Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intranasal and sinus disease may result in disabling head and facial pain and serious complications. Awareness of the symptoms of acute and chronic sinusitis and their various presentations will enhance diagnostic accuracy and improve patient outcome. It is important to remember that the nasal mucosa is under autonomic control. Sinus symptomatology, whether from anatomic abnormality or chronic inflammation, may occur with and will typically be exacerbated by increased parasympathetic outflow or reduced sympathetic tone. Thus, the possibility of underlying intranasal or sinus disease must be considered in patients with atypical migraine or vascular instability headaches. A new appreciation of the impact of sinusitis on facial and head pain syndromes is developing among otolaryngologists because of the improved diagnostic capabilities afforded by combined intranasal endoscopy and modified CT. In the past, patients with nasal complaints and facial pain who had normal plain radiographs were often passed off as "chronic nasal complainers" and given decongestants or the recommendation to see a psychiatrist. On the other hand, patients with symptoms and radiologic abnormalities often underwent radical surgery aimed at the maxillary or frontal sinus, sometimes with persistence or worsening of their complaints. Now, however, underlying causes for these problems can often be found in the ostiomeatal complex and corrected with minimally invasive surgery. In general, the major sinuses appear to be more sensitive to pain before the development of chronic mucosal changes. Minor disease in critical locations within the ostiomeatal complex may therefore give rise to greater symptomatology than diffuse disease in less critical sites. Although head CT may be a routine part of the neurologist's examination in patients with headache or facial pain, routine CT techniques are inadequate to evaluate fully the ostiomeatal complex and sinuses and must be modified to rule out adequately pain of sinus origin. Nasal endoscopic examination provides a noninvasive examination by which patients may be selected for sinus CT and is a necessary part of a complete evaluation. Close cooperation between the neurologist and otolaryngologist-head and neck surgeon is therefore essential for the accurate diagnosis of this often puzzling group of patients.
 ...
PMID:Nasal and sinus pain: current diagnosis and treatment. 307 26

Cavernous sinus thrombosis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses most commonly follows infections of the middle third of the face due to Staphylococcus aureus. Other antecedent sites of infection include paranasal (usually sphenoid) sinusitis, dental abscess and, less often, otitis media. Fever is a nearly constant finding, but headache may not be prominent. Periorbital edema, chemosis, proptosis, and limitation of extraocular movements (especially lateral gaze) develop in almost all recognized cases. Involvement of the opposite eye frequently appears within two days following the onset of unilateral signs. Although computed tomography may be helpful, magnetic resonance imaging is probably the diagnostic procedure of choice. Treatment includes appropriate antibiotics and, oftentimes, surgical drainage of the primary focus of infection. Less than half of the patients recover completely; the mortality rate is approximately 30%.
 ...
PMID:Septic thrombosis of the cavernous sinuses. 328 99

Sinusitis is common in allergic children. We are now aware that the commonest presentation of this disorder in the pediatric age group is persistent cough and purulent rhinorrhea. Headache and facial tenderness, frequently noted in adults with sinusitis, are not common. Much remains to be learned about diagnostic techniques and therapy of sinusitis. Nasal cytology can be valuable for discriminating between allergic and infectious disease, but lacks both sensitivity and specificity. Although there is a high correlation between radiographs showing significant sinus membrane thickening or clouding and recovery of bacteria from antral taps, it is possible to see positive films in asymptomatic individuals. Similarly, films may be unremarkable, although the history and physical examination yield convincingly positive evidence for sinus infection. The clinician must sometimes decide on therapy when the diagnosis is not definitive. Antimicrobial therapy for sinusitis should be given for 3 to 4 weeks in many cases. Amoxicillin remains a good choice for therapy, but antibiotics capable of clearing infections by beta lactamase-producing bacteria should be considered in refractory situations. The value of antihistamines, decongestants, nasal steroids, and cromolyn sodium are unstudied at this time. If several antibiotic courses fail to alleviate the signs and symptoms of sinusitis, surgery is indicated. Antral lavage and creation of nasoantral windows is the usual approach in children. Patients with sinusitis often have concurrent middle ear disease. Patients with current sinusitis have a higher incidence of immunoglobulin disorders than found in a normal pediatric sample. It appears that patients with sinusitis are more often allergic than would be expected from 2 typical population distribution. More evaluation is needed to clarify these associations.
 ...
PMID:Sinusitis in children. 328 28

A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.
 ...
PMID:[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. 328 78

