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

In younger patients, the clinical symptoms of sudden unilateral headache and facial pain, often combined with Horner syndrome and the cerebrovascular symptoms of TIAs or stroke, should indicate the diagnosis of spontaneous carotid dissection. Angiographic findings can verify this diagnosis, showing various signs of eccentric, narrowing stenosis, false lumen, pseudoaneurysms, or complete occlusion. An addition to noninvasive Doppler ultrasonography, B-mode and Duplex investigations, although more or less nonspecific, give some indications of the diagnosis; modern imaging techniques, especially MRI, can image the intramural hematoma directly. As the hematoma is the source of the intracranial emboli, the therapy of choice in this rarely diagnosed disease should be anticoagulation.
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PMID:[Carotid dissections]. 267 40

Neurological examination and Doppler sonography of a 50-year-old patient were suggestive of a spontaneous dissection of the left internal carotid artery (left-sided headaches, amaurosis fugax, Horner's syndrome and hemispheric stroke). Four-vessel angiogram performed several days after the onset of the symptoms showed dissection of both extracranial carotid arteries, more pronounced on right side where the dissection was clinically asymptomatic. Angiogram follow-up demonstrated a recanalization of both carotid arteries. A review of 15 other documented reports indicates that bilateral internal carotid dissection is usually associated with fibromuscular dysplasia. A large majority of cases does not clinically differ from unilateral carotid artery dissection.
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PMID:Spontaneous dissection of both extracranial internal carotid arteries. 268 19

Periocular pain may result from local pathology or be referred from distant sites. Ophthalmic examination will detect most local disease, although a careful search may be needed to determine the cause of subtle entities. Painful ophthalmoplegia results from a variety of neoplasms and inflammations, often in the area of the cavernous sinus. Cluster headache should be differentiated from more sinister causes of painful Horner's syndrome. Systemic diseases that cause periocular pain and migraine and other classic headache syndromes that may present with eye pain alone are also discussed.
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PMID:Ocular and periocular pain. 268 63

Two patients with a Horner's syndrome due to a probable 3rd neurone lesion were examined with regard to the pupillometric and evaporimetric patterns. The results are compared with those found in patients with a Horner's syndrome due to a 1st or 2nd neurone lesion, previously described by our group. Concurring with observations by others, the pupil on the symptomatic side did not dilate at all when stimulated with hydroxy-amphetamine eye drops. Postganglionic dysfunction may thus be distinguished from 1st and 2nd neurone dysfunction. Supersensitivity was present on the side of the Horner's syndrome, both on pupillometry (phenylephrine stimulation) and in the medial part of the forehead at evaporimetry (pilocarpine stimulation). The lateral part of the forehead, however, did not demonstrate deficient evaporation in these postganglionic sympathetic lesions.
Cephalalgia 1989 Mar
PMID:Horner's syndrome. Sweat gland and pupillary responsiveness in two cases with a probable 3rd neurone dysfunction. 270 76

Fifty-three patients with cluster headache, mean age 42.6 years, were examined by means of pupillometry. Pharmacological stimulation was carried out by the instillation of eye drops; the sympathomimetic agents hydroxyamphetamine (a norepinephrine releaser) and phenylephrine (an agent acting directly on the postsynaptic receptors) were applied. Pupillary dilatation was measured at set time intervals, comparing the responses of the symptomatic and non-symptomatic sides. The material was divided into groups according to the degree of basal anisocoria. The subgroup with the most pronounced basal miosis of the symptomatic side demonstrated a uniform pattern of deficient symptomatic side dilatation after OH-amphetamine and supersensitivity to phenylephrine. The other groups demonstrated the same general pattern, but to a far lesser degree. In cluster headache, the extent of nonresponsiveness to OH-amphetamine and of phenylephrine supersensitivity on the symptomatic side thus, at least partly, seems to be a function of the degree of anisocoria. The response pattern in cluster headache seems to differ from that of 3rd neuron Horner's syndrome with an anisocoria of the same extent.
Cephalalgia 1989 Jun
PMID:Cluster headache: pupillometric patterns as a function of the degree of anisocoria. 274 12

