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

There is a frequent coincidence of headache and sinusitis. In acute sinusitis, the localization of the headache can yield good diagnostic clues, while chronic inflammations do not offer reliable diagnostic indications. Further characteristics of rhinogenous headache are: typical periodicity during the day, occasional disturbances of sensitivity in a specific cutaneous area and certain typical pressure points in the facial region.
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PMID:[Headaches and sinusitis: (author's transl)]. 40 41

Sinusitis can occur as an acute, subacute, recurrent acute, or chronic clinical disease process in children. Sinusitis most often manifests as a prolongation or complication of a viral upper respiratory tract infection. Because children average six to eight upper respiratory tract infections per year, sinusitis is probably a more frequent diagnosis in the pediatric age group compared with adults who average two to three upper respiratory infections per year. Upward of 5 to 13% of children may experience sinusitis, but precise incidence data are not available because many imaging techniques currently available are inappropriate procedures for a prospective pediatric survey. Symptoms of acute sinusitis in children can vary from the more common persistent, purulent rhinorrhea and cough to the less common symptoms of fever, headache, facial pain, and swelling. Recurrent acute and chronic sinusitis may be associated with another condition such as a host-defense defect, cystic fibrosis, asthma, or a local condition that predisposes to obstruction of the sinus ostia such as nasal polyps, deviated septum, foreign body, or allergic inflammation. Diagnosis of sinusitis can be made on the basis of a careful history and physical examination with radiography reserved for confirmation of clinical impression or documentation of disease. Although fiberoptic rhinoscopy is used more frequently as an adjunct in adults for the evaluation and management of sinusitis, more studies need to be performed to document its clinical usefulness in children.
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PMID:Diagnosis of sinusitis in children: emphasis on the history and physical examination. 152 32

An accurate history is essential to the diagnosis of chronic sinusitis. Patients classically present with several weeks of daily facial pain or pressure between the eyes, headache, nasal congestion, postnasal drip, ear pain or blockage, and fatigue. The headache in chronic sinusitis is usually worse in the morning and following head movement. Purulent nasal discharge, spiking fever, an elevated white blood cell count, and intense, brief headache associated with nausea and vomiting are uncommon. Palpation, transillumination of the sinuses and anterior rhinoscopy are of minimal value in making the diagnosis. Fiberoptic nasopharyngoscopy can be used to identify the source of sinus discharge and the cause of obstruction. Although plain sinus radiographs are useful in diagnosing and monitoring acute sinusitis, they are of limited value in confirming chronic sinusitis. The sinuses are better imaged with computed tomographic scanning. Prolonged antibiotic therapy, in combination with decongestants and steroids, is usually effective for chronic sinusitis. In recalcitrant cases, sinus surgery may be necessary.
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PMID:Chronic sinusitis: an update. 157 14

The concentrations of azithromycin in sinus fluid and mucosal tissue were determined in a total of 23 patients with acute or chronic sinusitis. Five patients with acute sinusitis and four with chronic sinusitis were administered a five-day course of oral azithromycin (500 mg on day 1, 250 mg on days 2-5, all as single doses), and the remaining 14 patients, all with chronic sinusitis, received single oral doses of azithromycin (500 mg). With the five-day regimen, the mean levels of azithromycin in sinus fluid were markedly higher in patients with acute sinusitis (1.34 micrograms/ml) than in patients with chronic sinusitis (0.25 micrograms/ml) 24 h after the first dose. The levels of azithromycin in the sinus fluid increased from the first to the last dose in both patient groups; the mean levels of azithromycin 24 h after the last dose were 2.33 micrograms/ml in acute sinusitis patients and 0.38 micrograms/ml in chronic sinusitis patients. In chronic sufferers, the mean levels of azithromycin in the sinus fluid following a single oral dose were 0.25, 0.41, 0.57 and 0.22 micrograms/ml at 24, 48, 72 and 96 h, respectively, after administration. In these patients the mean sinus drug concentrations were much greater in the mucosal tissue (1.23 micrograms/g) than in the sinus fluid (0.41 micrograms/ml) 48 h after administration of the single dose. There were no treatment-related changes in laboratory function tests, and side effects were described as mild to moderate (five patients complained of nausea, abdominal pain or headache).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Azithromycin concentrations in sinus fluid and mucosa after oral administration. 166 32

Acute sinusitis in adults is manifested by fever, facial pain and purulent rhinorrhea, but children--who rarely have headache or facial tenderness--have persistent cough in addition to fever and purulent rhinorrhea. Sinus transillumination is diagnostically useful only in adults. In children, maxillary sinus radiographs are indicated. New studies show ultrasound examination to be less sensitive than plain radiographs. Cultures obtained by aspiration of the maxillary sinuses are useful in complicated cases. Amoxicillin is still effective as first-line treatment, but treatment failure requires a prompt change to trimethoprim-sulfamethoxazole or ciprofloxacin. Nosocomial sinusitis requires coverage for gram-negative bacteria, including Pseudomonas aeruginosa. Immunocompromised patients, including those with acquired immunodeficiency syndrome, require treatment for fungal organisms. Decongestants are of unproven value. Referral for irrigation and surgical drainage is indicated for recurrent or recalcitrant sinusitis. Flexible endoscopy allows visualization and debridement of diseased tissue in cases of chronic sinusitis.
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PMID:Acute sinusitis: diagnosis and treatment update. 146 11

