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

It is reported on the experiences of several years in 9,400 spinal anaesthesias in the urology in patients at an advanced age. Still at present the spinal anaesthesia has a dominating position in the urological intervention. Despite modern and differenciated anaesthetic methods the importance of the spinal anaesthesia is by no means reduced for most urological interventions, particularly for the transurethral operation technique, but it rather increased during the last years by the new local anaesthetics, by the development of thinnest spinal needles, but also the increased knowledge of the dangers of general anaesthesia. In urological diagnostics and therapy the spinal anaesthesia has still its full right and is less toxic for the patient and has less severe complications than the general anaesthesia. However, prerequisites for its use are: a) mastery of technique b) full assent of the patient c) psychic guidance of the patient during the whole duration of the intervention and d) balanced pre-, intra- and postoperative substitution of the volume e) overcoming of the established opinion that the spinal anaesthesia has a particular depressing effect on circulation and frequently causes post-spinal headache.
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PMID:[The current state of spinal anesthesia in urologic interventions]. 68 17

Demand for the newest and most elaborate Nuclear Medicine equipment is at an all time high. Never has there been more to offer than now with such improvements as large field of view, high resolution, whole-body capability and so on. The dedicated minicomputer systems that are available to go with these latest imaging devices are equally impressive. Still, the headaches associated with putting together a full capability camera/computer system are numerous. Things just do not seem to go together the way they ought to. If we are to truly get the most value out of our new equipment, we must put tremendous work loads on our clinical staff by expecting them to use very awkward and poorly configured systems in which several complicated steps are required to to produce the finished product ready for the reading room. The relatively low usage factor which most clinical Nuclear Medicine computer systems experience is not surprising when we consider the ridiculous way in which these systems are configured. It is time for a little human engineering to be introduced into the design process. Unfortunately, this proliferation of equipment is wasteful of money as well as the operator's time. It would make more sense to consolidate the multitude of displays and controlling elements into a single console which would allow a single operator to perform all necessary data processing operations quickly and interactively.
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PMID:Nuclear medicine computing. Where we have been, where we are and where we are going. 103 Aug 28

Patients diagnosed as suffering from common migraine according to the "Ad hoc committee" criteria of 1962 have been studied as for type of unilaterality of headache. Patients, with trauma to the face, head, and neck were excluded, together with patients with the faintest suspicion of aura and those with chronification of the headache. Common migraine criteria, as stipulated by the IHS and Vahlquist, were counted in every patient (n = 32), except the laterality which was a free variable (a total of 8 variables remaining). For comparison, as far as the number of migraine criteria is concerned, a group of cervicogenic headache patients was also studied (n = 30). Unilaterality with side shift of pain was present in 75% in the common migraine group; in 34% of the patients, a combined pattern, i.e. bilateral headache + unilaterality with sideshift was present. Common migraine, therefore, just as classic migraine, seems to be a headache characterized by unilaterality with side alternation of pain. Common migraine criteria were present to a high degree in common migraine patients selected in this way, i.e. ca. 6.8 of a maximum of 7. In cervicogenic headache, the corresponding figure was ca. 3.8 (of a maximum of 7). These figures are statistically significantly different (p < 1.3 10(-11), Mann-Whitney test). Still, the level of criteria is relatively high in cervicogenic headache, and 6 of 30 patients would fulfil the IHS common migraine criteria.
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PMID:Laterality of pain and other migraine criteria in common migraine. A comparison with cervicogenic headache. 142 60

We studied 50 patients (28 male and 22 female) with the hyper-IgD and periodic fever syndrome. Most patients originated from Europe, namely The Netherlands (28 cases; 56%), France (10 cases, 20%), and Italy (3 cases, 6%), but 1 patient was from Japan. A hereditary component is suggested by 18 patients coming from 8 families. The syndrome is typified by a very early age at onset (median, 0.5 years) and life-long persistence of periodic fever. Characteristically, attacks occur every 4-8 weeks and continue for 3-7 days, but the individual variation is large. Attacks feature high spiking fever, preceded by chills in 76% of patients. Lymphadenopathy is commonly present (94% of patients). During attacks, 72% of patients complained of abdominal pains, 56% of vomiting, 82% of diarrhea, and 52% of headache. Joint involvement is common in the hyper-IgD syndrome with poly-arthralgia in 80% and a non-destructive arthritis, mainly of the large joints (knee and ankle), in 68% of patients. Eighty-two percent of patients reported skin lesions with some attacks; these demonstrated vasculitis histologically. Serositis has been seen in only 3 patients (6%), while amyloidosis has not been recorded in any of the patients with this syndrome. Immunizations precipitated attacks in 54% of patients. All patients had a persistently elevated serum IgD level (> 100 U/mL), and in 82% of cases the serum IgA was likewise elevated. During attacks there is an acute-phase response adjudged by leukocytosis, neutrophilia, and increased ESR. The etiology remains to be elucidated, and treatment is supportive. The hyper-IgD syndrome is distinct from other periodic fever syndromes like systemic-onset juvenile rheumatoid arthritis, adult-onset Still disease, and familial Mediterranean fever.
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PMID:Hyperimmunoglobulinemia D and periodic fever syndrome. The clinical spectrum in a series of 50 patients. International Hyper-IgD Study Group. 819 36

