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

In order to contribute to the development of adoptive immunotherapy against malignant brain tumors, the pharmacokinetics and toxicity of intrathecally administered recombinant interleukin-2 in dogs and human patients were analyzed. The pharmacokinetics showed that a high concentration of IL-2 was maintained in the intrathecal cavity in both dogs and human (t1/2 = 1.41 and 1.68 hours, respectively) after administration. However, no activity of IL-2 was detected in the cerebrospinal fluid after the systemic administration of rIL-2 in one dog. No meningitis, ventriculitis or degeneration of neurons was seen histopathologically in dogs 3 weeks after the intrathecal administration of rIL-2 (200 units). A high concentration of IL-2 in the tumor cavity was maintained for a very long time (t1/2 = 14.8 hours) after the intratumoral administration of rIL-2 in one of the patients. Although low-grade fever and mild headache were sometimes observed after the intrathecal administration of rIL-2 in patients, there was no other side effect mentioned. Intrathecal or intratumoral administration of rIL-2 appeared to be an valuable procedure which should be evaluated in conjunction with adoptive immunotherapy against malignant brain tumors.
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PMID:[Pharmacokinetics and toxicity of intrathecal administration of recombinant interleukin 2]. 348 31

A 31-year-old man had been healthy until the end of August, 1984 when he developed a sore throat, rhinorrhea, and high fever (39 degrees C). He was found to have hematuria and leukocytosis, though his complaints were not severe, and was not absent from his work. From the September 30, he experienced continuous pains on both temple regions and the neck. On October 6, he visited our hospital without any inflammatory signs. A screening CT scan demonstrated a ring-like enhancing mass with remarkable perifocal edema in the right temporal lobe. On emergency admission on October 9, a low grade fever (37.4 degrees C) and slight leukocytosis were noted, but not other primary lesions were present. He had normal immunological function of both humoral and cellular types. A provisional diagnosis of malignant brain tumor was made, but a possibility of brain abscess was not completely ruled out. He was initially treated with antidiuretics and steroid with prophylactic antibiotics, and underwent follow-up CT scanning. After a 10-day period with no obvious changes in CT scan, he suddenly complained of severe headache and fever, and became stuporous. A subsequent CT scan showed signs of ventriculitis, and contrast-enhancing multiloculated capsules. A lumber puncture revealed an increased number of cells, and concentration of protein in the CSF. An emergency trephination and drainage of an abscess was performed. Gram positive, acid fast, and branching fungi were found in both the smear of pus, and the samples from surrounding brain tissues. These were later identified as Nocardia asteroides in bacteriological studies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Nocardia brain abscess and ventriculitis--resistance of Nocardia to sulfonamides and susceptibility to beta-lactams]. 370 32

Isolated fourth ventricle is an untoward but interesting complication caused by the shunt procedure, which has been recognized since the introduction of CT scanning. Auditory brain stem evoked potentials (BAEPs) were recorded in a patient with isolated fourth ventricle for assessment of brain stem function. Case 1. A 9-year-old boy. He had undergone repair of the lumbosacral meningocele at birth, followed by shunting procedures, including repeated shunt revision, for hydrocephalus which subsequently developed. CT scanning on admission revealed typical findings of isolated fourth ventricle, while neurological examination disclosed no abnormalities. BAEPs on admission revealed normal waves both in amplitude and latency. This patient has been doing well without further shunting procedures. Case 2. A 17-year-old male was admitted with complaints of headache, diplopia, nystagmus and ataxic gait. He had a history of operation for radical removal of cerebellar astrocytoma and lateral ventriculo-peritoneal shunt at 9 years of age. CT scanning on admission revealed a typical isolated fourth ventricle, and fourth ventricle-peritoneal shunt was performed. Postoperative serial BAEPs revealed gradual improvement of brain-stem function. Clinically he has been symptom-free thereafter except for slight nystagmus. Case 3. A 2-year-old female suffering from hydrocephalus developed after neonatal intraventricular hemorrhage and ventriculitis. After repeated revision of a lateral ventriculo-peritoneal shunt, she was admitted in semicoma with vomiting and opisthotonic posture. CT study revealed an isolated fourth ventricle and preoperative BAEPs showed marked abnormalities. Although fourth ventricle-peritoneal shunt was performed, no remarkable change in BAEPs was obtained, and neurological deficit of considerable degree persisted.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Brain stem auditory evoked potentials for assessment of isolated fourth ventricle in three patients]. 387 52

