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

A case of paranasal sinusitis due to Pasteurella multocida (P. multocida) is reported. A 39-year-old woman presented with chief complaints of rhinorrhea and headache. The patient kept a cat in her house and kept such close contact with it as to wake up by being licked every morning. Bacteriological examination revealed P. multocida isolated from her nasal discharge and also from the saliva of the cat kept by the patient. The two isolates were compatible with respect to biochemical properties, serotype and drug susceptibility. Therefore, P. multocida infection in this case was considered to have originated from the pet cat. P. multocida infection has been increasing recently. One of the reasons is a pet boom. In order to prevent acquiring the infection from a pet animal, we should have knowledge about this infection, advise the patient to avoid close contact with pets, and provide valuable information concerning these problems to society from the viewpoint of zoonosis.
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PMID:[Paranasal sinusitis due to Pasteurella multocida]. 846 82

Sudden, explosive headache is rather rare. Though dramatic for the patient and the physician, it does not necessarily herald an intracranial catastrophe. Benign and dangerous thunderclap headaches cannot be distinguished from the features of headache itself, but rather on the basis of the situation, the additional symptoms and the findings. This means that every sudden headache should be considered potentially dangerous and be investigated immediately. The dangerous forms comprise intermittent hydrocephalus, acute bacterial meningitis and above all vascular complications. Subarachnoid hemorrhage frequently must be ruled out by computed tomography and lumbar puncture. Intracerebral, especially cerebellar hemorrhage, as well as hypertensive crisis require immediate treatment. Fatal cerebral embolism complicating spontaneous dissection of craniocervical arteries (carotid or vertebral arteries) can be prevented by early anticoagulant therapy. To confirm diagnosis, additional investigations such as CT, lumbar puncture or cerebrovascular ultrasound, and in rare cases MRI, should be performed early as the available time for effective therapy in many situations is short. Many of the benign forms of sudden headache can be diagnosed with a focused interview (cold or drug induced and food dependent headaches, sinusitis, glaucoma). Others, such as neuralgia, cough and coital headache, can be diagnosed as benign only when additional investigations have ruled out symptomatic forms.
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PMID:[Acute headache]. 848 83

Isolated sphenoid sinusitis is an uncommon but potentially catastrophic infectious disease. The authors present 12 patients with acute, isolated sphenoid sinusitis and describe their presenting features and clinical courses. All patients experienced headache, facial pain, or both. Fever and leukocytosis were uncommon. Plain sinus radiographs and cranial computerized tomography scan were diagnostic. All patients were treated with antibiotics and recovered without infectious or neurological complications.
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PMID:Isolated sphenoid sinusitis. 848 66

A retrospective study was performed at two teaching hospitals--one in the United States and one in Canada--to determine the results of computed tomography (CT) examinations of the head in patients with nontraumatic headache. Of 1111 examinations performed over a 3-year period, 120 (10.8%) demonstrated an acute intracranial abnormality, such as hemorrhage, infarction or tumour; the frequency of such abnormalities was highest among inpatients and subjects over 40 years of age. Cranial and extracranial abnormalities, such as sinusitis and metastases to the calvarium, were found in 40 (3.6%) of the cases. Chronic abnormalities, such as cerebral atrophy or remote infarction, were the most significant findings in 202 (18.2%) of the cases. The cost of finding each case of acute intracranial abnormality was $5962 (US); for subarachnoid hemorrhage among patients in the emergency department, it was $15,837 (US).
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PMID:Computed tomography for nontraumatic headache: current utilization and cost-effectiveness. 850 31

This prospective study included 51 patients with chronic maxillary sinusitis who had 90 middle meatal antrostomy procedures. The aim of the study was to examine the long-term patency of the antrostomy 18-30 months post-operatively (average 26 months) and the relationship between the degree of patency and the degree of improvement in each of the symptoms of chronic maxillary sinusitis. Our results showed patency as follows: 80% widely patent (more than 8 mm), 9% patent (5-8 mm), 4.5% stenosed (less than 5 mm), 6.5% blocked by mucosal disease and none were closed by bone. For all symptoms, there was a significant relationship between the degree of patency and the degree of improvement (P < 0.01 for headache, nasal obstruction and pain, P < 0.05 for post-nasal discharge). We conclude from this study that middle meatal antrostomy has a long-term high patency rate and there is a significant relationship between the degree of patency and the degree of improvement in each of the symptoms of chronic maxillary sinusitis.
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PMID:Middle meatal antrostomy: long-term patency and results in chronic maxillary sinusitis. A prospective study. 850 44

