Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A twenty-seven year old women with meningo-encephalitis and paranoid symptoms is presented. The patient was admitted to a psychiatric unit where, two months previously, her brother had been under treatment for a paranoid schizophrenic episode. The diagnostic lumbar puncture was performed after several days of increasing periods of disorientation, stupor, incontinence, posturing, and perseveration. There was no fever, no signs of meningeal irritation, and no localizing neurologic deficit. The problem of recognizing organic brain disease presenting as an acute psychotic episode is discussed. In this case, the positive family history was given inappropriate emphasis, while the good pre-morbid adjustment of the patient and the symptoms of confusion and headache were inadequately considered. Viral meningo-encephalitis, particularly that due to herpes simplex, often presents with a picture of behavioral abnormalities and minimal physical signs, and is easily confused with a functional process.
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PMID:Meningo-encephalitis presenting as an acute paranoid psychosis. 21 81

The authors report the cases of three men who presented for evaluation of a rapidly progressing dementia. All were found to have a giant aneurysmal mass in the basifrontal region, and all were successfully treated by surgical excision of the mass. The presenting syndrome included rapidly progressive and severe loss of recent memory associated with confusion, chronic headache, wide-based staggering gait disturbance, urinary urgency, frequency, and incontinence, and a fine tremor of the hands exacerbated by purposeful movements. The clinical presentation, radiological assessment, and surgical treatment are discussed.
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PMID:Aneurysmal tumors of the basifrontal region. 84 29

The effect of bifemelane hydrochloride on dementia in the elderly was studied in thirty-one patients having cerebrovascular disorders. Alzheimer's disease, Parkinsonism and related diseases. The drug (150 mg) was administered orally three times daily for 10 weeks. The final global improvement rating was 77.4% for all patients. The rates of improvement for Alzheimer's disease were higher than those for cerebrovascular disorders, suggesting that this drug affects Alzheimer's disease through a cholinergic potentiating action. Psychotic, neurological and subjective symptoms, and the activity of daily life, were rated before, during and after treatment. All mean rates of improvement were based on observations made in the 4th week after the start of treatment. Improvement rates for global symptoms were more than 80% for emotional incontinence and prejudice or querulous attitudes toward the nurses, and in headache, tinnitus and dizziness among the subjective symptoms. The improvement in intellectual function was evaluated by the dementia rating scale for the elderly (DRSE), and a significant increase was found in DRSE after treatment with this drug. Side effects attributable to the drug were noted in one patient developing urticaria. It is thus suggested that bifemelane hydrochloride is useful in the treatment of different symptoms of dementia.
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PMID:The clinical effect of bifemelane hydrochloride on dementia in aged patients. 179 96

Sixty-three women with clinical and urodynamic evidence of stress incontinence were evaluated before and after incontinence surgery for symptoms of depression, nervousness, tension, sleep disturbances, decreased appetite, somatic weakness and headaches. Women treated successfully with surgery demonstrated a statistically significant improvement in their subjective psychologic status (P less than .05). Unsuccessful treatment, however, was not associated with a significant change in or deterioration of their symptoms. All the symptoms were evaluated individually to ascertain the specific effects of treatment. Sleep disturbances were significantly improved with successful treatment and worsened with unsuccessful treatment (P less than .05). Tension was significantly improved with successful therapy (P less than .05) but was unchanged if surgery was unsuccessful. Depression became worse with subjectively unsuccessful surgery. Headaches and appetite were not affected by the therapeutic outcome. Therapy can be instrumental in affecting the psychologic status of women with stress incontinence. If the psychologic disability continues after therapy and/or treatment is unsuccessful, a referral for psychologic evaluation should be considered.
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PMID:Stress incontinence in women. Psychological status before and after treatment. 181 93

Communicating normal pressure hydrocephalus (NPH) is an important remote complication of traumatic brain injury (TBI). The diagnosis of this hydrocephalus depends largely on clinical signs and symptoms, including cognitive deterioration, gait changes and incontinence. However, many of these signs are also seen during post-traumatic amnesia, making early recognition of this syndrome difficult. A case study of one man post-TBI, who presented with new-onset hypertension as a sign of NPH, prompted a retrospective chart review of all patients admitted over a 2-year period with a diagnosis of NPH. Ninety per cent of patients had one or more of the classic triad of NPH and 25% of patients had symptoms suggestive of raised intracranial pressure (unexplained nausea, headache and visual disturbance). Mean systolic and diastolic blood pressures among the 20 subjects for six consecutive days pre-operatively compared with those for days 8-14 and 15-21 post-operatively showed no significant differences; a subgroup of five patients (25%), however, demonstrated a significant change in blood pressure temporally related to shunting. We suggest that demonstration of new-onset systemic hypertension may also be a clinical sign suggestive of NPH useful in the evaluation of the TBI patient.
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PMID:Relationship of new-onset systemic hypertension and normal pressure hydrocephalus. 239 Jun 49

