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

Reversible posterior leukoencephalopathy syndrome is a clinical-radiological phenomenon associated with headache, vomiting, lethargy, visual disturbances and seizures, concomitant with radiological abnormalities predominantly within posterior cerebral white matter due to cerebral edema. There are multiple triggers as acute hypertension, cancer, hematological disease, renal pathology, red cells transfusions and different drugs. We present two patients with reversible posterior leukoencephalopathy under treatment for acute lymphoblastic leukemia because of the probable association with vinca alkaloids.
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PMID:[Reversible posterior leukoencephalopathy: report of two cases after vincristine treatment]. 1835 42

Revisible posterior leukoencephalopathy syndrome (RPLS) is a syndrome defined predominantly by a characteristic pattern of MR images but heterogeneity and reversibility of the abnormalities is unclear. Three patients with characteristic neuroimaging of RPLS are described. Case 1. A 29-year-old woman underwent cesarean section 3 days before developing headache, visual disturbance, mild conscious deterioration and increased blood pressure. MRI on admission showed predominantly white matter edema bilaterally affecting the occipital, temporal and posterior parietal lobes. Lesions were iso-, hypointense on T1 weighted and hyperintense on T2 weighted and fluid-attenuated inversion recovery (FLAIR) images. Diffusion-weighted image (DWI) did not demonstrate hyperintensity in the same regions. She responded well to initial treatment and showed complete recovery. Case 2. A 67-year-old man had headache and visual disturbance after thromboendarterectomy of the left femoral artery. Initial DWI demonstrated hyperintensity in the occipital lobe. The patient had visual abnormality at discharge. Case 3. A 40-year-old woman with early gastric cancer had headache immediately after the injection of contrast material during abdominal computed tomography (CT) examination followed by generalized convulsion. On the third day, she had severe headache and vomiting. Her consciousness deteriorated to lethargy. CT showed marked brain edema, intracerebral hemorrhage, thin subdural hematoma and midline shift. External decompression and hematoma evacuation was performed. She had left hemianopia and left hemiplegia 1 month later. This report has important implications concerning the accurate early diagnosis of RPLS using MRI including DWI and its utility in prompting initial treatment. It should be noted that some cases demonstrating the characteristic neuroimaging pattern of RPLS do not attain full recovery and that surgical intervention is required in some cases.
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PMID:[Three cases demonstrating the characteristic neuroimaging of reversible posterior leukoencephalopathy syndrome]. 1851 60

Eclampsia is a complication of preeclampsia and is characterized by the appearance of grand mal seizures and/or coma, in the absence of any other neurological abnormalities. Neither focal neurological deficit nor prolonged coma tends to develop following a crisis. Eclampsia should therefore lead us to consider other clinical entities that may require special treatment. We report the case of a pregnant woman who presented total bilateral loss of vision following a grand mal seizure. The patient was subsequently diagnosed with reversible posterior leukoencephalopathy syndrome, which has clinical and radiologic manifestations linked to several causes, such as hypertensive encephalopathy, eclampsia, kidney failure, and immunosuppressant therapy. The syndrome involves headache, altered states of consciousness, changes in vision (including blindness), and seizures; these symptoms generally coincide with a rapid increase in blood pressure. Diagnosis requires neuroimaging, and the typical finding is edema in the posterior zones of the brain hemispheres. The most widely accepted hypothesis concerning the pathophysiologic mechanism underlying this syndrome is failure of cerebral autoregulation with development of vasogenic edema. The prognosis is good and the alterations usually resolve completely with appropriate treatment, which is the same as for the management of eclampsia, with strict monitoring of blood pressure.
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PMID:[Eclampsia and total bilateral amaurosis in a woman subsequently diagnosed with reversible posterior leukoencephalopathy syndrome]. 1866 90

We report the clinical-radiological case of a 25 year-old female patient who developed reversible posterior leukoencephalopathy syndrome (RPLS) in the postpartum period, without evidence of preeclampsia-eclampsia or chronic arterial hypertension. RPLS is associated with diverse clinical entities including eclampsia. Ten days after giving birth, the patient presented with clinical symptoms of headache, elevated blood pressure and seizures. Reversible vasogenic oedema affecting the white matter in the posterior regions was the characteristic finding in magnetic resonance imaging (MRI) of the brain. Although the prognosis is favourable, treatment needs to be early and aggressive, with rapid control of the convulsions and arterial hypertension, with the aim of preventing ischemia and cerebral infarct from developing. There is a need to be highly alert and to consider the diagnosis of RPLS in women presenting with convulsions and other neurological symptoms in postpartum.
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PMID:[Posterior reversible leukoencephalopathy in a patient with postpartum eclampsia]. 1884 28

Different types of migraine have been reported in 20-40% of patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We describe a novel migrainous manifestation of CADASIL consisting in status migrainosus and persistent aura without infarction. The symptoms resolved after i.v. treatment with lorazepam and mannitol.
J Headache Pain 2009 Feb
PMID:CADASIL presenting as status migrainosus and persisting aura without infarction. 1895 86

