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

A 38-year-old man presented with headache, fever, and double vision associated with right abducens nerve paresis. He had neither nuchal rigidity nor visual field defect. Laboratory data revealed elevated erythrocyte sedimentation rate (ESR), eosinophilia, and lymphocytic pleocytosis in the cerebrospinal fluid (CSF). Provocation tests of pituitary hormones showed partial hypopituitarism. Magnetic resonance imaging (MRI) revealed swelling of the hypophysis and a mass lesion expanding into the right cavernous sinus. The supplement dose of dexamethasone for hypothalamic hypocortisolism manifested diabetes insipidus. Biopsy, carried out through the transsphenoidal approach, revealed giant cell granuloma. Systemic granulomatous diseases were ruled out, and the lesion was considered to be idiopathic giant cell granulomatous hypophysitis. Right abducens nerve paresis, diabetes insipidus and dysfunction of the anterior lobe were amended by the treatment with prednisolone for 4 months, and findings of the pituitary gland and stalk were normalized. The present case shows that glucocorticoid has an effect on amendment of idiopathic giant cell granulomatous hypophysitis.
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PMID:Idiopathic giant cell granulomatous hypophysitis with hypopituitarism, right abducens nerve paresis and masked diabetes insipidus. 1157 56

The N70 and P100 components of transient pattern visual evoked potentials (P-VEPs) were measured in migraine patients, with and without aura, and in normal subjects in order to evaluate their latency, amplitude and occipital scalp distribution. The aim was to find any typical electrophysiological abnormalities in migraine. P-VEP N70 and P100 were analyzed in 59 patients without any known visual field defect. Mean latency and amplitude values were within normal ranges for either N70 and P100 all over the occipital scalp; the only significant abnormality we found was related to the absolute right-left amplitude ratio either for N70 and P100 waves, providing an asymmetry in P-VEP scalp distribution; this finding was detected in 78.9% of patients with aura and 72.5% without aura. Our results show that in migraine patients, both P-VEP waves N70 and P100, have an asymmetric topographic distribution, even during interictal phases, that can be explained by a cortical disturbance in agreement with the neural hypothesis of headache.
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PMID:Asymmetric scalp distribution of pattern visual evoked potentials during interictal phases in migraine. 1169 25

Between 1991 and 2000, seven patients presented with symptomatic pineal cysts at our hospital (6 females, 1 male). Average age was 22 years (range 4-33 years). Headache was present in 6 patients, who were subsequently operated on. A scotoma and a transient inferior visual field deficit were minor signs in two patients respectively. A Parinaud syndrome with vertical gaze paralysis was found in none. In one child, paroxysmal pupillary dilatations and contractions ('springing pupils') constituted the only signs and a conservative policy was adopted. Four patients presented with hydrocephalus and were treated by an endoscopic resection of their pineal cysts (one stereotactically, three free-hand). Two other patients presented with a prolonged history of symptoms and signs: headache alone in one, headache with discrete neurological deficits in the other. Ventricles in these two patients were not dilated and therefore an open cyst resection by infratentorial supracerebellar approach was performed. Average follow-up in the six "operated" patients was 29 months (range 12-108 months). All four patients treated by endoscopy, are symptom-free at follow-up, whereas the two who were approached by open surgery, are not. Clinical presentation, radiological evaluation and treatment modalities of pineal cysts are discussed and compared with experiences reported in the literature. It is concluded that pineal cysts in the presence of obstructive hydrocephalus are a clear indication for endoscopy with a rigid endoscope.
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PMID:Symptomatic pineal cysts: clinical manifestations and management. 1195 36

We report the case of a 47-year-old man with an aneurysm of the anterior cerebral artery revealed by lateral homonymous hemianopic non congruent scotoma. The aneurysm was successfully treated with interventional radiology procedures. In 10p. cent of cases, intracranial aneurysms present prior to their rupture with headache or neuro-ophthalmological symptoms and signs. Isolated visual field defects are rare, and isolated compression of the optic tract is extremely unusual. Although rare, the development of a non-congruent controlateral homonymous hemianopic scotoma is highly suggestive of optic tract compression, and can be explained by the somatotopy of the fibers within the optic tract.
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PMID:[Aneurysm of the anterior cerebral artery disclosed by unique hemianopic scotoma]. 1197 95

Lymphocytic hypophysitis is a rare inflammatory disorder which is caused by autoimmune destruction of the pituitary gland. Almost all reported cases have been in women and the disease is often associated with pregnancy. We describe here the first male case of lymphocytic hypophysitis in Korea. The patient presented with headache, impotence, decreased libido, and deteriorated vision. Endocrinologic studies showed panhypopituitarism, and pituitary MRI imaging revealed a homogeneously enhanced pituitary mass with a thickened stalk. Treatment with prednisolone and thyroid hormone for five months was ineffective. Transsphenoidal resection of the pituitary mass was performed successfully with normalization of the visual field defect. Histologic examination revealed diffuse lymphocytic infiltration with dense collagenous fibrosis, consistent with lymphocytic hypophysitis. Lymphocytic hypophysitis should be considered in differential diagnosis even in men with hypopituitarism and an enlarged pituitary gland.
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PMID:First male case of lymphocytic hypophysitis in Korea. 1269 33

