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

Skull base osteomyelitis (SBO) arising from the sphenoidal paranasal air sinus infection without associated external otitis is rare. Initially SBO may have headache as the only symptom with cranial neuropathies occurring later. We report a 10-year-old immunocompetent girl with headache and chronic sinusitis, who developed a lateral medullary syndrome following streptococcal milleri sphenoidal osteomyelitis.
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PMID:Skull base osteomyelitis leading to lateral medullary syndrome in a child. 1725 80

Here we describe an 8-year old male child with homozygous sickle cell disease who presented with left parietal skull bone infarction and, during his stay in hospital, developed a right femoral deep vein thrombosis (DVT), both uncommon complications of the disease. He initially presented with severe headache and generalised tenderness of the calvarium, which did not respond to simple analgesics. Scalp swelling in and around the left frontal (including left orbit) and parietal regions developed 24 h after presentation. The differential diagnosis included incipient stroke, acute sickle bone crisis and osteomyelitis, with a possible complication of epidural haematoma, or orbital compression syndrome. An initial exchange blood transfusion did not lead to appreciable reduction in opiate requirements. Significant symptomatic relief was attained only after a second exchange transfusion. The DVT developed at the site of catheterisation (right femoral vein), and this was treated with maximal doses of enoxaparin followed by warfarin. The child is now well and off anti-coagulants. In this article we present a review of the literature and discuss possible mechanisms of these complications in our patient.
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PMID:Skull bone infarctive crisis and deep vein thrombosis in homozygous sickle cell disease- case report and review of the literature. 1745

Osteomyelitis of the frontal bone (eponymously known as Pott's puffy tumour) is an extremely rare and potentially life-threatening complication of frontal sinusitis. The entity was first described by Sir Percival Pott, an 18th century neurosurgeon. It is today considered a historical vignette with the introduction of modern antimicrobial agents. Early diagnosis and immediate active treatment are necessary to prevent severe neurologic sequelae. We report on a case of Pott's puffy tumour in a previously healthy young man with a progressively worsening headache and swelling of the frontal bone. Computed tomography and magnetic resonance imaging revealed features characteristic of this condition. Following emergency sinus trephination and 6 weeks of parenteral and enteral antibiotic therapy, the patient achieved a complete recovery.
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PMID:An unusual cause of headache: Pott's puffy tumour. 1747 15

Chronic rhinosinusitis is a complex, multifactorial illness that has genetic, infectious, immune, anatomic, allergic, and inflammatory components. The syndrome is defined based on imprecise symptoms that lack specificity for the condition. Nonetheless, certain relatively characteristic patterns of illness can be identified within the syndrome, and these provide some insight into the underlying cause(s) of CRS. Furthermore, they form a basis for the clinical assessment and management of patients. In general, CRS without NP is a more heterogeneous subgroup of patients more likely to have facial pain, headache, chronic recurrent infection, defects in systemic or local immune function, and more likely to experience local infectious complications, such as facial osteomyelitis. In contrast, CRS with NP patients are more likely to have male gender, anosmia/hyposmia, a history of prior sinus surgery, asthma and aspirin sensitivity, allergy to house dust mite, and AFRS. In the next 17 chapters, an in-depth discussion of factors contributing to the pathophysiology of CRS will be presented that will provide further insight into the clinical patterns of illness described herein. Armed with this information plus the clinical framework outlined in this chapter, a stepwise medical evaluation and treatment strategy will be presented in Chapter 19.
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PMID:Chronic rhinosinusitis patterns of illness. 1753 42

A 39-year-old African American man with no significant past medical history presented to our hospital with right hand weakness and pain in both arms. He had no fever, neck pain, headache, dizziness, vision changes, or weakness in his lower extremities. Magnetic resonance imaging of the cervical spine showed extensive abnormal enhancement of the C7-T1 vertebral bodies as well as the prevertebral and epidural spaces. Open biopsy of the lesion showed inflammatory changes consistent with osteomyelitis. Culture of the biopsy specimen grew Group B Streptococcus (GBS). HIV ELISA and blood cultures were negative. The patient was treated with intravenous vancomycin for 6 weeks with complete resolution of symptoms. GBS classically affects newborns and pregnant females. However, the incidence of infection from this pathogen in nonpregnant adults is increasing. Vertebral osteomyelitis due to GBS in nonpregnant adults is exceedingly rare. To our knowledge, this is the first reported case of GBS cervical vertebral osteomyelitis in an adult without risk factors for invasive GBS infection. This case illustrates that GBS should be included in the differential diagnosis of pyogenic vertebral osteomyelitis, irrespective of immune status and predisposing factors.
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PMID:Vertebral osteomyelitis in a healthy young adult. 1764 54

