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

Fistulas of the internal carotid-cavernous sinus are an unusual arteriovenous malformation. Two types exist: (1) spontaneous fistulas and (2) traumatic fistulas. This paper deals with the traumatic variety which is seen more commonly in men as a direct result of severe maxillofacial injury. Recent anatomic studies are correlated with the physical findings associated with carotid-cavernous fistula, ie, headache, chemosis, exophthalmos, pulsatile bruit, and multiple cranial nerve paralyses. A case report illustrates these findings. The differential diagnosis which varies from tumors, to cavernous sinus thrombosis, to intraorbital aneurysm is discussed. The role of angiography in diagnosis is described. Present management consists of intracranial ligation of the internal carotid artery with use of a muscle embolus to occlude the fistula and selective ligation of the cervical carotid.
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PMID:Carotid-cavernous fistula: a complication of maxillofacial trauma. 16 94

Mucoceles of the sphenoid sinuses are uncommon; 60 cases have been reported in the world literature to date. Signs and symptoms are caused by local expansion of the mucocele and include headache (the most common symptom), ocular field deficits, external ophthalmoplegia (particularly the sixth cranial nerve), and proptosis. Radiologic correlation in the form of plain films and polytomorgraphy is the most reliable guide in the diagnosis of sphenoid sinus disease. Therapy of these lesions is surgical, and drainage can be achieved via the external ethmoid or sublabial transseptal route. Three cases are presented: two had classical findings and the third was conspicuous by the presence of aseptic meningitis in the absence of local findings.
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PMID:Mucoceles of the sphenoid sinus. 50 84

Aneurysmal bone cyst of the skull is rarely seen. There are 29 reported cases in the literatures as far as we could collect. We reported an additional case of aneurysmal bone cyst of the skull which originated from the right parietal bone of 4-year-old boy. We have summarized these 29 cases. The age incidence in this series is from 14 month-old to 31 year-old. There are 11 cases under the age of 10. In most cases clinical symptoms are palpable mass or headache and exophthalmos. Eyeball displacement and proptosis are also the symptoms when this disease occurs at the orbital roof. According to the characteristic radiographic appearance, it is "blown-out pattern with a shell of periosteal new bone over the mass or soap-bubble appearance". However in our case the radiological finding was osteolytic. It is possible to remove totally when this lesion occurs in the cranial vault, but only curettage may be performed when the skull base is involved. Total removal is the best treatment. Radiation therapy is usually done in the recurrent cases. It is necessary to follow up for at least 4 years because of the rarity of recurrence beyond 4 years after the initial treatment. We also described the other differential diseases and pathogenesis of this disease.
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PMID:[Aneurysmal bone cyst of the skull -a case report- (author's transl)]. 73 37

Orbital auscultation is recommended as a screening technique in patients with subjective bruit or tinnitus, persistent conjunctivitis, exophthalmos, headache, seizure disorder and other neurologic and psychiatric symptoms. It can reveal carotid-cavernous fistula, cerebral arteriovenous malformation, an intracranial mass which is producing increased intracerebral pressure, Paget's disease and other vascular abnormalities.
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PMID:Orbital auscultation. 73 87

A 2 and a half year-old boy with neurofibromatosis developed unilateral proptosis, decreased visual acuity, and optic disk edema. After the discovery and removal of an optic nerve glioma, the patient had ten years of excellent health until he began having headaches, nausea, and vomiting. He had papilledema in his remaining eye. At exploration, a cerebellar astrocytoma and a neuroglial hamartoma were removed. The occurrence of a glioma of right anterior visual pathway associated with other primary intracranial lesions in patients with neurofibromatosis was not previously reported.
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PMID:Optic nerve glioma and cerebellar astrocytoma in a patient with von Recklinghausen's neurofibromatosis. 80 54

The familial occurrence of brain tumors are exceedingly rare except in cases with phacomatosis. We encountered pituitary adenomas in two sisters of a family, so far presenting no evidence of multiple endocrine adenomatosis (MEA). Case 1, K. O. a 26-year-old woman was admitted to our Hospital on September 10, 1970 with visual acuity and field disturbance, irregular menstruation and acromegaly. Neurological examination: Her visual acuity was Vd 0.6 and Vs 0.3, visual field was bitemporal hemianopsia, and ther was papilledema bilaterally. She had left exophthalmos and left abducens palsy. Roentgenogram of the skull, brain scanning, cerebral angiogram, pneumoencephalogram suggested the presence of a pituitary tumor. On Sep. 17, 1970, through a left frontotemporal craniotomy the tumor was removed subtotally. The pathological diagnosis was pituitary adenoma (chromophobe). Case 2, M. T. a 31-year-old woman, sister of case 1, was admitted to the Hospital on September 19, 1973, with mild headache, left visual field disturbance and amenorrhea. She had a child, and a past history of pulmonary tbc. Neurological examination: Her visual acuity was Vd 1.2 and Vs 0.03, and visual field of the right eye was temporal lower quandrant anopsia. There was optic nerve atrophy in the left eye. Plain X-ray craniogram, brain scanning, cerebral angiogram and pheumoencephalogram suggested the presence of a pituitary tumor. On Sep. 28, 1973, a right frontal craniotomy was performed. The tumor tissue with capsule was removed subtotally. The pathological diagnosis was pituitary adenoma (mixed type). In the literatures about familial brain tumors with histological diagnosis, glioma and glioblastoma are common, meningioma is relatively rare. Pituitary adenoma with no evidence of MEA is exceedingly rare. The two sisters presented in this paper, have no evidence of hyperparathyroidism, pancreas adenoma and peptic ulcer. So, we consider, at present, these cases should not be field in MEA.
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PMID:[Familial occurrence of pituitary adenoma (author's transl)]. 94 79