In 1918 the Norwegian neurologist Raeder was the first to describe a syndrome consisting of unilateral headache, facial pain and a Horner's syndrome which is incomplete; this syndrome is accompanied by multiple parasellar cranial nerve involvement. This syndrome was named "Raeder's syndrome" or paratrigeminal syndrome. A survey of the literature concerning "Raeder's syndrome" is given; there a two varieties of Raeder's syndrome, the migrainous or reflex type and the symptomatic type with multiple parasellar cranial nerve involvement. The first variety has a close relationship to cluster headache and to the so-called pericarotid syndrome. A case of an own patient suffering from multiple sclerosis and a migrainous type of Raeder's syndrome is described, assuming that his basic disease MS is independent of his Raeder's syndrome.
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PMID:[A case of Raeder syndrome in a patient with known multiple sclerosis]. 279 31

Cluster headache is an uncommon form of headache syndrome. It is characterised by paroxysms of severe unilateral head pain typically involving the orbit. There are often associated autonomic changes on the affected side such as lacrimation, nasal congestion and Horner's syndrome. Apart from episodic cluster headache, various subtypes such as chronic cluster headache, cluster headache variant and chronic paroxysmal hemicrania have been identified. There have been few reports of the incidence and clinical features of cluster headache in blacks; 7 black patients with various types of cluster headache are described.
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PMID:Cluster headache in black patients. A report of 7 cases. 313 88

In this study the variations in pupil diameter induced by different stimuli (dark-light adaptation, light reflex, electric stimulation of the sural nerve) were investigated in episodic (in the active or remission phases) and in chronic cluster headache (CH) patients. Pupil size monitoring was performed with a monocular, infrared TV pupillometer, and sural nerve stimuli were applied after the pain threshold had been measured as the flexion reflex threshold of the biceps femoris muscle (RIII reflex). The results were compared with those obtained in patients with "peripheral" (third neuron) Horner's syndrome and in healthy sex- and age-matched controls. On the symptomatic side we found an impairment of pupil response to light flashes and nociceptive stimuli; similar findings were sometimes evident on the pain-free side, too. These results substantiate previous observations that in cluster headache a dysfunction of the integrative central nervous system pathways also exists intercritically and mostly bilaterally, involving both autonomic regulation and pain perception mechanisms.
Cephalalgia 1988 Sep
PMID:Pupil responsiveness in cluster headache: a dynamic TV pupillometric evaluation. 319 99

Thirty-one patients with cluster headache were examined with regard to their forehead sweating pattern, by means of the Evaporimeter. Sweating was stimulated in two different ways: by body heating and by parenterally administered pilocarpine. The resulting increase in evaporation was frequently measured at different positions on both sides of the forehead, and the possibility of variations in the pattern related to the passage of time was specifically scrutinized. Some typical patterns emerged. The previously reported, marked asymmetries of response (deficient heat-induced sweating and pilocarpine supersensitivity of the symptomatic side) at the medial positions in the forehead were confirmed. However, the asymmetries invariably faded to some extent with the passage of time. Patients with cluster headache show gross similarities with, but also some minor differences from, the sweat pattern of patients with brain stem lesions causing a Horner's syndrome. A subdivision of the material into groups in accordance with the pupillometric pattern after sympathomimetic stimulation made it clear that the cases of definite evaporimetric asymmetries ("typical reactions") belonged to the group with a typical pupillometric pattern. These results suggest that from an "autonomic" point of view, subpopulations may exist within the clinical entity of cluster headache.
Cephalalgia 1988 Dec
PMID:Cluster headache: forehead sweating pattern during heating and pilocarpine tests. Variation as a function of time. 321 26

A 51-year-old male cluster headache patient had during five bouts in the course of 11 years always had the headache attacks on the left side. Autonomic abnormalities were, however, present on the right side. Pupillometrically, there was thus a Horner-like syndrome on the right (non-symptomatic) side, with miosis and a relatively more marked dilatation of that eye subsequent to topical application of a directly working sympathomimetic agent (phenylephrine) than after an indirectly working one (hydroxyamphetamine), whereas this was not the case on the symptomatic side. The findings on evaporimetry were not as clear-cut as the pupillometric findings; however, even facial sweating was consistent with a pathologic condition on the right (non-symptomatic) side. A primary dichotomy of pain and autonomic signs (that is, not due to change of side of pain localization) thus seems to be present in this case.
Cephalalgia 1988 Jun
PMID:Cluster headache: further observations on the dissociation of pain and autonomic findings. 340 15


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