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

The meninges of the brain are innervated by afferent nerve fibres containing SP and CGRP, two typical peptides found in sensory neurons. These fibres project to the trigeminal nuclear complex and the cervical dorsal horn. Discharge of the afferents may provide a physiological basis for some types of headaches. Considerable speculation surrounds the possible causes of meningeal afferent activation. Blood-borne substances released during subarachnoid haemorrhage are one possibility and there is a possibility that these also play a role in migraine. In the case of migraine, blood components, e.g. from platelets, cannot be excluded. To investigate the possible effects of platelets and plasma factors, the subarachnoid space of the rat was continuously perfused with artificial cerebrospinal fluid during extracellular recordings from single units of the caudal trigeminal nucleus. Washed and concentrated suspensions of adenosindiphosphate (ADP)--activated platelets and plasma, from which platelets had been removed--were introduced as a bolus into the continuous flow. Neurons in the caudal nucleus of the trigeminal complex receiving input from the meninges were stimulated. They did not respond to the activated platelet suspensions but showed intense responses to plasma. Plasma completely lost its ability to excite trigeminal neurons after heat inactivation (30 min, 56 degrees C). It is concluded that the complement system may be involved in the excitatory nociceptive effect of platelet-poor plasma.
 ...
PMID:Nociceptive neurons in the rat caudal trigeminal nucleus respond to blood plasma perfusion of the subarachnoid space: the involvement of complement. 1043 15

A 19-year-old male presented with a 4-week history of headache. Neurological examination showed bilateral papilledema. Computed tomography revealed a pineal region mass with remarkable obstructive hydrocephalus. Magnetic resonance imaging showed a pineal region tumor continuously invading through the tectum into the cerebral aqueduct and the fourth ventricle with the preservation of the adjacent structures. The tumor appeared an iso- to hypointense mass on T1-weighted images, a heterogeneous iso- to hyperintense mass on T2-weighted images, and a heterogeneously enhanced mass after administration of contrast medium. Histological examination after endoscopic biopsy confirmed that the tumor was a pineoblastoma. Radiotherapy was given to the whole brain and the spinal cord, and magnetic resonance imaging showed complete remission of the tumor. Pineoblastomas are highly malignant tumors with seeding potential through the neighboring ventricle or along the meninges, and this type of tumor becomes larger with local extension. We found no previous reports of the continuous extension into the fourth ventricle. The present case showed ventricular extension with minimal mass effect to adjacent structures, and did not disturb ventricular configuration. According to the unusual finding of ventricular extension, this rare case of pineoblastoma requires adjuvant chemotherapy.
 ...
PMID:Pineoblastoma showing unusual ventricular extension in a young adult--case report. 1048 41

Headache is often accompanied by referred pain in the face. This phenomenon is probably due to a convergence of afferent inputs from the meninges and the face onto central trigeminal neurons within the medullary dorsal horn (MDH). The possible existence and extent of this convergence was examined in rat and man. MDH neurons activated by stimulation of the parietal meninges were tested for convergent tactile and noxious mechanical input from all three facial branches of the trigeminal nerve. All 21 units with meningeal input could also be activated by facial stimuli. Brush stimuli applied to the supraorbital nerve area activated 86%, to the infraorbital nerve area 29%, and to the mental nerve area none of the units. Pinch stimuli applied to the supraorbital nerve area activated 95%, to the infraorbital nerve area 86%, and to the mental nerve area 52% of the units. The results suggest convergence of meningeal and facial inputs concentrated on the supraorbital nerve in rat. In man convergence was examined by probing neuronal excitability of MDH applying the blink reflex (BR) during Valsalva maneuver which probably increases intracranial pressure. The BR evoked by supraorbital nerve stimulation remained unchanged, while the BR evoked by mental nerve stimulation was significantly facilitated. This facilitation may be due to convergence of meningeal and facial inputs onto trigeminal neurons in man.
 ...
PMID:Convergence of meningeal and facial afferents onto trigeminal brainstem neurons: an electrophysiological study in rat and man. 1048 73

