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

We reviewed the results of acute management of patients who had sustained a dural tear during an operation on the lumbar spine, and we attempted to determine the long-term sequelae of this complication. In the five years from July 1989 to July 1994, 641 consecutive patients had a decompression of the lumbar spine, performed by the senior one of us; of these patients, eighty-eight (14 percent) sustained a dural tear, which was repaired during the operation. The duration of follow-up ranged from two to eight years (average, 4.3 years). Postoperative management consisted of closed suction wound drainage for an average of 2.1 days and bed rest for an average of 2.9 days. Of the eighty-eight procedures that resulted in a dural tear, forty-five were revisions; these revisions were performed after an average of 2.2 previous operations on the lumbar spine, all of which resulted in a scar adherent to the dura. Only eight patients had headaches related to the spinal procedure and photophobia in the postoperative period; these symptoms resolved in all but two patients, both of whom had had a revision operation. Each of the two patients had symptoms of a persistent leak of spinal fluid and needed a reoperation for repair. Overall, seventy-six patients had a good or excellent result and twelve had a poor or satisfactory result with some residual back pain. One patient had arachnoiditis, and another had symptoms of viral meningitis one month postoperatively. A dural tear that occurs during an operation on the lumbar spine can be treated successfully with primary repair followed by bed rest. Such a tear does not appear to have any long-term deleterious effects or to increase the risk of postoperative infection, neural damage, or arachnoiditis. Closed suction wound drainage does not seem to aggravate the leak and can be used safely in the presence of a dural repair.
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PMID:Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients. 987 30

Five patients, three women aged 87, 50, and 31 years, and two men aged 31 and 32 years, presented with severe headache of sudden onset. A sudden onset of unusually severe headache is suggestive of an intracranial haemorrhage or other serious disease, even in the absence of focal neurologic deficits. The diagnoses were subdural haematoma, cerebral venous sinus thrombosis, idiopathic thunderclap headache, subarachnoid haemorrhage, and viral meningitis, respectively. There are no characteristics from history or examination that accurately discriminate among all these causes; idiopathic thunderclap headache and subarachnoid haemorrhage are commonest. Consultation of a neurologist and further ancillary investigations are necessary for proper diagnosis and treatment.
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PMID:[Acute severe headache: a subarachnoidal hemorrhage?]. 1032 Dec 70

Central nervous system infections in adolescents range from the diffuse cerebritis of encephalitis to the regional inflammation of meningitis, and very focal disease of brain abscess. Clinical presentations reflect this wide spectrum, with encephalitis primarily characterized by altered mental status, meningitis by fever, headache, and neck stiffness, and brain abscess manifesting localizing findings. Encephalitis and viral meningitis are frequently caused by the seasonal enteroviruses and arboviruses, while most adolescent bacterial meningitis is due to Neisseria meningitidis and Streptococcus pneumoniae. The microbiology of brain abscess reflects underlying host risk factors. Gram-positive cocci are seen in patients with congenital heart disease, while respiratory flora including anaerobes are associated with sinus or otic disease. Lumbar puncture to characterize and culture the CSF remains the optimal test for the diagnosis and management of encephalitis and meningitis, while CT-guided needle biopsy may be both diagnostic and therapeutic for brain abscesses. New diagnostic tests include the use of PCR. A variety of safe and effective treatment regimens exists for most bacterial infections as well as for some herpesvirus infections. New vaccines are under study to further control bacterial meningitis.
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PMID:Serious infections of the central nervous system: encephalitis, meningitis, and brain abscess. 1091 31

An outbreak of aseptic meningitis due to echovirus 30 occurred in the Wingecarribee Shire, NSW, during October to November 1994, with 30 cases fitting the clinical case definition. Cases were ascertained from attendees of the local hospital. Medical files were reviewed and a standard questionnaire administered. Viral cultures were performed on CSF, throat swabs and stool specimens. The clinical presentation and laboratory findings were typical of viral meningitis. Cases were aged 8 months to 51 years; 26 were admitted to hospital. Headache was present in 93%, photophobia in 86%, vomiting in 69%, fever in 72%, and neck stiffness in 62%. In spite of temporal clustering, the mode(s) of transmission in this outbreak remain speculative. Although the route of transmission was not established, general hygiene measures to stop transmission were implemented when a common water source was excluded on epidemiological grounds.
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PMID:Outbreak of echovirus 30 meningitis in Wingecarribee Shire, New South Wales. 1108 17

