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

Ten patients with histologically verified intraventricular meningiomas were treated between 1974 and 1985. There were eight female and two male patients, ranging in age from 25 to 72 years with a mean age of 45.5 years. Headache and disturbed mentation were the most common presenting symptoms whereas corticospinal disturbance, altered mentation and homonymous hemianopia were the most common signs on formal neurological examination. Papilloedema was demonstrable in 50% of cases and evidence of dysphasia was apparent in 60% of patients with lesions affecting their dominant hemisphere. A single instance of drop attack occurred in a patient harbouring a third ventricular meningioma. Computed tomography, with and without contrast enhancement, and angiography were employed in all cases and proved highly sensitive and specific for tumour localisation and tissue diagnosis. In addition, angiography proved invaluable in demonstrating both vascular supply and the effects imposed upon the surrounding cerebral vasculature by tumour mass and hydrocephalus. Nine tumours occurred in the lateral ventricular trigone of which 5 were left-sided. A tenth tumour was located in the third ventricle. Twelve resections were performed in 10 patients. One patient was found to have a highly malignant cystic meningioma which recurred within 10 weeks of the original surgery and proved fatal shortly thereafter. A second patient whose initial resection was subtotal had a recurrence 3 years postoperatively which was totally resected. Lesions were approached most commonly through the posterior middle or posterior inferior temporal gyri. On 3 occasions a right posterior middle frontal gyrus approach was used and in one case a posterior parieto-occipital cortical incision was employed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intraventricular meningioma. A review of 10 cases of the National Hospital, Queen Square (1974-1985) with reference to the literature. 349 67

A patient is described who developed unilateral seizures whilst being treated with recombinant interferon for hairy cell leukemia. Special features included the relatively low dose of interferon, the focal aspect of the epilepsy and the high resistance to anticonvulsants. Oligoclonal banding of cerebrospinal fluid proteins may have resulted from polyclonal activation of bone marrow plasma cells during interferon treatment. Disturbances of consciousness, dysphasia, visual hallucinations, upper motor neuron deficit, tremor, dizziness, numbness, myalgia and headache, all of them neurological complications of interferon treatment, are discussed.
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PMID:Unilateral seizures in a patient with hairy cell leukemia treated with interferon. 393 49

Periventricular arteriovenous malformations (AVMs) have often been deemed inoperable because of their location in critical structures. Furthermore, the excision of large lesions may be complicated by the potential for serious brain swelling and hemorrhage due to "autoregulation breakthrough." Nonetheless, the unfavorable natural history of the untreated disease in a symptomatic young patient has induced us to approach these lesions using staged microsurgical excision combined with elective barbiturate coma for maximal cerebral protection. Between 1979 and 1983, six patients (four female, aged 12 to 60 years, and 2 male, aged 14 and 29) who harbored large AVMs in the basal ganglia, thalamic, and hypothalamic areas presented with subarachnoid hemorrhage (2 cases), progressive neural deficits (3 cases), and intractable headache (1 case). Nineteen staged operations were performed for the complete excision of these lesions. Among the first three patients, there was one death due to "autoregulation breakthrough" hemorrhage into the lateral ventricle during the excision of a lesion approached through the sylvian fissure using standard anesthesia techniques. This led to the adoption of the transventricular surgical approach and elective barbiturate coma to facilitate exposure of the lesion and to protect the adjacent vital structures from potential ischemia. Three patients were treated in this fashion uneventfully. Of the five successfully treated patients, two have returned to their preoperative status and one has completely recovered from global hemispheric ischemia and hemiplegia. The hemiparesis in one patient worsened as a result of postoperative hypertensive intraventricular hemorrhage, and one patient developed mild dysphasia and hemiparesis. This experience suggests that this approach offers a valid therapeutic regimen for the treatment of this disease. During the same period, three patients--one man (age 23) and two women (aged 29 and 22)--harboring four intraventricular AVMs presented with intraventricular hemorrhage. After the acute effects of chemical ventriculitis and hydrocephalus were overcome with cerebrospinal fluid diversion, all four lesions were excised microsurgically using the transtemporal approach. One patient demonstrated significant and progressive improvement of her preoperative memory deficit. The remaining two patients have both returned to their preoperative employment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Microsurgical excision of paraventricular arteriovenous malformations. 398 6

