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

A review of the medical records of 123 persons with Legionnaires' disease hospitalized in the 1976 Philadelphia epidemic showed that the manifestations of infection ranged from mild grippe to a severe pneumonia that also involved other organ systems. Early in the illness, constitutional symptoms predominated. Fever, malaise, myalgia, rigors, confusion, headache, and diarrhea were usually followed by nonproductive cough and dyspnea. Physical examination showed few abnormalities other than rales. Moderate leukocytosis with left shift, elevated erythrocyte sedimentation rate, elevation of serum levels of liver enzymes, and hematuria and proteinuria were characteristic. Chest radiograph showed patchy, often nodular, areas of consolidation. Progression of pneumonia led to respiratory failure and the need for mechanical ventilatory assistance for 19 patients; renal failure, primarily after shock, occurred in 18 persons. Twenty-six patients died. Treatment with erythromycin or tetracycline resulted in the lowest case-fatality ratios, but the associations were not statistically significant.
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PMID:Legionnaires' disease: clinical features of the epidemic in Philadelphia. 43 27

A case of papilloedema secondary to respiratory failure is reported which caused considerable diagnostic difficulty and led to extensive neurological investigation. Neurological complaints of headache and visual impairment overshadowed respiratory symptoms and were associated with gross haemorrhagic papilloedema. The case is compared with previous reports and the pathogenesis of papilloedema in respiratory failure is reviewed briefly. The similarity between the pathogenesis of this condition and benign intracranial hypertension is discussed.
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PMID:Papilloedema associated with respiratory failure. 59 98

The cases of six patients with Philadelphia Legionnaires' disease were studied during the acute phase and throughout the following year. This multisystems disease process developed abruptly with symptoms of chills, fever, myalgias, and headache. The unusual clinical association of fever with relative bradycardia was noted frequently. Pneumonia developed after the first few days and rapidly progressed to life-threatening respiratory failure despite penicillin and cephalosporin therapy. Improvement occurred within 48 hours after tetracycline or chloramphenicol was administered. No permament sequelae were noted on the one-year follow-up examination, and no secondary cases of infection occurred.
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PMID:Legionnaires' disease. Clinical findings and one-year follow-up. 68 92

Rhinocerebral mucormycosis was diagnosed in a 75-year-old woman with a history of type II diabetes mellitus. This rare opportunistic infection is caused by fungi belonging to the order of Mucorales. The patient had a severe osteomyelitis of the base of the skull, resulting in complaints of headache and diplopia. She was treated with intravenous colloidal amphotericin B, surgical excision, and later with liposomal amphotericin B. She died of respiratory failure. Mucormycosis is usually a rapidly fulminant infection. This patient showed a remarkably chronic course.
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PMID:[A patient with chronic mucormycosis]. 146 75

An 80-year-old man was admitted to our hospital with a complaint of insidious hearing loss and facial palsy. Chest X-ray film showed an abnormal shadow in the right lower lobe. Adenocarcinoma of the lung was diagnosed by transbronchial brushing cytology. During admission, headache and dysphagia appeared, although no abnormality was detected in the brain CT and MRI. Lumbar puncture yielded adenocarcinoma cells in the cerebrospinal fluid. A diagnosis of leptomeningeal metastasis from the adenocarcinoma of the lung was considered and intrathecal administration of methotrexate was performed. The patient's condition deteriorated gradually and he died of respiratory failure. Autopsy revealed massive invasion of tumor cells in the leptomeninges of the brain and spinal cord. This case illustrates that facial nerve palsy with insidious hearing impairment may appear as the initial symptoms in meningeal carcinomatosis resulting from lung cancer metastasis.
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PMID:[Insidious hearing loss and facial palsy as the presenting symptoms of meningeal carcinomatosis resulting from adenocarcinoma of the lung]. 175 49

A 64-year-old man was admitted to our hospital with leukopenia. On admission, leukocyte count in the peripheral blood was 1,600/microliters, containing 24.5% blasts of lymphoid appearance, which were negative for myeloperoxidase. A bone marrow aspiration showed hypoplasia with increased blasts (31.6%). The blasts were ultrastructurally positive for platelet peroxidase (PPO) and positive for platelet membrane glycoprotein IIb/IIIa complex. A diagnosis of acute megakaryoblastic leukemia was made. Chemotherapy with behenoyl-ara C (BH-AC) (150 mg/day) was transiently effective. However, after three months, numerous nodules without itching appeared over the entire body, particularly on the anterior chest. A biopsy of the skin lesion revealed a diffuse fibrosis with infiltrations of the blasts. Bone marrow aspirations were dry tap, and a bone marrow biopsy showed marked myelofibrosis. Then, severe headache, vomiting, and loss of consciousness developed, and a lumbar puncture revealed infiltrations of blasts. Although methotrexate was intrathecally injected, he died due to the respiratory failure. As far as we know, a case of acute megakaryoblastic leukemia with leukemia cutis and meningeal leukemia is quite rare. In addition, it is interesting that megakaryoblastic leukemia was accompanied with both the fibrosis of skin and the myelofibrosis.
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PMID:[Acute megakaryoblastic leukemia with leukemia cutis, meningeal leukemia, and myelofibrosis]. 175 56

