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

A 23-year-old soldier sustained a penetrating gunshot wound to the right frontoparietal region of the head in 1971 while serving in Vietnam. In 1984, he developed headaches and seizures, and a meningioma was found at the cranioplasty site. Recurrent meningiomas, requiring resection, developed at this site in 1988 and 1990. In 1994, he developed right proptosis. An extensive mass involving the right intraorbital region and the anterior and middle cranial fossa was found. Pathological examination of this tumor demonstrated malignant meningioma. Although antecedent head trauma has been implicated as a risk factor for meningioma, epidemiological studies of this association have yielded divergent conclusions. An explanation for this epidemiologic dichotomy is suggested.
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PMID:Posttraumatic meningioma: explanation of an epidemiologic dichotomy. 778 26

An unusual case of an intracranial glioma which demonstrated extramedullary growth is reported. The patient was a 39-year-old woman who had experienced headache, nausea and vomiting for about 1 month. On admission she showed slight disturbance of consciousness and bilateral papilloedema. CT scan and MR imaging disclosed a mass approximately 5 cm in diameter in the right frontal region, with clear demarcation from the neighboring gyri. Right external carotid angiogram revealed A-V shunts in the mass, but by right internal carotid angiogram, no abnormal findings were disclosed except for the deviation of normal intracranial vessels due to the existence of the mass. Therefore, a preoperative diagnosis of extramedullary tumor such as meningioma and epidermoid was made. Right frontal craniotomy was performed, and the tumor was proven to exist in subdural space. The boundary of the tumor to the brain surface was distinct except for one part. Histopathologically, the tumor cells had abundant eosinophillic cytoplasms, with eccentric-distribution of their nuclei. Furthermore, they were positive for staining for GFAP and S-100 protein. Therefore, a final diagnosis of gemistocytic astrocytoma was made. Reviewing some references the authors discuss here the form of development and progression of intracranial gliomas which demonstrate extramedullary growth such as this case.
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PMID:[A case of intracranial glioma which demonstrated extramedullary growth]. 781 73

We reported a rare case of multiple cavernous angioma accompanied with a convexity meningioma. A 41-year-old female developed generalized convulsion on October 8, 1985. Plain computed tomography (CT) scan revealed a round heterogeneous density mass in the right parietotemporal region, which was homogeneously enhanced. Angiography demonstrated a tumor stain fed by the right angular artery and the posterior branch of the right middle meningeal artery. Total removal of the tumor was performed. Since histological examination disclosed meningothelial cells, whorl formation, polymorphism and necrotic tissue, she received radiation therapy (total 50Gy) under the diagnosis of anaplastic meningioma. On November 10, 1988, she suddenly developed headache, nausea, motor weakness and homonymous hemianopia on the left side. CT scan revealed intracerebral hemorrhage (ICH) near the region where the meningioma used to be. Magnetic resonance image (MRI) demonstrated a high intensity mass at T1-weighted image and mixed intensity mass at T2-weighted image. Furthermore, there were multiple low intensity spotty lesions at the cerebral and cerebellar hemisphere in T1 and T2-weighted image. A few parts of these lesions showed central high intensity cores and perifocal low intensity areas, which were called ring formations or reticulated cores with black rims. The multiple lesions could not be detected by CT scan. ICH was evacuated. Histological examination revealed no specific pathology except necrotic tissue around the hematoma wall. Diagnosis of radiation necrosis was made. On October 25, 1992 she suddenly complained of left hemihypesthesia. CT scan demonstrated two high density spotty areas at the left caudate head and right thalamus. MRI showed these two lesions as reticulated cores with black rims.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multiple cavernous angiomas accompanied with a convexity meningioma: a case report]. 781 76