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by a sudden, severe headache at onset, vascular narrowing involving the circle of Willis and its immediate branches, and angiographic evidence of vasoconstriction reversibility within minutes to weeks of onset. RCVS is underrecognized and often misdiagnosed; it can defy clinical detection because it can mimic common conditions such as migraine and ischemic stroke. A lack of shared nosology has hampered awareness and understanding of the syndrome. Clinicians must consider primary angiitis of the central nervous system because of its high rates of morbidity and mortality if left untreated. RCVS has a number of primary and secondary associations (cerebral hemorrhage, vasoactive substances, the peripartum period, bathing, and physical exertion) but also occurs in isolation. RCVS can present in conjunction with hypertensive encephalopathy, preeclampsia, and reversible posterior leukoencephalopathy. This review provides an up-to-date account of RCVS.
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PMID:Reversible cerebral vasoconstriction syndrome: a thunderclap headache-associated condition. 1926 33

Reversible Posterior Leukoencephalopathy Syndrome (RPLS) is a relatively recently characterised neurological syndrome, first described by Hinchey et al in 1996, with neuroimaging findings of reversible vasogenic subcortical oedema. The clinical presentation can vary, is often non-specific but can include headache, global encephalopathy, seizures and visual disturbances. In this article we present such a case in a 79 year old woman, followed by a discussion of the typical presentations, associations, pathomechanisms and neuroimaging findings.
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PMID:The right scan at the right time: reversible posterior leukoencephalopathy syndrome mimicking bilateral occipital lobe infarcts. 1927 96

This is a case report of a 32-year-old woman with chronic severe anemia who developed headaches and seizures 5 days after receiving a blood transfusion of eight units (1600 ml) of packed red blood cells. Magnetic resonance imaging indicated vasogenic edematous lesions bilaterally over the occipital lobes that were consistent with reversible posterior leukoencephalopathy syndrome (RPLS). Her blood pressure was normal, and no other contributing factors for RPLS were found. It is likely that the initiator was the large volume of transfused blood, which disrupted cerebral autoregulation and damaged the vasculoendothelial system. Similar cases of RPLS following transfusion have been reported, and all reports involved middle-aged females with chronic severe anemia who received large volumes of transfused blood within a short period of time. Although blood transfusion is a common procedure with rare neurological complications, great caution should be taken with chronic severely anemic patients because a rapid elevation in hemoglobin may precipitate RPLS.
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PMID:Reversible posterior leukoencephalopathy syndrome caused by blood transfusion: a case report. 1928 Aug 71

A 10-year-old African American girl with sickle-cell anemia developed headaches and seizures associated with hypertension during hospitalization for a pulmonary abscess. Hypertension developed after multiple transfusions, associated with abnormally high hematocrit and headache. Magnetic resonance imaging was consistent with posterior leukoencephalopathy. Neurologic signs, hypertension, and high hematocrit resolved after erythrocytapheresis. Magnetic resonance imaging, 1 month after the episode, produced normal results. Because reversible posterior leukoencephalopathy syndrome was only described in sickle-cell anemia during severe acute chest syndrome, this report documents that milder illness can be associated with reversible posterior leukoencephalopathy syndrome in sickle-cell anemia, and also highlights subtle signs that may herald serious neurologic events in high-risk patients. Examination of the pathophysiology of reversible posterior leukoencephalopathy syndrome in the context of sickle-cell anemia suggests that patients with sickle-cell anemia and subtle neurologic signs should be treated with high vigilance.
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PMID:Reversible posterior leukoencephalopathy syndrome in sickle-cell anemia. 1930 44

Primary central nervous system vasculitis (PCNSV) is a rare inflammatory disease causing significant morbidity and mortality. We present a detailed history and clinical course of a patient with PCNSV along with a literature review. A 50-year-old Chinese female presented with a 6-month history of mild to moderate headache and sudden onset of visual loss. Early computed tomography of the brain showed multifocal infarctions. Over 3 weeks after admission, her clinical presentations changed considerably and her condition deteriorated. She became confused then fell in to semicoma, and developed left-sided paralysis and quadriparesis. At about 7 months after her illness, a magnetic resonance imaging of the brain revealed a tumour-like mass lesion within the right parietal lobe resulting in compressed posterior horn of the right lateral ventricle. In the end, a brain biopsy identified extensive vessel inflammation, which established the diagnosis of PCNSV. Steroid and immunosuppressive therapy dramatically improved the patient's condition. Our report highlights the importance of considering PCNSV as a differential diagnosis in patients who are suspected with encephalitis, multiple sclerosis, cerebral haemorrhage, cerebral thrombus, leukoencephalopathy, or brain tumour, etc. while their clinical presentations are exceptionally so changeable. This case also gives emphasis to the value of a brain biopsy in consolidating the diagnosis, and the efficacy of steroid and immunosuppressive therapy in PCNSV.
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PMID:Primary central nervous system vasculitis mimicking brain tumour: case report and literature review. 1937 Mar 53


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