We reported a case of multiple intracranial tuberculoma associated with miliary tuberculosis and reviewed the cases reported as intracranial tuberculoma in the past 11 years. A 41-year-old diabetic man was admitted to our hospital for the treatment of miliary tuberculosis and respiratory insufficiency. On admissIon, he had no neurological deficits except mild consciousness disturbance due to respiratory failure. He developed headache and mental confusion three weeks after the beginning of antituberculous therapy with isoniazid, streptomycin, rifampicin, and ethambutol. Neurological examination revealed that he had progressive right hemiparesis and was in a confusional state. Enhanced CT showed multiple intracranial nodular lesions. During 6 weeks, he had progressive neurological manifestations in spite of his initial antituberculous treatment. He responded well, however, to the chemotherapy with combination of isoniazid, kanamycin, pyrazinamide and ethionamide that were sensitive to tuberculous bacilli separated from his sputum. He became minimally right-hemiparetic by 6 weeks after the change of antituberculous medication. Serial enhanced CT scan proved to be of great value in the diagnosis and follow-up study of intracranial tuberculoma. From 1978 to 1988, there were 72 reported cases of intracranial tuberculoma in Japan; 37 were male, 32 were female and 3 were uncertain because of no detailed document. The age of onset was distributed from 6 month to 81 years in age and 2 peaks were seen in the second decade and fifth to seventh decade. Thirty-three (48%) out of 69 cases had multiple intracranial lesions. A few reports commented that neurological complications tended to appear even if they were under antituberculous therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case report of multiple intracranial tuberculoma associated with miliary tuberculosis and review of the literature]. 262 43

Five patients with chronic respiratory failure from neuromuscular disease and symptomatic worsening nocturnal hypoventilation were treated with nocturnal ventilation. Home ventilation at night was provided by a volume-cycled positive pressure ventilator attached to a nasal mask originally designed to administer nasal continuous positive airway pressure (CPAP) for obstructive sleep apnea. The device was well tolerated. Symptoms of headache, insomnia/somnolence, and impaired intellectual capacity rapidly disappeared with nocturnal ventilatory support. Daytime arterial PO2 and PCO2 improved after therapy. There are several advantages over commonly used, negative pressure devices for nocturnal ventilation. These include patient synchronization of tidal volume, ease of application, less cumbersome apparatus, more nocturnal patient mobility, and absence of production of upper airway obstruction.
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PMID:Nocturnal positive pressure ventilation via nasal mask. 354 11

Acute respiratory failure is a recognised complication of kyphoscoliosis, but such individuals exhibit a wide range of cardiorespiratory dysfunction ranging from clinically insignificant disease to severe respiratory failure and eventual death. We report a 49 year old lady with adolescent kyphoscoliosis who presented to her general practitioner with nocturnal headaches of such severity that opiates were given pending transfer to hospital over a distance of 50 miles. This induced acute respiratory failure for which assisted ventilation was required.
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PMID:Headaches, opiates and kyphoscoliosis--a dangerous mixture. 362 23

A case of subarachnoid hemorrhage complicated by neurogenic pulmonary edema and neurogenic myocardial damage is reported. A 50-year-old woman was admitted following the sudden onset of headache and disturbance of consciousness due to a ruptured internal carotid posterior communicating artery aneurysm on the right side. She showed respiratory failure due to pulmonary edema, which subsequently improved with the mechanical ventilation. After that, she manifested chest distress and hypotensive episode then occurred. An ECG showed QS wave and ST elevation which suggested the presence of inferolateral myocardial damage. Subsequent rises in serum GOT, GPT, LDH and CPK were noticed. CPK-MB and LDH I and V isozyme levels rose. An echo cardiogram showed hypokinesis of the apical half of the left ventricular septum. The patient died on 5th hospital day due to rerupture of the cerebral aneurysm. Autopsy revealed diffuse myocytolysis with coagulation necrosis of the heart muscle without occlusion of coronary arteries. A small hemorrhagic lesion was found in the hypothalamus. We suggested that a hypothalamic lesion due to subarachnoid hemorrhage stimulated the sympathetic nervous system which in turn discharged endogenic catecholamine. This was probably accompanied by vasospasm of the coronary arteries and systemic peripheral arterioles. Furthermore, myocardial oxygen consumption could have been increased by the increase in catecholamine. Finally, it gave rise to neurogenic pulmonary edema and extensive diffuse myocytolysis of the heart occurred.
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PMID:[Myocardial damage (myocytolysis) caused by subarachnoid hemorrhage]. 409 85


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