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

Present views on the cause and treatment of temporal arteritis, trigeminal neuralgia, pain arising from the neck, benign intracranial hypertension, and other headaches of intracranial origin are summarized. The clinical components of migraine are correlated with recent studies of cerebral blood flow, monoamine changes, and the platelet release reaction. Psychological, physiological, and pharmacological management is based on the holistic concept of migraine as an uninhibited protective reaction. Cluster headache is subdivided into three varieties which respond preferentially to different medication. Tension headache may depend more on vascular mechanisms than excessive muscle contraction, but treatment is still directed at behavioral management and relaxation training with the aid of antidepressant therapy.
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PMID:Headache. 702 51

Visual and oculomotor changes may be the only abnormalities in patients complaining of headache. Ocular signs are common during episodes of migraine and cluster headache. Temporal arteritis may be an extracranial cause of ocular signs. Intracranial disorders include painful ophthalmoplegia, pseudotumor cerebri and various causes of increased intracranial pressure. Neurophthalmologic evaluation in headache patients must include assessment of visual acuity and visual fields, examination of pupils (including pharmacologic testing), ophthalmoscopic examination and auscultation for bruits.
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PMID:Neurophthalmologic signs in headache syndromes. 706 59

Temporal arteritis is generally a benign and self-limiting disease, which has been recognized for approximately 50 years. Although it has been uncommon, it is becoming increasingly prevalent among elderly individuals. Its major complication involves loss of vision, and approximately 50 per cent of all untreated patients become blind in one or both eyes. This can be prevented by early recognition and prompt treatment of the disease process. Steroids given to suppress the inflammatory involvement of the arterial wall safeguard the blood supply to the eye. If vision is lost, however, the loss is usually permanent. Although its diagnosis can be confusing initially, temporal arteritis should be easily diagnosed by its local and systemic manifestations, including headache of recent onset in an elderly patient, visual disturbance, an increased sedimentation rate, and a classic palpable tenderness along the course of the temporal artery. Immediate hospitalization is recommended when the diagnosis is made and steroid therapy is begun, along with measures for symptomatic relief of headaches. With the increasingly aging population in the United States, one predicts that this disease entity of obscure etiology will become prevalent. Thus all physicians should have a basic knowledge and understanding of the disease process.
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PMID:Temporal arteritis. 713 20

Aortic dissection in a 61-year-old woman treated symptomatically and with a fatal outcome within three months by extension to the arch of the aorta and its major vessels, and as a direct result of haemopericardium. The association with temporal arteritis, presenting before the aortic complication by prolonged headache with raised sedimentation rate and painful inflammation of both temporal arteries, was confirmed by histopathological examination of the aorta. This revealed giant cell arteritis independent of atheromatous lesions. The association of aortic dissection and temporal arteritis is very rare. Clinical and pathological examination of the smaller arteries and in particular the craniocephalic arteries is therefore justified in all cases of aortic dissection. When it affects the aorta, temporal arteritis may favor aortic dissection as a result of changes in the media.
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PMID:[Aortic dissection and Horton arteritis]. 714 26

Giant-cell arteritis is a polysymptomatic disease of the elderly. Systemic symptomatology includes headaches, arthralgias, myalgias, tender temporal arteries, jaw claudication, low-grade fever, anemia, anorexia, malaise, and weight loss. Visual loss from anterior ischemic optic neuropathy and diplopia resulting from ischemia of the ocular muscles represents the major ocular manifestations of giant cell arteritis. When the diagnosis is suspected, blood for a sedimentation rate should be drawn, and, if it confirms the clinical impression, high dose prednisone should be started immediately and a temporal artery biopsy performed at a later date. Only by asking the proper questions and suspecting the diagnosis will this preventable form of blindness receive the prompt attention it deserves.
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PMID:Giant-cell arteritis. Signs and symptoms. 715 21

Polymyalgia rheumatica is a disease of the elderly, more common in women. Pain and stiffness localized in the proximal extremities respond well to low-dose corticosteroids. In roughly half of the cases, giant cell arteritis can be detected in apparently normal temporal arteries. There is no danger of ocular involvement in "pure" polymyalgia rheumatica, even with a positive biopsy. When cranial symptoms, such as headache or tenderness of the temporal arteries, appear, there is a great danger of ocular involvement, and high-dose corticosteroid treatment is advisable.
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PMID:[Ocular involvement in polymyalgia rheumatica (author's transl)]. 720 86

A 79-year old female patient with antecedents of headache and fever, was admitted because of fatigue, anorexia, anemia and elevated ESR. After admission she presented with rheumatic polymyalgia and synovial effusion in the knee. A first biopsy of the temporal artery was normal. After dismissing other possible causes a second biopsy of the contralateral temporal artery was bone and confirmed giant cell arteritis. Diagnostic value of a second temporal artery biopsy is discussed and justified by: a) a confirmed diagnosis is necessary for prolonged treatment with corticosteroids, b) if it is decided to treat the rheumatic polymyalgia with lower doses of corticosteroids than for temporal arteritis the certainty that no temporal arteritis is present and c) shortening the hospital stay and lowering the cost and number of diagnostic procedures. The frequency of arthritis and synovial effusion in temporal arteritis are also discussed.
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PMID:[Giant cell arteritis: diagnostic value of a second biopsy of the temporal artery (author's transl)]. 724 67

Cranial arteritis is commonly found in elderly individuals with headache and visual loss. Although otolaryngologic manifestations of cranial arteritis are said to be infrequent, approximately 25% of patients may have complaints or objective findings limited to the oral cavity. Masticatory claudication, tongue pain, and frank lingual infarction are the most common and should be recognized as indicators of a serious underlying arteritis. These symptoms are often confusing to internists, neurologists, and otolaryngologists, resulting in delays in diagnosis and initiation of proper therapy.
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PMID:Lingual infarction in cranial arteritis. 737 21

A retrospective study was made of 96 patients diagnosed as cranial arteritis of whom 32 were accepted using strict clinical criteria or a positive temporal artery biopsy. Unusual presentations of fever, psychiatric illness, headache-free patients and a 'normal' ESR are described. The recognition of these variations is important in the early diagnosis of temporal arteritis.
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PMID:Unusual variants in the presentation of temporal arteritis. 739 2

Cranial arteritis has the common presenting manifestations of headache and visual loss and is generally limited to elderly individuals. Nearly 50% of patients with the musculoskeletal disorder of polymyalgia rheumatica have an associated cranial arteritis, but the exact pathophysiologic relationship remains unclear. Although the literature suggests that otolaryngologic manifestations of cranial arteritis are infrequent, this report supports a contradictory viewpoint. Approximately 25% of patients with masticatory claudication, tongue pain, or frank lingual infarction. These oral manifestations should be recognized as indicators of a serious underlying arteritis.
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PMID:Cranial arteritis in otolaryngology. 741 66


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