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

This report is a case of intracranial neurinoma of the jugular foramen. A 21-year-old woman was admitted to our hospital with complaints of headache, nausea, tinnitus on the left and deafness on the left. The neurological examination revelaed bilateral choked disc, Bruns Cushing nystagmus, hearing disturbance on the left, slight disturbance of vestibular function on the left, diminished gag reflex on the left, curtain sign on the left, loss of taste on the posterior third of the left side of the tongue, and deviation of the tongue to the left on protrusion, accompanied with atrophy and fasciculation on the left. Skull-XP showed the enlargement of the jugular foramen. Pneumoencephalogram showed the enlargement of the fourth ventricle combined with the superior, posterior displacement of it's floor. We confirmed the diagnosis of the jugular foramen neurinoma on the left. By suboccipital craniectomy a walnutsized tumor was disclosed at the jugular foramen. The tumor was encapsuled with smooth, thick capsule and was colored in dark rouge. This tumor was removed totally and the postoperative course was uneventful. The pathological diagnosis was neurinoma. We consider that this tumor originated in the ninth or tenth cranial nerve.
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PMID:[Intracranial neurinoma of the jugular foramen-a case report (author's transl)]. 124 Nov 11

At the beginning, small cerebellar strokes may present only with acute onset of vertigo, unsteadiness and unidirectional nystagmus, like a vestibular neuritis. In some cases, it is associated with tinnitus and hearing disturbance, like an endolymphatic hydrops. Other cases may mimic a benign cupulolithiasis, with only a paroxysmal positioning vertigo. Attention should be focused on transient associated symptoms: headache and blurred vision. One should not wait for classical cerebellar clinical signs: they are subtle and they appear late. Within a few days, the clinical picture will change: vertigo will disappear, while unsteadiness will progress. The electronystagmography confirms the integrity of the vestibular peripheric system. The cerebral CT Scan will show the ischaemic lesions only several days after the onset of the symptoms. A magnetic resonance imaging is far more efficient. Small cerebellar strokes have a good prognosis: complete recovery may be hoped with acetylsalicylic acid treatment and kinesitherapy.
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PMID:[Acute vertigo caused by cerebellar vascular accident]. 134 26

The authors observed 6 cases of brain pseudotumours in children aged from 3 to 15 years. All patients had been referred with the diagnosis of brain tumour, with headaches, eye fundus changes fundus changes. Some children had nystagmus, squint, vomiting and dizziness. One child had pharyngitis, two had sinusitis. Contrast brain examinations gave normal results. Diet with salt and fluid restriction and oedema-reducing drugs (glycerol, mannitol, decadron) were used. In all patients the neurological and ophthalmological signs regressed within 3 to 12 weeks.
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PMID:[Pseudotumor cerebri in children]. 145 58

Chiari-I malformation is a deformity of the structures of the posterior fossa in which there is inferior herniation of the cerebellar tonsils through the foramen magnum without significant caudal dislocation of the brainstem. Patients are usually asymptomatic until adulthood, when they commonly present with recurrent headaches, weakness, vertigo and/or imbalance, nystagmus and hearing loss. A review of 226 consecutive patients evaluated for asymmetric sensorineural hearing loss revealed 32 patients with retrocochlear pathology. Three of these patients were discovered to have a Chiari-I malformation by magnetic resonance imaging as their only pathology. We suggest a possible association between a Chiari-I malformation and isolated asymmetric sensorineural hearing loss secondary to long-standing traction on the eighth cranial nerve.
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PMID:Chiari-I malformation associated with asymmetric sensorineural hearing loss. 158 2

An autopsy case of glioblastoma of the cerebellum associated with an intracerebellar hemorrhage and showing CSF seedings is reported. A 26 year-old male was admitted to our hospital with a 10-day history of headache, nausea and vertigo. On admission, disturbance of consciousness (10-20 by JCS), irregular respiration and central fixation of both eyes suggesting increased intracranial pressure and early stage of central herniation were recognized clinically. The cerebellar signs of dysmetria and nystagmus were also observed. CT scan and angiography revealed an avascular large mass in the right cerebellar hemisphere, obstructive hydrocephalus and upward transtentorial herniation. On MRI study, the mass was demonstrated to be a subacute hematoma with a small tumor in its margin. Total removal of the tumor and aspiration of the hematoma were performed. Histological examination revealed a highly cellular and pleomorphic astrocytic tumor with scattered small necrosis and glomeruloid capillary endothelial proliferation, typical of glioblastoma multiforme. During postoperative radiochemotherapy (focal irradiation to the posterior fossa), the tumor showed rapid regrowth and a second look operation was performed. He was readmitted 3 weeks after radiochemotherapy with complaints of severe headache, nausea and lumbago. He then suddenly became dyspnea, tetraplegic and bradycardic. Neuroradiological investigation revealed multiple masses in the suprasellar region, medulla oblongata and the cervical spinal cord, but no recurrence in the cerebellum. Malignant cells were noted on CSF cytology. During chemotherapy for CSF tumor dissemination, his condition deteriorated rapidly and he died 7 months after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Glioblastoma of the cerebellum: report of an autopsy case associated with intratumoral hemorrhage and CSF seedings]. 165 2

