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

Nervous system involvement in systemic lupus erythematosus is frequent. Psychiatric manifestations, seizures, headaches are most often observed. Movement disorders, hemiparesis, aseptic meningitis occur more rarely. Myelitis is exceptional as is peripheral nerve involvement. CT Scan shows cerebral atrophy and sometimes hemorrhages or ischemic lesions. Pathological examination usually demonstrates cortical microinfarcts, hemorrhage and meningitis, but lesions are not always found. In these case the cause of the neuropsychiatric disorder is unknown: a transitory vascular or immune mechanism has been proposed. Corticotherapy is effective in the majority of cases, but can be occasionally responsible for an exacerbation of neuropsychiatric symptoms.
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PMID:[Neuropsychiatric disorders in systemic lupus erythematosus: a general review (author's transl)]. 702 67

Five cases of subdural hematoma from arterial rupture (SDH-AR) are described and other 39 reported cases are reviewed. The average age of the patient is 59 and male to female ratio is 2:1. Fifty two percent of the patients have history of recent head injuries most of which are trivial. A very few patient have initial loss of consciousness. Approximately half of the patients with history of head trauma have long lucid interval (average of 7 days). Those patients without history of head trauma have spontaneous onset of the symptoms and some of the have acute onset of headache and loss of consciousness, simulating cerebrovascular accident. Natural history of the SDH-AR is progressing deterioration of the symptoms, resulting in coma and death. Skull fracture is seldom demonstrated in the patients with SDH-AR. Angiography shows and extracerebral avascular mass over the cerebral convexity with marked midline shift. In 3 cases including our 2 cases, extravasation of the contrast medium from the cortical artery is observed and this is a useful finding for making diagnosis of this disease. Computerized tomography reveals high density extracerebral mass with remarkable mass effect. Craniotomy discloses subdural clot and spurting arterial rupture from a branch of the cortical artery around the Sylvian fissure. In some cases, subarachnoid hemorrhage is observed but in none of the cases, cerebral contusion or laceration is present. It is presumed that the mechanism of the arterial rupture is gliding movement of the brain within the skull upon injury, tearing an arterial twig with dural attachment. Hypertension, arteriosclerosis and brain atrophy may be important contributing factors to this mechanism. Pseudoaneurysm of the cortical artery caused by closed head injury is also associated with this mechanism and may explain delayed sudden onset of the symptoms in some patients with SDH-AR.
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PMID:[Subdural hematoma from arterial rupture -mechanism of arterial rupture in minor head injury]. 713 4

The prognosis of chronic toxic encephalopathy in former house painters was examined in a prospective study with a two-year observation period. Twenty-six patients, who at the initial examination had cerebral atrophy and/or intellectual impairment, were selected for the follow-up study. No competitive etiological factors (including alcohol) to the encephalopathy were suspected. During the two-year follow-up interval these patients were not professionally exposed to organic solvents. At the follow-up examination neurological, biochemical, neuropsychological, and neuroradiological parameters were reassessed and compared to the original findings. Generally the condition was unchanged. Slight improvements with regard to headache and dizziness were reported by some. However, the neurological status, the neuropsychological impairment, and the cerebral atrophy, did not change significantly. In three patients further deterioration was observed. It is argued that our patients suffered from a brain disorder different from presenile dementia of the Pick-Alzheimer type. Other alternative etiological entities were also excluded. Our findings indicate that long-term exposure to organic solvents may lead to a chronic brain syndrome. Once intellectual impairment and/or cerebral atrophy had developed, reversibility is not observed. Nor is further progression to be expected if exposure is stopped. Occupational exposure to organic solvents should be maximally restricted as it represents a risk of inducing invalidating brain syndromes.
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PMID:Prognosis in chronic toxic encephalopathy. A two-year follow-up study in 26 house painters with occupational encephalopathy. 731 95

A total of 273 participants (186 with clinical dementia; 87 "normal" controls; mean age 72 years) in a prospective, longitudinal, dementia research study, underwent lumbar puncture (LP), where possible, on an annual basis. Reporting of symptoms after all LP's (n = 541) was 21.6%, the predominant complaints being mild localised back-pain (12.8%) and headache (10.7%). All symptoms were self-limiting. Analysis of headaches after all first LP's (n = 273) revealed an incidence of 14.2% with marked differences between subjects under 60 years of age (33%) and those over 60 years (10.1%), between subjects with "minimal" cerebral atrophy (19.5%) and those with "significant" atrophy (5.6%) and, to a lesser extent, between subjects with no or mild cognitive impairment (20.6%) and those with significant impairment (9.5%). Age under 60 years and lack of significant cerebral atrophy were shown to be independent predictors of headache. Acceptability of LP was high as demonstrated by agreement to a second procedure by 92.2% of eligible subjects. Our results show that LP can be successfully incorporated into research with the elderly.
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PMID:High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status. 763 73