Dural arteriovenous malformation of the posterior fossa was infrequently reported in the literatures. We presented 6 cases of dural arteriovenous malformation of the posterior fossa with the presentation of typical examples. Up to the end February, 1974, 119 cases of intracranial arteriovenous malformation were experienced in our clinic, in which there were 6 cases of dural arteriovenous malformation. The ages of our series ranged from 41 to 75 years old and 57 years old in average. Tinnitus and headache were two main symptoms which developed in most of the cases. As for the older symptoms, visual disturbance was seen in 4 cases, unilateral pulsating exophthalmos in 1 case and papilledema in 3 cases. There wers two cases which progressive dementia was developed by the cerebral anoxia due to arteriovenous shung. On examination, a pulsatile bruit was audible at the mastoid region in all cases and a thrill could be palpated along the occipital arteries. Many kinds of durl and/or tentorial arteries which were drained directly into the sinuses at the occipital portion as the feeding arteries were visualized angiographically. Moreover, the angiographical patterns of feeding arteries into the sinuses showed dynamic changes after the operation. As for the treatments, many kinds of surgery were carried out for the cases by the combination method of the next 6 ways. 1. ligation of external carotid artery 2. ablation of periosteum from occipital bone 3. occipital and/or suboccipital craniectomy 4. clipping of almost of all feeding arteries at dura mater and tentorium 5. ligation of threocervical trunk 6. ventriculo-atrial shunt or ventriculo-peritoneal shunt From our experiences, the most effective treatment is thought to be a direct closure of intradural arteriovenous shunt near the sinus at the occipital portion in the early stage.
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PMID:[Dura arteriovenous malformation of the posterior fossa-clinical and angiographical analysis of 6 cases]. 94 83

A case is reported of a primary rhabdomyosarcoma occurring in the right subfrontal region of a 16 year old girl. The patient suffered from dull frontal headache and proptosis for three months before hospitalization. The circumscribed and demarcated neoplasm involved the dura mater, and invaded the frontal sinus and roof of the orbit on the same side. The pathogenesis of the tumour is thought to be related to aberrant differentiation of unstable mesenchyme. A suggestion is made that the "medullomyoblastoma" should be classified as a type of neoplasm of mixed mesenchymal and neuroepithelial origin.
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PMID:Primary intracranial rhabdomyosarcoma producing proptosis. 95 May 63

A 72-year-old patient had a meningotheliomatous meningioma that invaded through the skull and into temporalis muscle. One year following craniotomy for removal of the neoplasm, he developed headaches, diplopia, and proptosis of the left eye. Biopsy of the orbital contents revealed a malignant supporting tissue neoplasm having a resemblance to the previous meningioma. No curative therapy was possible and the patient died 33 months after diagnosis. Autopsy examination showed extensive residual intracranial neoplasm and a 3-cm metastasis in the liver. The metastatic tumor appeared similar to the meningioma and did not appear malignant histologically. The case illustrates the distinct histologic variations in meningiomas and the difficulties in predicting their biologic activity. Aggressive local behavior may indicate possible malignant areas in the neoplasm. Therefore, examination of the neoplasm should be thorough. Such a correlation may suggest malignant biologic potential.
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PMID:Meningioma with sarcomatous change and hepatic metastasis. 103 80

Fibrous dysplasia involving the sphenoid sinus and the entire left sphenoid bone, manifested clinically by left proptosis and frontal headaches, was diagnosed in a 13-year-old black male. The case is unusual since it is only the third reported instance of fibrous dysplasia of the sphenoid sinus, and because the disease became clinically apparent at the onset of puberty in the patient. Since previous reporters have suggested that fibrous dysplasia remains stable or progresses slightly after the onset of puberty, the patient was not treated with radical surgery, but instead was observed closely. At this point, one year following admission, the patient's proptosis has disappeared and his symptoms are markedly improved.
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PMID:Fibrous dysplasia of the sphenoid sinus in an adolescent male. 118 63


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