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

Patients with renal failure may manifest a variety of neurologic disorders. Patients with chronic renal failure who have not yet received dialytic therapy may develop a symptom complex progressing from mild sensorial clouding to delirium and coma, with tremor, asterixis, multifocal myoclonus, and seizures. After the institution of adequate maintenance dialysis therapy, patients may continue to be afflicted with more subtle nervous dysfunction, including impaired mentation, generalized weakness, and peripheral neuropathy. These central nervous system disorders are referred to as uremic encephalopathy. The dialytic treatment of end-stage renal disease has itself been associated with the emergence of two distinct, new disorders of the central nervous system; dialysis dysequilibrium and dialysis dementia. The dialysis disequilibrium syndrome consists of headache, nausea, muscle cramps, obtundation, and seizures, and is a consequence of the initiation of dialysis therapy in some patients. Dialysis dementia is a progressive, generally fatal encephalopathy which affects patients on chronic hemodialysis. There are at least three different forms of dialysis encephalopathy: sporadic, epidemic; and that associated with renal disease in children. In addition to the foregoing neurologic diseases which are specifically related to uremia and/or dialysis, a number of other neurologic disorders occur with increased frequency in patients with end-stage renal disease on chronic hemodialysis. These include subdural hematoma, electrolyte disorders, vitamin deficiencies, drug intoxication, hypertensive encephalopathy, and acute trace element intoxication. Renal transplantation is associated with a variety of central nervous system infections, reticulum cell sarcoma, and central pontine myelinosis. The present manuscript will review the clinical, structural, and biochemical components of those neurologic disorders which are peculiar to the uremic state and its treatment with dialysis.
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PMID:Uremic encephalopathies: clinical, biochemical, and experimental features. 675 30

A review of the results of neuroradiological investigation of patients in whom computed tomography had shown no intracranial abnormality showed that the use of invasive studies, particularly pneumoencephalography, has declined since installation of a computed tomography scanner, and indications for such studies have become firmer. Diagnostic yield from invasive procedures in patients presenting with epilepsy, dementia, headache (including facial pain), or loss of consciousness is negligible.
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PMID:Use of invasive neuroradiological investigations in patients with normal computerised tomography. 681 30

Agarose isoelectric focusing was used to demonstrate oligoclonal bands in cerebrospinal fluid (CSF) and serum from 998 consecutive neurological patients. Compared with agarose electrophoresis, agarose isoelectric focusing was slightly more sensitive, showing more (and more easily discernible) oligoclonal bands. Agarose isoelectric focusing, which has good reproducibility, revealed oligoclonal bands in CSF in 95% of 43 patients with multiple sclerosis, 44% of 39 with aseptic meningoencephalitis, and 14% of 906 with other neurological diseases. Interestingly, oligoclonal bands were found in CSF from 12% of 162 patients with acute cerebral infarction and 23% of 53 with polyneuropathy, and also in 29% of 17 with dementia, while only 4% of 206 patients with headache, vertigo, or psychoneurosis had this CSF abnormality. We recommend this procedure for the routine examination of paired CSF and serum specimens for the presence of oligoclonal bands.
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PMID:Utility of isoelectric focusing of cerebrospinal fluid and serum on agarose evaluated for neurological patients. 683 58

Twenty-four patients, including two with aplastic anemia and 22 with malignancy, underwent marrow transplantation after preparation with mechlorethamine, 0.3 to 2.0 mg/kg body weight. Fourteen of the 21 neurologically evaluable recipients developed immediate neurotoxicity a median of 4 days after treatment (range, 0 to 34 days). Confusion and disorientation were observed in six patients, headache in six, hallucinations n four, lethargy in four, tremors in three, paraplegia in one, seizure in one, and vertigo in one. Whereas acute symptoms cleared in 11 patients, three remained symptomatic until death. Twelve evaluable patients survived more than 60 days; all six with previous acute toxicity subsequently developed delayed onset of new neurologic findings (personality change, confusion, seizure, diplopia, or dementia) a median of 169 days (range, 70 to 248 days) after treatment. Cerebrospinal fluid analysis was usually normal but cerebral computed tomographic scans showed ventricular enlargement and electroencephalograms showed diffuse slowing. Postmortem histologic examination of brain showed neuronal degenerative changes with increased vascularity, gliosis, and perivascular fibrosis. Neurotoxicity appeared to increase with age and mechlorethamine dose and was commoner in patients given additional procarbazine or cyclophosphamide.
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PMID:Immediate and delayed neurotoxicity after mechlorethamine preparation for bone marrow transplantation. 704 28

Lipoma of the corpus callosum is a rare intracranial condition, possibly congenital. It is often asymptomatic, but may present with headaches, seizures, hemiplegia, or dementia. An example of this disease is reported, and the condition reviewed. The radiological appearance is described, with emphasis on the value of computerized tomography in making the diagnosis. Surgery is of limited value but may be required in specially selected cases.
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PMID:Lipoma of the corpus callosum. Case report. 708 24

