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

Pseudotumor was diagnosed in six patients aged three to 38 years during an eight year period. The diagnosis was based on headache, choked disks and normal cerebrospinal fluid and CT scans. Other symptoms were visual impairment, VIth nerve palsy and ataxia. Sagital sinus trombosis was excluded by angiography or magnetic resonance imaging. Pharmacological treatment with digitoxin, acetazolamide, furosemide or corticisteroids reversed clinical symptoms and signs in two patients. In the other four, shunt surgery with cerebrospinal fluid diversion to the right atrium or the peritoneal cavity rapidly reversed clinical symptoms and signs.
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PMID:[Pseudotumor cerebri]. 200 May 87

Pseudotumour was diagnosed in six patients aged 3-38 years during an 8 years period. The diagnosis was based on headache, papilloedema, normal CT scan and cerebrospinal fluid (CSF) composition. Additional clinical symptoms were nausea, VIth nerve palsy, ataxia, blurred vision and frank visual reduction over time. Sagittal sinus thrombosis was ruled out by angiography or magnetic resonance imaging. In five of the six patients lumbar steady state infusion tests were performed to evaluate intracranial hydrodynamics and CSF resorbtion. All patients demonstrated a markedly increased opening pressure (range 13 to 48 mm Hg). CSF outflow resistance ranged from upper normal to pathologically increased levels (8-19 mm Hg/ml/min). Combined epidural intracranial pressure/middle cerebral artery blood velocity monitoring in 3 patients revealed a great number of B waves and a labile cerebral vasomotor state. Pharmacological treatment was tried with digitoxin, acetazolamide, furosemide and/or corticosteroids. Two patients did well on long-term treatment with digitoxin and furosemide, respectively. In the other four patients the clinical development was unsatisfactory on medical treatment alone. They were subsequently operated with implantation of a lumboperitoneal, cisternoatrial or cisternoperitoneal shunt. Shunting rapidly reversed clinical signs and symptoms, except for a partial persistent visual loss in an 18 years old boy who had experienced symptoms for 3 years resistant to pharmacological treatment.
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PMID:Pseudotumour cerebri-neurosurgical considerations. 208 40

A 19 year-old woman complained of headache and nausea occurring while she was taking minocycline for acne. Examination showed bilateral papilloedema and a bilateral VIth nerve palsy. Symptoms and signs rapidly resolved after the drug was stopped. Benign intracranial hypertension due to tetracyclines is well known in infants. It is rare in adults. Its pathophysiology remains unknown. The role of vitamin A is inconsistent. Others biological factors or personal susceptibility could be involved.
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PMID:[Benign intracranial hypertension and minocycline]. 213 95

Increased cerebrospinal fluid pressure of usually unknown etiology is called pseudotumor cerebri. The key symptoms are headache, papilledema and fluctuating visual disturbances. Six cases are presented to illustrate the clinical variability of this syndrome. Headache or papilledema may be missing in individual cases. The clinical diagnosis can be facilitated by the recognition of accessory signs and symptoms, such as VIth nerve palsy, tinnitus and other cranial nerve disorders or neck stiffness. For the therapeutic outcome it is essential to detect and monitor visual disturbances early in the course of the disease.
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PMID:[Clinical variants of pseudotumor cerebri syndrome]. 763 26

Review of the clinical features of 48 patients with chordoma and 49 patients with low-grade chondrosarcoma of the skull base disclosed overlapping clinical profiles but distinctive features. Both tumors occurred at all ages but chondrosarcoma tended to occur in the third and fourth decades. Twenty-five (52%) of the patients with chordoma and 24 (49%) of the patients with chondrosarcoma had ocular symptoms (diplopia or visual impairment) as the initial manifestation of the disease. Of the 59 patients (both groups) with diplopia, the diplopia was initially intermittent in 25 (42%). Headache and diplopia from an insidious abducens nerve palsy was most common in both groups. Abducens nerve palsy occurred in 22 (46%) of the patients with chordoma and 23 (47%) of the patients with chondrosarcoma. Normal examination results were more common in patients with chordoma, whereas visual loss, facial numbness, and multiple cranial neuropathies were more common in patients with chondrosarcoma. The similarities in the clinical features of these tumors reflect their common origin at the central skull base and the vulnerability of the abducens nerves at that site. The differences reflect the tendency of chordomas to originate from the clivus and chondrosarcomas to originate from the temporal bone.
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PMID:Neuro-ophthalmologic findings in chordoma and chondrosarcoma of the skull base. 842 Mar 85

