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

The author has performed clinical and follow-up studies of 80 acromegalic patients treated by transanthro-sphenoidal removal of the pituitary adenoma. Heredity for acromegaly or gigantism was recorded in 3.8% of the patients and other hereditary factors in 13.8%. Head trauma, meningitis or encephalitis was recorded in the case histories in 18.8%. The predominant symptoms were sweating, paraesthesiae, headache and joint pain. Acromegaly was in 37.6% associated with goitre, parathyroid adenoma, gastric or duodenal ulcer, parotid tumours of submandibular swelling. The fecundity among the married patients was good, 34.4% having three or more children. Successful pregnancies occurred after the transanthro-sphenoidal removal of the adenoma.
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PMID:Heredity and symptoms in acromegaly. 98 80

A previously healthy 26-year-old woman presented to the emergency department complaining of a severe, throbbing, and bifrontal headache. Initial vital signs were pulse rate, 130 beats/min; blood pressure, 128/50 mm Hg; temperature, 100.1 degrees F. Shortly thereafter the patient's pulse and temperature increased to 170 beats/min and 103 degrees F, respectively. Physical examination showed a tremulous, anxious woman in moderate distress who had a diffusely and symmetrically enlarged thyroid gland. A diagnosis of thyrotoxic crisis was made, and appropriate therapy instituted, including the use of an esmolol infusion for control of hypersympathetic activity. A review of the clinical presentation, diagnosis, and management of thyrotoxic crisis is presented.
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PMID:Emergency department management of thyrotoxic crisis with esmolol. 167 41

Two unusual cases of vascular headache, one caused by jugular venous compression from a goiter and one triggered by flushing associated with a CGRP-producing renal tumour, are reported. Their histories are compared with those experiencing other headaches of vascular origin. Two patients with a primary neural irritative lesion, one with a sphenoid sinus carcinoma and one with Tolosa-Hunt syndrome, presented with headaches resembling migraine. These case-histories are used to illustrate the interaction of nervous system and vascular system in the production of headache which has implications for the pathophysiology of migraine and cluster headache.
Headache 1991 Jul
PMID:Solved and unsolved headache problems. 177 58

We describe an epidemic of self-limited (6 weeks) thyrotoxicosis which affected 12 index cases, 5 household contacts, and 6 retrospectively identified cases in July, August, and September, 1987 in the town of Winterswijk (28,011 inhabitants), The Netherlands. A small goiter was present in 9 of the 12 index patients, tender upon palpation in only 2. Signs and symptoms of thyrotoxicosis were accompanied by a low grade fever in combination with fatigue, headache, myalgia, and a fine desquamation of the palms and soles. The apparent incubation time between family members was 6 days. Thyroid technetium uptake was decreased in 10 of 11 tested patients. Laboratory findings included elevated sedimentation rates (up to 68 mm/h), increased liver enzymes, lymphopenia in 2 patients, and absence of thyroid autoantibodies. HLA-B35, associated with classical subacute thyroiditis, was found in 1 patient only. An etiological agent was not identified. No evidence was found for thyrotoxicosis factitia. After 10 months, all patients were euthyroid, without a goiter or thyroid autoantibodies. Thus, a new variant of thyroiditis, atypical subacute thyroiditis, was probably the cause of this unusual outbreak. It is unclear at present if this variant of thyroiditis is common in communities and represents a separate disease entity.
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PMID:An outbreak of thyrotoxicosis due to atypical subacute thyroiditis. 229 55

Histologically-verified triple cancers that include a malignant brain tumor are rare. According to the Japan Autopsy Annuals, only 8 cases since 1958 have been so far documented. A case combining a malignant melanoma, a medulloblastoma, and a thyroid cancer is herein presented, along with a review of the literature. In March, 1983, a 27-year-old female who, 7 years prior to admission, had had malignant melanoma on the right hand removed, complained of headaches and vertigo. A CT scan revealed a right cerebellar mass lesions, which subsequently proved to medulloblastoma. Three years later, a struma was found and subtotal thyroidectomy revealed a papillary adenocarcinoma.
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PMID:[A histologically-verified triple cancer--report of a rare case involving a primary brain tumor]. 304 37