A 64-year-old woman had received radiotherapy, following surgery of a chromophobe pituitary adenoma. Six years after irradiation she began to complain of headache and dementia. Right vertebrogram demonstrated a right temporal mass lesion, stenosis and dilatation of middle cerebral artery and posterior, communicating artery in the field of irradiation. CT scan showed the irregular low density area at the right temporal region, and the irregular enhancement after an intravenous injection of contrast medium was seen at the small part of affected area. From these findings, radiation necrosis at the right temporal lobe was diagnosed. As vascular changes of the main cerebral arteries due to radiation are rare, we discussed on them from ever reported literature.
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PMID:[A case of radiation necrosis with vascular changes on main cerebral arteries (author's transl)]. 709 75

Eleven patients belonging to two generations of a Dutch family with cerebral and cerebellar haemorrhage, haemorrhagic infarction and infarction are described. Their ages varied from 44 to 58 years. The principal clinical characteristics was recurring cerebral haemorrhages, sometimes preceded by a history of migrainous headaches or mental changes. In 4 of the 6 autopsied cases, old and new multiple cerebral haemorrhagic infarcts and infarcts were found, in one case a single cerebral haemorrhage and in another a cerebellar haemorrhage. In 5 cases this resulted in secondary subarachnoid haemorrhage. In one case the infarcts were only slightly haemorrhagic and did not result in subarachnoid haemorrhage. This patient presented as dementia. Microscopically, in these 6 cases and in one biopsy specimen hyaline thickening of the walls of cortical arterioles was found. The arteries of the arachnoid showed marked tortuosity, concentric proliferation, and focal hyalinization of the walls. Amyloid was found in the hyalinized vessels in 5 cases, but not outside the central nervous system. We believe that we are dealing with an inherited disorder with an autosomal dominated mode of inheritance, in which microangiopathy leads to cerebral haemorrhage and (haemorrhagic) infarction. It seems likely that amyloidosis underlies the angiopathy, and that this family suffers from a condition similar to the one described by Gudmundsson in 1972.
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PMID:Familial cerebral amyloid angiopathy presenting as recurrent cerebral haemorrhage. 713 Oct 28

Axial tomograpum (CAT), of 59 patients with dementia and 102 controls suffering from headaches and dizziness were examined. The CAT was normal in 13 demented patients (22%) and in 37 controls (36,3%), and revealed enlarged spaces of the CSF in 46 anoic patients (78%) and 65 controls (63.7%). Multiple areas of subnormal density were observed in 23 anoic patients (39%) and in 6 controls (5.9%). This indicates that the multi infarct syndrome is frequently associated with dementia, while the correlations between Hydrocephalus and dementia is weak.
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PMID:[Cranial computerized tomography in senile dementia]. 716 98

Based on provisional clinical diagnosis, the choice of computed cranial tomography (CCT) or radionuclide brain scan (RBS) was retrospectively evaluated. In 1,333 selected cases, 551 had CCT only, 560 had RBS only, and 222 had both. CCT was the clinician's preference in cases of dementia, hydrocephalus, hemorrhage, aneurysm, arteriovenous malformation (AVM), primary tumor, visual abnormality, coma, and multiple sclerosis. RBS was preferred in headache, syncope, seizure, transient ischemic attack (TIA), metastatic disease, and encephalitis. Neither procedure appeared preferable in cases of psychosis, psychiatric disease, cerebral vascular accident (CVA), and abscess. Thirty-eight percent of CCTs yielded abnormal findings, not necessarily correlated with the provisional diagnosis. Thirty percent of RBS showed positive findings, mostly related to vascular abnormalities. On the basis of the provisional clinical diagnosis, CCT was more frequently requested for probable structural changes and RBS for probable perfusion abnormalities.
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PMID:Utility of the provisional clinical diagnosis as a basis for selection of computed tomographic or radionuclide brain scan. 727 14

An autopsy case of subacute encephalopathy with disseminated necrosis was reported. The patient, a 34-year-old male, complained of headache and generalized convulsion. He also showed constructional apraxia and dementia. These symptoms progressed slowly. Neurological examinations revealed no abnormalities except for a slight optic nerve atrophy. Laboratory examinations disclosed a high ratio of the titer of antibody of rubella virus. Based on the findings mentioned above, he was diagnosed as atypical subacute encephalopathy, and because of his usage of thinner for 10 years, intoxication by it was also suspected. An autopsy of the brain revealed disseminated small necrosis in the gray matter over the whole brain. The relationship between the genesis which provoked the atypical clinical course and pathological findings was discussed.
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PMID:An autopsy case of subacute encephalopathy with disseminated necrosis. 728 60


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