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

First time experienced severe headache combined with fever or meningism requires immediate evaluation by computer tomography (CT) to exclude subarachnoidal or cerebral hemorrhage, hydrocephalus or a tumor. If CT is normal,lumbar puncture must be performed to exclude meningitis and meningoencephalitis. Chronic or chronic recurrent headache without focal neurological deficits does not require EEG or CT. CT must be performed if the headache characteristics change or if the headache is combined with neurological deficits.
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PMID:[Usefulness of electrophysiology and neuroimaging in the evaluation of headache]. 1279 59

Brucellosis is an infectious disease with multisystem involvement caused by the genus Brucella. Neurological complications including meningitis, meningoencephalitis, myelitis-radiculoneuritis, brain abscess, epidural abscess, and meningovascular syndromes are rarely encountered. We present here a patient with sixth cranial nerve palsy that occurred during treatment for brucellosis, a form of presentation rarely been reported in English-language literature. We conclude that neurobrucellosis, pseudotumor cerebri, and side effects of tetracyclines which are frequently used in brucellosis should be kept in mind when considering intractable headaches and cranial nerve palsies in patients with brucellosis.
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PMID:Abducent nerve palsy during treatment of brucellosis. 1286 May 18

Q fever is a bacterial zoonosis caused by Coxiella burnetii, a unique intracellular coccobacillus, adapted to live within the phagolysosomes of macrophages and monocytes. It is highly infectious, with as little as one organism needed to cause clinical infection, making it an attractive organism for use in biowarfare. Despite its high infectivity, it has low virulence, and most patients undergo only asymptomatic seroconversion. Acute clinical manifestations are a nonspecific febrile illness, pneumonia, hepatitis, and neurologic abnormalities ranging from headache to meningoencephalitis. Chronic Q fever can result in endocarditis, hepatitis, or a chronic fatigue syndrome. Diagnosis usually is made by serology because culture of the highly contagious organism is potentially hazardous. Tetracyclines are the antibiotics of choice. When individualized therapy is possible, a 14- to 21-day course of doxycycline usually is used. In a mass casualty situation, a 5- to 7-day course of doxycycline is recommended, both for therapy and prophylaxis. For chronic infections such as endocarditis, 18 months of doxycycline supplemented with hydroxychloroquine is currently the best therapy.
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PMID:Q fever as a biological weapon. 1450 80

A 25-year-old woman complaining of general fatigue, headache, high fever, and nuchal rigidity, was admitted. She was diagnosed as pneumococcal meningoencephalitis after the cell culture of cerebrospinal fluid (CSF). Despite the administration of vancomycin (VCM), she fell into a coma without amelioration of the symptom. VCM was replaced by pipellaciline because antibacterial sensitivity showed the pneumococci were sensitive to the penicillins. She remained unconscious showing progressive hydrocephalus after the open drainage operation. The lumbar drainage at the L 4-5 level and the intrathecal administration of VCM were performed to improve the mal-circulation of CSF. After the procedure, the cell count of CSF showed a significant decrease and her consciousness level was recovered gradually. The patients with pneumococcal meningitis may occasionally require the lumbar drainage with the intrathecal administration of appropriate antibiotics, in case they fail to show response to the conventional therapy.
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PMID:[A case of acute pneumococcal meningitis treated with spinal drainage and vancomycin administration]. 1459 80

Leptospirosis is a systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage. In this article, we present three children between 10 and 13 years of age with leptospirosis. The purpose of this paper is to emphasize that leptospirosis is a problem in our country with farmers/cattle and that leptospirosis should be considered in certain ill children. The main symptoms were headache, fever, fatigue, abdominal pain and unconsciousness. Two patients had hepatic and renal involvement. The other had hepatic, pulmonary and probably pericardial involvement. In all children spirochetes were demonstrated in blood and urine smears by dark-field microscopy and they were also isolated from urine and blood cultures by using Flecher medium. All patients were treated with penicillin; however, one subsequently required additional antibiotics due to Klebsiella pneumoniae septicemia. While one patient was discharged in a good health, the others were taken to their home by parents without completing treatment. In conclusion, we would like to emphasize that leptospirosis is still a public health problem in our region (Eastern Turkey) in where the majority of population are farmers and raise domestic animals such as cattle in rural areas. Additionally, leptospirosis should be considered in children admitted with headache, unconsciousness, fever and abdominal pain.
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PMID:Report of three children with leptospirosis in rural area of the east of Turkey. 1460 61

An aggressive case of lymphocytic hypophysitis is described which was successfully treated with azathioprine after failure of corticosteroids. The patient, aged 53, had frontal headache, diplopia, and diabetes insipidus. Cranial magnetic resonance imaging (MRI) showed an intrasellar and suprasellar contrast enhancing mass with involvement of the left cavernous sinus and an enlarged pituitary stalk. A putative diagnosis of lymphocytic hypophysitis was made and prednisone was prescribed. Symptoms improved but recurred after the dose was reduced. Trans-sphenoidal surgery was attempted but the suprasellar portion of the mass could not be pulled through the pituitary fossa. Histological examination confirmed the diagnosis of lymphocytic hypophysitis. Two months later he developed aseptic meningoencephalitis which was treated with high dose methylprednisolone pulse therapy. MRI revealed a progression of suprasellar mass. At this stage azathioprine treatment was begun. Four weeks later MRI shown no evidence of residual lesion and no pituitary stalk enlargement. After follow up of 18 months without azathioprine there was no clinical or radiological evidence of the disease. This is the first evidence of the efficacy of azathioprine treatment in a patient with lymphocytic hypophysitis.
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PMID:Lymphocytic hypophysitis successfully treated with azathioprine: first case report. 1461 25