14 normal volunteers, 23 patients with euthyroid goiter, 9 patients with hypothyroidism and 17 patients with hyperthyroidism were injected with 400 micrograms thyroliberin (thyrotropin releasing hormone, TRH). The documented side effects were the same in all the 4 groups studied. Subjective symptoms such as flushing, nausea, urinary urgency, dizziness and headache in decreasing sequence were mentioned by 86% of subjects. Shortly after thyroliberin injection, a mean increase of 26 +/- 13 mm Hg for systolic and 14 +/- 6 mm Hg for diastolic blood pressure as well as an increased heart rate by 7.2 +/- 6.6 min-1 was demonstrated. Plasma catecholamines were lowered in patients with euthyroid goiter and hyperthyroidism and raised in patients with hypothyroidism, compared with the controls. Thyroliberin administration was associated with an activation of the sympathoadrenal system. The increments in plasma epinephrine and norepinephrine concentrations were proportional to initial values, but were insufficient to affect blood pressure. The mean increase of 28% for plasma epinephrine and 21% for norepinephrine were maximal in the second to the forth minute, where subjective symptoms, blood pressure and heart rate were already decreasing. In view of the rapid onset of the subjective symptoms as well as the chronotropic and the pressor response, thyroliberin may partly exert these effects centrally or directly on the vascular system, independently of catecholamines. Since individual systolic blood pressure increased by as much as 64 mm Hg, caution is advised in selecting patients with risk factors for testing.
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PMID:[Adverse reactions and changes in norepinephrine and epinephrine in the plasma after intravenous thyroliberin in persons with normal and abnormal thyroid function]. 311 48

A personal series of 256 cases of acromegaly/gigantism seen over a 20-year period from 1963 is described. The insidious nature of the condition resulted in delay in diagnosis which was often made by a doctor when seeing the patient for an unrelated problem. Other features which commonly led to the diagnosis being made were headache, change in appearance, carpal tunnel syndrome, amenorrhoea and diabetes. The Hardy system for grading the radiological appearance of the pituitary tumour was used. Widely invasive tumours were not common but tended to occur in patients with younger age of onset and high GH levels. The occurrence of various symptoms and clinical features was noted and the changes resulting from reducing the GH level to normal. The incidence of hypertension, but not of coronary artery disease, is increased and the blood pressure may be reduced following successful treatment. The effects on the upper and lower respiratory tract are reported as well as sleep apnoea and problems associated with anaesthesia. Skin manifestations included sweating, pigmented skin tags, acanthosis nigricans and cutis verticis gyrata. In the skeletal system the incidence of kyphoscoliosis and osteoarthritis especially of the hip is reported: the question of hip replacement is discussed. Diabetes mellitus disappeared in most cases if the acromegaly was cured. In men but not in women the incidence of colloid nodular goitre was increased as was hyperthyroidism in middle-aged women. In two patients a parathyroid adenoma was present: hypercalcaemia was present in five additional patients, but the cause was not determined. The common occurrence of amenorrhoea in the younger women was noted, it was not always associated with hyperprolactinaemia, and often responded to successful treatment of the acromegaly. The association of acromegaly with hirsutism and galactorrhoea is confirmed. The incidence of impotence and loss of libid in the men is discussed: in a proportion of those in whom the acromegaly was cured, potency returned, but in a number depression occurred and what was believed to be psychogenic impotence persisted. Hyperprolactinaemia was found in 49 out of 151 patients with active acromegaly in whom the prolactin level was measured. Previous reports have indicated a doubling of death rates in acromegalics. In this series there were 47 deaths observed compared to 37.2 expected. The increased death rate was in women of all ages and in men under the age of 55, The increased deaths in the women were from cardiovascular and cerebrovascular causes and from breast cancer.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Acromegaly. 330 90