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 62-year-old man underwent lumbar metrizamide myelography complicated initially by a bout of aseptic chemical meningitis. Afterward, he suffered persistent headache, nausea, and blurred vision and, 12 weeks after his myelography, computed tomographic scans showed abnormalities consistent with a chronic ventriculitis. The case is presented; its pathological substrate and clinical implications are discussed.
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PMID:Ventriculitis after metrizamide lumbar myelography. 404 57

A case is reported of a brain abscess, which ruptured into the lateral ventricle and was treated using intraventricular irrigation with antibiotics. A 37-year-old man was suffering from a headache and high fever. Precontrast CT scan revealed a heterogeneous low density area in the left temporal lobe, and postcontrast CT scan showed a multilobular ring-like enhanced mass. Diagnosed as a brain abscess, intravenous administration of antibiotics was performed. On the sixth day the patient suddenly became drowsy. Postcontrast CT scan revealed an enhanced effect in the left lateral ventricular wall. Drowsiness was attributed to increased intracranial pressure and severe ventriculitis. Bilateral continuous ventricular drainage via the anterior horn of the lateral ventricle was performed. The drainage fluid from the left lateral ventricle was just like pus. Intraventricular irrigation with antibiotics between the bilateral anterior horns of the lateral ventricle, was performed in order to save the patient. The infusion fluid, Lactate Ringer's solution containing Cefazolin sodium, was infused into the right ventricle and CSF-like pus was drained from the left ventricle. The CSF reading gradually improved, and on the 14th day postoperatively irrigation was terminated. The postoperative course was uneventful. The diagnosis, treatment, and prognosis of patients with brain abscesses have improved dramatically as a result of more reliable methods of identifying infecting organisms, more effective antibiotic regimens, the development of microsurgical techniques and CT scan. However, despite these advances, the prognosis for brain abscess ruptured into the ventricle is usually very pessimistic.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Brain abscess ruptured into the lateral ventricle: the usefulness of treatment by intraventricular irrigation with antibiotics. A case report]. 807 4

We report a 43-year-old woman who suffered from Listeria monocytogenes meningitis. She was admitted to our hospital because of headache, nausea, vomiting, and fever. On admission she had no abnormal neurological signs except for severe nuchal stiffness. Cerebrospinal fluid (CSF) examination on the day of admission revealed pleocytosis and increased total protein level. The CSF culture demonstrated Listeria monocytogenes. Because ampicillin therapy was not effective, erythromycin (8 g/day) was added. After 12 hours of erythromycin therapy, the patient complained of moderate hearing difficulty. Erythromycin was then stopped on the next day. Her hearing improved and became normal within 48 hours after discontinuation of erythromycin. Contrast MRI of the brain revealed enhancement of the ependyma of the lateral ventricle, suggesting the presence of ventriculitis. By parenteral administration of ampicillin and cephazolin, clinical symptoms improved quickly, and abnormal CSF and MRI findings were normalized. Listeria meningitis accompanied with ventriculitis has been reported in neonates and infants, but not in adults. In addition, this is the first case with erythromycin-induced hearing loss in the Japanese literature. Hearing should be regularly examined in patients who are treated with high-dose erythromycin (> or = 4 g/day), and the drug should be immediately discontinued when the patient develops hearing loss.
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PMID:[Erythromycin-induced hearing loss in a patient with Listeria monocytogenes meningo-ventriculitis]. 897 38

