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

Of 488 children with central nervous system neoplasms, 43 (8.8%) had glioblastomas, 22 of which were in the cerebral hemispheres, 16 in the brain stem, two in the cerebellum, and three in the spinal cord. The male to female ratio was 3:2. Glioblastoma multiforme of the cerebral hemispheres occurred at a mean age of 12.7 years, and the frontal lobe was the most commonly involved. Main presenting symptoms included headache (85%), nausea or vomiting (65%), and seizures (35%). Papilledema (45%) was the most common physical finding. The longest survivals were achieved by a combination of operation and radiation (22 months). Brain stem glioblastomas occurred at a mean age of 6.7 years, with the pons as the most frequent site. Nausea or vomiting (50%) and headache (36%) were the main presenting symptoms; the major physical findings were ataxia (43%), cranial nerve palsies (28%), and paresis (28%). The length of survival was greatest with radiation alone (10.5 months). The period of survival of children with glioblastoma multiforme was significantly increased with steroid therapy. Glioblastoma multiforme behaves similarly in children and adults. Intracranial glioblastomas have a more rapidly fatal course than that of other similarly situated gliomas in childhood.
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PMID:Glioblastoma multiforme in children. 17 31

A 55-year-old man having hemiplegia after the sudden onset of a stroke was referred for rehabilitation. Cerebral angiography had demonstrated occlusion of the left middle cerebral artery and steroid therapy had been started. Attempted tapering of the steroid therapy on admission for rehabilitation resulted in the patient having severe headaches and confusion. Blink reflex evaluation, somatosensory cerebral evoked potential determinations and visual evoked responses were all consistent with a widespread process involving the parietal lobe of the patient's left cerebral hemisphere. Computerized axial tomography indicated an abnormality consistent with a space-occupying lesion. Craniotomy revealed the presence of a glioblastoma multiforme in the left cerebral hemisphere. Electrodiagnostic evaluation was entirely consistent with the operative finding of widespread involvement of the patient's left parietal lobe. Stroke patients whose conditions deteriorate over time must be serially evaluated in order to determine possible other causes of their symptoms.
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PMID:Glioblastoma multiforme presenting as stroke: an electrophysiological and clinicopathological case report. 22 22

At the UCH in Ibadan, Nigeria, we have seen forty-three patients with verified neoplasms of the brain comprising most histologic types of the glioma/paraglioma series. The astrogliomas formed the largest group, followed by the pinealomas in 16.27% and the medulloblastomas and ependymomas, each occurring in 13.95% of the patients. By the end of the third decade of life 83.7% of these neoplasms have become clinically manifest; the largest number being found in the first decade. Just over half (51.16%) of all the neoplasms and also two-thirds of the patients in whom the masses were found in the posterior fossa were children under 15 years. In nearly all cases the duration of symptomatology on admission to hospital was under 6 months. Headaches, papilloedema and altered states of consciousness were frequent; and the prognosis in general has been poor. The classical glioblastoma multiforme and the acoustic neurinoma are quite uncommon in the Nigerian African; but a fairly full spectrum of the 'gliomas' has been clearly identified in the group of primary brain tumours at Ibadan.
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PMID:Gliomas of the brain among Nigerians. 82 3

An autopsy case of glioblastoma of the cerebellum associated with an intracerebellar hemorrhage and showing CSF seedings is reported. A 26 year-old male was admitted to our hospital with a 10-day history of headache, nausea and vertigo. On admission, disturbance of consciousness (10-20 by JCS), irregular respiration and central fixation of both eyes suggesting increased intracranial pressure and early stage of central herniation were recognized clinically. The cerebellar signs of dysmetria and nystagmus were also observed. CT scan and angiography revealed an avascular large mass in the right cerebellar hemisphere, obstructive hydrocephalus and upward transtentorial herniation. On MRI study, the mass was demonstrated to be a subacute hematoma with a small tumor in its margin. Total removal of the tumor and aspiration of the hematoma were performed. Histological examination revealed a highly cellular and pleomorphic astrocytic tumor with scattered small necrosis and glomeruloid capillary endothelial proliferation, typical of glioblastoma multiforme. During postoperative radiochemotherapy (focal irradiation to the posterior fossa), the tumor showed rapid regrowth and a second look operation was performed. He was readmitted 3 weeks after radiochemotherapy with complaints of severe headache, nausea and lumbago. He then suddenly became dyspnea, tetraplegic and bradycardic. Neuroradiological investigation revealed multiple masses in the suprasellar region, medulla oblongata and the cervical spinal cord, but no recurrence in the cerebellum. Malignant cells were noted on CSF cytology. During chemotherapy for CSF tumor dissemination, his condition deteriorated rapidly and he died 7 months after the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Glioblastoma of the cerebellum: report of an autopsy case associated with intratumoral hemorrhage and CSF seedings]. 165 2

A 74-year-old male was admitted because of severe headache, vertigo, and vomiting. A computed tomographic scan showed heterogeneously enhanced tumors in the supra- and the infratentorial regions, apparently attached to the cerebellar tentorium. He died 2 months after the onset despite external decompression and a ventriculo-peritoneal shunt. The autopsy showed both tumors were intra-axial and not attached to the dura mater including the cerebellar tentorium. The histological diagnosis of either tumor was glioblastoma multiforme. This case could be classified as multicentric gliomas. In the 23 reported cases, including our case, most died soon after the onset of symptoms. Some, however, with low grade tumors had a comparatively long life span after the onset. It is, therefore, important to investigate the histology of these tumors for correct prognosis.
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PMID:Multicentric glioblastoma multiforme occurring in the supra- and the infratentorial regions--case report. 169 50

