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

A 55-year-old man having hemiplegia after the sudden onset of a stroke was referred for rehabilitation. Cerebral angiography had demonstrated occlusion of the left middle cerebral artery and steroid therapy had been started. Attempted tapering of the steroid therapy on admission for rehabilitation resulted in the patient having severe headaches and confusion. Blink reflex evaluation, somatosensory cerebral evoked potential determinations and visual evoked responses were all consistent with a widespread process involving the parietal lobe of the patient's left cerebral hemisphere. Computerized axial tomography indicated an abnormality consistent with a space-occupying lesion. Craniotomy revealed the presence of a glioblastoma multiforme in the left cerebral hemisphere. Electrodiagnostic evaluation was entirely consistent with the operative finding of widespread involvement of the patient's left parietal lobe. Stroke patients whose conditions deteriorate over time must be serially evaluated in order to determine possible other causes of their symptoms.
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PMID:Glioblastoma multiforme presenting as stroke: an electrophysiological and clinicopathological case report. 22 22

Cogan syndrome is a multisystem inflammatory vascular disease, characterized by nonsyphilitic interstitial keratitis and vestibuloauditory symptoms. Recent reports have directed attention to involvement of other organ systems. Respiratory, cardiovascular, gastrointestinal, and musculoskeletal problems are common, as are laboratory abnormalities and general symptoms such as fever, chills, and weight loss. Prominent neurologic problems in two patients prompted a review of 79 cases of Cogan syndrome. More than half had nervous system involvement, including electroencephalographic or spinal fluid abnormality, headache, psychosis, coma, convulsion, neuropathy, and stroke. Cogan syndrome should be considered when neurologic deficits are accompanied by eye, ear, and systemic symptoms.
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PMID:Neurologic manifestations of Cogan syndrome. 30 11

It is important to establish the diagnosis of temporal arteritis because the disease is treatable; treatment may prevent blindness and even death. Temporal arteritis usually occurs in people older than 51 years of age, although very rarely, histologically documented disease occurs in younger people. The onset may be occult, so that there are few findings. A multitude of signs and symptoms may occur such as fever, headaches, malaise, weight loss, anemia, stroke, cranial nerve palsies, polymyalgia rheumatica, aortitis and other large vessel involvement. The eye may suffer from ischemic optic neuropathy (anterior or posterior), central or cilio-retinal arterial occlusion, ophthalmic artery ischemia, or extraocular muscle palsies. An arterial biopsy showing giant cell arteritis establishes the diagnosis. However, a negative biopsy does not rule out the disease because of the occasional presence of skip areas. Arteriography has only rarely yielded a positive temporal artery biopsy when the initial biopsy done elsewhere was negative. As a diagnostic parameter, the erythrocyte sedimentation rate is nonspecific, being elevated in diseases other than temporal arteritis and sometimes being falsely lowered by technical factors. Furthermore, the temporal artery biopsy is occasionally positive despite a normal erythrocyte sedimentation rate. Treatment is aimed at relieving the patient's symptoms and normalizing the erythrocyte sedimentation rate. Because of the wide spectrum of clinical and laboratory finding in temporal arteritis, no one specific treatment regimen with systemic corticosteroids works for all patients. Temporal arteritis is a well known disease of the elderly which ir rarely fatal but results in significant visual morbidity (Hinzpeter & Naumann, 1976; Spencer & Hoyt, 1960). Since Hutchinson's (1890) description, more than a thousand articles have been written on the subject (Cohen & Smith, 1974). Despite this, many unanswered questions and controversies remain concerning the diagnosis, prognosis and treatment of temporal arteritis. My goal is to review these questions and areas of controversy.
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PMID:Controversies regarding giant cell (temporal, cranial) arteritis. 39 20

A woman with left atrial myxoma had progressive disturbance of intellectual function, headache, and prominent constitutional symptoms. The absence of stroke is noteworthy. Multiple high-density lesions with contrast enhancement were seen by CT scan, suggesting metastatic neoplasms, hematomas, or hemorrhagic infarcts. Serial study showed progressive enlargement of the lesions. The only cerebral lesion examined histologically proved to be an organizing hematoma, originating most likely from adjacent small arteries found to be plugged by embolic myxoma.
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PMID:Atrial myxoma with intellectual decline and cerebral growths on CT scan. 44 74

We report about a dialysis procedure, the circulation stability of which is comparable to hemofiltration treatment. Hemodynamic parameters were measured invasively and different procedures were compared for each patient. In RD and HF significant reduction in cardiac output (HF: --20%, RD: --21.5%), stroke volume (HF: --20%, RD: --17%), pulmonary artery pressure (HF: --57%, RD: --45:6%) and plasma volume (HF: --12%, RD: --15%) were found. Blood pressure and heart rate (HF: --1%, RD: --3%) remained stable despite the high utrafiltration rate. Peripheral resistance rose significantly (HF: + 20%, RD: + 25.9%). Compared with HG, the most important advantage during RD is the improved tolerance to treatment without typical hemodialysis-induced symptoms. In comparison to that, we found under conventional dialysis an inadequate increase in peripheral resistance (HD: + 6.1%). A following strong compensatory hyperventilation with drop in PCO2 was paralleled with typical symptoms like nausea and headache. Because of resttriction of this compensatory mechanism, hypotension and arrhythmia will be induced of the following peripheral tissue perfusion and central acidosis.
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PMID:Recirculation dialysis (RD) (20 to 40 liters of dialysate) with venous bicarbonate buffering - an alternative procedure to hemofiltration (HF). 47 80