Simple and rapid latex-based diagnostic tests have been used for detecting specific antigens or antibodies in several diseases. In this article, we present the preliminary results obtained with a latex agglutination test (LAT) for diagnosing neurocysticercosis by detection of antibodies in CSF. A total of 43 CSF samples were assayed by the LAT: 19 CSF samples from patients with neurocysticercosis and 24 CSF samples from patients with other neurologic disorders (neurosyphilis, n = 8; neurotoxoplasmosis, n = 3; viral meningitis, n = 4, chronic headache, n = 9). The LAT exhibited 89.5% sensitivity and 75% specificity. The use of LAT seems to be an additional approach for the screening of neurocysticercosis with advantage of simplicity and rapidity. Further studies could be performed using purified antigens and serum samples.
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PMID:A rapid latex agglutination test for the detection of anti-cysticercus antibodies in cerebrospinal fluid (CSF). 1189 15

Three children, two girls aged 4 and 2.5 years and one boy aged 8 years, presented with nuchal rigidity and symptoms such as fever, headache and nausea. Upon investigation they had: torticollis on the bases of an upper respiratory tract infection, viral meningitis and bacterial meningitis (meningococcus type C) respectively. They all recovered well after treatment. Nuchal rigidity can be caused by many illnesses other than bacterial meningitis. Lumbar puncture should be performed when meningeal irritation is suspected. In children this can be identified using the Vincent test as well as the Kernig and Brudzinski tests.
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PMID:[Nuchal rigidity in children: meningitis or not?]. 1274 Nov 76

A 27-year-old man presenting with recurrent meningitis associated with the activation of hepatitis was reported. Although he showed headache only, he was diagnosed as viral meningitis with high transaminase activities on admission. Human herpes virus-6 (HHV-6) DNA was revealed in the liver tissue by the polymerase chain reaction. This case was considered viral meningitis with HHV-6 associated hepatitis. It is suggested that the importance of viral evaluations not only herpes virus type 1 x 2, cytomegaro virus and EB virus, but also HHV-6 infection in a case of recurrent meningitis with hepatitis simultaneously.
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PMID:[A case of recurrent meningitis with association of human herpes virus-6 hepatitis]. 1293 36

We report an unusual case of carcinomatous meningitis presenting as a headache in a previously well woman. It occurs in only 3-5% of solid tumours and is an unusual form of presentation for underlying primary malignancy. This 44-year-old woman initially presented with subacute headache of 3 weeks duration and was treated as migraine, and later thought to have viral meningitis. The diagnosis was made from cytology examination on repeated lumbar puncture of cerebrospinal fluid (CSF). Within a month of onset of symptoms, the patient developed gradually worsening headache, right 6th cranial nerve palsy with associated diplopia as well as refractory generalised tonic-clonic seizures. Treatment included CSF drainage through insertion of Ommaya reservoir, and palliative systemic chemotherapy. Further palliative chemotherapy was withheld upon patient's and family's request. The patient died shortly after initial treatment; 7 weeks after her initial presentation to her general practitioner with headache.
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PMID:An unusual case of headache. 1294 70

Adult cases of viral meningitis caused by echovirus type 13 (E13) were studied. E13 was isolated from 8 of 11 adult patients (73%) with viral meningitis between April and September 2002 in Fukui Prefecture. The mean age was 27.4 +/- 6.4 years (4 males and 4 females). The disease was prevalent among adults, especially younger adults as well as children. The symptoms and signs were as follows; headache (100%), fever (100%), nausea and/or vomiting (88%), Kernig's sign (88%), and increased deep tendon reflexes (50%). The average cell counts in cerebrospinal fluid (CSF) were 118 +/- 111/mm3. Of the 2 patients, polynuclear cells were dominant during the early phase of the disease. The prognosis was good. Since May 2002, the number of patients with viral meningitis caused by E13 has rapidly increased. Most of the reported patients were children. We should consider the possibility of E13 infection as a cause of adult viral meningitis.
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PMID:[Adult cases of viral meningitis caused by echovirus type 13]. 1450 58

We report a case of hydrocephalus due to posterior cranial fossa subdural effusion. The patient was a 4-year-old boy, presenting headache and nausea, with a medical history of viral meningitis 2 months before. Cerebrospinal fluid provided no evidence of infection, and symptoms caused by increased intracranial pressure gradually deteriorated, although glycerol infusion was effective temporarily. Computed tomography revealed marked ventriculomegaly with subdural effusion in the right posterior cranial fossa. The subarachnoid space in the posterior fossa was very tight, and the cerebellum and brain stem were compressed anteriorly. Magnetic resonance imaging demonstrated stenosis of the aqueduct and foramens of Luschka and Magendie. The cerebeller tonsil was dislocated inferiorly, indicating impending herniation, so an emergency operation was performed. Ventriculoperitoneal shunt was undertaken after implantation of an Ommaya reservoir for the posterior fossa subdural effusion. The patient's postoperative course was uneventful, and the symptoms were improved. Although hydrocephalus and subdural effusion following viral meningitis is rare, neuroimaging studies such as CT and MRI should be examined when a young child suffers from symptoms of increased intracranial pressure.
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PMID:[A case presenting with hydrocephalus and posterior fossa subdural effusion]. 1451 82


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