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)

AVMs are congenital malformations of central nervous system blood vessels. The majority of lesions become symptomatic prior to age 40. Hemorrhage and epilepsy are the most frequent presenting symptoms. Disabling headache, transient, progressive, and permanent neurological deficit, heart failure, hydrocephalus, macrocephaly, and intellectual impairment may also occur. Long-term mortality is approximately 18%, and morbidity leading to disability occurs in 30% of patients. Aggressive management when possible is indicated.
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PMID:Natural history and pathophysiology of arteriovenous malformations. 54 27

The three best-described genetic polymorphisms of drug metabolism--the debrisoquin/sparteine type of oxidative polymorphism (hereafter referred to as the debrisoquin polymorphism), the polymorphism of N-acetylation, and the mephenytoin type of oxidative polymorphism--are reviewed. For all three polymorphisms, the poor-metabolizer phenotype is inherited as an autosomal recessive trait. The debrisoquin and mephenytoin oxidative polymorphisms involve defects in two separate cytochrome P450 enzymes. The prevalence of the poor-metabolizer phenotype for debrisoquin ranges between 2% and 10% for groups of various ethnic origins. The poor-metabolizer phenotype for mephenytoin comprises about 5% of the Caucasian population and about 20% of the Japanese population. N-acetyltransferase is a cytosolic enzyme whose clinical polymorphism was discovered using isoniazid as the substrate probe. The prevalence of the slow-acetylator phenotype among American and European Caucasian and American black groups is about 50%; among the Japanese it is about 10%. More than 20 agents are substrates for debrisoquin hydroxylase, about 15 for N-acetyltransferase, and 3-5 for mephenytoin. In poor metabolizers, debrisoquin can cause hypotension, and sparteine can cause blurred vision, headache, and dizziness. Clinical consequences of the slow-acetylator phenotype include increased susceptibility to systemic lupus erythematosus induced by procainamide and hydralazine, peripheral neuropathy induced by isoniazid, hydralazine, and dapsone, and sulfasalazine-induced dose-related leukopenia, nausea, vomiting, headache, and vertigo. After administration of mephenytoin, poor metabolizers have increased somnolence and intellectual impairment. Awareness of genetic polymorphisms of drug metabolism should improve understanding of interindividual variability in drug disposition and response.
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PMID:Polymorphic drug metabolism. 268 60

Sleep apnoea syndromes are a frequent disease, with an incidence of more than 1% in the adult population, a strong male predominance, and a maximal frequency between 40 and 60 years. Their clinical manifestations are dominated by snoring and daytime sleepiness, at times associated with morning headaches, intellectual deficiency, sexual impotence. Obesity, hypertension and polycythemia are not uncommon. These patients are at risk for accidents due to sleepiness, sudden death due to sleep apnoea-related cardiac arrhythmias, ischemic attacks related to hypertension and polycythemia and right heart failure secondary to pulmonary hypertension and alveolar hypoventilation. The most frequent form of sleep apnoea syndromes include obstructive and mixed apnoeas. Their mechanism involves both anatomic factors (upper airway narrowing) and functional factors (defective activation of upper airways dilatory muscles) which lead to upper airway occlusion upon inspiration during sleep. Two therapeutic strategies are possible: a surgical one, uvulopalatopharyngoplasty, the efficacy of which is inconstant and unpredictable and nasal continuous positive airway pressure, which is constantly efficacious but constraining. Central sleep apnoea syndromes are rare, less clearly defined and more difficult to treat.
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PMID:[Sleep apnea syndromes in adults]. 332 Dec 51

Glioblastoma multiforme is the most common primary brain tumor of adults, as well as the most malignant. Its etiology is unknown, but the tumor is thought to arise through dedifferentiation of adult astrocytes. It occurs most frequently between the ages of 40 and 60, in men more often than in women (1.5:1). Important early symptoms include subtle personality change, headache, weakness, and intellectual impairment; specific complaints and physical findings depend on the location of the lesion. The initial diagnostic test should be a CT-scan; it will detect more than 90% of malignant astrocytomas. Surgery remains the cornerstone of treatment; patients receiving radical debulking have a median survival of 8 months compared to the 3 month survival of unoperated cases. Modern neurosurgical technique, neuroanesthesia, mannitol, and corticosteroids have reduced the surgical mortality to 3%. Most patients also receive 4500 rads of whole-brain irradiation and 1800 rads to the operative site; radiotherapy increases the median survival of operated patients by 2 to 3 months. An additional small increment in survival time and some improvement in quality of survival can be achieved by nitrosourea chemotherapy; the latter is usually given as 100 mg/m2/day x 3 days of BCNU every eight to ten weeks. Experimental treatments under study include the use of radiosensitizers, the role of immunotherapy and the application of microwave-induced hyperthermia. Two-year survival remains 10% to 20%, and there are virtually no five-year survivors. An optimal combined modality treatment plan, one in which each cellular compartment of this truly multiforme tumor is effectively addressed, remains to be designated.
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PMID:Glioblastoma multiforme. 624 15

