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

A case of aspergillotic abscess with granuloma is reported. A 45-year-old man was admitted to our hospital on Apr. 10, 1984 due to the rupture of an aneurysm of the anterior communicating artery. Neck clipping of the aneurysm was proposed on Apr. 12, 1984, but was not performed because of cardiac arrest with unknown etiology during the operation. Neck clipping was performed on Apr. 23, 1984. Antibiotic therapy was prolonged for about three weeks. About 6 months after surgery, he was readmitted on Oct. 12, 1984 with the chief complaint of general fatigue and headache. On readmission, laboratory examinations were normal except for leukocytosis, elevated ESR and positive CRP. Neurological examination revealed left papilledema, disorientation and memory disturbance. On lumbar puncture, the cerebrospinal fluid showed 2 lymphocytes, 71 mg percent protein, 94 mg percent glucose. The skull and chest X-ray findings were normal. The CT scan revealed an irregular low density area in the left frontal lobe with abnormal enhancement. Steroids and antibiotic therapy were initiated. Since mass signs on CT scan increased gradually, partial removal of abscess and granuloma was performed on Nov. 5, 1984. From the necrotic granuloma, Aspergillus was microscopically recognized and Aspergillus fumigatus was cultured on Sabouraud's medium. Immunologically, serum immunoglobulin levels and the subset of lymphocytes were normal. Tuberculin reaction was negative. After the operation, amphotericin-B and 5-fluorocytosine (5-FC) were administered. Nevertheless mass signs on CT scan increased again. The fourth operation was performed on Dec. 6, 1984.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of cerebral aspergilloma following radical operation of a cerebral aneurysm]. 352 Mar 67

Temporal arteritis is generally a benign and self-limiting disease, which has been recognized for approximately 50 years. Although it has been uncommon, it is becoming increasingly prevalent among elderly individuals. Its major complication involves loss of vision, and approximately 50 per cent of all untreated patients become blind in one or both eyes. This can be prevented by early recognition and prompt treatment of the disease process. Steroids given to suppress the inflammatory involvement of the arterial wall safeguard the blood supply to the eye. If vision is lost, however, the loss is usually permanent. Although its diagnosis can be confusing initially, temporal arteritis should be easily diagnosed by its local and systemic manifestations, including headache of recent onset in an elderly patient, visual disturbance, an increased sedimentation rate, and a classic palpable tenderness along the course of the temporal artery. Immediate hospitalization is recommended when the diagnosis is made and steroid therapy is begun, along with measures for symptomatic relief of headaches. With the increasingly aging population in the United States, one predicts that this disease entity of obscure etiology will become prevalent. Thus all physicians should have a basic knowledge and understanding of the disease process.
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PMID:Temporal arteritis. 713 20

A 32-year-old woman was bedridden for a year because of chronic pain and headaches. She had insomnia, depression, suicidal thoughts and a severe chemical allergy. She had been on steroid therapy for two years and became Cushingoid with striae in the arm pits, groins and abdomen. However, she had no hypertension, nor the buffalo fat and hirsutism. She was very edematous, with a weight gain from 112 to 180 lbs. The fluid retention did not conform to the syndrome of inappropriate antidiuretic hormone. Studies revealed abnormal scalp EEG discharges and high-voltage seizure discharges in the posterior thalamus. Electrothalamic stimulation suppressed the thalamic discharges and relieved the patient's pelvic pain and headaches. After one month of several thalamic stimulations per day, she was able to get out of bed and ambulate. In addition, the patient no longer was edematous and was tolerating perfumes and floor detergents. Steroids were progressively reduced without complications of withdrawal. She went from a completely steroid dependent state to independent during the first 1-1/2 yrs of thalamic stimulation. With continued thalamic stimulation she has done well for 8-1/2 yrs, weighs 112 lbs, keeps house and drives a car. It's speculated the illness is a chronic pain multiple syndrome predominantly due to mesothalamic discharges and body infirmities. The mesothalamic discharge implicated neural networks, which represent biologic systems, i.e. pain, sleep, fluid retention, etc. Therapeutic stimulation attenuates the discharges and the neural networks return to their normal set points of homeostasis.
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PMID:Mesothalamic discharge in a chronic pain, allergy and fluid retention syndrome (case report). 766 2