Current theories propose that the primary dysfunction in migraine occurs within the CNS and that this evokes changes in blood vessels within pain-producing intracranial meningeal structures that give rise to headache pain. Migraine is now thought of as a neurovascular disorder. It has been proposed that genetic abnormalities may be responsible for altering the response threshold to migraine specific trigger factors in the brain of a migraineur compared to a normal individual. The exact nature of the central dysfunction that is produced in migraineurs is still not clear and may involve spreading depression-like phenomena and activation of brain stem monoaminergic nuclei that are part of the central autonomic, vascular and pain control centers. It is generally thought that local vasodilatation of intracranial extracerebral blood vessels and a consequent stimulation of surrounding trigeminal sensory nervous pain pathways is a key mechanism underlying the generation of headache pain associated with migraine. This activation of the 'trigeminovascular system' is thought to cause the release of vasoactive sensory neuropeptides, especially CGRP, that increase the pain response. The activated trigeminal nerves convey nociceptive information to central neurons in the brain stem trigeminal sensory nuclei that in turn relay the pain signals to higher centers where headache pain is perceived. It has been hypothesized that these central neurons may become sensitized as a migraine attack progresses. The 'triptan' anti-migraine agents (e.g. sumatriptan, rizatriptan, zolmitriptan naratriptan) are serotonergic agonists that have been shown to act selectively by causing vasoconstriction through 5-HT1B receptors that are expressed in human intracranial arteries and by inhibiting nociceptive transmission through an action at 5-HT1D receptors on peripheral trigeminal sensory nerve terminals in the meninges and central terminals in brain stem sensory nuclei. These three complementary sites of action underlie the clinical effectiveness of the 5-HT1B/1D agonists against migraine headache pain and its associated symptoms.
 ...
PMID:Pathophysiology of migraine--new insights. 1056 28

We reported a case of spontaneous intracranial hypotension (SIH) who exhibited a remarkable leakage and collection of CSF in the spinal vertebral column. A 28-year old woman suddenly developed a severe occipital headache and vomiting. She had no headache while lying, but the headache was severe while sitting and standing. She had no recent history of trauma, but she fell down and hit her neck while skiing 6 months before the onset of headache. Neurological examination, urine and blood tests failed to reveal abnormal findings. Lumbar puncture showed a very low CSF pressure of 10 mmHg. Brain MRI demonstrated diffuse thickening and contrast enhancement of the meninges and spinal MRI displayed a CSF collection in the epidural spaces. RI cisternography showed a CSF leakage and an early accumulation of isotope in the kidneys and urinary bladder. Myelography revealed a CSF leakage at the C2 level from the spinal sac out to the extravertebral tissue and a CSF collection in the epidural spaces in the cervical to lumbar spinal canal. The root sleeves were also visualized by the CSF leakage. Thus, we demonstrated in this patient with SIH the location of CSF leakage at C2 dural sac and an extensive collection of leaked CSF in the epidural spaces, which apparently played a role in the occurrence of SIH.
 ...
PMID:[A case of spontaneous intracranial hypotension with a remarkable leakage and collection of CSF]. 1061 60

There is little known about high altitude headache, except that it is an important and serious problem that often heralds the onset of acute mountain sickness. We do know that the brain itself is an insensate organ except for its meninges which contain sensory axons projecting from the trigeminal nerve. These nerve fibers travel in proximity to meningeal blood vessels and constitute an important component of the trigeminovascular system. Signals generated at high altitude which may activate the trigeminovascular system can arise from brain, blood or the blood vessel wall, include protons, neurotransmitters and other potential noxious agents which can discharge or sensitize small unmyelinated fibers. Brain edema and raised intracranial pressure may cause headache by compressing brain structures leading to displacement and stretching of the pain-sensitive intracranial structures. Small hemorrhage may irritate and discharge these fibers chemically. Furthermore, high altitude seems capable of decreasing the threshold of response to sensory stimulation. Therefore, headache can be attributed to activation of a common pathway, the trigeminovascular system by both chemical or mechanical stimulation.
 ...
PMID:High altitude headache. Lessons from headaches at sea level. 1063 99