The patient, a 25-year-old male, was admitted with a 2-year history of double vision and recurrent suboccipital headache. Neurological findings on admission revealed nystagmus, double vision in the far field, bilateral abducense palsy, weakness in the bilateral legs, hypalgesia and hypesthesia under the L5 level, gait disturbance and hypotonia of the anal sphincter. Plain skull X-ray showed marked digital impression and disappearance of the posterior clinoid process and the dorsum sella. Myelography disclosed a filling defect dorsal to upper and midcervical cord. Intraventricular injection of metrizamide outline cystic dilatation and caudal migration of the fourth ventricle. Occipital craniectomy and laminectomy from C1 to C6 was performed. Operative findings showed thickened arachnoid membranes and cystic expansion of the fourth ventricle lying dorsal to the cervical cord. Caudal portion of the ventricle was removed, and V-P shunt was placed into the fourth ventricle to maintain decompression of the cystic part of the fourth ventricle. This patient is considered to represent a case of cystic dilatation (or ventricular diverticulum) of the fourth ventricle in Arnold-Chiari malformation. We stress that posterior decompression with V-P shunting procedure is recommended as the treatment of choice for such Arnold-Chiari type II malformation.
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PMID:[Cystic dilatation of the fourth ventricle--case report]. 179 25

Thirty patients with histologically confirmed posterior fossa ependymomas operated on between January 1976 and December 1988 were reviewed. The median age was 44 years (range, 1-69 yr). There were 7 children (aged 5 yr or younger) and 23 adults (aged 16 yr or older). There were 18 female patients and 12 male patients. Headache, nausea and vomiting, and disequilibrium were the most frequent symptoms. The most common findings were ataxia and nystagmus. Gross total resection was performed in 8 patients (27%), subtotal resection in 21 patients (70%), and biopsy in only 1 patient (3%). Tumors were low grade in 73% and high grade in 27%. Twenty-seven patients underwent posterior fossa radiotherapy (median dose, 5400 cGy). Fourteen patients also underwent spinal irradiation (median dose, 3520 cGy). Age was the only significant prognostic factor identified (P less than 0.01). The 5-year survival rates were 76% for adults and 14% for children. All 14 patients who died had recurrent or residual tumor at the primary site. This review suggests that in patients with primary posterior fossa ependymomas the following is true: 1) the young patient (5 yr old or younger) has a poor prognosis; 2) there was a trend toward a better 5-year survival rate with a gross total resection; 3) if recurrence occurs, it will be at the primary intracranial site; and 4) symptomatic spinal seeding does not occur frequently.
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PMID:Posterior fossa ependymomas: report of 30 cases and review of the literature. 187 43

A case of acquired nystagmus alternans (alternating nystagmus) is reported. The patient was a 14-year-old boy who presented with fever and headache, followed by dysbasia, truncal ataxia, and positional vertigo. Neuro-otological examinations revealed spontaneous downbeat nystagmus, bilateral gaze nystagmus and rebound nystagmus. Both cell count and protein volume were elevated in the cerebrospinal fluid, and a diagnosis of cerebellitis was made. About one month later, nystagmus alternans was observed, but it disappeared after 7 months. The presence of spontaneous downbeat nystagmus, rebound nystagmus, as well as cerebellar signs indicated that a cerebellar lesion was mainly responsible for the nystagmus alternans in this patient.
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PMID:A case of acquired nystagmus alternans associated with acute cerebellitis. 192 21

A 68-year-old woman had an abrupt onset of severe headache, nausea, vertigo, difficulty in standing and dysarthria. A CT scan of the brain disclosed bilateral symmetrical round infarctions involving the middle cerebellar peduncles. She exhibited marked limb ataxia, gait ataxia, dysarthria and transient gaze nystagmus. Occlusion of the right vertebral artery associated with a stenosis of the basilar artery just proximal to the origin of the anterior inferior cerebellar arteries shown in angiograms were thought to be the cause.
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PMID:A case of bilateral cerebellar peduncle infarction. 194 54

We report a patient with neurinoma of the spinal accessory nerve, who complained of intermittent occipital headaches, nausea, vomiting, blurred vision and unsteady gait. Neurological examination revealed papilledema, bilateral horizontal nystagmus and right cerebellar signs. Computed tomography revealed mild hydrocephalus, a low-attenuated lesion with a faint capsule after enhancement and partial compression of the 4th ventricle in the right posterior fossa. Vertebral angiography revealed no definite tumor vessels or stains. Under the impression of a posterior fossa tumor, a suboccipital craniectomy with a C1 and C2 laminectomy was performed. A 4 x 4 x 2.5 cm3 dumbbell tumor arising from the left spinal accessory nerve at the C2 level was found 4 x 4 x 2.5 cm3. The tumor extended upward through the foramen magnum with upward displacement of both tonsils to the right jugular foramen with slight adhesion to the right IX, X and XI cranial nerves. The left spinal accessory nerve was severed from the pedicle at the C2 level, and the tumor was totally removed. Diagnosis was made during the operation. The pathological examination showed neurinoma with cystic degeneration. During the following year, atrophy of the left sternocleidomastoid and trapezius muscles were noticed. Up to the time of this writing, there had been no clinical recurrence.
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PMID:Neurinoma of the spinal accessory nerve: report of a case. 197 3


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