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

The spontaneous development of a cytomegalovirus infection in a healthy adult is described. This illness manifested with fever, headache, malaise, an absolute lymphocytosis with atypical lymphocytes, and liver function abnormalities, but without tonsillitis, pharyngitis, lymphadenopathy, or splenomegaly. Aseptic meningitis also was present. The pathogenesis of cytomegalovirus mononucelosis and its relationship to other related syndromes are discussed.
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PMID:Spontaneous cytomegalovirus mononucleosis-like syndrome and aseptic meningitis. 18 29

Mucoceles of the sphenoid sinuses are uncommon; 60 cases have been reported in the world literature to date. Signs and symptoms are caused by local expansion of the mucocele and include headache (the most common symptom), ocular field deficits, external ophthalmoplegia (particularly the sixth cranial nerve), and proptosis. Radiologic correlation in the form of plain films and polytomorgraphy is the most reliable guide in the diagnosis of sphenoid sinus disease. Therapy of these lesions is surgical, and drainage can be achieved via the external ethmoid or sublabial transseptal route. Three cases are presented: two had classical findings and the third was conspicuous by the presence of aseptic meningitis in the absence of local findings.
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PMID:Mucoceles of the sphenoid sinus. 50 84

A case of accessory middle cerebral artery associated with internal carotid artery aneurysm was reported. A 50-year-old female was admitted to our hospital with complaints of headache, nausea, vomiting and conciousness disturbance. Lumbar puncture showed bloody CSF. Right carotid angiogram revealed saccular aneurysm of the internal carotid-posterior communicating artery and accessory middle cerebral artery originating from the horizontal portion of the right anterior cerebral artery. No other vascular lesion was observed on other angiograms. Operation was performed 2 days after admission. The neck of the aneurysm was clipped. Postoperative aseptic meningitis was cured by frequent lumbar punctures, and her course was uneventful. The etiological hypothesis of these cerebral vascular anomalies was briefly discussed.
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PMID:[A case of accessory middle cerebral artery associated with internal carotid artery aneurysm (author's transl)]. 53 Mar 68

Clinical manifestations of lymphocytic choriomeningitis (LCM) virus infection in 15 patients are described. These patients were University Hospital personnel who had had contact with hamsters, subsequently shown to harbor the virus. Fever with striking myalgias, headache and rigors were the most common symptoms. Only 2 of the 15 patients had clinically overt and documented aseptic meningitis. Leuikpenia was observed in 10 of 11 patients and thrombocytopenia in 8 of 8 patients tested. A biphasic illness was seen in eight patients. In a patient who has been exposed to laboratory animals, particularly to hamsters, a nonspecific influenza-like febrile illness accompanied by leukopenia and thrombocytopenia may represent LCM virus infection.
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PMID:Lymphocytic choriomeningitis in university hospital personnel. Clinical features. 113 38

The first reported outbreak of echovirus 18 meningitis in the United States occurred during the summer of 1972 in Durham, North Carolina. One hundred three cases of aseptic meningitis were seen at Duke University Medical Center over a period of four months. Most of the patients were less than 25 years old, black, and residents of Durham County or nearby counties.. Symptoms included headache (92%), fever (76%), nuchal rigidity (67%), and nausea and/or vomiting (51%). In contrast to previously published reports of echovirus 18 infection, diarrhea and rash were infrequent (6% and 5%, respectively). There were no deaths. Counts of white blood cells in the cerebrospinal fluid ranged from 0 to 1,540 cells/mm-3, but 90% of the patients had less than 500 cells/mm-3. Echovirus 11 was recovered from the cerebrospinal fluid of 55 of 78 patients, and echovirus 11 was isolated from two patients. Virus was recovered from the cerebrospinal fluid of 12 patients despite white blood cell counts in cerebrospinal fluid of less than 10 cells/mm-3.
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PMID:An epidemic of echovirus 18 meningitis. 116 69