The short- and long-term effects of administration of lithium carbonate in cluster headache (CH) have been investigated. Of the 90 patients treated (78 males and 12 females), 68 had episodic CH and 22 had the chronic form of the disease. The doses used were almost always 900 mg/day. Eleven of the 22 patients with chronic CH showed a definite, constant improvement both short and long term. In 7 of the 22 patients, lithium treatment provided excellent results initially but was later followed by some transient worsening; in the remaining 4 only partial benefits were observed initially and treatment proved still less effective after a few months. The effects of cessation of lithium administration after at least five months of continuous treatment were studied in 9 cases. In 6 of them the attacks re-appeared immediately, whereas in 3 the attacks occurred again only after free intervals of four to six months. Of the 68 patients with episodic CH, 26 proved highly responsive to treatment, 26 only partially responsive, and 16 refractory. In 3 cases, after one to three years of continuous treatment, euthyroid goitre developed, which disappeared after the drug was discontinued.
Cephalalgia 1983 Jun
PMID:Lithium carbonate in cluster headache: assessment of its short- and long-term therapeutic efficacy. 640 15

Pituitary adenomas are frequently encountered, benign intracranial tumours. Clinically classified according to their capacity to produce and secrete hormones, pituitary tumours are diagnosed from the clinical manifestations and biochemical findings of specific pituitary hormone overproduction or of impaired pituitary function due to pressure on normal pituitary cells, the pituitary stalk or the hypothalamus. Additionally, the tumour may result in neurological manifestations due to its effect as an intracranial space-occupying lesion. Pituitary adenomas may present acutely with pituitary apoplexy after intrapituitary haemorrhage or infarction. The subsequent hypofunction of the pituitary with concomitant neurological sequelae of an expanding intracranial mass are often associated with excruciating headache, diplopia and visual field defects. Gradually developing neurological deficits or secondary endocrine failure over several years may precede the recognition of non-secretory tumours (30-40% of pituitary adenomas) as well as some of the hormone-producing adenomas, especially when they expand beyond the confines of the sella turcica. Asymptomatic masses occur in the pituitary in 5-27% of unselected autopsy series. About 10-20% of pituitaries imaged as part of a brain study contain lesions 'consistent with a pituitary adenoma', with about half being pituitary adenomas ('incidentalomas'). Many advocate screening such cases for a wide spectrum of pituitary function abnormalities. Clinical judgement should be utilized to determine the extent of the work-up and the frequency of follow-up. Acromegaly, a clinical syndrome caused by excess growth hormone secretion, accounts for one-sixth of resected pituitary tumours. This disorder leads to chronic progressive disability and a shortened life span, with approximately 50% of untreated acromegalic patients experiencing premature death. The prevalence of acromegaly has been estimated to range from 50 to 70 per million, with the age of diagnosis usually between the third and fifth decades. Conditions associated with acromegaly include glucose intolerance, diabetes mellitus, lipid abnormalities, cholelithiasis, goitre, and hyperthyroidism, respiratory complications, hypertension, cardiovascular disease, and calcium metabolism abnormalities. An association between acromegaly and cancer, especially of the colon, is now recognized. Epidemiological series have indicated that cancer of the colon, breast and other types of malignancy are a cause of death with increased frequency in acromegalics compared with expected rates. Hypopituitary symptoms secondary to the mass effect of macroadenomas in acromegalic patients are common. Among premenopausal women, menstrual irregularities and galactorrhoea have been reported in 40-70%, while more than half of the men complain of impotence and decreased libido.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Clinical features and differential diagnosis of pituitary tumours with emphasis on acromegaly. 762 86

Seventy patients with toxic goitre treated surgically in two surgical firms in Khartoum during a 10-years period were studied. Of these patients 62.9% had diffuse goitres, 34.3% nodular and 2.8% hot clinically solitary nodules. The age ranged between 15 and 54 years and the M:F ratio was 1.0:6.7. Ninety per cent of the patients had large size goitres (grade III). Preoperative carbimazole and inderal were found to be superior to other drug combinations. Subtotal thyroidectomy was the standard procedure and no serious postoperative complications were noted. Fifteen patients had postoperative hectic period i.e. fever, headache and tachycardia that responded to temporary inderal and steroids. Surgical treatment of toxic goitre in developing countries could be extended to include more patients since drug availability and patient compliance are minimal.
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PMID:Surgical management of toxic goitre in Khartoum. 836 53


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