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

We report a case of cluster-like headache in a patient with a trigeminal neurinoma. Symptomatic cluster headache was suspected because of the absence of typical periodicity and the persistence of background headache. Magnetic resonance imaging findings were consistent with a trigeminal neurinoma.
Headache 1995 Jan
PMID:Cluster-like headache in a patient with a trigeminal neurinoma. 786 35

Malignant schwannomas are rare neoplasms that are seldom found in the head and neck. Few cases have been reported involving paranasal sinuses and none of them was of the "epithelioid" type. In this report, an unusual case of epithelioid malignant schwannoma involving the maxillary sinus, nasal cavity and orbit is presented. The patient was a 27-year-old male with a history of headache, nasal obstruction and epistaxis. Histologically, the tumour had a biphasic pattern with spindle and epithelioid elements which led to a differential diagnosis with malignant melanoma. It had also to be distinguished from other neoplasms, such as squamous cell carcinoma and olfactory neuroblastoma because of it location. Immunohistochemical positivity for S-100 protein, glial fibrillary acidic protein and vimentin together with negativity for HMB-45 and cytokeratins, as well as mesaxon formation detected with electron microscopy were conclusive in the diagnosis. The patient was treated with surgical excision and radiotherapy but local recurrence and metastases occurred, and he died within 1 year after initial diagnosis.
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PMID:Malignant sinonasal epithelioid schwannoma. 811 30

A 51-year-old man is reported who was suffering from an extensive right-sided glossopharyngeal neurinoma (4.6 x 3.4 cm). The patient was admitted with a history of headache for six to seven years and vomiting for two years accompanied by a progressive hearing loss, tinnitus and dizziness during the last year. Audiometry indicated a perceptive deafness in the whole frequency range up to 70 dB HL, while electronystagmography (ENG) showed a loss of vestibular function of the right side, but there were no signs of a jugular foramen syndrome. Magnetic resonance imaging (MRI) revealed a large tumor portion in the right cerebello-pontine angle with only a small part in the jugular foramen. The neurinoma was completely removed by microsurgery through a suboccipital approach with preservation of nerves VII-XII. The postoperative course was uneventful and normal function of facial and caudal cranial nerves (Nn IX-XII) were proven by electromyography and magnetic stimulation, with exception of a transitory hypesthesia in the palatine region which completely normalized within a few months. The right-sided hearing loss was unchanged, but vertigo improved. In comparison with literature review the lack of temporary or permanent postoperative dysfunctions of caudal cranial nerves as well as of the facial nerve was extraordinary in the reported case.
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PMID:Radical removal of a large glossopharyngeal neurinoma with preservation of cranial nerve functions. 822 91

Stereotactic radiotherapy utilizing a linear accelerator has been investigated. (1) Radiosurgery, (2) fractionated stereotactic radiotherapy, and (3) fractionated radiotherapy followed by stereotactic boost have been performed according to pathology, size, and prognosis of diseases. Accuracy in localization of the treatment center was within one millimeter using a CT simulator. From July, 1990 to December 1992, 69 lesions in 63 patients have been treated using the stereotactic radiotherapy according to prospective dose-escalation design. Five patients have experienced transient worsening of nerve palsy or headache, but these complications were self-limited. No late radiation damage was observed over a mean follow-up period of 12.5 months. Encouraging improvements were obtained in patients with metastasis, AVM, and acoustic neurinoma although the follow-up period was too short to be conclusive. Stereotactic radiotherapy utilizing a linear accelerator is thus suggested as a safe and effective approach providing that dose-volume-time relationship is well controlled.
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PMID:[Prospective dose-escalation study in stereotactic radiotherapy utilizing a linear accelerator: report from East Hokkaido Radiosurgery Study Group (EHRSSG)]. 825 18

The case of a 56-year-old female patient is presented; she was hospitalized for decreased vision of both eyes, discrete hemeralopia, vertigo, right hypoacusis and occipital headache. The eye fundus examination showed lesions of retinitis pigmentosa in the inferotemporal sector and decreased arterial calibre. The patient was diagnosed neurologically as a right acoustic neurinoma with pontocerebellar syndrome. No other cases with the same symptomatology were noticed in the patient's family.
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PMID:[Sectorial retinitis pigmentosa and acoustic neurinoma]. 828 22