The clinical features of 19 patients with neurological manifestations unexplained by another disease and positive serology for Borrelia burgdorferi were studied. ECM was present in only 11% of the cases and 32% referred tick bite. The characteristic features for suspicion of NB according to our series was the presence of polyneuritis in 84% of the cases specially in the form of multiple mononeuritis and involvement of the facial nerve (79%) leading to even greater suspicion with the association of V pair involvement. Seizures, sleep disorders, and higher mental dysfunction may be found in association with other more characteristic neurological features. The typical triad of NB (aseptic meningitis, facial paralysis and polyradiculoneuritis) was found in 21% of the patients and in the absence of another disease to justify the same neuroborreliosis (NB) seemed evident. In all the cases components of this triad were found. Headache, arthralgia, fever and, less frequently, arthritis are other symptoms often past with the presence of anti-BB antibodies. Patients with the shortest evolution most frequently presented antecedents of facial paralysis, sensory alterations and Romberg's sign than patients of longer evolution. CSF demonstrated the presence of pleocytosis in 24% of the cases and in only one patient a slight increase in the intrathecal activity of IgG was observed which may be of use in differential diagnosis with MS. MR showed alterations in 61% of the patients and, while not specific, the lesions present subcortical predominance.
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PMID:[Positive anti-Borrelia antibodies in patients with clinical manifestations compatible with neuroborreliosis]. 161 Jun

Besides general complications of immunosuppression such as increased susceptibility to opportunistic infections or malignancy, individual immunosuppressive agents are associated with specific side effects. Nephrotoxicity is the major side effect of cyclosporine (CsA). Various attempts have been made to minimize this toxicity, such as monitoring drug blood levels, modifying the protocol, and coadministering other agents. Other side effects caused by CsA are hepatotoxicity, hyperkalemia, hypertension, tremor, gum overgrowth, and hirsutism. Azathioprine (AZA) causes dose-related bone marrow suppression, commonly leading to leukopenia. Careful monitoring of complete blood cell count and dosage adjustment according to white blood cell count are usually adequate to prevent serious leukopenia. The side effects of corticosteroids are numerous and include slow wound healing and de novo insulin-dependent diabetes mellitus. Many complications are dose related, and with low dosage or discontinuation of steroids, their frequency rapidly decreases. Antilymphoblast and antithymocyte globulins (P-ALG) are foreign antibodies and may cause allergic-type reactions such as fever, chill, and hypotension. The initial side effect of monoclonal antibody (muromonab-CD3, OKT3) is similar to that of P-ALG. It includes high fever, shaking chills, headache, rigors, and hypotension. To prevent it, acetaminophen, an antihistamine, and a steroid usually are administered before injection. Because this agent is also associated with high frequency of pulmonary edema, it should not be given to any patient who has more than 3% body weight gain during the week prior to therapy. In rare case, it causes aseptic meningitis or encephalopathy, which is manifested by fever, severe headache, and seizure.
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PMID:Complications associated with immunosuppressive therapy and their management. 174 17

We analyzed the 259 pediatric patients (69% males, 31% females) treated for aseptic meningitis at the Department of Pediatrics (Inselspital), University of Berne, Switzerland, during the 10-year period from 1978 to 1987. 79% were in- and 21% outpatients. The main study purpose was the evaluation of clinical presentation, diagnostic workup, course and prognosis of this disease entity. The clinical characteristics (fever, meningitic signs, headache, nausea and vomiting, and usually normal consciousness) were not discriminative for differential diagnosis. On the other hand, pleocytosis in cerebrospinal fluid averaged 406 x 10(6) cells/l (57% mononuclear cells) at first lumbar puncture, and 6 to 12 hours later showed both slight decrease of total cell count and clear shift to mononuclear cells (71%). The course of the disease was always short and benign. Complications, usually of a neurologic nature, occurred in only 10% and all were mild and reversible. Nevertheless, follow-up interview by phone identified 21% of patients with transient post-meningitic disorders, especially prolonged episodes of stress-induced headache. However, except for one case of chronic hydrocephalus, there were no severe or persistent sequelae. Neither complications nor sequelae correlated with patient age or laboratory findings. Our results confirm that aseptic meningitis in children is relatively benign, and underline the importance of rest and relaxation during convalescence. Rapid, reliable and cheap viral diagnostic tests in the cerebrospinal fluid could simplify the management of the individual patient with regard to repeated lumbar punctures (in 36%), surveillance in the hospital (in 79%), and antibiotic therapy (in 25%).
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PMID:[Aseptic meningitis in pediatrics]. 849 79

A 41-year-old man had three episodes of acute aseptic meningitis from the age of thirty-six. With each episode he had severe occipital headache associated with a mononuclear pleocytosis and an increase in CSF protein. He had a neuroepithelial cyst originating from the choroid plexus of the right cerebellomedullary cistern. Spontaneous ruptures of the cyst probably caused recurrent chemical meningitis. A neuroepithelial cyst must be considered in the differential diagnosis of intracranial cystic tumors presenting with aseptic meningitis.
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PMID:Neuroepithelial cyst presenting as recurrent aseptic meningitis. 194 17

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.
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PMID:Clinical observations and virological study of aseptic meningitis in the Kaohsiung area. 198 74


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