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

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

We present a 81-year old male who developed dementia, gait disturbance and right hemiparesis. He was well until the age of 74 when he developed a hemorrhagic infarction in the right occipital region, which left him left homonymous hemianopsia. One year later he had one TIA attack consisting of dizziness, headache, and some clouding of consciousness. At that time, atrial fibrillation was found. At age 79, he was attacked by right hemiparesis. Cranial CT scans revealed a lesion consistent with a hemorrhagic infarct in the left middle cerebral artery territory. Two months prior to his final admission, he had a gradual onset of forgetfulness, labile affect, nocturnal agitation and hallucination which were followed by gait disturbance and urinary incontinence. On admission, he was alert but moderately demented. In addition he showed difficulty in repetition, limb kinetic and ideomotor apraxia of the left hand indicative of sympathetic apraxia, and constructional apraxia bilaterally. Granial nerves appeared intact except for left homonymous hemianopsia. His gait was wide-based and small stepped. No weakness or ataxia was noted. Deep reflexes were diminished on the left side. Plantar reflex was equivocally extensor of the left. Light touch and pain was slightly diminished on the right side. Cranial CT scans revealed a large low density area in the left fronto-temporo-parietal region. Also ventricular dilatation, diffuse low density change in the subcortical white matter, and diffuse cortical atrophy were seen. His clinical course was complicated by melena, anemia, pneumonia, cardiac failure and renal failure. He expired 2 months after his admission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 81-year-old man with dementia, gait disturbance, hemiparesis, and sympathetic apraxia]. 833 25

Throughout history writers have attempted to describe the symptoms and evoke the misery of "a dismal headache." Writers from Plato to Stephen King have used the phenomenology of headache to illustrate their work. Lewis Carroll, for example, vividly describes the central scotoma, tunnel vision, phono-phobia, vertigo, distortions in body image, dementia and visual hallucinations that often accompany migraine. Although many authors have discussed the topic seriously, others have addressed the issue in a dismissive and even contemptuous manner, relegating this very real disorder to the status of a medical stepchild. We will examine headache etiology, triggers and treatment and explore the attitudes toward headache and headache sufferers found in literature. We have recently seen a growing understanding of the physiological basis of headaches. However, this knowledge has not yet reached the level of literature or popular culture. In an age when it seems every Sunday night brings a new "disease of the week" movie, and every human ill is subjected to often intense and numbing scrutiny by the media, the anguish of a chronic migraine sufferer will probably remain unexplored--unless she kills her husband and children during an attack.
Headache 1993 Feb
PMID:Sometimes Jello helps: perceptions of headache etiology, triggers and treatment in literature. 845 26

We report a case of Creutzfeldt-Jakob disease in a 38-year-old man, transmitted by a cadaveric dural graft. In August 1985, he underwent cranial nerve decompression for hemifacial spasm and received a cadaveric dural graft for dural closure. He had been well until he began to complain of blurred vision and headache in May, 1990. He developed dementia, myoclonus and urinary incontinence over the subsequent 3 months. He was admitted to our hospital in August, 1990. On admission, he was somnolent and showed gait disturbance, myoclonus in extremities and elevated deep tendon reflexes symmetrically. The results of analysis of blood, urinary and cerebrospinal fluid were normal. The initial computed tomography (CT) and magnetic resonance imaging detected no abnormality. Electroencephalography showed typical periodic synchronous discharge (PSD). There was progressive worsening of his neurological symptoms, and this developed into mutism in September, 1990. CT, 11 months after clinical onset, showed marked enlargement of the ventricles and the sulci. In view of his rapid worsening clinical course, PSD findings on electroencephalography, and delayed progressive changes of CT findings, the diagnosis of CJD disease was made. The cadaveric dural graft was suspected as the cause of the patient's condition. Since Thadani et al reported the first case of CJD transmitted by cadaveric dural graft in 1988, 3 other cases have been reported. This is most likely the 5th reported case of Creutzfeldt-Jakob disease transmitted by cadaveric dural graft.
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PMID:[Creutzfeldt-Jakob disease transmitted by cadaveric dural graft: a case report]. 845 5

We report a patient with Morgagni syndrome. The main aim of this paper is to discuss hyperostosis frontalis interna (HFI) and coexisting clinical feature and to describe the pathomorphology in detail on the basis of MRI images of the skull. The patient, a woman, was 82 years old when she first came to our hospital. She had a 20-year history of hypertension and chronic headache, and had been excessively obese till three years before. On admission she presented with a broad spectrum of clinical symptoms and signs including insomnia, disorientation to place, loss of memory, dementia, night delirium, reduced deep tendon reflexes in the lower extremities, urinary incontinence and upward gaze palsy. Because of a fair recovery within several days, it was suspected that so-called "treatable dementia" played a considerable role in the above-mentioned clinical state. Laboratory testing data, including hormone levels, were all within normal limits. EEG examinations showed slowed, diffuse, and poorly developed alpha-waves with no paroxysms. Cranial CT in horizontal sections disclosed a deformed frontal bone with convexlens-shaped thickening bilaterally and diffuse high density on both sides. MRI images revealed more detailed structures: the outer plate, diploe and inner plate of the skull, and abnormal ossifications. Based on these findings we diagnosed her illness as Morgagni syndrome. Recent reports, though few in number, have tended to focus on the EEG findings, hormones and psychiatric states in this syndrome, and descriptions of the HFI itself seem to be rare. The true cause of this syndrome is not yet known, so this rare presentation of MRI images of HFI is thought to be important in explaining this peculiar phenomenon in the skull.
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PMID:[MRI findings of hyperostosis frontalis interna--a case of Morgagni syndrome]. 875 3