Human anaplasmosis (formerly human granulocytic ehrlichiosis) and human monocytic ehrlichiosis (HME) are emerging tick-borne infections caused by obligate intracellular bacteria in the family Anaplasmataceae. Clinical findings include fever, headache, myalgia, leukopenia, thrombocytopenia, and hepatic inflammatory injury. Whereas Ehrlichia chaffeensis (HME) often causes meningoencephalitis, this is rare with Anaplasma phagocytophilum infection. The abilities of infected primary host monocytes and neutrophils and of infected HL-60 cells to cross human umbilical vein endothelial cell-derived EA.hy926 cell barriers and human brain microvascular cells (BMEC), a human blood-brain barrier model, were studied. Uninfected monocyte/macrophages crossed endothelial cell barriers six times more efficiently than neutrophils. More E. chaffeensis-infected monocytes transmigrated than uninfected monocytes, whereas A. phagocytophilum suppressed neutrophil transmigration. Differences were not due to barrier dysfunction, as transendothelial cell resistivities were the same for uninfected cell controls. Similar results were obtained for HL-60 cells used as hosts for E. chaffeensis and A. phagocytophilum. Differential transmigration of E. chaffeensis- and A. phagocytophilum-infected leukocytes and HL-60 cells confirmed a role for the pathogen in modifying cell migratory capacity. These results support the hypothesis that Anaplasmataceae intracellular infections lead to unique pathogen-specific host cell functional alterations that are likely important for pathogen survival, pathogenesis, and disease induction.
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PMID:Divergent interactions of Ehrlichia chaffeensis- and Anaplasma phagocytophilum-infected leukocytes with endothelial cell barriers. 1463 57

The rat lungworm (Angiostrongylus cantonensis) is the principal cause of eosinophilic meningitis or meningoencephalitis worldwide. It is endemic in Taiwan and the Asia Pacific area. We report the case of a 10-year-old boy who was referred to us suffering from intermittent headache, low-grade fever and blurred vision of 4-5 days' duration. He had been treated for gastroenteritis just prior to referral. The patient's history was unremarkable, except that he raised snail (Ampullarium canaliculatus) as pet at home. On physical examination, the patient's consciousness was alert and well oriented. No papilledema was found on fundal examination. The neurological examination revealed normal cranial nerve function, mild weakness of both lower limbs and normal deep tendon reflexes, but positive Babinski and Kernig signs. Laboratory findings showed peripheral eosinophilia, elevated immunoglobulin E level, cerebrospinal fluid eosinophilic pleocytosis and the presence of stage 3 A. cantonensis larvae, which confirmed the diagnosis of eosinophilic meningitis. A 2-week course of mebendazole combined the glucocorticosteroids was beneficial in relieving headache, paresthesia and the other eosinophilic meningitis symptoms in the patient.
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PMID:Eosinophilic meningitis in a child raising snails as pets. 1473 22

The Vogt-Koyanagi-Harada (VKH) syndrome is an uncommon disorder characterized by uveitis and neurologic and cutaneous abnormalities, including tinnitus, vertigo, headache, meningoencephalitis, vitiligo, alopecia, and poliosis. The VKH syndrome has been reported to occur in association with other autoimmune disorders. We report a case of a patient with severe ulcerative colitis who developed VKH syndrome. We postulate that the patient's history of a traumatic brain injury might have been responsible for an abnormal "immunologic milieu" and the occurrence of ulcerative colitis, VKH syndrome, and severe reactive arthritis.
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PMID:Vogt-Koyanagi-Harada syndrome and ulcerative colitis. 1498 67

A 44-year-old woman suffered fever, headache and meningism during a summer stay in a region of central Italy where sand-fly fever is endemic. A few days after returning to the Netherlands, she appeared mentally and physically slow but had no fever. Because of the possibility of viral meningitis an examination of the cerebrospinal fluid (CSF) was carried out. This revealed a cell count of 1074/3 cells. Toscana virus antibodies of the IgG and IgM subclass were detected in two respective serum samples and in the CSF. This led to the diagnosis 'Toscana virus meningo-encephalitis'. Toscana virus is classified amongst the sandfly fever virus group. These viruses are transmitted by sand flies (Phlebotomus species) which reside in humid areas around the Mediterranean. Toscana virus is the main cause of viral meningoencephalitis in some areas of central Italy and possibly in southern Spain. The patient recovered within a few days without antiviral therapy. Toscana virus meningo-encephalitis should be included in the differential diagnosis of holidaymakers with neurological symptoms returning from the Mediterranean.
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PMID:[Meningitis caused by Toscana virus during a summer stay in Italy]. 1500 57


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