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

A post-mortem examined case of herpetic brainstem encephalitis is presented. Clinically, the patient had cephalalgia followed by ataxia, drowsiness and multiple palsies of some cranial nerves, developing into death in eight days. The pathologic examination of the brain showed necrotizing encephalitis in multiple foci limited to the brainstem, more distinctly in the pons and medulla oblongata. The technique of immunoperoxidase revealed rare glial cells with intranuclear immunoreactivity for herpes antigen. Rare viral particles with the morphological characteristics of the herpesvirus were identified in the nuclei of neurons in 10% formol fixed material. This is the second reported case of herpetic brainstem encephalitis confirmed by post-mortem examination. The pathway used by the virus to reach the central nervous system and its posterior dissemination to the oral cavity, the orbitofrontal region and the temporal lobes as well as to the brainstem, after a period of latency and reactivation, are discussed.
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PMID:[Herpetic brain stem encephalitis: report of an autopsied case with immunohistochemical and electron microscopy studies]. 303 59

We report 3 cases of posterior fossa subdural effusion resulting from head trauma, and we review 20 previously reported cases. All patients with the acute type presented with progressive deterioration of consciousness associated with stiff neck, seizure, and dyspnea (apnea). By contrast, in the subacute or chronic type, persistent headache, multiple cranial nerve pareses, and ataxia were characteristic. Occipital bone fracture was common in the acute type, and supratentorial subdural effusion was more frequently associated with the subacute or chronic type. Evacuation of the subdural fluid collection through a burr hole is the most common and effective treatment, but subdural-peritoneal shunting or closed drainage of the subdural fluid collection may be necessary. The prognosis of posterior fossa subdural effusion after head trauma is relatively good.
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PMID:Posterior fossa subdural effusion due to head trauma. 317 66

A 23-year-old pregnant woman presented with sudden diplopia, ataxia, hemiparesis, and headache secondary to a brain stem hemorrhage. Magnetic resonance imaging (MRI) revealed a hematoma associated with a probable cavernous hemangioma of the rostral brain stem. In this report, we discuss the MRI findings leading to the preoperative diagnosis, as well as the surgical techniques involved in the successful resection.
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PMID:Surgical excision of a cavernous hemangioma of the rostral brain stem: case report. 320 Mar 80

Aneurysm of the vein of Galen is a very rare disease. The authors present a case of secondary aneurysm of the vein of Galen which was confirmed by characteristic clinical symptoms, brain CT and angiographic findings. The patient was a 14-year-old right handed girl with intermittent headache, nausea, vomiting, dysphasia and gait disturbance. Neurologic examination revealed dysarthria, nasal voice, blurring of both margins of optic discs, truncal ataxia and dysdiadochokinesia. Sensory function was normal but right hemiparesis was seen. Roentgenogram of the skull revealed diffuse thinning of the calvarium, widening of sella turcica and erosion of clinoid processes. Computed tomogram of the brain showed dilatation of all ventricles and round hyperdense mass behind the third ventricle in the midline. The lesion was enhanced markedly and homogeneously. Left and right internal carotid angiograms showed arteriovenousmal-formation with drainage to the aneurysm of the vein of Galen.
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PMID:A case of aneurysm of the vein of Galen. 327 Oct 52

MR has emerged as the imaging modality of choice for the brain in patients presenting with seizures, chronic headaches, progressive neurologic deficits, ataxia, vertigo, hearing loss, visual loss, congenital abnormalities, signs of increased intracranial pressure, dementia, suspected multiple sclerosis, and in the vast majority of other elective neurologic problems. CT should currently be considered the primary imaging modality in patients with acute neurologic deficits (stroke), acute onset of severe headaches, and when fine bone detail is required. Acutely injured patients are more readily studied with CT. The vast majority of patients in whom CT is preferred are seen in emergent situations, frequently in hospital emergency rooms. The effects of trauma beyond the acute stage are best evaluated with MR. In the future, MR is likely to become the procedure of choice in even more clinical situations than at present. A summary of currently recommended primary imaging modalities in various clinical situations is provided in Table 1.
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PMID:Imaging strategies for MR of the brain. 328 31

A 41 year old male presented with headache, lethargy, and ataxia and found to have a left temporal lobe mass and a leukoerythroblastic peripheral blood smear. The latter prompted an iliac crest bone marrow biopsy on which a diagnosis of metastatic glioma was made and verified by immunohistologic characterization. The patient was treated with cranial irradiation and simultaneous systemic BCNU (bis-dichloroethylnitrosurea) with complete response. This case with diffuse bone marrow involvement demonstrates that a glioblastoma is capable of extracranial metastases without previous intervention. From a review of reported cases of gliomas of extraneural metastasis, it is concluded that untreated gliomas are capable of vascular spread although less frequently than previously manipulated tumors.
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PMID:Intracranial astrocytoma with diffuse bone marrow metastasis: a case report and review of the literature. 329 52