A successful case undergoing the ECA-PCA bypass operation with the use of an interposition saphenous venous graft for vertebrobasilar progressing stroke was reported and details of the operative techniques were described. A 40-year-old man was admitted because of confused mental state following sudden onset of headache, vomiting, vertigo, and ataxic gait. Neurological examinations revealed he was confused and restless, and left-sided Weber's syndrome, bulbar palsy and dysphasia were noticed. CT scan showed multiple small low density areas with no enhancement scattering in both occipital lobes and cerebellar hemispheres. Angiographical studies showed that the left vertebral artery was occluded at the vertebrobasilar junction and the right vertebral artery stenosed up to 90% or more at the branching site of the PICA. There was no visualization of the vertebrobasilar system through the right posterior communicating artery. The left posterior communicating artery was not examined. The patient was treated with Urokinase amounting to 740,000 units for ten days. Thirteen days later, however, he became progressively drowsy and he became unable to speak and swallow. Quadriparesis also appeared. Progressive deterioration of these brain stem ischemic symptoms was assumed to originate from critically lowered perfusion of the vertebrobasilar circulation. Therefore, the ECA-PCA anastomosis by means of a venous graft was carried out on the right side in expectation of the rapid restoration of the blood flow in the affected brain stem. A venous graft was chosen because it would carry larger amount of blood immediately after completing the bypass surgery than small calibered arterial graft such as a superficial temporal artery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[ECA-PCA anastomosis with the use of an interposition saphenous vein graft for vertebrobasilar progressing stroke]. 404 16

The Authors describe a case of aphasia acquired in childhood together with epilepsy (syndrome of Landau and Kleffner) and treated for seven years. The patient had simple and complex partial attacks, motor dysphasia, frequent and heavy headache, and electroencephalographic paroxysmal anomalies with multifocal distribution. While the disease evolved with regression of disphasia and epilepsy, the EEG alterations persisted. In view of similar cases reported in the literature and the present treatment the Authors feel that syndrome is an inflammatory disease, its evolution being slow. The results of neuroradiological investigations support such hypothesis. The prognosis is poor (anomalies of speech persisted in 2 out of 3) and further studies are essential. A systematic use of cerebral biopsy is suggested.
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PMID:[Contribution to our knowledge of the Landau and Kleffner "acquired aphasia with epilepsy" syndrome]. 619 30

In a comparative randomized double-blind study, 73 patients underwent myelography using iopamidol (36 patients) or metrizamide (37 patients) as contrast medium. The overall diagnostic adequacy of iopamidol myelography was found to be comparable to that of metrizamide myelography. The incidence of examinations graded as superior (64%) or adequate (36%) with iopamidol was equivalent to that with metrizamide (57% superior, 43% adequate). Adverse reactions after iopamidol myelography were fewer, less severe, and generally of shorter duration than those associated with metrizamide. In the iopamidol group, adverse reactions occurred in nine (25%) patients, all of whom experienced mild or moderate headache, one with nausea, vomiting, and fatigue. In the metrizamide group, adverse reactions occurred in 17 (46%) patients, all of whom experienced mild or moderate headache, six with nausea and vomiting and four with back and leg pain. Of nine individuals who underwent myelography using 300 mg 1/ml metrizamide injected via lateral C1-C2 puncture, three experienced a toxic encephalopathy with confusion, dysphasia, headache, nausea, and vomiting, and a fourth individual suffered severe nausea, vomiting, fever, and irregular pulse. Encephalopathy was not observed in any of the 11 patients in whom myelography was performed via lateral C1-C2 puncture with a similar concentration of iopamidol. No seizures were encountered, and no clinically significant changes in laboratory studies were observed with either contrast medium.
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PMID:Iopamidol and metrizamide for myelography: prospective double-blind clinical trial. 638 81

A case report of a 20-year old nulliparous woman who developed a stroke after taking the oral contraceptive (OC) pill Niroday (norethindrone 1 mg and mestranol .05mg) for 2 years is presented. The patient was admitted to the University Hospital in Jamaica after falling and losing power in the right arm and leg. She was a nonsmoker in good general health and had never previously been hospitalized. She was conscious with mild dysphasia when examined and complained of severe generalized headaches. There was grade 1 power in the right arm and leg, and an upper motor neurone right facial palsy. The left plantar response was down-going and the right equivocal. Fundoscopy was normal. Most clinical findings were normal, but a left Carotid angiogram showed complete occlusion of the middle cerebral artery at its origin and later films showed a good collateral circulation from the anterior cerebral vessels in particular. The patient was treated with a low dose aspirin and the OCs were discontinued. Physiotherapy was instituted and continued on an outpatient basis on her discharge 3 weeks after admission with grade 3 power in the right leg and grade 2 in the right arm. After careful exclusion of other known causes of stroke, the evidence, supported by data from the literature, points to the contraceptive pill as the causative factor in the development of the thrombotic stroke. The widespread use of OCs in the Caribbean should alert clinicians to the possibility of future cases, and women at risk should use other forms of contraception.
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PMID:Oral contraception and cerebral thrombosis in a Jamaican. 663 26