A 13-year-old girl with large richly vascularized acoustic neurinoma is reported. The family history and clinical evidence failed to suggest neurofibromatosis in the family. The clinical syndrome included paroxysmal headaches, vertigo, loss of consciousness and left ear hearing loss. The application of Nd-YAG laser during the operation reduced bleeding and enabled radical removal of the tumour.
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PMID:[A case of acoustic neurinoma in a girl aged 13]. 850 52

Hydroxyapatite cement, a new biomaterial presently under clinical investigation, has been demonstrated to have potentially wide application in cranial reconstruction. We describe our experience with this biologic bone cement in the reconstruction of suboccipital craniectomy defects in seven patients after vestibular schwannoma removal. With up to 2-year follow-up, cranial bone integrity has been reestablished in five patients. Dissolution of cement has occurred in dependent areas and appears to be technique related. Cranial bone contour appears dependent on the amount of cement used. The frequency of debilitating postoperative headache was reduced in these patients when compared to patients who had no reconstruction of the craniectomy defect. Reconstruction of the bony defect after suboccipital craniectomy with hydroxyapatite cement is not only useful to restore cranial contour, but also appears to reduce some of the functional deficits attributed to this surgical approach.
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PMID:Reconstruction of suboccipital craniectomy defects with hydroxyapatite cement: a preliminary report. 854 95

A 66-year-old female presented with a large organized hematoma within an acoustic neurinoma. She had suffered from diminished hearing for 20 years and had headache 1 week before presentation. Computed tomography demonstrated an inhomogeneously high density cerebellopontine angle mass, and magnetic resonance imaging showed a mass with heterogeneous intensity and gadolinium-diethylenetriaminepenta-acetic acid enhancement of only the peripheral surface of the mass and the inner parts of the internal auditory meatus. At operation the majority of the mass was soft and feature-less with a firm capsule, and a yellowish soft tumor was removed from the perimeatal area. Histological examination showed the mass was an acoustic neurinoma with a large organized hematoma. Extensive hemorrhage from an abnormal vascularity in the tumor had repeated followed by granulomatous organization.
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PMID:Acoustic neurinoma with a large organized hematoma--case report. 870 Mar 15

A case of right trigeminal neurinoma extending from the cavernous sinus to the cerebellopontine angle in a 48-year-old male is reported. The patient first noticed right facial numbness in June 1993. Six months later, he experienced headaches with occasional nausea, diplopia, ataxic gait, tinnitus and dysphagia and was referred to our department on January 21, 1994. Neurological examination on admission showed multiple cranial nerve palsy from the 4th to 11th nerve on the right, and the cerebellar sign on the right. Initial CT and MRI revealed a large mass lesion extending from the right cavernous sinus to the right cerebellopontine angle. On February 16, 1994, radical resection of the tumor, except the lesion invading the cavernous sinus, was performed via a combined retroauricular and preauricular transpetrosal transtentorial approach. The histological diagnosis was neurinoma. The patient's postoperative course was uneventful and there was good clinical improvement, although the right facial numbness and mild diplopia persisted. On April 6, 1994, radiosurgery was performed with a maximum dose of 28 Gy and a marginal dose to 14 Gy to the remaining cavernous sinus lesion. Two weeks after radiosurgery, the patient achieved a complete return to his daily routine. Two-year follow-up CT and MRI showed a small residual les on in the right cavernous sinus alone. There was no evidence of tumor growth. No new neurological deficits had developed, and the patient's the double vision had resolved. Thus, the patient has been able to maintain a satisfactory level of activities of daily living. We wound like to emphasize the clinical value of the strategy used to treat this patient which combined microsurgery with subsequent radiosurgery.
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PMID:[Therapeutic effectiveness of combined microsurgery and radiosurgery in a patient with a huge trigeminal neurinoma]. 888 34

A 45 year old woman with bifrontal headaches and progressive diminution in vision over 6 months was found to have bilateral papilloedema. CT scan showed large right frontal lesion with surrounding oedema. Right basal frontotemporal craniotomy was performed to excise the multinodular, intraparenchymatous tumor. Hispathology confirmed the diagnosis of schwannoma. Post-operative course was uneventful with disappearance of pre-operative signs and symptoms.
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PMID:Intraparenchymal schwannoma of the frontal lobe. 913 44


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