Inflammatory pseudotumors (IPT) are rare lesions composed of inflammatory cells admixed with collagen tissue. Although IPT are ubiquitous, intracranial locations are rare. In this study, four intracranial IPT of the plasma-cell-granuloma (PCG) type are reported. Four patients presented with lesions located, respectively, in the right cavernous sinus, the left cavernous sinus with extension to the tentorium cerebelli, the vermis cerebelli, and the pituitary stalk. All patients were operated on, but complete resection could not be achieved in cases 1 and 2. Follow-up was favorable in all cases, although case 1 still complained of headaches 2 years after operation. All cases were studied on histologic and immunohistochemical bases, and ultrastructural analysis was performed on two cases. In cases 1, 2, and 4, IPT were made up of plasma cells admixed with lymphocytes and rare histiocytes in a fibrous tissue-the density of which varied from case to case. In case 3, the mass was composed of plasma cells associated with numerous foamy histiocytes and polymorphonuclear cells. No light chain restriction could be demonstrated when immunohistochemistry was performed, and ultrastructural study did not disclose features reminiscent of meningioma or histiocytosis X. Intracranial IPT should not be confused with other diseases such as meningioma, lymphoproliferative disorders, or histiocytosis X. Although intracranial locations are much rarer than pulmonary ones, histology is identical in both sites and shows different patterns in its evolution. This is in agreement with the inflammatory origin of this lesion.
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PMID:Intracranial plasma cell granuloma: a report of four cases. 782 2

A case of deep sylvian meningioma without dural attachment in a 12-year-old boy was reported. He had been suffering from severe headache for a month. Neurological examination was normal. CT scan and MR images showed a well-enhanced 7 cm mass lesion with small cysts, located in the left sylvian fissure. Peritumoral edema was slight and the midline structures were minimally shifted in spite of its large size. A fronto-temporal craniotomy was made and the tumor was grossly totally removed. The tumor had no dural attachment and existed in the left sylvian fissure, involving the middle cerebral artery and its branches. The histological diagnosis was transitional meningioma without malignancy. The postoperative course was uneventful except for transient mild left oculomotor palsy for several days. He is doing well now one year after the surgery and follow-up MR images showed no recurrence. Intracranial meningioma is rare in children. According to the literature, meningioma in children is slightly more frequent in males. There is a higher incidence of lack of dural attachment and cystic tumors than in adults. Deep sylvian meningioma without dural attachment is also very rare. Including our case, 13 cases of deep sylvian meningioma were reported in the literature. Four of them were under 20 years old. We report this case in detail with other cases reported previously.
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PMID:[Deep sylvian meningioma: a case report of a child]. 784 11

Hemorrhage occurs extremely rare in meningioma. We have found only 17 cases of meningioma associated with subdural hematoma in the reviewed literature. We report a similar case of a 26-year-old woman who complained initially of paralysis of her left arm evolving into loss of consciousness accompanied by a spasm of the extremities and foam in the mouth. In the days immediately preceding admission into hospital she complained of headache, unsteadiness in walking and vomiting. On admission she was bradypsychic, time-disoriented and drowsy. Latent left-sided hemiparesis was established. A right carotid angiography gave indication of a subdural hematoma. The patient was operated on in an emergency. After evacuation of the hematoma a smooth tumour was found embedded in the brain with a cyst in it. The tumour was the size of an egg, soft and elastic. There were several bleeding vessels underneath. During operation the tumour was not in contact with dura mater. The histologic diagnosis was fibroblastic meningioma. After treatment the patient was discharged in good condition with slight hemiparesis.
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PMID:Meningioma accompanied by a subdural hematoma. A case report. Review of 17 cases in the literature. 792 58