Nearly half a century ago Revers reported that administration of a paste prepared from succus liquiritiae, a dried watery extract of the roots of Glycyrrhiza glabra, resulted in a reduction in abdominal symptoms as well as radiographic evidence of healing in patients suffering from gastric ulcer. Subsequent studies demonstrated that this preparation could prevent the formation of gastric ulcers in experimental animals and confirmed the salutary effects in patients, but found that approximately 20% of patients so treated developed facial and dependent edema, often accompanied by headache, shortness of breath, stiffness, and pain in the upper abdomen. Although these symptoms suggested an allergic reaction, they were not accompanied by eosinophilia or relieved by antihistamines. These untoward effects usually subsided with a reduction of dose, although in some patients treatment had to be discontinued entirely. Given this profile of side effects, enthusiasm for licorice as a remedy for peptic ulcer disease soon faded. However, the popularity of licorice flavoring in candy and in other products such as chewing tobacco persists to this day, as do the problems in electrolyte and blood pressure homeostasis that can occasionally occur in individuals ingesting large quantities of licorice-containing products. Although the pattern of the renal response suggested that the active ingredients in licorice were acting directly on the mineralocorticoid receptors in the kidney, an even more fascinating explanation for the toxic effects of licorice has emerged in the past decade.(ABSTRACT TRUNCATED AT 250 WORDS)
Steroids 1994 Feb
PMID:Licorice ingestion and blood pressure regulating hormones. 819 41

This study was designed to test the effects of oral steroid therapy on the kinin levels and symptoms of experimental rhinoviral colds. Forty-seven men were randomized to receive prednisone (20 mg) or placebo. Therapy was administered three times a day for 5 days, after one dose was given 11 hours before inoculation with rhinovirus. Viral titers, symptom scores, and kinin and albumin concentrations in nasal washes were monitored. The mean kinin levels were lower in the steroid group (287 vs 449 pg/ml, p = 0.005) with significant differences in kinin levels on days 3 and 4 (p < 0.01). No significant difference in total symptom scores was seen between the two groups. Except for increased sneezing (p < 0.01) and mucus weights (p < 0.05) on day 1 in patients treated with prednisone, there were no significant differences in individual symptom scores. Headache tended to be less prominent in steroid recipients. Mean viral titers were higher in the steroid group (1.13 vs 0.79, p = 0.03) with significant differences in the daily viral titers on days 3 (p < 0.05) and 4 (p < 0.01). Steroids reduced kinin levels in rhinoviral infections, but that reduction was not associated with a significant reduction in symptoms. This study also provides evidence for the enhancement of viral growth in steroid recipients.
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PMID:Oral prednisone therapy in experimental rhinovirus infections. 865 77

Neurocysticercosis, the most common parasitic disease of the central nervous system, was treated surgically for a long time. Praziquantel (an isoquinolone) and albendazole (an imidazole) are anticysticercal drugs that are currently being used for the treatment of neurocysticercosis. Both have been reported to eliminate or markedly reduce the number and size of cysticerci. Albendazole is less expensive than praziquantel, and is as effective when given for 8 days as compared to longer periods. In a small number of comparative trials, albendazole appeared to be slightly more effective than praziquantel for the treatment of parenchymal cysticercosis. Albendazole has also been found effective in ventricular, subarachnoidal and racemose forms of the disease. However, the response to treatment is not universal. Treatment with these drugs has been associated with a high frequency of adverse reactions, probably due to the host's inflammatory reaction to the dying parasites. Headache, nausea and seizures are common but usually transient. Steroids appear to ameliorate these effects and their concomitant administration has been advocated. However, no data are available to support this view. The rationale of medical therapy in spinal cysticercosis is presently based on the reported efficacy of anticysticercal drugs in cerebral cysticercosis. A marked improvement in an associated seizure disorder following anticysticercal therapy has been observed. Though seizure control is better, the total duration of anti-epileptic drug therapy has not been determined. Some single enhancing computed tomography lesions in patients of epilepsy may be benign forms of neurocysticercosis. The spontaneous resolution of a majority of these lesions has led to doubts of them being merely infective in aetiology. Also, a controlled trial could not demonstrate any beneficial effect of albendazole on such lesions. Hence, most authors recommend that these patients should be treated with anti-epileptic drugs only. Doubts persist about the efficacy of anticysticercal drugs in altering the natural course of the disease and the reported tendency of cysticercus lesions to resolve.
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PMID:Drug treatment of neurocysticercosis. 932 40