Paranasal sinus cancer is rather rare, with an incidence of less than 1 per 100,000 per year, the frontal sinus being the primary site in only 0.3%. Following clinical and radiological examinations, the diagnosis often remains elusive, the condition mistakenly being considered to involve mucocele, pyocele or osteomyelitis. This article reports on a 60-year-old pigeon breeder with squamous cell carcinoma originating in the frontal sinus. The presenting symptoms were a gradually worsening sharp headache, double vision and an oedematous left eyelid. CT and magnetic resonance imaging demonstrated erosion of the orbital roof around an area 10 mm in diameter, without direct infiltration of the bulbus. Twelve months following a frontal craniotomy, tumour excision and postoperative radiotherapy, the patient is symptom-free. A detailed description of this patient and a review of the published work are presented.
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PMID:Primary carcinoma of the frontal sinus: a case report and a review of literature. 1795 48

Staphylococcus aureus bacteremia is a frequent occurrence in patients with indwelling catheters. Endocarditis, osteomyelitis, and septic arthritis are common metastatic complications. A hemodialysis patient developed fever, headache, neck pain, sore throat, and dysphagia in the setting of S. aureus bacteremia. Contrast computed tomography scan of the neck revealed a retropharyngeal phlegmon. Recurrent bacteremia led to the identification of the access graft as the infectious source. We present this case to increase awareness among emergency physicians that retropharyngeal infection by S. aureus can arise by hematogenous spread and should be considered in the differential diagnosis of a bacteremic patient with sore throat or neck pain.
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PMID:Retropharyngeal phlegmon in a hemodialysis patient with Staphylococcus aureus bacteremia. 1829 11

A previously healthy 10-year-old patient with headache, otalgia, and hearing loss was diagnosed with pachymeningitis and methicillin-resistant Staphylococcus aureus otitis media and bacteremia. Despite antimicrobial therapy, intracranial extension progressed, including clival osteomyelitis, sphenoid sinusitis, cavernous sinus inflammation and cranial nerve palsies, until the sphenoid sinus was drained. This case exemplifies an aggressive MRSA intracranial infection that advanced despite antibiotic therapy.
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PMID:MRSA with progression from otitis media and sphenoid sinusitis to clival osteomyelitis, pachymeningitis and abducens nerve palsy in an immunocompetent 10-year-old patient. 1847 69

Posttraumatic osteomyelitis may occur as a direct result of bony injury after trauma or arise as a nosocomial infection after the treatment of trauma. Most cases arise after an open fracture, but bony infection can also arise from spread of infection from contiguous soft tissues or by puncture wounds. Motor vehicle accidents, sport injuries, and the use of orthopedic hardware to manage trauma have contributed to the apparent increase in prevalence of posttraumatic osteomyelitis. We report on a case of Pott's Puffy tumor in a previously healthy woman who had an episode of minor forehead trauma 1 month before presentation to the emergency department (ED), complaining of persistent headache and swelling of her forehead. Results of computed tomography (CT) revealed features characteristic of this condition. After postobliteration of the left frontal sinus via a bicoronal approach with an iliac crest bone graft and some dental extractions and 2 weeks of antibiotic therapy, the patient achieved a complete recovery.
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PMID:Pott's Puffy tumor after minor head trauma. 1860 52

Limited therapeutic options are available for vancomycin intermediate-resistant Staphylococcus Epidermidis (VISE) infections and no optimum therapy has been established. We report a case of VISE skull osteomyelitis that was successfully treated with linezolid. The patient was a 53-year-old man who presented with headache, nausea and dysphasia. Brain computerized tomography (CT) demonstrated a subdural hematoma in the left hemisphere. Craniotomy and hematoma evacuation was performed and he showed good recovery despite a scalp wound infection caused by methicillin-resistant Staphylococcus aureus (MRSA). The organism isolated from the scalp wound was sensitive to vancomycin. The patient was treated with intravenous vancomycin for 44 days. However, he showed a high fever, persistent positive methicillin-resistant Staphylococcus Epidermidis (MRSE) blood cultures, and a deteriorating clinical status. He underwent infected skull bone flap removal and linezolid treatment for 35 days. During one year of follow up, he has not had any further episodes of osteomyelitis or fever. Linezolid has shown to be effective agent to eradiate osteomyelitis caused by VISE.
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PMID:Linezolid Treatment for Osteomyelitis due to Staphylococcus Epidermidis with Reduced Vancomycin Susceptibility. 1909 38


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