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

A patient with bacterial endocarditis had headaches, cerebrospinal fluid pleocytosis and normal cerebral angiograms. Fifteen days later, while on appropriate antibiotic therapy, he developed an intracerebral hematoma due to a mycotic aneurysm. Mycotic aneurysm is an infrequent but serious complication of bacterial endocarditis. An aneurysm should be considered whenever a patient with bacterial endocarditis has neurologic symptoms even when the patient is receiving antibiotics.
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PMID:Cerebral hemorrhage from a mycotic aneurysm developing during appropriate antibiotic therapy. 58 May 12

Bacterial endocarditis caused by Actinobacillus actinomycetemcomitans is a rare disease. A 48-year-old man who had a Starr-Edwards aortic valve prosthesis inserted in 1972 was admitted for evaluation of confusion, headaches, anorexia, weight loss, diarrhea and weakness. Six blood cultures yielded gram-negative organisms which were subsequently identified as A. actinomycetemcomitans. Treatment with ampicillin and gentamicin resulted in cure which has been maintained after an observation period of eleven months. This represents the second report of A. actinomycetemcomitans endocarditis in a patient with a prosthetic valve.
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PMID:Actinobacillus actinomycetemcomitans endocarditis in a patient with a prosthetic aortic valve. 88 Dec 58

Four patients with fungal endocarditis after open-heart surgery were confirmed microbiologically. Two of them died, and the other 2 were treated with intravenous administration of miconazole. Clinical symptoms of the disease were similar to those of bacterial endocarditis, but headache and sweating were more predominant. This complication was likely to be found and treated with effective anti-fungi drugs. We suggest that reoperation is the only possible way to cure those with residual shunt or vegetation, and that prevention of postoperative fungal endocarditis is of great importance because of its refractoriness. Measures of preventing fungal endocarditis after open-heart surgery are discussed.
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PMID:[Fungal endocarditis after open-heart surgery. Report of 4 cases]. 181 22

We successfully performed craniotomy and mitral valve replacement on a patient with bacterial endocarditis and ruptured intracranial aneurysm. A 15-year-old woman with fever and heart murmur was admitted to another hospital. Infective endocarditis and mitral valve regurgitation was diagnosed and treated with antibiotics. About one month after admission the patient suddenly showed severe headache and hemiparesis. Brain CT demonstrated intracerebral and subarachnoidal hemorrhage. The patient was unconscious when transferred to Mitsui Memorial Hospital where cerebral angiography showed anterior cerebral aneurysm and echocardiography showed mitral valve vegetation. We judged the necessary mitral valve replacement could be delayed until the aneurysm had been stabilized. We therefore began treatment using a different antibiotic but, in spite of this, 10 days later the aneurysm had enlarged dramatically. As conservative treatment was ineffective, a clipping operation was done to prevent re-rupture at the time of mitral valve replacement which could not be delayed much longer. 10 days later, cerebral 4 vessel study was done which showed no abnormality. Mitral valve replacement was then done and the patient was discharged in good health 64 days after the valve replacement.
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PMID:[Valve replacement in infective endocarditis with mycotic aneurysm]. 226 95

Eighteen patients with occipital hematomas are analyzed. Six patients with medial occipital hematomas presented with headache and visual blurring and examination showed homonymous hemianopsia. Three of these six patients were normotensive; three others were hypertensive with chronic vascular changes. Three patients with lateral occipital hematomas presented with headache but had no neurological deficit. All were hypertensive and had evidence of chronic hypertensive vascular changes. Nine patients with larger occipital hematomas which extended into the temporal and parietal region with intraventricular and tentorial extension had an underlying etiology defined by laboratory studies (excessive anticoagulation, coagulation disorder, systemic lupus erythematosus, bacterial endocarditis). None of these patients were hypertensive. The clinical outcome was good in patients with medial and occipital hematomas; however with the larger and more extensive occipital hematomas, clinical outcome was dependent upon the underlying etiology. None of these 18 patients had recurrent stroke.
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PMID:Occipital lobe hemorrhages; clinical-computed tomographic correlations. 320 38