It is presented the clinical case of a man 60 years old, heterosexual, suffering from chronic bronchopathy from old date, inveterate smoker, with previous diskotomy, herniotomy, who presents a symptomatology characterized from recurrent fever, productive cough, dyspnea, asthenia and headache for 6 month. He was admitted to hospital for fever and for a sensory slightly obnubilated. A series of investigations for typhus fever, cytomegalovirus, all with negative results were performed. He resulted negative also to the test to PPD as well as to markers of B and C hepatitis and the test for HIV. The study of the principal cancer markers also gave negative results, while the blood smears displayed leukopenia with monocytosis. The magnetic nuclear resonance of the brain showed the presence of multiple lesions of the brain and along the meninges: the examination of the liquor underlines the presence of the Cryptococcus neoformans, making to set the diagnostic of cryptococcal meningitis. The immunological study showed low values of CD4 in presence of normal values of CD8 and of a normal natural killer function. The exitus happened at 64th day. The interest of the case consists in the fact that in the medical Italian literature, unlike the international one, are not described cases of cryptococcal meningitis in patients not infected by HIV.
 ...
PMID:[A rare case of cryptococcal meningitis unrelated to AIDS]. 1070 79

Intracranial fibrous tumors are unusual growths that occur almost exclusively in young individuals. Most of these lesions are intra-axial, however, on extremely rare occasions they arise from the leptomeninges and compress the adjacent brain. The authors report the case of a benign solitary fibrous tumor of the meninges in a 14-year-old girl who presented with a 5-month history of generalized headaches. NMR imaging displayed a left parietal mass, which mimicked a meningioma.
 ...
PMID:Solitary fibrous tumor of the meninges. 1077 53

Nasopharyngeal carcinoma (NPC) is a highly prevalent malignancy in southeast China, Hong Kong, and Taiwan. Spread of this tumor is known to occur via three main routes, i.e., local invasion of adjacent structures, regional metastasis to neck nodes, and hematogenous metastasis to distant organs. In this report, we describe a rare case of NPC disseminated via the leptomeninges, so called meningeal carcinomatosis (MC). The patient was a 62 year-old man who presented with multiple cranial nerve palsies and a headache, and was diagnosed with NPC in August 1988. The primary tumor regressed completely after induction chemotherapy and radiation therapy. Computerized tomography (CT) 17 months after radiation therapy showed multiple enhanced nodules scattered along the temporal meninges. The nodules increased in number and size in the subsequent CT scan 4 months later. The patient declined further invasive procedures and oncologic treatments, and he expired at home 9 months after the development of MC. It is speculated that perineural invasion and access to the subarachnoid space was the major cause of MC in this case. The case, although rare, possibly highlights a rare route of tumor dissemination in NPC.
 ...
PMID:Nasopharyngeal carcinoma with leptomeningeal dissemination: case report. 1083 8

A literature review from 1966 using Medline with keywords 'cerebral haemorrhage' and 'facial pain' failed to reveal any cases in which facial pain was the initial feature of intracranial haemorrhage. The following case describes ipsilateral facial pain which is previously undescribed as a presentation of intracranial bleeding. A 53 year old female who was previously well, with no significant history of headache, developed right facial pain from the orbit to the maxilla. Ten to 15 min later she developed nausea and vomiting with unsteadiness and confusion. She had difficulty with left-hand fine finger movements, with normal sensation and reflexes but an extensor plantar response on the left. Facial pain persisted for 3 days. Initial imaging revealed a 4 x 3 cm right temporal lobe haemorrhage with mass effect and oedema extending into the subarachnoid space. Angiogram revealed a right temporal lobe arteriovenous malformation. The basis of the pain remains speculative but includes sensation from the torn vessel wall being referred to the face and subarachnoid blood irritation of the meninges in the middle cranial fossa. Another possibility is irritation of somatosensory cortex II, but why this should result in only ipsilateral pain is unclear. Facial pain should be an alerting symptom to the neurologist when it appears with no apparent cause.
 ...
PMID:Facial pain as a presenting feature of intracerebral haemorrhage. 1093 19


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>