We report the case of a patient with a pontomedullary epidermoid cyst extending into the prepontine cistern. The patient presented with a progressive VIth nerve palsy, ataxia, and headache. Magnetic resonance imaging demonstrated a well-defined pontomedullary tumor with a high fat content. We excised the lesion using a microsurgical approach through the floor of the fourth ventricle. Postoperative magnetic resonance imaging confirmed the removal of both intra- and extra-axial components. We discuss the anatomic configuration, radiological appearances, and management of this unusual pathological finding.
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PMID:Microsurgical excision of a pontomedullary epidermoid cyst with prepontine extension: case report. 883 13

The syndrome of spontaneous intracranial hypotension (SIH) is an uncommon cause of postural headache. We describe three patients with classical low pressure headache associated with low CSF pressure, one of whom presented with sudden deafness and another with a unilateral VIth nerve palsy. Initial magnetic resonance imaging (MRI) scans revealed bilateral diffuse subdural fluid collections in all three cases. Follow up MRI scans performed on two patients at 6 months demonstrated partial resolution of the subdural collections but persistent striking meningeal enhancement despite clinical recovery. These findings differ from previous reported cases wherein clinical resolution of postural symptoms was preceded or closely followed by resolution of the MRI changes.
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PMID:Spontaneous intracranial hypotension: clinical and magnetic resonance imaging characteristics. 935 Apr 1

A 19-year-old woman presented with frontal headaches, papilledema, and binocular horizontal double vision due to a left VI nerve palsy. MRV demonstrated sagittal sinus and bilateral transverse sinus thrombosis. The clinical and neuro-radiologic signs resolved after anticoagulation.
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PMID:A sticky situation. 1243 96

Cerebral sinus vein thrombosis is rare in children. So far, only three other cases have been reported in a child with diabetes mellitus. This 10 year-old female presented with classic signs of diabetic ketoacidosis which resolved with standard fluid and insulin therapy. Headache persisted despite biochemical improvement and 6th nerve palsy became evident on Day 3. On Day 5, sudden deterioration in mental status to the point of coma with loss of airway protective reflexes prompted repeat imaging including magnetic resonance venography which demonstrated thrombosis of the superior sagittal, straight, right transverse, right sigmoid and proximal posterior aspect of the left transverse sinuses. Selective thrombolysis using rTPA was performed emergently. Complete lysis of the thrombosed veins was observed within 35 hours. Low molecular weight heparin was continued for 6 months. Significant clinical improvement was noted within 48 hours of the procedure. Six weeks later recovery was complete. Complete hematological work-up for hypercoagulable state revealed a heterozygous mutation of the prothrombin gene (G20210A). Children with this mutation are generally asymptomatic unless challenged by a second risk factor, in this case by severe dehydration and diabetic ketoacidosis. Our patient presented a unique diagnostic challenge at the time of her acute neurological deterioration. Rapid, aggressive intervention with super-selective thrombolysis resulted in complete resolution of severe and potentially life devastating neurological symptoms.
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PMID:Resolution of severe sinus vein thrombosis with super selective thrombolysis in a pre-adolescent with diabetic ketoacidosis and a prothrombin gene mutation. 1766 98

Primary CNS lymphoma (PCNSL), a rare form of non-Hodgkin lymphoma that is confined to the brain, is usually of B-cell origin. Primary leptomeningeal lymphoma, regardless of T or B-cell origin, is an unusual site of presentation. Out of 100 consecutive PCNSL patients that we have followed up in our center during the last 10 years, five had T-cell lymphoma (5%). All presented with leptomeningeal involvement as the sole manifestation and four of them presented with neuronal lymphomatosis. Presenting symptoms included signs of elevated intracranial pressure with 6th nerve palsy; headache and bilateral 3rd nerve palsy; mononeuritis multiplex and unilateral hearing loss; bilateral 7th nerve paralysis and bilateral uveitis. Because neither the CSF nor the MRI were indicative, meningeal or nerve biopsies were required for conclusive diagnosis. Four patients died 10-19 months from disease onset and one patient is alive 36 months following the diagnosis. We conclude that T-cell PCNSL can present as an isolated leptomeningeal involvement which may be associated with neurolymphomatosis affecting cranial and peripheral nerves. These manifestations mimic other neurological conditions such as pseudotumor cerebri or vasculitis. Diagnosis is difficult and, as a result, frequently delayed. This calls for early consideration of meningeal or nerve biopsy whenever CSF findings are inconclusive.
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PMID:Primary T-cell CNS lymphoma presenting with leptomeningeal spread and neurolymphomatosis. 1859 37


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