A retrospective case note survey of chronic subdural haematomata was carried out in an attempt to throw some light on the difficulties encountered in clinical diagnosis. The combination of raised intracranial pressure headache, fluctuating drowsiness and mild hemiparesis, although highly suggestive of subdural haematoma, is not always encountered, and epilepsy, aphasia, hemianopia and dense hemiplegia can all occur contrary to 'text book' descriptions. Head injury or other aetiological factors are commonly absent. The presentation may mimic tumour, dementia, cerebrovascular accident or subarachnoid haemorrhage. Non-invasive investigations may yield false negative results, although in the case of radionucleide scanning and computerized axial tomography the reliability is approaching 90 per cent. The diagnosis will, however, remain an unexpected finding at angiography in a percentage of cases.
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PMID:Chronic subdural haematoma. 48 90

Using 99mTc-labeled macroaggregated albumin (99mTc-MAA), we made an examination of the cerebral blood flow distribution with various kinds of cerebrovascular diseases in 151 cases. The particle size of MAA used in this study ranged from 10 to 100 micron. Scan was performed after injection of 3 mCi of 99mTc-MAA into common carotid artery. No side effects were observed except for one case with headache. Distribution of 99mTc-MAA was found to be homogeneous in normal cerebral hemisphere but not in the lesion. Most lesion was shown as nonradioactive area. Meningioma with hypervascularity was represented as hot area. By this method cerebral infarct could be easily represented not only in main artery but also in such a very small artery as hardly detected by CAG. This method is therefore useful for detecting cerebral infarct, sequela of cerebral apoplexy, head injury and others. The dose of 99mTc-MAA used in this method is much lower compared with those of common brain scan, its excretion is speedy, and therefore internal radiation exposure is diminished.
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PMID:[Diagnostic evaluation on cerebral hemisphere scintigraphy using 99mTc-MAA (author's transl)]. 54 44

Employing optical density methods, platelet aggregation in response to 1.275, 1.7, and 3.4 micrometer adenosine diphosphate was tested in 46 patients with migraine and 46 controls matched by age, sex, and race. The migraine patients demonstrated platelet hyperaggregability when compared with controls, as manifested by a lower threshold for the platelet-release reaction and increased platelet stickiness following aggregation. There was no correlation of platelet hyperaggregability with the severity of migraine or with the occurrence of migraine-associated neurologic symptoms, suggesting that platelet hyperaggregability is a concomitant feature of the migraine syndrome but not dependent on the occurrence of the actual headache. As platelet hyperaggregability may predispose to development of intravascular platelet aggregates or mural thrombi, the hyperaggregability found here may help explain the increased incidence of stroke and heart attack in migraine patients that has been reported elsewhere.
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PMID:Platelet aggregability in migraine. 56 34

Data from 694 patients hospitalized with stroke were entered in a prospective, computer-based registry. Three hundred and sixty-four patients (53 percent) were diagnosed as having thrombosis, 215 (31 percent)as having cerebral embolism 70 (10 percent) as having intracerebral hematoma, and 45 (6 percent) as having subarachnoid hemorrhage from aneurysm or arteriovenous malformations. The 364 patients diagnosed as having thrombosis were divided into 233 (34 percent of all 694 patients) whose thrombosis was thought to involve a large artery and 131 (19 percent) with lacunar infarction. Many of the findings in this study were comparable to those in previous registries based on postmortem data. New observations include the high incidence of lacunes and cerebral emboli, the absence of an identifiable cardiac origin in 37 percent of all emboli, a nonsudden onset in 21 percent of emboli, and the occurrence of vomiting at onset in 51 percent and the absence of headache at onset in 67 percent of hematomas.
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PMID:The Harvard Cooperative Stroke Registry: a prospective registry. 56 91

A patient with bacterial endocarditis had headaches, cerebrospinal fluid pleocytosis and normal cerebral angiograms. Fifteen days later, while on appropriate antibiotic therapy, he developed an intracerebral hematoma due to a mycotic aneurysm. Mycotic aneurysm is an infrequent but serious complication of bacterial endocarditis. An aneurysm should be considered whenever a patient with bacterial endocarditis has neurologic symptoms even when the patient is receiving antibiotics.
Stroke
PMID:Cerebral hemorrhage from a mycotic aneurysm developing during appropriate antibiotic therapy. 58 May 12


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