Unresectable meningioma is the cause of a serious clinical problem, for whom no satisfactory mode of treatment is currently available. Meningiomas are known to have receptors for diverse hormones. In this sense, somatostatin receptors were found in every meningioma specimen studied in a recent report. In addition, somatostatin has been able to inhibit meningioma cell proliferation in vitro. A brief report of clinical use of somatostatin long-life analogue octreoctide upon three patients diagnosed of unresectable meningioma is here presented. Doses used were gradually increased up to 1000, 900 and 1500 micrograms/24 h during 16, 6 and 7 weeks, respectively. There was an almost perfect tolerance to the drug (in one case a mild and transient abdominal discomfort and diarrhea could be observed). An important alleviation of headaches in 2 cases, and a transient but objective improvement in ocular movements and signs in 1 case were noticed. No change (neither growth nor shrinkage) was observed by CT scan at the end of treatment course in the three cases studied. In 1 case a partial resection was performed and tissue specimen was found to contain somatostatin receptors. Although in our very limited experience no brilliant results are presented, duration of treatment or doses used could have been insufficient. Data herein presented seem to support recently reported findings in which no growth inhibition of meningioma cells cultured in vitro by adding octreoctide to the medium was observed. So, in our opinion, clinical use of octreoctide on unresectable meningioma deserves further experience, that must be carried out with great caution.
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PMID:Clinical use of octreotide in unresectable meningiomas. A report of three cases. 793 48

Headache is a common complaint. In most patients, it is usually a problem of migrainous or tension-type headache. It is crucial that a physician is able to differentiate sinister causes of headache from the more benign ones. Six cases are presented to illustrate the fact that there are clues in the history to suggest a sinister cause of headache even though there are minimal or no neurological deficits on physical examination. At some point of time, these cases were examined by a senior physician but they were diagnosed as migrainous or tension-type headaches. The first case is a 41-year-old labourer with cryptococcal meningitis. He presented with severe headaches at a relatively late age. A 20-year-old female complained of the worst headache she ever had and this was due to a subarachnoid haemorrhage. The third case was a young woman with a large parietal meningioma. Her headaches had recently assumed a different character. The fourth case involved an investment manager who developed headaches with transient diplopia and projectile vomiting and investigations revealed an ependymoma. A shipyard worker complained of a constant headache which disturbed his sleep. Two weeks after medical consultation, the character of his headache changed and he developed diplopia in all directions of gaze. He succumbed to pituitary apoplexy. The final case is a 28-year-old woman who had a complicated migraine. CT scan of the brain showed a large arterio-venous malformation.
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PMID:Warning symptoms of sinister headache. 799 8

To our knowledge, this is the first report ever on the implementation and results of gamma knife radiosurgery in a regularly dialysed patient. The case presented is that of a 59 year-old female patient with a meningioma. Her initial clinical presentation was with sustained headache. Diagnosis was made by using a brain CT scan and MR imaging. Treatment was performed literally without opening the skull. There was only one complication, namely that of postirradiation brain edema, which developed 19 weeks after the operation, and responded dramatically to steroid administration. This is one of the rare side effects of gamma knife therapy, but does not seem to be related to the fact that the patient was uremic. Gamma knife therapy was successful in this patient and her safety was no more compromised than that of a nonuremic patient undergoing radiosurgery.
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PMID:Gamma knife radiosurgery in the treatment of a meningioma in a patient on maintenance hemodialysis: a case report. 807 68

Seventy-three patients with posterior fossa meningioma were operated upon between July 1975 and September 1992. The authors attempt a simple classification of these tumours. Fifty-five were women (average age: 48 years) and 18 were men (average age: 52 years). Frequently, there was gait disturbance except in tentorial meningioma where headache was the most common symptom. The most common physical finding was a cranial nerve deficit (77%). All patients underwent CT and angiography. More recently, MRI was used and found very helpful. Surgical approaches used were either a suboccipital craniectomy, a subtemporal craniotomy or a combined suboccipital-subtemporal approach. Tumour resection was complete in 57 (78%) cases. There were no operative deaths. Thirty-three per cent of patients were left with permanent deficits: mainly cranial nerve deficit (47%). Seventy-seven per cent of patients out of the 57 who could be followed up are functioning independently, 21% of these having no neurological deficit. With proper neuroradiological evaluation, good selection of patients and microneurosurgical techniques posterior fossa meningiomas can be completely excised with an acceptable complication rate.
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PMID:Surgical management of posterior cranial fossa meningiomas. 816 22


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