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

A man of 35 years, who had had three attacks of subarachnoid hemorrhage in the previous 3 years, was admitted to hospital with complaints of headache and priapism. There had been intermittent priapism with abnormal acceleration of sexual desire since the first attack, and erection of the penis had persisted with intolerable pain after the last attack of subarachnoid hemorrhage. A carotid angiogram revealed an aneurysm at the junction of the left internal carotid and posterior communicating arteries. Clipping of the aneurysmal neck was successfully performed. However, priapism continued for 22 days after the operation and resulted in sexual impotence. The neurological problems of priapism are discussed with special reference to a hypothalamic lesion caused by the ruptured intracranial aneurysm in this report.
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PMID:A case of priapism with ruptured intracranial aneurysm. 9 54

Clinical (prearteriographic) and arteriographic diagnoses were grouped into six categories each for analysis of central nervous system and systemic complications of 5,000 catheter cerebral arteriograms. Within each category, there was no significant difference in complication rate between clinical and arteriographic diagnoses. The highest complication rates (1.2%-1.9%) were in patients with cerebrovascular occlusive disease, posttraumatic or postoperative conditions, and subarachnoid hemorrhage. Significantly lower complication rates (0.2%-0.5%) were found in patients with tumor, seizure or headache, and patients with normal arteriographic findings.
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PMID:Complications of catheter cerebral arteriography: analysis of 5,000 procedures. II. Relation of complication rates to clinical and arteriographic diagnoses. 10 Oct 46

A 54-year-old man experienced a right occipital headache accompanied by a roaring sound, nausea, vomiting, right facial weakness, and stiff neck. Vertebral angiography revealed an aneurysm of the right anterior inferior cerebellar artery (AICA) at the internal acoustic meatus which was later excised with favorable results. The literature is reviewed; operations have been reported in eight other cases. Inconstant waxing and waning cerebellopontine angle symptoms and signs can be found when a history of subarachnoid hemorrhage is lacking.
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PMID:Anterior inferior cerebellar artery aneurysms. Case report. 30 70

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

The author has operated on 40 patients with giant intracranial aneurysms, using various surgical approaches. Giant aneurysms predominated in females (3:1) and were most common in the age group 30 to 60 years. Patients presented with subarachnoid hemorrhage (17), visual disturbance (18), chronic headache (14), transient or progressive hemispheric deficit (6), seizure (2), dementia (2), and cerebrospinal fluid rhinorrhea (1). Giant aneurysms were located at the carotid artery (25), the basovertebral artery (8), the anterior communicating artery (5), and the middle cerebral artery (2). Eight of 40 patients had one or more other aneurysms and/or associated arteriovenous malformations. Aneurysms were treated with intramural thrombosis (21), neck occlusion (7), trapping (10), proximal parent artery ligation (1), and aneurysmorrhaphy (1). After as much as 8 years of follow-up, 32 patients (80%) showed complete or marked improvement in signs and symptoms; two patients (5%) had a poor recovery. There were six surgical mortalities (15%). Giant aneurysms can be treated with respectable results if the surgeon selects the technique best suited to the particular aneurysm. In general, neck occlusion, trapping, and aneurysmorrhaphy are best for giant aneurysms of the anterior circulation, and intramural thrombosis is best for those of the posterior circulation. Extra- and intracranial vascular anastomotic techniques are also of value. For success, a flexible approach is essential.
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PMID:Direct surgical treatment of giant intracranial aneurysms. 50 18

We represent a case of vitreous hemorrhage due to subarachnoid hemorrhage from a ruptured aneurysm of the right vertebral artery to draw attention to this complication. A 53-year-old man was admitted to our hospital because of generalized headache and reduced visual acuity of both eyes. On admission the patient was alert and there were moderate nuchal stiffness and mild symmetrical hyperreflexia in the extremities. Ophthalmological consultation revealed bilateral retinal, subhyaloid and vitreous hemorrhages. Four-vessel angiography demonstrated an aneurysm of the right vertebral artery. At operation, it became clear that the aneurysm was a dissecting one. The vertebral artery was clipped at the most proximal intracranial portion. Postoperative course was smooth and uneventful except deteriorated visual acuity. His visual acuity deteriorated continuously to hand movements 18 days after subarachnoid hemorrhage. His visual acuity, however, gradually improved without specific treatment. At the time of this writing, his visual acuity is 1.0 on both sides. Vitreous hemorrhage is a rare complication following a reptured aneurysm. Pertinent literature concerning fundal hemorrhage, especially vitreous hemorrhage, associated with subarachnoid hemorrhage suggests that it may occur as a result of sudden increase of intracranial pressure.
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PMID:[Vitreous hemorrhage as a complication of subarachnoid hemorrhage (Terson's syndrome) (author's transl)]. 53 Mar 66

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 case of aneurysm of the left internal acoustic meatus has been reported. The patient was 53-year-old man who was admitted with the history of sudden onset of a severe occipital headache 18 days previously. He also noted nausea, vomiting and became drowsy at that time. He was seen at a local clinic and a lumbar puncture showed bloody fluid. The next day his level of consciousness improved but he noted left tinnitus and neck stiffness. On admission, he only complained of a left tinnitus. The rest of the neurological examination was normal. Craniogram was of no abnormal findings. Cerebral angiogram showed an aneurysm at the left internal acoustic meatus fed by the left internal auditory artery. At operation, the aneurysm was clipped at the entrance of its feeding artery via retroauricural-retromastoidal craniectomy. The postoperative course was satisfactory except for the decrease of the left auditory acuity to 50dB. Postoperative angiogram revealed a complete disappearance of the aneurysm. In the literature only six cases have been reported, which were summarized in Figure 1. Clinical features of such an aneurysm are subarachnoid hemorrhage and symptoms of cerebello-pontine angle, namely tinnitus, hearing disturbance and facial palsy etc. Besides, on skull x-ray film, sometimes enlargement of the internal acoustic meatus has been found.
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PMID:[A case of aneurysm of the left internal acoustic meatus (author's transl)]. 65 16

In a group of 281 cases of subarachnoid haemorrhages including 105 cases of intracranial aneurysms confirmed on autopsy or by angiography the authors analyse the symptoms preceding subarachnoid haemorrhage and suggesting presence of aneurysm. The most frequent symptom suggesting presence of intracranial aneurysm were headaches, especially associated with other symptoms such as dizziness, nausea, paraesthesiae of extremities, visual disturbances. A careful analysis of these symptoms and early radiological examination may help in establishing the diagnosis of aneurysm before its rupture.
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PMID:[Symptoms preceding rupture of subarachnoid aneurysms: an analysis]. 68 25

Neurological features of 24 patients with nervous system gnathostomiasis were reviewed. The commonest presenting features were radiculomyelitis or radiculomyelitis terminating with encephalitis, and subarachnoid haemorrhage. A primary encephalitic form was noted in 2 patients. The salient feature of the disease was a sudden onset of extremely severe radicular pain and/or headache followed by paralysis of the extremities and/or the cranial nerves. Migration signs were also the hallmark of nervous system gnathostomiasis. No single area of the nervous system was inaccessible to the highly invasive gnathostome lava. Multiplicity and/or rapid progress of lesions beyond the degree of cerebral oedema could only be explained by further migration of the parasite. Death occurred in 6 patients from direct extensive involvement of vital centres in the brain stem or from complications such as pneumonia or septicaemia. Multiple cranial nerve palsies were usually bad prognostic signs.
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PMID:Neurological manifestations of gnathostomiasis. 83 36


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