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

32 patients are described, who 1971-1974 were hospitalized because of temporal arteritis. The admissions diagnoses were: 5 temporal arteritis. 7 Neuroretinitis. 4 Blood vessel obstruction. 2 Cerebral tumor. 14 Vision disturbances up to sudden blindness of unknown cause. In the early stages when intermittent visual disturbances with vague headaches of older patients (average age 68 years) are present, a temporal arteritis is often not recognised. In the region of the papilla the retinal arteries show obvious luminal narrowing. The papilla is already early on somewhat blurred and oedematous. The complaints continue bilaterally with intervals from days to months. Hence the treatment: bilateral resection of the temporal artery. Histologically: from our 32 patients 27 showed the classical picture of "giant-cell arteritis" with chronic inflammatory reaction of all layers of the wall and partial to complete obstruction of the vessel lumen. Local therapy: parabulbar application of cortisone. General therapy: Daily rheomacrodes infusions, Soludecortin, 100 mg per day (with latter "tailing off") and strophantin when the patient is not already digitalised.
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PMID:[Temporal arteritis, clinical picture, treatment and prognosis (author's transl)]. 120 71

Arteritis of the aged (giant cell arteritis) masquerades as a degenerative, infectious, neoplastic or even functional disorder in the elderly. In the absence of obliterative vascular changes, the diagnosis is often overlooked when too rigid diagnostic criteria are employed. Four elderly women presented with fever of unexplained origin as the initial manifestation of this disease. The temporal arteries were conspicuously normal in all four, and other traditional clinical clues, such as visual disturbances, headache or manifestations of polymyalgia rheumatica were likewise infrequent of entirely absent. Influenza immunization and uncomplicated rectal surgery preceded the onset of illness in two. Anemia and an increased erythrocyte sedimentation rate are important diagnostic features, particularly in the face of spontaneous clinical improvement accompanied by defervescence and disappearance of nonspecific liver dysfunction. Occult intestinal perforation complicated steroid therapy in one case. Significant and sometimes hectic fever may be a common pattern for this arteritis in its earliest stages, when palpably abnormal temporal arteries, obliterative vascular changes and other traditional diagnostic clues are more likely to be absent.
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PMID:Arteritis of the aged (giant cell arteritis) and fever of unexplained origin. 125 89

The erythrocyte sedimentation rate (ESR) is a frequently used but nonspecific indicator of inflammation or infection. Clinicians often check an ESR in patients with symptoms of headache, facial or jaw pain, and visual loss, as an aid in the diagnosis of temporal arteritis. We present two patients with these complaints, who did not have temporal arteritis, nor any other inflammatory condition or infection, but had ESRs near or above 100 mm/h, leading to diagnostic confusion. An occult nephrotic syndrome, with or without renal insufficiency, can cause such a highly elevated ESR, and was discovered in these patients.
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PMID:Renal causes of elevated sedimentation rate in suspected temporal arteritis. 128 54

Symptomatic or secondary headache occurs when pain itself is a symptom of disease. It is well known that within the general population the percent frequency of secondary headache is lower than that of primary headache. Moreover, some forms do not seem to evidence particular clinical, diagnostic or physiopathological importance. The Authors investigate here a number of clinical aspects of secondary headache, in particular headache in vascular disease (stroke, hypertension, Horton's arteritis). Particular attention is paid to headache in brain neoplasia due to the interest brought about by the diagnostic problems of this disease. Lastly postural headache and its prevalence in the general population is examined. Various physiopathological aspects of this form (stress, psychosocial events) are evaluated.
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PMID:[Symptomatic headaches in internal medicine: the classification, physiopathological and diagnostic aspects]. 129 96

Temporal arteritis is a systemic disease with local temporal artery symptoms, generalized constitutional symptoms and ocular involvement which affects the elderly. A study was undertaken to assess the clinical features of patients with temporal arteritis in a large multispecialty clinic practice. The study group consisted of 516 patients with clinical suspicion of temporal arteritis, of which 97 (18.8%) had a positive biopsy for arteritis. The records of these 74 females and 23 males were retrospectively reviewed for clinical implications of the disease. The average age of the cohort was 71.7 years, and male to female ratio was 1:3.2. There were 95 caucasians and 2 blacks. The most common clinical findings at presentation were abnormal temporal artery (65.9%), headache (64.8%), myalgias or arthralgias (46.6%), visual symptoms (37.1%) and fever (35.1%). Multiple symptoms were present in 97% of the patients. The erythrocyte sedimentation rate was > 50 mm per hour in 91% of patients. Corticosteroids were used to treat 95/97 patients. Twenty-seven (28%) of the patients completed treatment over an average 36.3 months. Sixty-eight (72%) other patients were either lost to follow-up, died, or continue on therapy. Complications of corticosteroid treatment occurred in 43 (44.3%) of patients, and complications of temporal arteritis occurred in 14 (14.4%). A review of biopsy data showed no difference in length of biopsy or yield of biopsy in the patients with positive and the patients with negative histology. Temporal arteritis is a systemic disease which responds well to corticosteroid treatment. Complications of the disease as well as of treatment make definitive diagnosis imperative.
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PMID:Temporal arteritis. Clinical implications for the vascular surgeon. 144 81