The prevalence of all neurological disorders in a Japanese town was calculated, with a result of 91.1 per 1,000 population. The prevalence of cerebrovascular disease was 28.8; myelopathy and/or radiculopathy caused by deformity of the spine or disc herniation, 23.9; neuralgia, 11.5; dementia, 10.4; peripheral nerve disturbance, 5.5; epilepsy, 4.4; Parkinson's disease, 2.0; mental retardation, 2.9; brain/spinal tumor, 1.4; headache, 10.8, and vertigo/dizziness, 4.4. The prevalence of headache and vertigo/dizziness was also calculated from the results of the questionnaires sent to inhabitants: headache, 79.6, and vertigo/dizziness, 60.8. Neurological disorders are common in Japan and likely to continue to increase.
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PMID:Prevalence of neurological disorders in a Japanese town. 881 3

Depression often goes unrecognized and untreated in older adults, in part because of its atypical presentation and the comorbid medical conditions in this population. Depression may coexist with dementia and is more often seen in patients with certain medical illnesses. Drug therapy is effective in treating depression in 65 to 75% of older patients. Selective serotonin reuptake inhibitors (SSRIs) are often used in this population because of their proven efficacy, safety, and tolerability. The most common side effects of SSRIs are GI disturbances and headaches, which may be minimized by slow dose escalation. Compared with younger adults, the elderly generally require smaller doses but show a similar time course of response to anti-depressant therapy.
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PMID:Depression: making the diagnosis and using SSRIs in the older patient. 886 55

The thalamus is believed to play an integrative role in the central nervous system. In the present study, thalamic rCBF was measured in 65 CVD patients and 15 normal volunteers by stable Xe/CT scanning. ROIs were chosen in the thalamic slice at a level 5cm over the OM line, and mean CBF was 7 cm over the OM line. The clinical factors focused on in multiple regression analysis were: age (A), sex (Se), stage from onset (St), lesion side (Sd); unilaterality or bilaterality, size (Sz) thalamic lesion (Tl). GCS (G), HDS-R (H); Hasegawa dementia score (revised), symptoms (Ss) such as anxiety, dizziness, head-headed feeling and headache, and neurological deficits (N). Each factor was graded and scored. Statistically, there was a significant correlation between thalamic rCBF (Y) and mean CBF (X) in the less affected hemisphere: Y = 1.82X + 2.2, r = 0.801, p < 0.001, n = 65. Multiple regression analysis of the thalamic rCBF revealed that the Sz factor was significant (p < 0.0001) on the lesion side: Y = 76.7-10.2Sz, r = 0.644, p < 0.001, n = 51, while the Se, Sd and St factors were significant (p < 0.005) on the less affected side: Y = 71.9 + 9.7Se-6.8Sd-5.0St, R = 0.585, p < 0.001, n = 65. The thalamic index (X), an indicator of thalamic atrophy, and thalamic rCBF were significantly correlated: Y = 28.7X + 10.2, r = 0.386, p < 0.001, n = 80. In conclusion, thalamic rCBF appeared to reflect the degree of organic changes and time course in the cerebral hemisphere, because factors such as size, sex and stage were statistically significant.
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PMID:[Assessment of thalamic regional cerebral blood flow in patients with cerebrovascular disease]. 888 29

In 1993, the World Health Organization launched a global initiative aimed at increasing public and professional awareness of the public health aspects of neurological disorders. The initial phase of this project has been carried out through the organization of a series of symposia on prevalence, severity and costs of neurological disorders including dementia, stroke, epilepsy and headache. The main objective of the next phase of the project is to develop an international educational programme on neurology and public health and to establish a network of training centres in different regions of the world.
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PMID:The World Health Organization's global initiative on neurology and public health. 907 21

We report about the treatment and outcome of 30 patients with dural arteriovenous fistulas including the transverse and sigmoid sinuses treated between 1986 and 1995. All patients underwent panangiography for definitive diagnosis. The dAVF were supplied by the external carotid artery system alone (14 patients), both external and internal carotid systems (10 patients) or both anterior and posterior circulation (6 patients). Depending on the venous drainage the fistulas were classified following a modification of Djindjian's description with 18 patients revealing Type I (main sinus with antegrade flow), 5 Type II a (main sinus with reflux into the contralateral sinus). 5 Type II b (cortical veins), 1 Type II a+b (both) and 1 of Type III (direct cortical drainage). Bruit, pulsatile tinnitus and headaches were the most common symptoms. 6 patients presented with intracranial haemorrhage, 4 with progressive neurological deficit or seizures and 3 with dementia. Arterial embolization was performed in all cases except one, where a transvenous approach for balloon occlusion of the transverse sinus was performed. 21 patients were treated by single or repeated embolization alone. Only in 9/21 cases did arterial embolization result in complete occlusion of the fistula. In 12/21 patients incomplete occlusion was achieved. Following embolization 8 patients underwent additional surgery including coagulation of the feeding arteries and arterialized veins, sinus resection and reconstruction of the sinus. Overall, 18 patients were cured, 11 improved and 1 patient was unchanged. There was a total number of 5 complications including transient stroke, transient facial nerve palsy, and a small necrotic skin area following embolization. Venous infarction of the occipital lobe was induced by transvenous occlusion and surgical resection of the transverse sinus in one patient each, respectively. From our results we conclude that the endovascular therapy alone is the treatment of choice in case of Type I fistulas. In dAVF of Type II and III repeated endovascular treatment seems not to be sufficient and additional surgery is necessary.
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PMID:Dural arteriovenous fistulas including the transverse and sigmoid sinuses: results of treatment in 30 cases. 920 70


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