination therapy, which has been maintained for more than 3 years.
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PMID:Clinical and magnetic resonance imaging regression of progressive multifocal leukoencephalopathy in an AIDS patient after intensive antiretroviral therapy. 1146 8

The authors report the unusual case of a 58-year-old woman (MJP) suffering from left temporal throbbing headache, associated with confusion. Magnetic resonance imaging showed a 5 x 3 x 2 cm hematoma at the left posterior temporal--parietal junction (PTPJ). Repeated MRI of MJP's brain performed during a 4-month follow-up period showed decrease in hematoma size (2.3 x 1.5 x 1) with evidence for development of encephalomalacia and resorption of blood products involving the area of hemorrhage. MJP had mild transcortical sensory aphasia characterized by difficulty with reading and processing, with semantic paraphasic errors while speaking and some difficulty with repetition. MJP had remained normotensive and seizure free, on Vasotec therapy and Dilantin prophylaxis. An in vivo proton magnetic resonance spectroscopy (1H-MRS) performed during an 8-month follow-up period showed reduced concentration for N-acetyl aspartate (NAA) by 19.3% (F=4.09, P<0.04), and myo-inositol by 32.0% (F=5.16, P<0.02) in the left orbital frontal cortex (OFC) as compared with 16 healthy subjects (age- and sex-matched). Cognitive tests (the Wechsler abbreviated scale of intelligence (WASI) and the Stroop color--word interference) showed a significant impairment suggesting involvement of higher-order cognitive functioning (memory, learning, and general intelligence) and attentional system. The Spielberger state-trait anxiety inventory (STAI) showed increased anxiety at the moment of the current examination and decreased tendency to be anxious over a long period of time. The Beck Anxiety and Depression Inventory revealed minimal anxiety and mild to moderate levels of depression. It is hypothesized that the PTPJ hematoma triggered long-distance pathways linking PTPJ area and frontal lobe, including OFC, which resulted in abnormal chemical changes in the left OFC and in cognitive tests impairment, and in long-term anxiety state changes.
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PMID:Effect of posterior temporal-parietal hematoma on orbital frontal chemistry in relation to a cognitive and anxiety state: a combined 1H-MRS and neuropsychological study of an unusual case as compared with 16 healthy subjects. 1186 Nov 28

A 20-year-old woman recently diagnosed with acute posterior multifocal placoid pigment epitheliopathy developed headaches, weakness, and paresthesias. MR imaging of the brain revealed an acute infarct (demonstrated by diffusion-weighted images) in the head of the right caudate nucleus, a chronic infarct with encephalomalacia in the body of the corpus callosum, and multiple foci of abnormal signal intensity in the white matter of the centrum semiovale.
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PMID:Acute and chronic brain infarcts on MR imaging in a 20-year-old woman with acute posterior multifocal placoid pigment epitheliopathy. 1641 58

Previous studies have rarely described the association between Noonan syndrome and moyamoya syndrome. Although most affected children with moyamoya exhibit ischemic symptoms, headache is also a frequent symptom. We report the case of a 9-year-old girl with Noonan syndrome and moyamoya syndrome that manifested as recurrent headaches without history of transient ischemic attack. Brain magnetic resonance imaging and magnetic resonance angiography revealed bilateral moyamoya syndrome and mild ventriculomegaly with focal encephalomalacia at right peritrigonal region. Disruption of vascular development during the prenatal stage has been proposed as the cause of cerebrovascular disease in Noonan syndrome. However, genetic factors may also contribute.
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PMID:Moyamoya syndrome in a child with Noonan syndrome. 2176 56

Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity with typical symptoms including headache, seizures, visual disturbance, altered mental status, vomiting, nausea and focal neurologic signs. In this article, we report recurrent and atypical PRES in a child with hypertension due to end-stage renal disease (ESRD) who was on a peritoneal dialysis program for 6 months. After the second hypertension attack, PRES findings did not recover and persisted as encephalomalacia. As far as we know, this case is the first child with ESRD who developed encephalomalacia after recurrent episodes of PRES. When a patient with a history of PRES presented with new clinical and neuroradiological findings, recurrent PRES should be considered.
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PMID:Recurrent and atypical posterior reversible encephalopathy syndrome in a child with hypertension. 2291 96

A 14-year-old male presented with paresthesias on the right upper and lower extremities, headache, and vomiting. In addition to worsening paresthesia and weakness on the right side of his body, blurred vision, fever, and skin lesions developed. He also had skin lesions characterized with 3-10 mm papules with a white atrophic center surrounded by pink rim mostly on the trunk and lower extremities. Brain magnetic resonance imaging showed chronic subdural effusion and encephalomalacia of the left cerebral hemisphere. Cerebrospinal fluid (CSF) examination revealed increased protein levels. Electromyography was consistent with diffuse polyradiculoneuropathy. Skin biopsy confirmed the diagnosis of a rare vasculopathy: Degos disease. A case presenting with chronic subdural effusion, encephalomalacia, elevated CSF protein, and polyradiculopathy should be carefully examined for skin lesions, which may suggest the diagnosis of Degos disease.
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PMID:Severe neurologic involvement of Degos disease in a pediatric patient. 2340 Feb 46


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