Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Approximately 45% of benign peripheral nerve sheath tumors occur in the head and neck region. Of these, schwannomas (neurilemomas) arising from the nasal cavity and paranasal sinuses account for less than 4%. Pathologic features of this subset are not well documented. We report a series of five cases of sinonasal schwannoma and one in the nasopharynx. The male-to-female ratio was equal, and the age at presentation ranged from 38 to 65 years of age (median, 52 yr). Four of the lesions were located within the nasal cavity, one arose from the maxillary sinus, and one originated in the nasopharynx, with extension into the Eustachian tube. Two cases showed local bony destruction, with intracranial extension. Presenting clinical symptoms included nasal obstruction, epistaxis, rhinorrhea, anosmia, facial swelling, headache, and serous otitis media; the two cases with intracranial spread also presented with visual disturbances. All of the six cases were treated by surgical excision. Clinical follow-up in five cases ranged from 6 to 48 months (median, 27 mo). Histologically, all of the lesions shared many cytomorphologic features common to schwannomas arising at other sites, and all of the six cases showed strong, diffuse immunoreactivity for S-100 protein. Four cases showed features of the cellular variant, and one showed focal granular cell change. An unusual and previously poorly documented histologic feature, distinct from schwannomas arising at most other anatomic sites, was a lack of encapsulation, which, when combined with hypercellularity, often raised suspicion of malignancy. Because none of the cases in this series has shown either local recurrence or postoperative metastasis to date, lack of encapsulation and locally destructive growth in an otherwise histologically typical schwannoma arising at this site should not suggest malignant potential.
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PMID:Schwannomas of the sinonasal tract and nasopharynx. 926 19

A 58-year-old woman developed slowly progressive hearing loss, anosmia, and unsteady gait. She had neither repeated episode of headache nor a past history of neurosurgical operation or head injury. Neurological examination revealed anosmia, moderate degree of sensorineural hearing loss. She showed loss of caloric response bilaterally. No nystagmus was found. Romberg sign was present. No cerebellar ataxia was noted in the finger-to-nose or the heel-to-knee test. No adiadochokinesis was noted. Deep tendon reflexes were increased in both upper and lower extremities. Sensation was intact. She showed disturbance of the righting reflex in the tilt-table examination. CSF were under normal pressure, xanthochromic with siderophages. CSF total protein and ferritin level were elevated. T2-weighted image (TE4000/TR100) of high field strength magnetic resonance imaging (MRI) showed marginal hypointensity of the brain stem, the Sylvian fissures, the tips of temporal lobes, anterior cerebellar surfaces and the entire spinal cord. Angiography of the cerebral vessels and spinal arteries failed to identify the source of bleeding. It seemed likely that she had lost bilateral vestibular and auditory functions caused by hemosidelin deposition to her eighth nerves which are often affected by this disorder. Her disturbance of gait and station was apparently similar to cerebellar ataxic gait, however, she did not have limb ataxia. The electronystagmogram revealed marked degree of vestibular dysfunction (VOR) and relative sparing of cerebellar function (OKN). Her disturbance of the righting reflex in the tilt-table examination and the characteristic feature of her Romberg sign with directional preponderance also indicate that the bilateral loss of vestibular functions, i.e., vestibular ataxia caused her dysequilibrium syndrome. It is our impression that vestibular ataxia might precede cerebellar ataxia commonly reported so far.
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PMID:[A case of superficial siderosis of the central nervous system with bilateral vestibular dysfunction]. 936 92

A 58-year-old woman, with recurrent headaches, exhibited cerebellar alaxic gait, anosmia, deafness and a pyramidal syndrome, with a progressive onset. In cerebrospinal fluid there was erythrocytes and siderophages. MRI on T2-weighted images revealed a marginal hypo-intensity, leading to the diagnostic of superficial siderosis of the central nervous system. None haemorragic lesion was found. The patient was given Trientine. Unfortunately she worsened on later examinations.
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PMID:[Case of superficial hemosiderosis of the central nervous system treated with trientine]. 977 49