Sixteen patients (8 female, 8 male) with primary angiitis of the CNS (PACNS), were followed prospectively in a vasculitis clinic. Diagnosis was by angiography in patients without underlying disease. Median age at diagnosis was 36.5 years, and median duration of follow-up was 28 months. Onset was acute in 14 patients (88%), with 3.5 weeks (median) from onset symptoms to diagnosis. Three women developed symptoms within 3 weeks postpartum. The most frequent symptoms were severe headaches (12, 75%), stroke (6, 30%), transient ischaemic attack (TIA) (4, 28%), seizures (7, 44%), visual aberration (3, 19%), and cognitive impairment (5, 31%). Laboratory data included high ESR (2, 13%), leucocytosis (8, 80%), thrombocytosis (1, 6%), positive antinuclear antibody titre (3, 15%), and high levels of complement (5, 31%). Lumbar puncture was performed in 12 patients (75%). CSF analysis was abnormal in five patients (42%). EEG was abnormal in 5/9 patients. The major CT/MRI scan findings were cerebral haemorrhage (4, 25%), brain infarcts (5, 31%), brain atrophy (2, 13%) and non-specific lesions (2, 13%). Four patients had normal studies. All patients received corticosteroids (CS), and five were treated with oral cyclophosphamide. Two patients relapsed despite CS and cyclophosphamide therapy. All patients are alive, and at the last assessment, eight had a permanent neurological deficit, which included paresis (3, 19%), neurocognitive abnormalities (2, 13%), visual loss (2, 13%) and seizure activity (5, 31%). Our data suggest a non-progressive, non-fatal course in those PACNS patients diagnosed angiographically and treated with CS with or without cyclophosphamide.
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PMID:Primary angiitis of the CNS diagnosed by angiography. 804 67

During an 8-year period, fifteen patients with subacute or chronic epidural haematoma were seen among 110 treated cases of extradural haematoma corresponding to a frequency of 13.6%. Increasing headache, nausea, vomiting, mild drowsiness and cranial nerve palsy were the symptoms resulting in the correct diagnosis in most cases. Clinical and pathological findings are described, and the factors influencing the course of events are discussed. The most important factors are cerebral atrophy, age, source of bleeding and location. By means of early CT (computed tomography) diagnosis of haematoma, fatal outcome could be prevented in most of the cases.
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PMID:[Subacute and chronic epidural hematoma after craniocerebral trauma]. 814 52

Sixteen patients with chronic periorbital venous vasculitis without nerve involvement and 9 patients with active episodic cluster headache were studied as to cerebrospinal fluid (CSF) pressure. Eighty-one percent of the patients with chronic and 33% with episodic symptoms had pathologically increased CSF pressure. Magnetic resonance imaging of the brains in the chronic group showed empty sella in 60%, cerebral atrophy in 21% and white matter lesions with high signal intensity on T2 weighted sequences in 29%. Abnormal obesity was found in 31% of the patients with chronic periorbital venous vasculitis under 60 years of age. Venous vasculitis is suggested as a cause of intracranial hypertension, empty sella, and endocrinologic dysfunctions.
Headache 1994 Feb
PMID:Periorbital venous vasculitis, intracranial hypertension and empty sella. 816 74

A 47-year-old woman was thirdly admitted to our hospital for therapy to multi-drug resistant tuberculosis of the lung in June 88. Although she was treated with TH, PAS and EVM, M. tuberculosis were positive constantly in her sputum. She complained of sleep disturbance, irritability, headache on September 89, she was diagnosed reactive depression. But her symptoms were progressive, low level of intelligence test in November, apatic in December and became spastic paralysis and vegetable state at next year. She was died of pneumonia in November 90. Her autopsy findings showed no brain atrophy nor meningitis. Microscopically, central chromatolysis were showed in Betz cells and anterior horn cells, these findings sometimes suspected for Peragulla, but we could not obtained definite pathological diagnosis, because we could not have been obtained findings indicating for Peragulla. Finally, we reported the clinical course and autopsy findings of dementia occurred during therapy for multi-drug resistant pulmonary tuberculosis.
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PMID:[A dementia occurred during therapy for multi-drug resistant pulmonary tuberculosis]. 823 Sep 59

The frequency of post-lumbar puncture headache (PLPH) was registered prospectively in 395 consecutive demented patients at a dementia diagnostic unit. The incidence of PLPH was low, occurring in only 8 patients (2.0%), the severity was mild, and the duration was less than 2 days in all cases but one. The reasons for this low frequency of PLPH in patients with dementia disorders may include disease- and/or age-related low pain sensitivity, rigid dural fibres and arteriosclerotic vessels, and large CSF space due to cerebral atrophy. Analysis of CSF is essential to identify secondary causes of dementia, preferentially chronic infections. The low frequency and severity of PLPH found in the present study shows that, with low risk of complications, lumbar puncture can be included in the routine clinical examination of demented patients.
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PMID:Low frequency of post-lumbar puncture headache in demented patients. 825 60

A retrospective study was performed at two teaching hospitals--one in the United States and one in Canada--to determine the results of computed tomography (CT) examinations of the head in patients with nontraumatic headache. Of 1111 examinations performed over a 3-year period, 120 (10.8%) demonstrated an acute intracranial abnormality, such as hemorrhage, infarction or tumour; the frequency of such abnormalities was highest among inpatients and subjects over 40 years of age. Cranial and extracranial abnormalities, such as sinusitis and metastases to the calvarium, were found in 40 (3.6%) of the cases. Chronic abnormalities, such as cerebral atrophy or remote infarction, were the most significant findings in 202 (18.2%) of the cases. The cost of finding each case of acute intracranial abnormality was $5962 (US); for subarachnoid hemorrhage among patients in the emergency department, it was $15,837 (US).
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PMID:Computed tomography for nontraumatic headache: current utilization and cost-effectiveness. 850 31


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