Gliomatosis cerebri (GC), is a rare neoplastic disease (less than 150 cases reported in the literature) with a diffuse, widespread proliferation of neoplastic glial cells in the brain, generally affecting both hemispheres and involving the gray and white matter [1-3]. Less commonly, the cerebellum, the brain stem and the medulla can be affected. Histologic evaluation reveals neoplastic astrocytes with varying levels of differentiation. Perineuronal and perivascular spread of tumor infiltration is observed. Demyelination can be found in the affected areas. A well-preserved underlying neuroanatomic architecture is considered characteristic [2]. Clinical signs vary and are non-specific, including changes in the mental state and headaches, followed by focal motor deficits and convulsive episodes [4]. The prognosis is poor, ranging from weeks to some years after the manifestation of the symptoms. Steroids may be useful in the short term, but chemotherapy is of little value and radiotherapy of questionable benefit. The literature was reviewed and the radiological pattern of three new cases of GC is reported. In two cases the diagnosis was achieved ante-mortem.
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PMID:Gliomatosis cerebri: findings with computed tomography and magnetic resonance imaging. 988 Dec 57

Progressive diaphyseal dysplasia (PDD), a rare disorder of bones, in recent years has been accepted as a systemic disease within the spectrum of connective tissue disorders associated with immunological abnormalities. Steroids have been used in the treatment of PDD with variable success. In this report PDD is described in a 5-year-old boy who presented with leg pain, fatigue, headache and anorexia with an onset in infancy. Physical examination revealed a waddling gait, thorax deformity and thickening in the upper extremities. The diagnosis was made by radiologic demonstration of cortical thickening and a narrowed medullary cavity of the long bones of extremities. Bone scintigraphy showed areas of increased osteoblastic activity in the diaphyseal part of the long bones of extremities and the skull. Electron microscopic examination revealed myopathic and vascular changes. Serum immunoglobulin A, G and M levels were elevated and CD4 positive T cell numbers were low. Deflazacort, a steroid with a similar anti-inflammatory effect to prednisolone but with fewer adverse effects, was started in a dose of 1.2 mg/kg/day. Deflazacort treatment resulted in clinical and radiological improvement within 12 months with no side effects. In conclusion, steroids may be recommended as an effective method of treatment in PDD and deflazacort may be a safe alternative steroid.
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PMID:Deflazacort treatment in progressive diaphyseal dysplasia (Camurati-Engelmann disease). 1045 3

Patients must be cognizant of the time course of the cluster headache periods to optimally tailor their therapy. Steroids provide the fastest onset of prophylactic effect. Once steroids are initiated, it remains difficult to wean patients off of them, and that is why it is always recommended to associate another prophylactic agent from the onset with the steroids. All triptans can be considered; however, only injectable sumatriptan and zolmitriptan have been the subject of controlled studies, and the former remains the gold standard because of its speed of action. Lithium, although not a first-line therapy, remains mainly efficacious for the chronic form of cluster headache. There does not seem a significant tendency for analgesic rebound-withdrawal headache with cluster headache compared with migraine. Scientific studies of the treatment of cluster headache are inherently difficult because of the rarity of the syndrome, the short duration of attacks, and the relatively short duration of the cluster period, along with the presence of spontaneous remissions. Moreover, still a significant proportion of the available evidence on this subject is uncontrolled. Active, rather than placebo, control individuals are recommended. As far as surgical procedures are concerned, although only recently introduced and less documented, gamma-knife radiosurgery should be preferred to the procedures associated with craniotomy, which are inherently associated with a higher complication potential risk.
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PMID:Cluster Headache and Cluster Variants. 1451 23

A case of giant cell arteritis with systemic and panocular involvement is reported here. This elderly Indian male presented with symptoms of unilateral temporal headache and intermittent jaw claudication for a month followed by diplopia and blurring of vision and later loss of vision in the right eye. The right eye showed some limitation of ocular movements, presence of relative afferent pupil defect, anterior segment ischaemic changes and anterior ischaemic optic neuropathy. Visual evoked potential showed an absent P1 wave while the left eye with normal 6/6 vision sowed a prolonged P1 wave. Fundus fluoresceine angiography showed delay in choroidal perfusion. His erythrocyte sedimentation rate (ESR) was 120 mm/hr and he was started on oral prednisolone. Superficial temporal artery biopsy obtained one week after starting steroids was positive for giant cell arteritis. Steroids led to the resolution of optic disc swelling, disappearance of anterior segment signs, full recovery of right ocular movements and no further deterioration of the fellow eye. On steroids, he developed insomnia and progressive myopathy which resolved and is now symptom free at lower doses of steroids.
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PMID:Giant cell arteritis with panocular involvement in an Indian male. 1455 35


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