Over a 2-year period, 21 patients with clinical and radiologic evidence of persistent or recurrent frontal sinusitis who had a prior ethmoidectomy and/or frontal sinusotomy underwent an endoscopic Lothrop procedure. The patients' chief complaints were headaches (13), nasal obstruction and/or purulent rhinorrhea (4), orbital abscess/cellulitis (2), anosmia (1), and cough (1). Preoperative frontal headaches were present in 19 patients. The common frontal ostium remained patent (> 50% of intraoperative size) by flexible fiberoptic examination and transillumination 2-24 months postoperatively in 12 of 21 patients (57%). Eighteen of 21 patients (86%) had improved or resolved chief complaints. All but 4 of 19 patients (21%) with preoperative frontal headaches had improved or resolved symptoms. Two patients required additional surgery during the follow-up period. The endoscopic Lothrop procedure is a viable option before frontal sinus obliteration in patients with recurring frontal sinusitis who have failed conventional endoscopic techniques. The surgical technique and results will be presented.
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PMID:Endoscopic Lothrop procedure: the University of Miami experience. 980 33

Olfactory groove meningioma is a rare clinical entity. The principal symptoms associated with olfactory groove meningiomas are anosmia and headache which lead the patient to the ENT specialist. Frontal sinusitis, migraine and neuralgia are most frequent incorrect diagnoses. This retrospective study of 13 consecutive patients who underwent excision of Olfactory Groove meningiomas in the North Staffordshire Royal Infirmary, Department of Neurosurgery over a 20-year period was undertaken to study the presenting features, duration of symptoms, results of surgery, and long-term follow-up. Symptoms were present for less than 6 months to 3 years. Although excision was thought to be complete reoccurrences occurred in four patients. The morbidity of surgery was significant.
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PMID:Olfactory groove meningiomas. 1060 98

From 1989 to 1999, 237 consecutive patients with chronic sinusitis and/or nasal polyposis entered a prospective study on the effect of functional endoscopic sinus surgery (FES). Nasal stenosis associated with massive nasal polyposis was the most frequent problem found in 61% of the patients. The rest had long-lasting symptoms of chronic sinusitis. Duration of symptoms averaged 9.3 years. Most frequent symptoms preoperatively were: nasal stenosis, chronic secretion, anosmia, frontal pain, headache and maxillary pain. All patients had the operation performed under general anaesthesia. 86% of the patients have been operated bilaterally. In 72% the posterior ethmoid was opened, and in 54% the sphenoid was opened. The maxillary ostium has been enlarged in 82% of the patients and the frontal recess opened in 51% of the cases. No serious complications were registered. Annoying bleeding was experienced in 21%, hampering the intended procedure. In three patients rhinoliquore was observed. One case was treated during the procedure; the last two patients were in no need of surgical treatment. At the 1-year follow-up study, 45% of the patients were totally satisfied with the results and without symptoms, and 44% were definitely feeling better.
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PMID:Functional endoscopic sinus surgery in chronic sinusitis--a series of 237 consecutively operated patients. 1090 8

Olfactory neuroblastoma is a rare tumor originating in the upper nasal cavity. It rarely extends intracranially. We report a clinical case of olfactory neuroblastoma with intracranial extension and distant metastasis. A 35-year-old man complained of nasal stuffiness and bleeding, headache and vomiting. Neurological examination showed anosmia and papilledema. MRI showed a huge mass that occupied the right nasal and paranasal cavities, and extended into the right frontal base. The tumor was removed totally and was histologically diagnosed as olfactory neuroblastoma. About two months after surgery, however, MRI demonstrated a rapid recurrence of the tumor in the nasal and paranasal cavities and the frontal lobe. Metastatic lesions were also seen in the right cervical lymph nodes. Chemotherapy was administered using cisplatin and etoposide. The tumor in the frontal lobe shrunk markedly but the other lesion persisted. Whole brain irradiation and local irradiation of the cervical lymph nodes were performed. The tumors became smaller but did not disappear. MRI demonstrated spinal dissemination. Irradiation of the whole spinal cord was performed. The metastatic lesions disappeared. The patient was discharged without neurological deficits, but died of pneumonia 15 months after surgery. Olfactory neuroblastoma is a slow-growing tumor and is highly radiosensitive, but it rarely extends or develops multiple distant metastases and seldom shows a short survival time, as in our case. A review of the literature documented responses in patients treated with a cisplatin-based drug combination. We recommend systemic control using cisplatin-based chemotherapy in addition to irradiation to prevent local recurrence in cases of advanced or metastatic olfactory neuroblastoma.
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PMID:[A case of olfactory neuroblastoma with intracranial extension and distant metastasis]. 1106 69