The SSCT findings of the SNP pattern are nearly diagnostic for this entity. SNP is characterized by the major findings of nasal polypoid masses and infundibular enlargement. Patients may also show individual sinus involvement with polypoid masses and/or opacification of the paranasal sinuses without visualization of polypoid masses. The presence of polypoid masses within the sinuses also can be inferred if the major findings are present, especially if there are the minor findings of nasal septal and sinus trabeculae attenuation and bulging of the lateral ethmoid sinus walls. Air/fluid levels are frequent in SNP but do not always indicate acute sinusitis. Patients typically present with nasal stuffiness and rhinorrhea. They often have facial pain and less often headaches. Common associations exist between SNP and atopy (either allergic or nonallergic), asthma, infection, cystic fibrosis, and aspirin intolerance. Therapy may be either medical or surgical, with steroids being the mainstay of the medical treatment. FESS provides a relatively atraumatic means of removing polyps and creating better sinus drainage. Regardless of the type of therapy, recurrences are common, requiring repeated bursts of systemic steroids, nasal steroid maintenance, and frequent additional surgical procedures. Identification of the SNP pattern on SSCT helps the otolaryngologist to institute an appropriate therapy aimed at alleviating symptoms. The SSCT is adequate for evaluation of SNP in the vast majority of cases and serves as a detailed road map for the treating endoscopic surgeon.
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PMID:Sinonasal polyposis. 178 79

We present the case of a patient with old frontal headache, who was admitted with frontal acute sinusitis symptoms at the emergency service. The radiology study shows a compatible image with frontal osteoma, which was extirpated as being asymptomatic, by frontal osteoplastic technique. The case is described and it is made a frontal osteoma review and the surgical technique used to do it.
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PMID:[Frontal osteoplasty technique. Report of a case of giant frontal osteoma]. 203 64

Magnetic resonance (MR) imaging and computed tomography (CT) are useful for the evaluation of central nervous system (CNS) lupus. This report describes the use of cranial MR and CT in 21 patients with systemic lupus erythematosus (SLE) with acute neuropsychiatric symptoms manifested by headache, seizures, focal neurological deficits, psychosis, or organic brain syndrome. Computed tomography was found to be insensitive and detected only diffuse atrophy (two cases), cerebral infarct (one case), and intracerebral haemorrhage (one case) in the 21 patients. Cranial MR images obtained with a General Electric 1.5 tesla Signa unit detected labile and fixed areas of increased proton intensity interpreted as focal oedema (eight cases), infarct (10 cases), haemorrhage (one), atrophy (seven), and acute sinusitis (two). Focal oedema was characterised by labile, high intensity lesions in the gray or white matter of the cerebellum, cerebrum, or brain stem, which completely resolved after aggressive corticosteroid treatment. Most high intensity reversible or fixed lesions evident on MR were not apparent on cranial CT images. In several patients sequential MR images were valuable in monitoring the efforts of treatment. Although histological confirmation of the high intensity brain lesions apparent on MR is desirable, prior necropsy studies suggest that pathological confirmation may be difficult owing to the paucity of recognisable brain lesions in patients with CNS lupus. It is concluded that for the evaluation of acute neuropsychiatric SLE MR is useful and provides more information than cranial CT.
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PMID:Magnetic resonance and computed tomographic imaging in the evaluation of acute neuropsychiatric disease in systemic lupus erythematosus. 261 53

In a controlled randomized double-blind trial carried out by 47 physicians in private practice with totally 152 patients with sinusitis the therapeutic success of the following homeopathic drug preparations was investigated: Group A: combination of luffa operculata D4, kalium bicromicum D4 and cinnabaris D3. Group B: combination of kalium bicromicum D4 and cinnabaris D3. Group C: luffa operculata D4. Group D: placebo. Criteria for the therapeutic result were headache, blocked nasal breathing, trigeminal tenderness, reddening and swelling of nasal mucosa and postnasal secretion. There was no remarkable difference in the therapeutic success among the investigated homeopathic drug combinations nor between the active drugs and placebo. Averaged over all four groups 81% of the patients with acute sinusitis and 67% of the patients with chronic sinusitis recovered. In the literature comparable therapeutic results are reported for antibiotic therapy, decongestant nose drops and for the drainage of nasal cavities.
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PMID:[Efficiency of homeopathic preparation combinations in sinusitis. Results of a randomized double blind study with general practitioners]. 266 26

The presence of a radiographic sinusal opacification without any other clinical sign or symptom cannot lead to the diagnosis of "Sinusitis", if considered alone. In a previous paper we observed a high prevalence of patients with both clinical and radiographic signs of sinusitis and a high prevalence of neutrophils in the nasal secretions, now we tried to discover which clinical signs and symptoms are more likely to indicate an acute sinusitis. We compared cough, headache, bacteriological culture of nasal secretions with a sinusal CT scan, without finding any relationship. On the contrary, neutrophils in the nasal secretions and Rx are strictly inter-related with CT scan, with a sensitivity of 77% and a specificity of 100%.
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PMID:[Diagnostic considerations on sinusitis in childhood]. 764 18


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