We present a case with brain abscess associated with entrapment of the lateral ventricle appearing more like remarkable brain edema in the temporo-occipital lobe than ventricular dilatation. A 72-year-old man suffering from headache and vomiting visited our clinic. CT and MRI showed brain abscess in the right parieto-occipital lobe, associated with ventriculitis. Lumbar puncture also revealed purulent meningitis. Both symptoms and CSF findings improved after administration of antibiotics. The improved condition continued for two months after admission, but disturbed consciousness and left hemiparesis than appeared. MRI and CT showed entrapment of the lateral ventricle and brain edema of the right temporo-occipital region without ventricular dilatation. Because brain edema was thought to be caused by transudate of the CSF through the ventricular wall, lobectomy of the right temporal lobe and opening of the temporal horn were carried out. Although left hemiparesis and disturbed consciousness and brain edema disappeared after the operation, subdural effusion appeared. Using a subdural-peritoneal shunt, the subdural effusion was prevented and disappeared. In this case, we thought Hounsfield Unit (HU) of the brain edema caused by transudate of CSF through the ventricular wall (12.6) was markedly lower than that of so-called vasogenic edema (25.1) due to active inflammation. Measurement of the HU seemed to be a useful means to differentiate the types of brain edema in this situation from that of vasogenic edema caused by brain abscess, and thus a means for selection of the appropriate treatment.
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PMID:[Brain abscess and ventriculitis associated with entrapment of the lateral ventricle appearing more like remarkable brain edema than ventricular dilatation--a case report]. 1126 Aug 92

We describe the clinical, radiological and neuropathological findings in an adult AIDS patient presenting with ventriculitis and hydrocephalus as the primary manifestations of cerebral toxoplasmosis. Clinical symptoms including fever, headache, changes in mental status and focal neurological deficits were non-specific. Cranial computed tomography showed a subtile ventricular dilatation whereas magnetic resonance imaging disclosed triventricular hydrocephalus due to stenosis of the aqueduct and a periventricular nodular rim of high signal intensity on T2- and proton density-weighted images. This rim also showed a slight enhancement on post-contrast T1-weighted images. Focal intracerebral lesions could not be delineated, neither by neuroimaging nor by pathology. Neuropathological examination showed severe ventriculitis with large ependymal and subependymal necrosis as well as dilatation of the lateral and the third ventricle. The only microorganism demonstrated at histology in the central nervous system was Toxoplasma gondii. We conclude that ventriculitis and hydrocephalus without any focal parenchymal lesion may be the only manifestations of CNS toxoplasmosis. It is important to recognize this unusual form of presentation of cerebral toxoplasmosis in order to perform specific therapy.
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PMID:Primary cerebral toxoplasmosis: a rare case of ventriculitis and hydrocephalus in AIDS. 1594 61

Osteomas of the cranial sinuses are rare, benign bony tumors that can be complicated by the formation of an intracranial pneumatocele. If not treated promptly, a pneumatocele can lead to abscess formation, meningitis, or ventriculitis. In the present case, an intracerebral pneumatocele was formed when an 18 cm(3) osteoma breached the posterior wall of the frontal sinus creating a one-way valve through which air could enter the intracranial cavity. The patient presented after forceful sneezing with nonspecific symptoms of headache, nausea, and vomiting. CT demonstrated a frontal collection of loculated air with mass effect within the left cerebral hemisphere. A partly mineralized mass occupied the left superior nasal ethmoid sinus and left frontal sinus. Of interest pathologically in this case, the tumor had a substantial osteoblastoma-like component. Surgical repair involved frontal craniotomy to remove the osteoma and debride frontal sinus mucosa, plugging the frontal nasal ducts and sinus with fat and bone wax, and dural restoration using an underwater closed drainage system to vent intracranial air and stabilize the patient.
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PMID:Frontal sinus osteoma with osteoblastoma-like histology and associated intracranial pneumatocele. 2227 56


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