In the vast majority of cases infections of the paranasal sinus system are rhinogenic. Usually these spread via the middle nasal meatus and the anterior ethmoid to the dependent larger sinuses, especially to the frontal and/or maxillary sinus. If a sinusitis does not heal or is constantly recurring, a focus of infection has remained in a stenotic cleft of the lateral nasal wall, irritating nasal function and where from infection time and again may spread to the dependent sinuses. These Infection foci may be very circumscribed and limited, and not always must present with the typical triad of sinusitis symptoms: pathological secretion, nasal obstruction and cephalgia. Frequently only one of these symptoms prevails. By the means of nasal endoscopy and polytomography these foci can exactly be localized. After clearing the infection foci, which easily can be achieved under endoscopic guidance, mucosal function usually is restored and the dependent larger sinuses heal without having been touched.
 ...
PMID:[Role of the lateral nasal wall in the pathogenesis, diagnosis and therapy of recurrent and chronic rhinosinusitis]. 330 29

The correlation of Waters view radiographs and A-mode ultrasound for diagnosing sinusitis was evaluated in 75 subjects with allergic rhinitis who presented with signs and symptoms suggesting sinus disease. All patients had Waters view radiographs, which were read by a radiologist (E. G.) who was not provided with historical information. Ultrasound tracings were obtained by registered nurses who were trained to perform this procedure. Tracings were interpreted by two representatives of American Electromedics Corporation, the manufacturer of the Echosine ultrasound machine used in this study. Most common symptoms among the patients were cough and rhinorrhea. The complaint of headache correlated negatively (p = 0.001) with an abnormal radiograph, whereas physical findings of copious and purulent rhinorrhea correlated positively (p = 0.05 and 0.001, respectively). Middle ear abnormalities on examination and tympanometry were more common in those with abnormal radiographs, p less than 0.05 and p less than 0.01, respectively. If the radiograph is considered to be a "gold standard," sensitivity of ultrasound varied from 44% to 58% and specificity from 55% to 61%, dependent on which criteria are applied to the radiograph to consider it normal. A-mode ultrasound is not sufficiently comparable to radiography to be used as its substitute for diagnosing sinus disease.
 ...
PMID:Blinded comparison of maxillary sinus radiography and ultrasound for diagnosis of sinusitis. 351 Nov 25

Amalgam tattoos are common oral lesions. The case presented here involved a 33-year-old woman who had had an amalgam tattoo for 2 years and complained of localized soreness and occasional swelling as well as systemic symptoms of weight loss, fatigue, sinusitis, and headaches. After excisional biopsy of the lesion, the patient's complaints ceased dramatically. It is suggested that alterations in healing due to the presence of amalgam particles led to systemic as well as local disease.
 ...
PMID:An amalgam tattoo causing local and systemic disease? 354 95

A multi-centered clinical study was carried out to evaluate the efficacy of ofloxacin in otorhinolaryngological infections in Japan. Ofloxacin was used at a dosage of 300 mg to 800 mg daily for three to 20 days in 206 cases of various infectious diseases in the otorhinolaryngological field such as otitis media, external otitis, paranasal sinusitis, tonsillitis and pharyngolaryngitis. Its efficacy rate was 79.9%. Minor side effects were seen in three cases (1.5%), gastro-intestinal disorders in two and headache in one. The antibacterial activity of ofloxacin was compared with the activity of pipemidic acid, nalidixic acid and norfloxacin against clinically isolated microorganisms. Ofloxacin was highly superior to pipemidic acid and nalidixic acid, and slightly more active than or equivalent to norfloxacin.
 ...
PMID:Clinical efficacy of ofloxacin in the treatment of otorhinolaryngological infections. 354 57

Seven cases of acute sphenoid sinusitis were reviewed. Two happened after deep sea diving. Headache of variable location and fever were the most predominant presenting symptoms (5/7). Purulent discharge in the cavum was present in three. Correct diagnosis was delayed from six to twenty-four days after beginning of symptoms, when a neurologic deficit became apparent : mainly paralysis of the sixth and third cranial nerves. Computed axial tomography was the most useful radiologic procedure for demonstrating sinus opacification in every patient. Two patients died, three had complete recovery, one had persistent epileptic focus after brain abscess. Last patient had paraparesis and incontinence of urine after study of cerebrospinal fluid (C. S. F.) flow with methylene blue. Cannulation of the sphenoid sinus was performed in two patients and surgical drainage in three. Gram negative microorganisms and Staphylococcus aureus were isolated from the sphenoid sinus of only three patients. Blood cultures were negatives in every cases and C. S. F. in six. First choice antibiotics was an association of aminoglucosides and broad-spectrum penicillin in six cases. It always had to be changed.
 ...
PMID:[Acute sphenoid sinusitis in adults]. 356 11

A case of sphenoid sinusitis is presented. This case exemplifies the need to consider sinusitis in the differential diagnosis of severe headache, even without the accompanying signs and symptoms of sinusitis. The clinical, presentation, diagnostic work-up, potential complications, and treatment of sphenoid sinusitis are reviewed.
 ...
PMID:Acute headache in childhood: a case of sphenoid sinusitis. 367 Nov 40


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>