Presented is a case of a 74 years old patient whose ailment was diagnosed as Horton's disease (temporal arteritis) on the basis of general clinical symptoms (constant headache, sclerosis of the temporal artery, anorexia and sleeplessness) and ocular signs (poor visual acuity and pale papilloedema).
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PMID:[Temporal arteritis]. 145 83

The elderly as a whole suffer fewer headaches than the young. For the majority headache will represent a minor annoyance to be endured or treated with any available drug in the medicine chest. For some, migraine headaches or tension-type headaches become entwined with every daily activity. With the advent of modern pharmacology, headache can often be treated successfully. Trigeminal neuralgia is a source of particularly high morbidity among the elderly, but may be treated very satisfactorily with carbamazepine or baclofen. Paroxysmal hemicrania is exquisitely sensitive to indomethacin, while cluster headache patients receive relief from oxygen inhalation, corticosteroids or lithium. Headache may be the signature of the disease which leads to serious morbidity and mortality. The 'sentinel' headache of subarachnoid haemorrhage is evaluated by a physician in 15% of patients who will eventually rupture an intracranial aneurysm. Morning headache with nausea and vomiting may represent increased intracranial pressure caused by a tumour, haematoma or abscess. The elderly patient with a new headache needs emergency evaluation for temporal arteritis and rapid corticosteroid treatment if the diagnosis is confirmed, to prevent blindness. The broad spectrum of headache, at times a benign aggravation, while at others the harbinger of death, makes the careful evaluation of each headache imperative. This article attempts to make the difficult evaluation of head pain a little easier.
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PMID:Treatment of the elderly patient with headache or trigeminal neuralgia. 179 4

Headache is no doubt one of the most frequent symptom in Horton's disease. Nevertheless it has neither received a clear definition nor it has been studied in its pathogenetic aspects. The authors report 32 cases of Horton's disease in acute phase with arteritic localizations in different areas. Among them 24 (75%) had headache which appeared with different features from case to case. The authors identify 3 different kinds of headache, all recognizable in the secondary medical forms: epicritic headache (the most frequent), deep headache and generic headache (the rarest). The characters and the pathogenetic mechanisms of each form are also described.
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PMID:[Headache in Horton's disease: the clinical picture and physiopathogenetic mechanisms]. 188 54

The analysed clinico-biological manifestations, evolutive course and treatment of 30 patients with GCA are presented. The most frequent symptoms were fever and headache. 33% of patients had FOD criteria. 26% had various visual alterations. All patients were initially treated with steroids. Of the 26 patients followed up, 21 (81.7%) experienced some sort of complication: Cushing iatrogenic, osteoporosis, vertebrae collapse, aseptic necrosis of the femur head, arterial hypertension, diabetes mellitus, hyperlipidemia, steroid myopathy. 6 patients were treated with cyclophosphamide, following severe complications secondary to steroid therapy, and all of them had a good clinical evolution.
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PMID:[Giant-cell arteritis: the clinico-biological manifestations and the complications secondary to steroid treatment]. 191 67

Temporomandibular joint (TMJ) dysfunction may manifest itself clinically by a variety of presentations ranging from headache, pre-auricular pain or tenderness, otalgia, to mandibular hypomobility. Some symptoms may mimic forms of facial pain such as: temporal arteritis, migraine, cluster headache, trigeminal or glossopharyngeal neuralgias, myofascial pain dysfunction, or muscle contraction (tension) headache. This article will focus on a relatively new diagnostic tool that may be used to examine the TMJ for intracapsular pathology which may be responsible for the presenting patients' symptoms.
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PMID:The role of diagnostic arthroscopy in the management of temporomandibular joint dysfunction. 196 Jul 86


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