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

The use of ibuprofen by patients with systemic lupus erythematosus poses a major threat of aseptic meningitis. Although previously reported cases have all been in young adults, our case of ibuprofen-induced meningitis occurred in a 73-year-old woman. This report greatly expands the age population that may suffer meningitis from this analgesic, now available over the counter, and emphasizes the importance of recognizing this causative relationship in patients with headache.
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PMID:Ibuprofen-induced meningitis in an elderly patient with systemic lupus erythematosus. 270 78

The symptoms and clinical course of meningococcaemia in 14 cases are described; 10 patients died; in one of the four survivors amputations were inevitable for necrosis of hands and feet. The foremost symptoms at the first time that a doctor was contacted were fever, lethargy, petechiae and purpura. The fulminant course is shown by the high number of resuscitation at the time of admission or in the first hours after admission, and by the time between first symptoms and death. The mortality of meningococcaemia is mostly not due to meningitis. Most patients die of septic shock even before signs of meningitis can develop. The early signs of meningococcaemia are not those of meningitis, but those of sepsis. Meningism and headache are rare symptoms. The severest symptoms are fever and lethargy, in combination with petechiae and purpura. The fulminant course of the disease requires immediate admission. Treatment of infection and septic shock may be lifesaving.
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PMID:[Not meningitis but septic shock as the killer in acute meningococcal disease]. 271 11

A 14-year-old boy was admitted to our hospital complaining of dull headache, high fever and decreased visual acuity of his left eye. Physical examination on admission revealed nuchal rigidity, positive Kernig's sign, slight hyperreflexia of deep tendon reflex, and decreased visual acuity of his left eye to 0.1. The chest was clear to percussion and auscultation, and no abnormal findings was observed on chest x-ray examination. On laboratory examination, leukocytosis (12,800/mm3) and increased erythrocyte sedimentation rate (83mm/hr) was observed. Cerebrospinal fluid (CSF) examination showed pleocytosis (308/3, mono 286, poly 22) and slight elevation of protein without decrease of glucose content (52mg/dl). On ophthalmologic examination, characteristic anterior and posterior uveitis was found in both eyes, more on the left. Antibody titer to psittaci was significantly elevated in both serum and CSF in his clinical course, therefore, this case was diagnosed as psittacosis meningitis complicated with uveitis. Minocycline (200mg/day) was administered from the 30th hospital day. The effect of this drug was dramatic, and fever and dull headache rapidly disappeared. In addition, fundus oculi examination on the 85th hospital day, revealed no abnormality in his eyes, and his visual acuity returned to normal level (1.0). This case was considered to be extremely rare case of psittacosis, because in addition to meningitis, the patient complicated with uveitis without any respiratory signs and symptoms.
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PMID:[A case of psittacosis meningitis complicated with uveitis]. 274 82

Visualization of transverse intracranial sinuses by means of standard radiograms of the skill is a rather unusual finding. In order to detect the radiological evidence of this important intracranial venous collector, the authors examined 5.638 radiograms, collected since January 1982 until December 1986 at the Neuroradiological Ophtalmic Centre of the University of Bologna. 87 cases (1.54%) resulted positive, with a prevalence of young (mean age 23 years) and female (88%) patients. Among these, an involvement of the optic nerve was the most consistent finding. In fact, it was observed in 47 cases (54%) suffering from: retrobulbar optic neuritis (25 cases), papillitis (13 cases), optic disk edema (6 cases), optic chiasma syndrome (2 cases) and stasis papilla (1 case). Moreover, the report of headache in 20 further cases may have significative implications with respect to the pathogenetic hypothesis about the accentuation of the transverse sinus. Our data suggest that a primitive inflammatory disorder, such as asymptomatic meningitis or meningoencephalitis--early developed in the life--, can induce a persistent local damage also with the radiological alteration. Thus, we presumed that this sign may represent a significant marker of a compromised anatomofunctional condition predisposing to relapsing inflammatory processes. A very interesting possible clinical correlation with demyelinating disorders is also discussed for its pathogenetic implications.
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PMID:Neuroophthalmological implications of the radiological finding of the transverse sinus. 277 May 30

Spontaneous pneumocephalus secondary to neoplasia is a rare condition. It may present with headaches, rhinorrhoea, otorrhoea, or meningitis in various combinations. A case of unusual presentation, with several months delay in diagnosis, with remarkable postoperative improvement is reported and the literature reviewed.
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PMID:Chronic spontaneous tension pneumocephalus due to benign frontal sinus osteoma. 278 24