Patients with agammaglobulinemia are particularly susceptible to chronic enteroviral infections of the central nervous system. Data on 42 patients were obtained by literature review, communications with other physicians, and personal experiences. Thirty-eight patients had congenital immunodeficiencies, most frequently X-linked agammaglobulinemia. Most patients who could be assessed were receiving maintenance therapy with intramuscular gamma-globulin before their enteroviral infection. Seven patients had not been recognized as hypogammaglobulinemic before the onset of infection. The commonest pathogens were echoviruses (37 of 41 cases), especially type 11 (11 cases). Thus far, four patients have had sequential or simultaneous infections with a second enteroviral serotype. Other features of the disease have included weakness, lethargy or coma, headaches, hearing loss, seizures, ataxia, and paresthesias. Some patients have also had nonneurologic manifestations of chronic enteroviral infection, including fever, the dermatomyositis-like syndrome, edema, rashes, and hepatitis. Treatment has consisted primarily of antibody administration, either in intravenous immunoglobulin preparations or in immune plasma. Twelve patients have received intraventricular immunoglobulin through reservoir devices; six of these 12 have improved substantially, as judged by clinical criteria.
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PMID:Chronic enteroviral meningoencephalitis in agammaglobulinemic patients. 329

A 61-year-old woman is presented with a bilateral total ophthalmoplegia as an initial ocular symptom, caused by a midbrain hematoma. She complained of acute headache, nausea, vomiting and bilateral closure of her eyelids. Examination on admission showed meningeal irritation; mild consciousness disturbance; bilateral total ophthalmoplegia; left hemiparesis; ataxia in all extremities, more marked to the left. Computed tomography demonstrated a small hematoma in the midbrain tegmentum. Angiography demonstrated midbrain arteriovenous malformation, and she was treated conservatively. Abduction of both eyes and adduction of the left eye appeared on the next day of the ictus, and after that, improved gradually. Left ptosis had improved since one week after the ictus. Light reflex of the left pupil had seen 5 days after the ictus. At the same time, the left pupil revealed an oval-shape. Right internal ophthalmoplegia continued to exist. One year later, the right eye deviated externally, and the left deviated inferio-medially. Abduction of both eyes was normal. Infraduction of both eyes was seen, but limited on the left. Upgaze paresis remained unchanged, and adduction of the right eye was absent. Adduction of the left eye showed almost full recovery. There was right complete ptosis, but left ptosis became indefinite. These ocular findings indicated typical right oculomotor paresis plus superior rectus paresis of the left eye, which suggested a destructive lesion in the right oculomotor nucleus. Also, her left extremities showed a hemiparesis as a pyramidal tract sign (Weber's syndrome) and an ataxia as a cerebellar sign (Claude's syndrome).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Midbrain arteriovenous malformation causing bilateral total ophthalmoplegia as an initial ocular symptom--a case report]. 337 Jan 70

Primary sarcoma in the central nervous system is rare. From 1954 to 1986, 1417 neoplasms of the central nervous system were treated in our hospital and only one case of primary leiomyosarcoma of the pineal gland was seen. The patient, a forty-seven year old man, had diplopia for 2 months, headache and ataxia for 2 weeks before admission. The CT scan showed a space occupying lesion in the pineal gland. During operation, a mass, 3 x 2.5 x 2 cm in size, was found in the pineal and subtotal resection was performed. The pathological diagnosis of primary leiomyosarcoma of the pineal gland was established. The patient died the next year of the operation. Finally, the histogenesis, clinical manifestations, diagnosis and differential diagnosis are discussed with a review of literature.
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PMID:[Primary leiomyosarcoma of the pineal gland--a case report]. 345 45

The efficacy and tolerability of vigabatrin (gamma-vinyl GABA, GVG), given as add-on therapy to 23 adult outpatients with severe drug-resistant epilepsy (17 with partial seizures), were studied using a double-blind, placebo-controlled, crossover design. The study consisted of two 7-week periods during which vigabatrin and placebo were administered in random sequence. Dosage was 1.0 g twice daily for patients weighing less than or equal to 65 kg and 1.5 g twice daily for patients weighing greater than 65 kg. Three patients were dropped from the study, two for reasons unrelated to treatment and one because of the appearance of vertigo, headache, dysarthria, and ataxia, which subsided rapidly when vigabatrin was stopped (3 g daily). Sixteen of the 20 patients available for analysis showed a decrease in the total number of seizures as compared with the placebo period. Of these, 12 showed a greater than 50% reduction in seizure frequency and 4 of the 12 showed a greater than 75% reduction. Both the total number of seizures and the number of partial seizures were significantly reduced by vigabatrin (p less than 0.01). Only in the patient who dropped out were severe adverse effects seen. The most frequently reported unwanted effect was mild drowsiness, which developed in seven patients on vigabatrin and in one on placebo. Positive effects, however, were also seen with six patients who reported an improved sense of well-being while receiving vigabatrin as compared with only 1 during the placebo period. No consistent changes in electrocardiogram (ECG), electroencephalogram (EEG), and visual-, auditory-, and somatosensory-evoked potentials were seen during the study.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Vigabatrin in the treatment of epilepsy: a double-blind, placebo-controlled study. 353 69


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