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

Bacterial endocarditis caused by Actinobacillus actinomycetemcomitans is a rare disease. A 48-year-old man who had a Starr-Edwards aortic valve prosthesis inserted in 1972 was admitted for evaluation of confusion, headaches, anorexia, weight loss, diarrhea and weakness. Six blood cultures yielded gram-negative organisms which were subsequently identified as A. actinomycetemcomitans. Treatment with ampicillin and gentamicin resulted in cure which has been maintained after an observation period of eleven months. This represents the second report of A. actinomycetemcomitans endocarditis in a patient with a prosthetic valve.
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PMID:Actinobacillus actinomycetemcomitans endocarditis in a patient with a prosthetic aortic valve. 88 Dec 58

A case of aspergillosis of the sphenoid sinus manifested as an isolated sixth nerve palsy occurred in a 74-year old diabetic woman who had no complaints of headache or symptoms suggestive of sinusitis. A CT scan demonstrated a large mass occupying the sphenoid and ethmoid sinuses extending posteriorly to the clivus. There was a calcific density within the opacified sinus and bony erosion of the sphenoid walls and the sella turcica. The patient underwent a sublabial transseptal sphenoidotomy with removal of necrotic material and debridement of the surrounding tissue. Histologic examination revealed granulation tissue with chronic inflammatory cells and abundant dichotomously branching hyphae. Postoperatively the patient was given amphotericin B and 5-fluorocytosine. Three months later the sixth nerve palsy had completely cleared and the patient had no other complaint. Sphenoid sinus aspergillosis is a rare disease and may have variable clinical manifestations according to involvement of different structures located closely to the sinus. Our patient developed an isolated sixth nerve palsy which was at onset considered to be caused by diabetes. Computerized tomography scans disclosed abnormalities strongly indicative of invasive aspergillosis. It illustrates the need of appropriate work-up in cases of an isolated sixth nerve palsy even in patients with diabetes or other risk factors.
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PMID:[Invasive aspergillosis of the sphenoid sinus and paralysis of the 6th nerve]. 130 68

A 51-year-old Italian woman developed migraine-like headaches with increasing frequency 5 years after menopause. The simultaneous onset of severe bilateral uveitis, neurological signs such as vertigo, hearing loss, small sensomotor hemisyndrome, cognitive brain dysfunction and lymphocyte liquor pleocytosis confirmed the diagnosis of Vogt-Koyanagi-Harada syndrome, a rare disease of probably autoimmune origin with destruction of pigment containing neuroepithelium. Other vasculitic diseases, especially those of infectious or rheumatologic origin, were excluded. Systemic corticoid treatment suppressed the activity of the illness but on dose reduction relapses occurred. Additional immunosuppressive medication prevented uveitic relapses and made it possible to reduce the corticoid dose.
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PMID:[Rare form of uveitis with neurological symptoms: the Vogt-Koyanagi-Harada uveomeningoencephalitic syndrome]. 154 80

A 40-year-old patient presented with intractable headache, panhypopituitarism and diabetes insipidus 5 months after a severe shock syndrome. The magnetic resonance imaging of the brain confirmed a hemorragic necrosis of the pituitary gland. On follow-up, the patient recovered a normal pituitary function, except for the persistence of a partial ACTH deficiency. The pituitary image also normalized. Pituitary apoplexy is a rare disease of severe prognosis due to its neurological and endocrine consequences. It can now be more easily recognized by the new imaging techniques.
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PMID:Spontaneous pituitary apoplexy with transient panhypopituitarism and diabetes insipidus. 164 16

Two cases of TSH-secreting pituitary adenoma were reported. Endocrinological and immunohistochemical features of these cases were described and problems in diagnosis and treatment of the rare disease are discussed. [case 1] A 28 year-old woman suffered from hyperthyroidism with a relatively high value of serum TSH (T3; 350 ng/dl, T4; 10.0 micrograms/dl, TSH; 24.5 microU/ml). She was treated with antithyroid drug and then underwent subtotal thyroidectomy. Although the levels of serum T3 and T4 were lowered to within normal range, the level of serum TSH still remained high. One month later, she developed frontal headache, amenorrhea and bitemporal hemianopsia. A CT scan showed an enhanced mass in the sellar and suprasellar region. Preoperative endocrinological studies showed elevated values of TSH (47 microU/ml) and its alpha-subunit (9.0 ng/ml). The levels of both T3 (190 ng/dl) and T4 (10.0 micrograms/dl) were near the upper normal limit. Serum TSH was suppressed by administration of exogenous T3, but did not respond to exogenous TRH, l-Dopa nor bromocriptine. Under the diagnosis of TSH-secreting pituitary adenoma, the patient was operated on by craniotomy and received local radiation therapy (50 Gy). In 1990, 12 years after the treatment, she is well and endocrinologically normal. Immunohistochemical study revealed that most tumor cells were positive for TSH. [case 2] A 28 year-old woman visited our hospital for examination of hyperthyroidism. Serum level of TSH was detectable (4.5 microU/ml). A CT scan performed at that time disclosed no pituitary tumor. Thyroid function was normalized by antithyroid drug, but the level of TSH was still high and progressively increased.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two cases of TSH-secreting pituitary adenoma; endocrinological, diagnostic and therapeutic approach to the disease]. 194