A patient was admitted complaining of fever and headache. He was suspected of meningitis due to nuchal rigidity, and a lumbar puncture was performed. The patient was diagnosed as having cryptococcal meningitis, as Cryptococcus neoformans was found in an India ink preparation of the cerebrospinal fluid. Both amphotericin B and low-dose flucytosine (50 mg/kg/d) were concomitantly administered to the patient and his clinical symptoms improved. However, the combination therapy induced granulocytopenia and thrombocytopenia, which resolved after discontinuance of the drugs. Amphotericin B alone failed to cause granulocytopenia or thrombocytopenia. These results suggest that the mechanisms of granulocytopenia and thrombocytopenia may be toxic reactions to flucytosine in the azotemic state caused by amphotericin B. Our report emphasizes the need for clinicians to monitor for granulocytopenia and thrombocytopenia in patients receiving treatment with both amphotericin B and flucytosine, even when flucytosine is administered in a low dose.
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PMID:Granulocytopenia and thrombocytopenia associated with combination therapy of amphotericin B and low-dose flucytosine in a patient with cryptococcal meningitis. 280 May 81

Fourteen cases of tuberculous meningitis complicated by moderate or severe hydrocephalus identified by CT are reported. The accumulation and blockage of tuberculous exudate in the basic cisterns and ependymitis in the cerebrospinal drainage pathway are the important pathological features of this disease. There may be a correlation of hydrocephalus with hyponatraemia. Headache, vomiting, and impaired consciousness are common symptoms, although a few cases did not show obvious symptoms of raised intracranial tension. The study suggests a relation between the degree of hydrocephalus and the pressure on lumber puncture. If patients with impaired consciousness, especially in the chronic stage show no improvement during medical treatment, ventricular shunt may bring about remarkable improvement.
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PMID:[Tuberculous meningitis with hydrocephalus: a clinical and CT study]. 280 55

Eight patients with acquired immune deficiency syndrome (AIDS) presented complications affecting the nervous system. The complaints were headache, seizure, confusion or hallucination. Neurologic manifestations included meningitis, focal deficits, cranial nerve palsy, and dementia. Cerebrospinal fluid exhibited a decrease in the percentage of T helper lymphocytes with an inverted helper-to-suppressor cell ratio. The neurologic manifestations of AIDS may depend on multiple factors, such as HIV infection of the central nervous system, concomitant infections with other agents or meningeal invasion by systemic lymphoma or Kaposi's sarcoma. Many patients develop a diffuse encephalopathy which characteristically begins with impaired concentration and mild memory loss, and progresses to severe global cognitive impairment and dementia. Perivascular infiltrates and scattered microglial nodules, consisting of aggregates of microglia and astrocytes, are the most common findings in these patients.
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PMID:[Neurologic complications accompanying acquired immunodeficiency syndrome (AIDS): study of a group of 8 cases]. 295 8

Angiostrongylus (Parastrongylus) cantonensis is the commonest cause of eosinophilic meningitis in the world. Infective third-stage larvae develop in slugs and snails. Humans are infected primarily in the central nervous system after ingesting an infected intermediate host. Damage by motile worms, inflammatory responses to foreign bodies, and possible toxicity of worm substances work in concert to produce the pathologic and clinical picture of neurologic angiostrongyliasis. This disease manifests itself by headache, paresthesias, generalized weakness, and occasionally visual disturbances and extraocular muscular paralysis. Eosinophilic pleocytosis is the major laboratory finding. Although the diagnosis of neurologic angiostrongyliasis is usually made clinically, serologic methods such as ELISA (enzyme-linked immunosorbent assay) can be helpful. Occasionally, living larvae can be identified histologically in the CSF, eye, or other tissue. There is no specific treatment for this disease. Corticosteroids may be useful to relieve increased intracranial pressure. The role of anthelmintic drugs, such as thiabendazole and ivermectin, is not yet known. The prognosis of neurologic angiostrongyliasis is usually good; however, fatal and chronic cases do occur. Appropriate preparation of food, control of mollusks and planarians, and elimination of rodents are important measures in limiting the further spread of eosinophilic meningitis caused by A. cantonensis.
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PMID:Angiostrongylus (Parastrongylus) eosinophilic meningitis. 230 Jul 39

A 26-year-old man addicted to alcohol was admitted to hospital with headache and rhinorrhoea. Investigation revealed Pasteurella ureae meningitis and bacteraemia. A course of intravenous cefotaxime and penicillin G, followed by surgical correction of a nasocranial fistula, led to full recovery. Fourteen cases of serious extrarespiratory infections due to P. ureae are briefly reviewed.
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PMID:Actinobacillus (formerly Pasteurella) ureae meningitis and bacteraemia: report of a case and review of the literature. 306 58


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