At the age of 29, a woman developed central nervous system manifestations of incontinence, psychosis and a grand mal seizure in February 1982. She was diagnosed as having systemic lupus erythematosus (SLE) based on photosensitivity, oral ulcers and elevated antinuclear and anti-DNA antibodies titers. Three years and one month later the patient had episodes of severe headache and vomiting during the course of maintenance treatment. CT examination of the head revealed blood within subarachnoid cisterns, and a small berry aneurysm was found at the distal portion of the basilar artery by cerebral angiography. The possible role of SLE-associated cerebral vascular changes in the development of this aneurysm is discussed.
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PMID:A case of central nervous system lupus associated with ruptured cerebral berry aneurysm. 250 73

Utilizing data from seven independent double-blind controlled trials for cerebrovascular diseases (CVD) in chronic stages, a study was performed to describe the short-term prognosis of cognitive impairment with CVD patients and to identify correlating factors. 943 patients out of 2,818 with CVD (cerebral infarction, cerebral hemorrhage and brain arteriosclerosis) were selected. The subjects had more than moderate intellectual deterioration, i.e., less than 21.5 points on Hasegawa's dementia scale (HDS) at the baseline of the trials. The improvement rate was estimated at 11% (102/943) with more than a 10 point change on HDS in 8 weeks and 34% (322/943) with more than a 5 point change. Long duration of illness, old age, severe initial global severity rating and severe initial cognitive impairment were correlated significantly with aggravation of cognitive impairment. However, sex, type of CVD, complication and rehabilitation were not markedly related with aggravation. In addition, it appeared clear that there was a tendency of improving cognitive impairment on patients with severe subjective symptoms (vertigo, headache, dull headache, feeling of congestion), anxiety, irritability in consequence of the covariance analysis of adjusting for duration of illness, age, global severity and initial cognitive impairment. On the other hand, incontinence, impairment of activities of daily living (excretion), motor weakness and low total protein correlated significantly with aggravation. These findings might be explained on the basis of changes in stages from reversible to irreversible with cognitive impairment, the contribution of aging and the influence of peripheral symptoms.
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PMID:[Short-term therapeutic prognosis of cognitive impairment with cerebrovascular diseases in chronic stages]. 261 1

An unusual case of adult-onset aqueduct stenosis is discussed. The patient presented with a 3-year history of bowel and bladder incontinence without associated dementia, gait disturbance, headache, visual loss, or hypothalamic dysfunction. The absence of the midportion of the sylvian aqueduct in this patient is verified by magnetic resonance imaging.
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PMID:Adult aqueductal stenosis presenting as double incontinence: a case report with magnetic resonance imaging. 230 64

Ten years after a diagnosis of sarcoidosis, a 33-year-old woman presented with a severe headache of 5 days' duration. Neuroradiologic evaluation revealed a large cystic lesion of the left temporal lobe, causing a mass effect. An exploratory operation proved the lesion to be a loculated portion of the temporal horn of the lateral ventricle. Drainage of the loculated ventricle relieved the patient's cephalgia. Within 2 months, however, pain in the head recurred and an unsteady, broad-based gait appeared. Reevaluation disclosed hydrocephalus for which a ventriculoperitoneal shunt was inserted. After this procedure, the patient did well neurologically for 1 year, after which seizures, personality changes, incontinence, and disturbance of gait developed. Death occurred after revision of the shunt, and widespread granulomatous disease was found at autopsy. Neurosarcoidosis, with emphasis on intracranial mass lesions in sarcoidosis, is discussed; the role of surgical treatment in some of these lesions, and in hydrocephalus, is stressed.
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PMID:Neurosarcoidosis causing ventricular loculation, hydrocephalus, and death. 371 3

Pupillometry was used to evaluate the effect of oral or topically applied adrenomimetic drugs and of local morphine on pupillary size in headache patients and controls. In headache sufferers, a disruption of adrenergic transmission is suggested since the iris adrenergic nerve terminal is apparently poor in NE; this neuron also exhibits a reduced capacity of neurotransmitter synthesis and an adrenoceptor hypersensitivity. The spontaneous reduction of pupillary size detected in headache sufferers also suggests a decreased sympathetic input. The miosis, registered after conjunctival instillation of morphine, demonstrates that iris is a possible example of an opioid-dependent adrenergic neuron in man. A poor modulation of the iris adrenergic transmission induces, in headache sufferers, a neuronal incontinence and therefore a chronic intrasynaptic leakage of NE, resulting in an exhausted empty neuron on the one hand and a compensatory hyperactivity of the effector muscular cell on the other. Since indirect evidence suggests a morphine modulation of the iris adrenergic neuron, a deficiency of endorphin modulation could be the mechanism of disruption of iris adrenergic transmission. Apart from the theoretical aspects, the exploration of iris neuroeffector junction represents a noninvasive an simple diagnostic tool in headache.
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PMID:Disruption of iris adrenergic transmission as an index of poor endorphin modulation in headache. 611 94


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