We reported a 31 year-old man with repeated episodes of migraine at a frequency of about once a week on and after January, 2000. In January 2001, scintillating scotoma and pulsating headache appeared followed by left hemianopsia. His platelet count decreased to 80,000/microliter and high intensity areas were observed in the right occipital lobe and hippocampal gyrus on the FLAIR image of brain MRI. Subsequently performed brain MRA and vertebral angiography revealed segmental stenosis and obstruction in the right posterior cerebral artery. Under the diagnosis of migrainous infarction, sodium ozagrel and lomerizine hydrochloride were administered. Idiopathic thrombocytopenic purpura was additionally diagnosed based on the decreased platelet count which was then treated with predonisolone. After these treatment, his migraine attack disappeared. In this patient, platelet destruction due to idiopathic thrombocytopinic purpura and subsequent release of serotonin seemed to have involved in the occurrence of migrainous infarction.
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PMID:[A case of migrainous infarction accompanying idiopathic thrombocytopenic purpura]. 1271 87

We report a case of pseudomigraine with pleocytosis (PMP) characterized by temporary neurological deficits and elevated cell counts in cerebrospinal fluid (CSF). A 28-year-old woman was admitted to our hospital with a second episode of right side throbbing headache accompanied by hemianopsia without scintillating scotoma of left side, hand numbness and weakness of left hand. Two months before the admission, she experienced a first identical episode, which lasted several hours. On admission to our hospital, neurological examination showed left hemianopsia, mild left hemiparesis, dysesthesia of left hand, exceeded tendon reflex of left upper limb, stiff-neck and positive Kerning's sign. CSF examination showed mild elevation of mononuclear cell counts. No abnormal findings on brain CT and MRI (including diffusion weighted image) were observed. 99mTc-HMPAO single photon emission computed tomography (SPECT) demonstrated extensive hypoperfusion at right cerebral hemisphere, corresponding to her neurological deficits. Her electroencephalography (EEG) showed reduced amplitude on the right occipital area. The reduced amplitude of cortical component of somatosensory evoked potential (SEP) by left median nerve stimulation were observed. On the third day after the admission, her symptoms improved and cell count of CSF was normalized. One week after the onset her SEP, EEG and SPECT were normalized on their retrials. She has never recurred these symptoms. We established a diagnosed of psedomigraine with pleocytosis as the first Japanese case.
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PMID:[A case of pseudomigraine with pleocytosis]. 1273 86

A 60-year-old Asian man presented with left rubeotic glaucoma secondary to a central retinal vein occlusion. He was successfully treated with laser diode cyclophotocoagulation of the ciliary body. Nine months later he developed right progressive visual loss, headache, corneal oedema, anterior chamber cells, flare, mutton fat keratic precipitates, a swollen disc, and a minimal inferior visual field defect. A diagnosis of sympathetic ophthalmia was made, which was confirmed by characteristic findings seen on fluorescein and indocyanine green angiography.
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PMID:Sympathetic ophthalmia following ciliary body laser cyclophotocoagulation for rubeotic glaucoma. 1506 39

A 43-year-old woman developed right frontal headache and decreased vision in her OD 14 months after treatment of an intracranial aneurysm by wrapping with cotton gauze. A junctional visual field defect was present, and an MRI revealed a contrast-enhancing mass involving the right optic nerve, lateral chiasm, optic tract, and cavernous sinus. Biopsy demonstrated a marked inflammatory reaction mixed with strands of birefringent cotton gauze. Despite treatment with high-dose corticosteroids, visual loss progressed to bilateral blindness. This is the 30th reported case of an intracranial inflammatory tumor developing from a gauze-wrapped aneurysm ("gauzoma" or "muslinoma") and the worst reported visual outcome. Most cases have occurred in women and involved the optic nerves or chiasm. Visual improvement has sometimes occurred after treatment with abscess drainage, debulking, and/or corticosteroids. A rare complication of aneurysm wrapping, gauzomas causing visual loss have been reported up to 54 months after surgery.
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PMID:Visual dysfunction caused by gauze wrapping of an intracranial aneurysm. 1520 39

A 37-year-old male transported by an ambulance with severe pulsating headache after transient was scintillating scotoma and right hemianopia. He had experienced migraine attacks 2-10 times every year since he was 22 years old. His initial vital signs were stable, the neurological findings while he rested in bed were normal and the head CT examination showed no abnormality. MR angiography revealed narrowing of his cerebral arteries, especially noticeable on the left side. The headache improved after administration of eletriptan hydrobromide. The diffusion weighted image on the next day showed high intensity areas in the left cerebellar hemisphere, vermis, left insular and occipital lobe. The MRA indicated enlargement of the diameter of the cerebral arteries. These findings suggested the usefulness of MRA and diffusion weighted image to evaluate migraine.
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PMID:[A case of the usefulness of MR angiography and diffusion weighted image to evaluate migraine]. 1552 93


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