Neurologic accidents are today the first cause of mortality following bacterial endocarditis through ischemia or mycotic aneurysm rupture. Authors propose a protocol management by complete cerebral angiography and CT scan as soon as the least neurologic sign appears. A headache is the most frequent of these signs. 35 patients were explored during 3 years and 10 treated surgically. These authors conclude that: mycotic aneurysm must be detected aneurysm with subarachnoid haemorrhage must be operated on as soon as possible. With unruptured aneurysm, surgical decision is more difficult: sequential angiography after excision of the most dangerous aneurysm, demonstrates that an aneurysm can appear, enlarge, diminish or spontaneously resolve. Carrying on with this protocol should allow an answer to this question.
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PMID:[Should the aneurysms of Osler's disease be investigated and operated on prior to hemorrhage?]. 380 68

The treatment of 13 patients with bacterial intracranial aneurysms is reported. The incidence of bacterial intracranial aneurysms was 4% of all patients admitted with intracranial aneurysms and 3% of all patients admitted with bacterial endocarditis. Each patient had neurological signs or symptoms suggestive of intracranial disease prior to the diagnosis of an aneurysm. Alpha Streptococcus was the most common infecting organism. All patients were treated with specific, high-dose antibiotics, and five patients underwent surgery as well. There were no surgical deaths. Six of eight nonsurgically treated patients died. A review of the literature confirms a high mortality for patients treated with only antibiotics, and a low mortality for elective surgery. The authors conclude that 1) patients with bacterial endocarditis, who develop sudden severe headache, focal neurological signs or symptoms, or seizures, should undergo serial cerebral angiography every 7 to 10 days throughout their hospitalization; 2) if an aneurysm is identified it should be excised whenever possible; and 3) patients with proximal or multiple aneurysms should be considered for surgery.
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PMID:Bacterial intracranial aneurysms. 689 2

We experienced two cases of infective endocarditis associated with cerebral mycotic aneurysm. Case 1: 58 year-old man underwent emergency aortic and mitral valve replacement due to active infective endocarditis and congestive heart failure diagnosed by transesophageal echocardiography. After the operation, he did not wake up and his bilateral pupils were dilated. Computed tomography demonstrated massive intracranial hemorrhage and severe brain edema. He died from multiple organ failure 22th postoperative day. Rupture of cerebral mycotic aneurysm was strongly suspected. Case 2: 56 year-old man was admitted with severe headache and high grade fever. Computed tomography demonstrated intracranial hemorrhage. Cerebral mycotic aneurysm was detected at left distal middle cerebral artery by cerebral angiography. Infective endocarditis and mitral regurgitation were also diagnosed by echocardiography. He underwent cerebral mycotic aneurysmectomy after intensive antibiotics therapy, followed by successful mitral valve replacement. We review the literatures and discuss the problems of surgical management of infective endocarditis with cerebral mycotic aneurysm.
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PMID:[Surgical treatment of infective endocarditis associated with cerebral mycotic aneurysm]. 922 58

A 59-year-old man presented with an internal carotid artery (ICA) bacterial aneurysm which ruptured during surgery for treatment of another bacterial aneurysm. He had been admitted to our hospital because of the recurrence of colon cancer. He had undergone aortic and mitral valve replacement because of closure incompetence due to bacterial endocarditis two months previously. Two months after treatment for colon cancer, he developed fever, and arterial blood culture demonstrated. Staphylococcus epidermidis. A few days later, he suddenly suffered severe headache and vomiting, followed by deterioration of consciousness. CT showed subarachnoid hemorrhage and angiography showed a saccular aneurysm at the opercular portion of the left middle cerebral artery (MCA). Immediate clipping of the aneurysm was attempted. The carotid cistern was opened via a left frontotemporal craniotomy, but an ICA aneurysm, which had not been previously recognized, ruptured suddenly. The ICA aneurysm was wrapped with Vascwrap with some difficulty. The MCA aneurysm was then trapped. Postoperatively, the patient continued to be stuporous for a few days. Two weeks later, he died of complications caused by pneumonia. Bacterial aneurysm is more likely to be located in the distribution of the distal arterial tree, mainly in the distribution of the MCA. The difficulty of preoperative diagnosis and the unpredictable clinical course of bacterial aneurysms are emphasized.
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PMID:[Multiple bacterial aneurysms: case report]. 959 17

We describe a patient with SLE and antiphospholipid syndrome who presented with severe headache and fever. Lumbar puncture analyses indicated meningitis. Kingella kingae was isolated from her blood cultures. A large mobile vegetation was seen on her mitral valve. The association between SLE, Libman-Sacks endocarditis and bacterial endocarditis is discussed.
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PMID:Kingella endocarditis and meningitis in a patient with SLE and associated antiphospholipid syndrome. 1087 36


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