Tumors at the trigone of the lateral ventricles are relatively rare. The authors have operated on eight cases with trigonal tumors during a 10-year period. Four cases were true intraventricular tumors arising from the ventricular walls, consisting of two meningiomas, one cavernous angioma, and one choroid plexus papilloma. On the other hand, the remaining four cases were paraventricular tumors originating in the adjacent brain and consisted of three astrocytomas and one glioblastoma multiforme. Although these trigonal tumors were readily detected with computed tomographic (CT) scanning, differential diagnosis was difficult because of their similar appearances on CT scans. The initial symptoms were headache in seven, and the neurological examination revealed personality changes, choked disc, visual field defects, hemiparesis, etc., in four, and no deficits in the remaining four cases. All cases were operated on via superior or middle temporal gyrus incision, and the surgical results were good except for one case who died of postoperative brain edema. In the four cases with tumors located in the dominant hemisphere, two were left with sensory aphasia, dyslexia, dyscalculia, and hemianopsia which improved within 6 months. In these two cases, postoperative CT scans revealed cerebrospinal fluid retention with severe edema along the surgical route which disappeared spontaneously within 3 months. We consider that the temporal gyrus incision was the safest approach, even though the tumor was located in the dominant side.
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PMID:Tumors at the trigone of the lateral ventricle--clinical analysis of eight cases. 170 58

All brain tumours diagnosed since 1967 in a University Hospital in the Southern region of Brazil were reviewed and clinical information concerning age, sex, symptoms and evolution were analysed. 88.1% of tumours were primary neoplasms and the rest secondary deposits. There was a male predominance and the second and fifth decades of life were the most affected. The main presenting symptoms were headache, vomiting, hemiparesis, loss of vision and epilepsy. The commonest tumour was of astrocytic origin (36.3%) amongst which the malignant ones, including glioblastoma multiforme, predominated. These tumours were frequent in the cerebral hemispheres (31.3%), particularly in the frontal lobes. The time of evolution from the beginning of the clinical manifestations until the first hospital admission was also studied. The authors discuss the clinical and pathological observations in relation to other large series analysed in the literature.
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PMID:Brain tumours in south Brazil: a retrospective study of 438 cases. 226 82

We experienced a case of glioblastoma multiforme which exhibited dementia, gait disturbance, headache, and urinary incontinence six months after subtotal removal of the tumor. These symptoms were not due to tumor recurrence, but to communicating hydrocephalus. Communicating hydrocephalus in cases of malignant brain tumors has not often been reported. We discuss the development of this abnormality.
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PMID:Communicating hydrocephalus occurring in the postoperative course of glioblastoma multiforme. 256

Brainstem tumors arise in portions of the rhombencephalon and mesencephalon. Some authorities include diencephalic tumors in this group. We have reviewed our clinical experience of 69 children (less than 21 years of age) with brainstem tumors evaluated and treated at Duke University Medical Center (DUMC) from 1960 to 1986. There were 19 patients with group 1 tumors (thalamus, third ventricle region, or midbrain) and 50 with group II tumors (pons, medulla oblongata). The common presenting signs and symptoms were ataxia, headache, motor loss, and cranial nerve palsies. The most commonly employed diagnostic imaging studies were air examinations and CT. Preradiotherapy confirmation of malignancy was obtained in five group I patients (astrocytoma, 4; germinoma, 1) and 8 group II patients (astrocytoma, 3; anaplastic astrocytoma, 2; glioblastoma multiforme, 3). All patients received radiotherapy. The 5-year survival rate for the entire population was 40%. The survival rate for group I patients was significantly better than that observed for group II patients. In the 50 group II patients neither patient sex nor age nor presence of cranial nerve palsies nor pretreatment CT scan findings nor field size influenced survival. A long duration of symptoms positively influenced survival. The vast majority of tumor recurrences were within the radiation field. Half of the patients had either stable or improved Karnofsky status 6 months following completion of irradiation. The management strategy for childhood brainstem tumors is discussed.
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PMID:Selection of a management strategy for pediatric brainstem tumors. 270 33

There have been conflicting opinions regarding the correct volume to be used in radiotherapy fields for brain stem tumors of childhood. Whereas many clinicians recommend limited fields designed to cover the tumor volume with a margin, some have advocated whole brain radiotherapy. Using our clinical experience at Duke University Medical Center, we have made an attempt to determine the proper irradiation volume in this group of tumors. We have evaluated 38 patients with brain stem tumors in children less than 18 years of age. The most common presenting symptoms were headache, ataxia, and hemiparesis. Thirteen patients had a histologic diagnosis made prior to treatment or post-mortem. All had either an anaplastic astrocytoma or a glioblastoma multiforme. Tumors were located in the thalamus, hypothalamus, or midbrain in 9 patients and in the pons or medulla oblongata in the remaining 29 patients. All patients received a course of radiotherapy. The mean minimum tumor dose was 52.6 +/- 5 Gy given at 1.7 to 2.0 Gy/fraction. Twenty-three patients received radiation to a limited field and 14 received whole brain irradiation. In one patient, the field size could not be ascertained. The five year survival of the total group was 39%. The survival of patients with thalamic, hypothalamic, or midbrain tumors was 73% compared with 28% for those with tumors of the pons or medulla oblongata (p = 0.0159). Eighty-eight percent of the tumor recurrences in evaluable patients (22/25) occurred within the radiotherapy fields. Patients were stratified for tumor location and no difference was observed in survival or relapse-free survival among those individuals treated with limited irradiation fields or whole brain irradiation fields. When our results are examined in conjunction with previously published data, the bulk of existing evidence supports the use of limited fields for irradiation of brain stem tumors of childhood.
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PMID:Pediatric brain stem tumors: patterns of treatment failure and their implications for radiotherapy. 298 30


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