Sinusitis is a very common and increasingly recognized disorder affecting patients of all ages and genders. It is most commonly due to infection of the paranasal sinuses with symptoms varying from cough and anterior nasal drainage in children to headache and post nasal drip in adults. Diagnosis relies heavily on medical history with corroboration by careful physical examination including nasal endoscopy. The most accurate imaging technique to evaluate sinusitis and to delineate the extent of involvement of individual sinuses and identify possible anatomic abnormalities is computerized tomography scanning in the coronal plane. The mainstay of medical treatment of sinusitis is antibiotics with adjuvant treatments such as saline irrigation, decongestants, mucolytics and antiinflammatory agents playing a more secondary role. The use of these agents will be discussed in detail after an introduction about the risk factors, diagnosis and bacteriology of the disease. Surgical treatment of sinusitis will be the subject of another article.
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PMID:Medical treatment of sinusitis. 855 75

The association of headache and sinusitis was studied in 207 patients who underwent surgery for chronic sinusitis that failed to respond to medical management. Sixty-nine percent of the patients had headaches and 31% did not. In 9% headache was the only symptom and the diagnosis of sinusitis was made on clinical and/or CT grounds. The pain was usually pressure in character, moderate in intensity and lasted for hours. Its location usually, but not always, pointed to the sinuses involved. Discreet sphenoid or ethmoid disease discovered on imaging may be responsible for midline pains. Sinusitis may also trigger or aggravate vascular headaches.
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PMID:Sinusitis and headache. 855 77

The CT imaging and clinical presentation in 14 children with coexistent intracranial sepsis and sinusitis were reviewed. A routine CT head scan (10-mm thick semi-axial slices through the cranium done before and after intravenous contrast medium administration) was found to be an inadequate initial investigation as the intracranial collection was missed in four patients and the abnormal sinuses not shown in six. In half the children the diagnosis of sinusitis was unsuspected at the time of admission. The dominant clinical features were fever, intense headache and facial swelling in early adolescent males. In this clinical setting we recommend: (1) the routine scan is extended through the frontal and ethmoidal sinuses and photographed at a window level and width showing both bone detail and air/soft tissue interfaces; (2) direct coronal projections are performed through the anterior cranial fossa if no collection is seen on the routine study; (3) an early repeat scan within 48 h if the initial study shows no intracranial pathology but the fronto-ethmoidal sinuses are abnormal and there is a high clinical suspicion of intracranial sepsis; and (4) in the presence of intracranial sepsis the vault is viewed at bone window settings to exclude cranial osteomyelitis.
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PMID:Sinusitis and intracranial sepsis: the CT imaging and clinical presentation. 857 33

The clinical presentation, radiological and laboratory evaluation, treatment, and risk factors of sinusitis in a cohort of 376 human immunodeficiency virus (HIV)-infected children from a placebo-controlled clinical trial of intravenous immunoglobulin (IVIG) as prophylaxis for infections were examined. Ninety-five episodes of sinusitis were described in 60 patients; one-third of the patients had two or more episodes. Sinusitis episodes were commonly associated with nonspecific, chronic symptoms (67.4%, persistent nasal discharge; 54.7%, nocturnal or persistent cough), whereas symptoms more specific to acute sinusitis were less frequent (17.9%, headache or facial pain; 9.5%, periorbital swelling; 25.3%, temperature of > or = 102 degrees F; 9%, total white blood cell count of > or = 15,000/mm3). The sinuses primarily involved were the maxillary sinus (85.9%) and the ethmoidal sinus (42.3%); 36% of episodes involved two or more sinuses. Preceding respiratory infections did not appear to increase the risk of sinusitis, and CD4+ lymphocyte counts in children with and without sinusitis did not differ. Neither monthly IVIG prophylaxis nor three times weekly trimethoprimsulfamethoxazole prophylaxis for Pneumocystis carinii pneumonia decreased the risk of sinusitis. Sinusitis in HIV-infected children is most often subacute and recurrent. Evaluations of new modalities for prophylaxis for sinusitis are needed.
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PMID:Sinusitis in children infected with human immunodeficiency virus: clinical characteristics, risk factors, and prophylaxis. National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial Study Group. 858 39

The new Institute of Medicine definition of primary care requires that primary care clinicians address the large majority of personal health care needs of their patients. The unit of assessment for this is the episode of care, defined as a health problem from its first encounter with a health care provider through the completion of the last encounter. An episode of care is distinct from an episode of disease or illness. In this article, episode-of-care date from Dutch family practice, classified with the International Classification of Primary Care, illustrate this approach. Data on women 25 to 44 years of age are presented. The top 20 new reasons for encounter and new episodes of care as well as the relations between a reason for encounter (headache) and disease (sinusitis) support the potential of episode-oriented epidemiology and some important clinical considerations in family practice.
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PMID:Episode of care: a core concept in family practice. 860 6


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