A systematic follow-up showed that out of 785 headache patients 1/4 had odontogenic pathogenic factors with possible connections to the headache syndrome and were indicated to be operated. 158 could be systematically examined and (surprisingly enough) improvement of headache syndromes ranking at 2/3 was about equally frequent within the group of those who had undergone dental operation and those that had not wanted to do so. In sub-groups different responses to operation were observed: cephalaea (permanent headache), better than migraine (attack figured headache); etiology of wisdom-tooth better than other tooth-pathology; upper jaw better than lower jaw. Our results once more underlined the multifactorial etiology of headache, that is opposed to a monocausal oriented headache diagnosis (as the IHS-nomenclature tries to impose). Still it has considered to be relevant that a good diagnostic examination in the field of tooth-, jaw- and mouth medicine should be conducted in every headache patient, even in "typical" migraine patients. When indicated, operations should be done; however the patient properly informed that improvement is not obligatory. Same time all the other possible etiologies for headaches shall be regarded and if positive treated.
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PMID:[Odontogenic (concomitant) etiology of headache]. 943 10

The hyperimmunoglobulinemia D syndrome is characterized by early onset of attacks of periodic fever and an elevated serum polyclonal Ig D (> 100 U/ml). Symptoms during attacks include joint involvements (arthralgia/arthritis), skin lesions, swollen lymph nodes, headache and abdominal complaints (vomiting, diarrhea and pain). The ethiopathogenia is unknown. It is transmitted by autosomal recessive inheritance. The hyperimmunoglobulinemia D syndrome should be distinguished from other periodic febrile syndroms such as systemic-onset juvenile rheumatoid arthritis, CINCA syndrome, FADA syndrome, familial mediterranean fever and adult-onset Still disease. There is no therapy for the syndrome but the prognosis is good because the frequency and severity of the attacks tends to diaeminish with age.
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PMID:[Hypergammaglobulinemia D syndrome]. 1149 72

Clinicians working in the field of headache face great difficulty in managing patients with daily headache. Many of these patients have a history of episodic migraine that over several years has transformed into a chronic headache. Others have a history of episodic tension-type headache that also has chronicized. Still others present clinical characteristics that resemble both headache forms. In this article, we review the clinical and pathophysiological aspects of chronic daily headache and discuss the problems associated with its diagnosis.
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PMID:Chronic migraine and chronic tension-type headache: different aspects of the chronic daily headache spectrum. Clinical and pathogenetic considerations. 1281 1

A 20-year-old, previously healthy woman, presented with high fever, headache and myalgia 3 days after her return from a holiday in Southeast Asia. Laboratory data on admission demonstrated a pronounced increase in plasma creatinine, marked thrombocytopenia and moderately elevated liver aminotransferases. After having ruled out malaria, dengue fever was primarily suspected and supportive intravenous fluid therapy was initiated. Still, 1 day after admission, platelet counts dropped even further and she became anuric although she did not appear hypovolemic. On day 2 after admission, urine production commenced spontaneously and the patient slowly recovered. All laboratory test results had returned to normal approximately 2 months later. Serological analysis for dengue fever was negative. It turned out that the patient had been trekking in the jungle while in Thailand and we, therefore, analyzed serology for Leptospira spirochetes which was clearly positive. The patient was diagnosed with leptospirosis which is a serious condition associated with a high mortality when complicated by acute renal failure. Differential diagnoses in patients with acute renal failure and tropical infections are reviewed. The importance of early recognition of leptospirosis, and prompt treatment with antibiotics in suspected cases, is emphasized.
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PMID:Acute renal failure after a holiday in the tropics. 1717 21

Increased, decreased or normal excitability to transcranial magnetic stimulation (TMS) has been reported in the motor (M1) and visual cortices of patients with migraine. Light deprivation (LD) has been reported to modulate M1 excitability in control subjects (CS). Still, effects of LD on M1 excitability compared to exposure to environmental light exposure (EL) had not been previously described in patients with migraine (MP). To further our knowledge about differences between CS and MP, regarding M1 excitability and effects of LD on M1 excitability, we opted for a novel approach by extending measurement conditions. We measured motor thresholds (MTs) to TMS, short-interval intracortical inhibition, and ratios between motor-evoked potential amplitudes and supramaximal M responses in MP and CS on two different days, before and after LD or EL. Motor thresholds significantly increased in MP in LD and EL sessions, and remained stable in CS. There were no significant between-group differences in other measures of TMS. Short-term variation of MTs was greater in MP compared to CS. Fluctuation in excitability over hours or days in MP is an issue that, until now, has been relatively neglected. The results presented here will help to reconcile conflicting observations.
J Headache Pain 2012 Jan
PMID:Increased variability of motor cortical excitability to transcranial magnetic stimulation in migraine: a new clue to an old enigma. 2188 5

Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening inflammatory disorder characterized by uncontrolled proliferation and activation of histiocytes with phagocytosis of normal hematopoietic cells. A 41-year-old woman, 19 weeks pregnant with twins, and a history of Still's disease, presented with rash, fever, and headache. Laboratory studies revealed transaminitis, hyperbilirubinemia, and eventually severe neutropenia as well as elevations in ferritin, lactate dehydrogenase, and C-reactive protein. A bone marrow biopsy confirmed HLH. She declined standard HLH-treatment but responded well to high-dose corticosteroids. Her blood counts remained stable following corticosteroid taper, and she delivered healthy twin girls at 30-week gestation. Few cases of HLH during pregnancy have been reported. In some cases, the condition has proved fatal. Therefore recognizing signs and symptoms of HLH is essential to avoid treatment delay. In our case, high-dose corticosteroids alone were a safe and effective therapy for the mother and fetuses resulting in long-term disease control.
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PMID:Hemophagocytic lymphohistiocytosis in pregnancy: a case report and review of treatment options. 2316 71


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