A series of 111 intracranial tumours in elderly patients, investigated by modern methods, is reviewed. The clinical picture of progressive neurological deficit, and/or intellectual impairment, did not differ greatly from that of younger patients, but the manifestations of raised intracranial pressure (headache and papilloedema) were much less common in the elderly. Intermittency of symptoms appeared to be a relatively common phenomenon with meningiomas, occurring in four of 12 symptomatic cases. Operative treatment, for removal of meningiomas or relief of obstructive hydrocephalus, produced improvement in almost all cases, with a low morbidity and mortality. High-dose steroid therapy produced substantial, if temporary, benefit in 51% of hemisphere tumours.
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PMID:Intracranial tumours in the elderly: diagnosis and treatment. 673 Nov 72

Neurotoxic volatile organic solvents used by house and car painters may lead to professional toxic encephalopathy after several years of exposure. The symptoms are memory impairment, fatigue, personality changes, headache and dizziness. Vestibular dysfunction was found in 55% of 113 painters examined, mainly in the form of reduced caloric vestibular reactions. No correlation between vestibular dysfunction and the duration of exposure, cerebral atrophy or intellectual impairment could be demonstrated. Vestibular examination may be helpful in detecting early changes in exposed persons and in determining more accurate safety limits for harmful chemicals.
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PMID:Vestibular dysfunction in occupational chronic solvent intoxication. 697 23

A 32-year-old man with a history of delayed puberty and obesity was seen initially with bitemporal hemianopsia and headache in 1974. Neuroradiologic studies showed a mass in the chiasmatic cistern and hypothalamus. Surgical exploration of the chiasm was unrevealing. Slowly progressive memory loss and intellectual impairment developed. Necropsy in 1978 disclosed a large cavernous hemangioma in the diencephalon.
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PMID:Cavernous hemangioma in the diencephalon. 723 69

The prognosis of chronic toxic encephalopathy in former house painters was examined in a prospective study with a two-year observation period. Twenty-six patients, who at the initial examination had cerebral atrophy and/or intellectual impairment, were selected for the follow-up study. No competitive etiological factors (including alcohol) to the encephalopathy were suspected. During the two-year follow-up interval these patients were not professionally exposed to organic solvents. At the follow-up examination neurological, biochemical, neuropsychological, and neuroradiological parameters were reassessed and compared to the original findings. Generally the condition was unchanged. Slight improvements with regard to headache and dizziness were reported by some. However, the neurological status, the neuropsychological impairment, and the cerebral atrophy, did not change significantly. In three patients further deterioration was observed. It is argued that our patients suffered from a brain disorder different from presenile dementia of the Pick-Alzheimer type. Other alternative etiological entities were also excluded. Our findings indicate that long-term exposure to organic solvents may lead to a chronic brain syndrome. Once intellectual impairment and/or cerebral atrophy had developed, reversibility is not observed. Nor is further progression to be expected if exposure is stopped. Occupational exposure to organic solvents should be maximally restricted as it represents a risk of inducing invalidating brain syndromes.
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PMID:Prognosis in chronic toxic encephalopathy. A two-year follow-up study in 26 house painters with occupational encephalopathy. 731 95

Obstructive sleep apnoea (OSA) is characterized by abnormal breathing during sleep, and occurs when the upper airway is obstructed but respiratory effort continues. Causes of OSA include obesity, overindulgence in alcohol, and the use of sedatives. The patient complains of unrefreshed sleep, morning headaches and drowsiness, sometimes leading to depression and intellectual impairment. The treatment of choice is weight loss; however, the patient may also require mechanical nocturnal support to prevent the upper airway collapsing and causing OSA. A simple and effective non-surgical treatment for OSA is nasal continuous positive airway pressure.
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PMID:Management of obstructive sleep apnoea. 837 59

The authors present the case of a 60-year-old man with obstructive hydrocephalus caused by a large basilar artery tip aneurysm, in whom direct surgical clipping of the aneurysm neck was considered hazardous. After endosaccular aneurysm occlusion, his symptoms (headache, intellectual impairment, and gait disturbance) and ventricular dilation immediately improved without placement of a ventricular shunt. To the authors' knowledge, this is the first case of its kind treated solely endovascularly.
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PMID:Endosaccular aneurysm occlusion with Guglielmi detachable coils for obstructive hydrocephalus caused by a large basilar tip aneurysm. Case report. 1050 91


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