A 42 years old woman was noticed to have an abnormal shadow in the left lower field of lung at the time of periodical chest radiographic examination in July 1979. She didn't show any signs or symptoms of inflammation such as fever, increased rate of blood sedimentation, leukocytosis and so on by that time. Four weeks prior to admission she started to complain of mild but continuous headache and then developed anorexia, dysarthria and weakness in the right half of the face. She was admitted to the Kyoto University Hospital on September 14, 1979. On admission, slight bilateral papilledema, right hemiparesis and total dysphasia were present. She was afebrile and no abnormal finding in serological examination was shown. A heterogenously enhanced mass was demonstrated by CT scan in the left posterior frontal lobe, which was surrounded by severe cerebral edema. A provisional diagnosis of metastatic tumor from the lung was made. At the time of craniotomy, an abscess cavity was found and aspirated. Then the radical extracapsular ablation and external decompression was carried out. Histologically many Nocardia species were identified in the abscess cavity. The patient was treated by administration of a mixture of trimethoprine and sulfamethixazole (Bakter), and minocycline. Subsequently the developed Corynebacterial epidural empyema which was successfully evacuated two months after the first operation. She had been placed on Baktar for ten months since the second operation. She presented no sign of recurrence in six months after the cessation of drugs.
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PMID:[Nocardia brain abscess: a case report (author's transl)]. 707

Thirty-four patients were submitted to the conventional cervical myelography by administration of metrizamide (Amipaque) through three routes (lumbar 23, suboccipital 6, C1-C2 lateral 5). After the injection of metrizamide (4-11 ml, 170-250 mgI/ml), all procedures of the cervical myelography were done as soon as possible within 9 minutes. The adverse reactions of Amipaque were observed in 29 cases (85%) out of 34 cases initially 1 hour after cervical myelography and disappeared completely in an average of 16 hours. The total number of the side effects was 140 incidences such as meningeal irritation (headache 18, nausea 17, vomiting 17), cerebellar signs (dizziness 11, dysarthria 8, tremor 5, bradylalia 2, dysmetria 2, tipsy feeling 2, dysdiadochokinesis 1), autonomic signs (flushing 7, pale face 4, fever 4, sweating 2, hiccup 2, fatigability 2, micturition disturbance 1), sensory signs (exacerbation of numbness 6, perioral numbness 3, back pain 1, chest pain 1), motor signs (focal muscle spasm 5, exacerbation of paresis 4, areflexia 1), psychiatric signs (dysphasia 3, disturbance of consciousness 2, euphoria 1, persecutory delusion 1) and muddiness 7. We observed that waxing and waning of side effects correlated tightly with transient cortical penetration of dye in CT and cortical dysfunction mainly slowing of the background activity and slow wave burst in EEG. According to high frequency of side effects in our study, we suggest that a greater incidence of side effects may result when high concentration of Amipaque comes in contact with the cerebral cortex by using an inadequate fluoroscopic table which has only fixed one plane image and rough positioning control. Slow absorption into blood stream may affect appearance and maintenance of side effects. In order to decrease side effects after Amipaque cervical myelography, we propose that we should introduce a mobile rotating chair coupled with high power image and chose C1-C2 lateral route using 1500-1700mgI of Amipaque.
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PMID:[Side effects of metrizamide (Amipaque) cervical myelography (author's transl)]. 711 May 15

Patients with classical migraine whose auras included paraesthesiae or numbness in the hands have been reviewed. In 55 of 111 patients the symptoms were on the same side of the body as the headache and in only 20 on the opposite side to the headache. In the remaining 36 patients one or other was incompletely lateralised. Five right handed patients described dysphasia at the same time as paraesthesiae in the their non-dominant hand. These findings are incompatible with the notion that the headache is due to reactive hyperaemia following localised cerebral ischaemia, and it is suggested that the ischaemic and hyperaemic processes are both the result of some more generalised vasomotor disturbance.
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PMID:Asymmetry of the aura and pain in migraine. 731 Apr 27


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