Vogt-Koyanagi-Harada syndrome is a rare disease, which probably has a cell-mediated autoimmune pathogenesis, marked by ocular (anterior and/or posterior uveitis), dermatological (poliosis, canities, vitiligo) and neurological (meningo-encephalitis) disorders of variable severity in variable combinations. The clinical pattern in the case reported here showed severe neurological involvement (headache, ataxia and confusional state) followed by anteroposterior uveitis. Instrumental investigations (cerebrospinal fluid, VEPs, BAEPs, EEG, CT and MRI brainscans) confirmed the diagnosis. The response to cortisone therapy was excellent. We emphasize the importance of the neuroradiological investigations, because of their peculiarities, and review the reports of cases with marked meningo-encephalitic impairment, given the dearth of reports in the neurological journals.
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PMID:Vogt-Koyanagi-Harada syndrome: clinical and instrumental contribution. 195 5

A long-term hemodialysis patient with a giant intracranial vascular channel, which has been called a giant serpentine aneurysm, is presented. A 50-year-old man with an eight-year history of hemodialysis treatment was admitted because of headache, nausea and double vision. Computed tomographic scans and nuclear magnetic resonance revealed intracranial abnormal shadow. The left vertebral arteriography showed that the distal portion of the left vertebral artery was dilated to 17 mm in diameter. The basilar artery showed a large tortuous vascular channel and globular aneurysms over 25 mm in diameter. This giant serpentine aneurysm is a rather rare disease. To our knowledge, it has not been reported as a complication in a hemodialysis patient, although fourteen cases have been reported in the literature. In our case, several conditions such as long-term hypertension, hyperlipidemia, hypercalcemia, atherosclerosis and abnormal blood flow due to arteriovenous fistula for hemodialysis treatment might be considered to play a role in the formation of the giant serpentine aneurysms.
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PMID:Giant serpentine aneurysm in a long-term hemodialysis patient. 318 May 24

Aneurysm of the vein of Galen is a very rare disease. The authors present a case of secondary aneurysm of the vein of Galen which was confirmed by characteristic clinical symptoms, brain CT and angiographic findings. The patient was a 14-year-old right handed girl with intermittent headache, nausea, vomiting, dysphasia and gait disturbance. Neurologic examination revealed dysarthria, nasal voice, blurring of both margins of optic discs, truncal ataxia and dysdiadochokinesia. Sensory function was normal but right hemiparesis was seen. Roentgenogram of the skull revealed diffuse thinning of the calvarium, widening of sella turcica and erosion of clinoid processes. Computed tomogram of the brain showed dilatation of all ventricles and round hyperdense mass behind the third ventricle in the midline. The lesion was enhanced markedly and homogeneously. Left and right internal carotid angiograms showed arteriovenousmal-formation with drainage to the aneurysm of the vein of Galen.
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PMID:A case of aneurysm of the vein of Galen. 327 Oct 52

A 72-year-old woman, previously in good health, suffered for 2 years from attacks of a complex neuropsychiatric syndrome lasting from 2 days to 4 weeks. These episodes, which were followed by intervals of nearly complete recovery, were usually marked by fever, headache, mental confusion, vomiting ataxia, anisocoria, epileptic seizures and stiffness of the neck. Neuroradiological investigation revealed only slight ventricular dilatation. In 13 CSF examinations, there was reduced glucose, increased protein, considerable rise of the IgG index and constant oligoclonal bands. There was also an increase of polymorphonuclear leucocytes, lymphocytes or epithelial-like cells. As all microbial, viral or mycotic tests were negative and the patient recovered, the case was considered to be benign recurrent meningitis of Mollaret. The nosological position of this rare disease, as well as its probable pathogenetic mechanisms, are discussed.
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PMID:A case of benign recurrent meningitis of Mollaret. 616 85

Dural sinus thrombosis, a relatively rare disease, is difficult to diagnose because of variable symptomatic manifestations. We successfully treated a case of dural sinus thrombosis by direct thrombolysis using an endovascular technique in combination with postoperative anticoagulant therapy. The patient, a 19-year-old female, developed a headache affecting her whole head on December 13, 1993. She was admitted to our hospital the next day. Neurological examination upon admission revealed no neurological abnormalities, nor was there any abnormality in CT scan, either plain or enhanced, taken on the day of admission. The patient's consciousness deteriorated in the early morning of December 22. MRI and cerebral angiography revealed thrombi from the confluence of the sinuses to the right transverse and sigmoid sinus, with disturbed circulation through deep cerebral veins. Systemic thrombolytics, steroid and mannitol were started, but, on the next day, the third ventricle was compressed by bilateral swelling of the basal ganglia, with hydrocephalus. Since her consciousness deteriorated further despite ventricular drainage and barbiturate therapy, direct thrombolytic therapy was performed on December 25. A catheter was placed in the superior sagittal sinus, and 600,000 units of urokinase was locally injected, followed by postoperative anticoagulant therapy. The patient's condition improved rapidly. On CT scan, the bilateral swelling of the basal ganglia disappeared along with the hydrocephalus. At about 1 month after endovascular surgery, MRI and cerebral angiography revealed recanalization of the deep cerebral veins, straight sinus and confluence of sinuses with improved opacification of the left transverse sinus, although the right transverse sinus was found to be re-occluded.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case report of dural sinus thrombosis: direct thrombolytic therapy using endovascular surgery]. 773 71


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