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

A 65-year-old woman with diabetes mellitus and chronic otitis media developed headache, fever, and hoarseness, all of which did not responded to the oral antibiotics. As stiff neck and lower cranial nerve palsies appeared, bacterial meningitis was suspected. Neurological examination revealed the right hearing disturbance, right recurrent laryngeal nerve palsy, left sternocleidomastoid muscle atrophy and bilateral tongue atrophy. The CSF examination revealed mild pleocytosis and elevated protein, but no bacterial organism was cultured from the CSF. CT scans showed bilateral mastoiditis, and the right mastoid process and a posterior part of the petrous bone were eroded, indicating the exposed bony structures to the posterior fossa. MRI scans demonstrated the thickening of the dura mater of the posterior fossa and the right cerebellar tentorium. This is a rare example of bacterial pachymeningitis of the posterior fossa, the clinical symptoms and MRI findings of which resolved solely by antimicrobial agents without corticosteroid.
 ...
PMID:[A case of hypertrophic pachymeningitis, resolved by antimicrobial therapy]. 1547 Oct 88

Thanks to the potency of antibiotics, life-threatening complications of otitis media are rare. In many cases, however, the symptomatology is veiled, and the course of the disease tends to be protracted. Secondary symptoms may preponderate and often mask those associated with the ear itself. If a case of otitis media fails to clear up, or mastoiditis develops, or sensorineural deafness, vertigo, headaches, seizures, or meningism occur, the possibility of an otogenous complication must immediately be considered and the patient submitted to diagnostic imaging without delay, so as to ensure early surgical treatment of a possible lesion in the ear.
 ...
PMID:[Endocranial complications in otitis media: what you need to remember]. 1583 94

Sigmoid sinus thrombosis following mastoiditis is a rare, but potentially life-threatening, condition. Its treatment usually consists of systemic antibiotics and mastoidectomy. In this report, we describe a pediatric case of sigmoid sinus thrombosis following mastoiditis, presenting with nonspecific symptoms such as fever, otalgia, and headache. Diagnosis was based on magnetic resonance imaging. The patient responded very well to intravenous antibiotics with a rapid clinical improvement and complete recanalization of the thrombosed sigmoid sinus. In conclusion, mastoiditis may present few clinical symptoms. In case of treatment failure or new-onset neurologic deficit in children with acute otitis media, life-threatening complications associated with mastoiditis should be considered. Early diagnosis is important, as favorable prognosis can be achieved with conservative management without performing any surgical intervention.
 ...
PMID:Sigmoid sinus thrombosis following mastoiditis: early diagnosis enhances good prognosis. 1616 Jun 68

Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.
 ...
PMID:[Pseudotumor cerebri secondary to dural sinus thrombosis: pediatric case report]. 1617 28

The incidence of intracranial complications of acute otitis media (AOM) has decreased and the need for operative and medical treatment is declined during the antibiotic era. To describe pathognomonic signs, evaluation management, operative findings, clinical course and outcome of otitic hydrocephalus and lateral sinus thrombosis as complications of AOM and mastoiditis in pediatric patients. Two children, 9 and 13 years old, with the diagnosis of OH and TK and MRI findings are presented. Intracranial complications in children resulted from unsuccessful treatment of AOM, which led to acute mastoiditis and lateral sinus thrombosis. Both of the presented children had thrombus in their sigmoid sinus preoperatively, demonstrated by MRI, causing decreased blood flow. Both patients underwent a mastoidectomy and delamination of sigmoid sinus with puncture of sinuses. After medical and surgical treatment, blood flow through the sinus increased significantly. In both cases signs of increased intracranial pressure ceased. The clinical presentation of otogenic lateral sinus thrombosis (LST) as a complication of acute otitis media (AOM) can be masked by antibiotic treatment. The episodes of vomiting, headache, visual impairment and a history of AOM seem to be indicative for otitic hydrocephalus. MRI scans of patients with similar symptoms should be carefully studied to facilitate the early diagnosis of dural sinus thrombosis with increased intracranial pressure. Contrast-enhanced computed tomography scan and magnetic resonance imaging play a major role in determining diagnosis and treatment plans in this intracranial complications. Management included systemic antibiotics, short-term heparin anticoagulation and surgical decompression. In our patients intensive i.v. antibiotic treatment, steroids, anticoagulants and surgery led to a significant improvement in the clinical condition.
 ...
PMID:Otitic hydrocephalus associated with lateral sinus thrombosis and acute mastoiditis in children. 1689 5

SummaryMalignant tumours of the mastoid are rare, the majority being squamous cell carcinomas. We report two cases whose clinical presentation mimicked mastoid abscess with intracranial complications. The first case is a twenty year Nigerian lady who presented to the Emergency Room of the Otorhinolaryngology Department with a one month history of headache, low grade fever, left facial palsy, neck stiffness and left post-auricular swelling on a background of left chronic suppurative otitis media since childhood. An initial diagnosis of meningitis and mastoid abscess secondary to chronic suppurative otitis media was made but histology of the mastoid specimen revealed keratinizing squamous cell carcinoma, which was treated with palliative primary radiotherapy. The second case is a 45-year old man with a chronic mastoiditis and mastoid abscess that was later found to be suamous cell carcinoma of the mastoid and was managed with combination of surgery and radiotherapy. The report highlights advanced stage of the disease at presentation, and discusses the etiology and management. To the best of our knowledge, these are the first cases of this entity to be documented in Africans.
 ...
PMID:Squamous cell carcinoma of the mastoid - a report of two cases. 1729 38