The upper midface area comprises mainly the naso-orbito-ethmoidal (NOE) region which plays a paramount role in facial expression. Fractures of this area often result in neglected bony defects in the fragile periorbital region with major secondary impairments such as traumatic telecanthus, orbital dystopia, and/or enophthalmos. Permanent cranial nerve deficits also can occur as the result of post-traumatic/post-operative sequelae. Seventy-one patients (age range 7-78 years) with severe high midface trauma, treated from January 1989 to December 1996, were reviewed with a minimum follow-up of 2 years. The patient population has been distributed according to the fracture type in three groups: Group 1 (n = 35): Isolated NOE with/without associated central midface injury; Group 2 (n = 22): NOE associated with craniofacial injury and Group 3 (n = 14): NOE associated with orbital displacement. The estimated post-surgical parameters included qualitative and quantitative data from the long-term clinical evaluation. Persistent headache and/or concentration difficulties were mainly noted in Group 1. Smell reduction or anosmia was reported mainly in Group 2. Deficits of the trigeminal and/or the facial nerve were found in Group 3. Enophthalmos and/or telecanthus were predominantly seen with injuries associated with orbital displacement.
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PMID:Late sequelae after high midface trauma. 1115 23

A 44-year-old patient died from amyotrophic lateral sclerosis (ALS) after nine years of heavy exposure to cadmium (Cd) in a nickel cadmium (Ni-Cd) battery factory. Two years after starting work he and co-workers had experienced pruritus, loss of smell, nasal congestion, nosebleeds, cough, shortness of breath, severe headaches, bone pain, and proteinuria. Upper back pain and muscle weakness progressed to flaccid paralysis. EMG findings were consistent with motor neuron disease. Cd impairs the blood-brain barrier, reduces levels of brain copper-zinc (Cu-Zn) superoxide dismutase (SOD), and enhances excitoxicity of glutamate via up-regulation of glutamate dehydrogenase and down-regulation of glutamate uptake in glial cells. High levels of methallothionein, a sign of exposure to heavy metals, have been found in brain tissue of deceased ALS patients. The effects of Cd on enzyme systems that mediate neurotoxicity and motor neuron disease suggest a cause effect relationship between Cd and ALS in this worker.
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PMID:Amyotrophic lateral sclerosis in a battery-factory worker exposed to cadmium. 1137 40

Enlargement of paranasal sinuses with air is rare with less than 50 cases reported in the medical literature. This craniofacial malformation was first described by Meyes in 1898 and its aetiology still remains unknown. Local pain, ocular alterations, anosmia, headache and cosmetic disturbances are the most common symptoms. We present a case of pneumosinus dilatans diagnosed in a male, 8 years of age. He presented with left fronto-orbital bossing that enlarged slowly until he was 12 years old, at which point its growth appeared to increase dramatically. Computerized tomography revealed an enlargement of the frontal and ethmoidal sinuses, with marked deformation of the anterior wall and of the roof of the left frontal sinus, as well as the roof of the ethmoid and upper sinus medial orbital wall. The sinus walls were of normal thickness. Access was via a bicoronal incision and osteotomy of the deformed fronto-orbital bossing. Reconstruction was undertaken with a periosteal flap and hydroxyapatite bone cement (Norian) following sinus mucosal stripping and obliteration of the sinus with fat. Six months postoperatively, the patient was without recurrence and had a good cosmetic result.
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PMID:Pneumosinus dilatans of the frontal and ethmoidal sinuses: case report. 1206 86


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