Thrombophlebitis of dura venous sinuses is a rare intracranial complication of otitis media, which may be sometimes accompanied by symptoms or sepsis. Anatomical conditions and early diagnosis of this vascular complication determine the treatment modality. Aim of this study was the assessment of diagnostics and treatment of venous sinuses thrombophlebitis in acute and chronic otitis media considering anatomy and the venous sinuses and status of coagulation system. Otogenic thrombophlebitis may occur in lateral, transverse, upper and lower petrosal sinuses, and rarely in cavernous. In some cases thrombophlebitis proces may expand into brain or emissary mastoid veins. Lateral sinus thrombophlebitis in chronic otitis media usually appears clinically as septic fever, earache, and increasing neurologic signs. In acute otitis media when thrombophlebitis develops the patient complains about headache, high fever and visual acquity. Diagnosis of venous sinus thrombophlebitis is based on clinical signs, radiological imaging (CT scan, MRI), bacteriological examinations and laboratory biochemical tests. Contrast enhanced CT scan shows "delta sign". Septic thrombophlebitis sinus sigmoidei is caused by mixed bacterial flora. Surgical treatment in cases with septic thrombus consists of radical modiffied ear operation and lateral sinus exposure. Thrombectomy and jugular vein ligation is performed when sepsis or thrombus is present. Mastoidectomy and tympanic cavity drainage is performed in cases with lateral sinus thrombosis in acute mastoiditis. Intravenous antibiotics therapy should be continued for 2 weeks. Anticoagulants should be given taking into consideration parameters of coagulation system and the type of thrombus. Treatment results of venous sinuses thrombophlebitis are good if they are not accompanied by other intracranial complications.
 ...
PMID:[Thrombophlebitis of venous sinuses in otitis media]. 1855 16

Streptococcus pneumoniae accounts for approximately 50% of bacterial meningitis cases in the United States annually. Since the advent of antibiotics, pneumococcal meningitis as a complication of a primary otogenic focus has been rare in the United States. The widespread use of immunosuppressants and increasing bacterial resistance to commonly prescribed antibiotics may contribute to a higher incidence of complications of otitis media in the future, similar to that of the pre-antibiotic era. We report a case of otogenic pneumococcal meningitis with pneumocephalus in an adult male on chronic immunosuppressant therapy. A 33-year-old man with Crohn's disease and azathioprine use presented to our Emergency Department with progressive headache while taking antibiotics for otitis media. Initial computed tomography scan of the brain revealed pneumocephaly, and cerebrospinal fluid analysis and culture diagnosed pneumococcal meningitis. The patient continued to have fevers while receiving intravenous antibiotics and underwent bilateral myringotomies; his clinical course subsequently improved significantly. Meningitis is a rare complication of Streptococcus pneumoniae infections since the advent of antibiotics; however, it may become more frequent with increasing antibiotic resistance and a growing population of immunocompromised patients. Additionally, pneumocephalus in the setting of meningitis and otitis media should raise the suspicion for mastoiditis (even without overt clinical findings) and early consultation with an otolaryngologist is warranted.
 ...
PMID:Otogenic pneumococcal meningitis with pneumocephalus. 1859 73

Septic thrombophlebitis caused by head and neck infection has become a rare disorder due to the development of antibiotics. We report herein two cases of septic thrombophlebitis of the head and neck. Case 1 was a 7-year-old girl, who presented with fever, otalgia, and headache. Acute otitis media was diagnosed in another hospital. A computed tomography (CT) scan and magnetic resonance imaging (MRI) demonstrated mastoiditis with thrombophlebitis of the right lateral and sigmoid sinuses. Case 2 was a 39-year-old woman, who presented with left neck pain, fever chills and severe pharyngalacia. Peritonsillar abscess was diagnosed. A CT scan demonstrated a left internal jugular vein thrombus in addition to multiple pulmonary nodules with emboli. A diagnosis of Lemierre's syndrome was made based on these findings. Both cases were successfully treated by intravenous antibiotics. A lack of awareness of these conditions and a delayed diagnosis may lead to potentially fatal consequences. A clinical suspicion of septic thrombophlebitis seems to be essential to make an accurate diagnosis during the early stage of the disease and archive a successful outcome.
 ...
PMID:Thrombophlebitis of the head and neck: report of two cases. 2018 29

Acute otitis media is the most common bacterial infection in children. Despite efficient antibiotic therapy, there are still reports of both intratemporal and intracranial complications with potential risk of high morbidity and mortality. Mastoiditis, apical petrositis and labyrinthitis are caused by the extension of purulent middle ear infection into nearby structures. Giuseppe Gradenigo first described the clinical triad of acute otitis media, unilateral pain in the region innervated by the 1 masculine and 2 masculine branches of the trigeminal nerve and ipsilateral abducens nerve paralysis. This is a serious but rare complication of middle ear infection that should be suspected in every patient with unilateral headache and abducens nerve palsy. We report a case of Gradenigo's syndrome in a 6-year-old boy.
 ...
PMID:[Gradenigo's syndrome: a case-report]. 2054 25


<< Previous 1 2 3 4 5 6 Next >>