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)

Glomus tumors, also called paragangliomas, are challenging lesions, demanding accurate knowledge of complex anatomy and pertinent approaches. We present the case of a 39-year-old male presenting with headache, vertigo, tinnitus, hearing loss, and hoarseness. Neurological assessment showed facial paralysis House-Brackmann IV and lower cranial nerves deficits. Preoperative magnetic resonance imaging (MRI) demonstrated two large lesions, suggestive of a glomus jugulare, and carotid body paragangliomas. Considering worsening of the symptoms and the important mass effect of both lesions over the neurovascular structures, microsurgical excision was offered, after preoperative tumor embolization. We preferred to approach both lesions in the same operation, starting by the cervical tumor. Initially there was not an easily identifiable dissection plane between the tumor and the carotid artery, but it was achieved after performing a subadventitial dissection, being possible to resect the entire lesion. The jugular foramen lesion was approached through a postauricular transtemporal approach, skeletonizing the sigmoid sinus, jugular bulb, and facial nerve, following a complete mastoidectomy. The tumor, extending to the intradural compartment, middle ear, internal auditory canal, petrous internal carotid artery, and internal jugular vein was completely removed. Postoperative MRI demonstrated complete resection of both lesions, and pathology confirmed to be paragangliomas. In the immediate postoperative period, the facial paralysis evolved to House-Brackmann grade VI, improving to grade III during follow-up. The patient underwent a vocal cord medialization in order to improve voice quality and swallowing. These are challenging lesions and extensive laboratory training is mandatory to be familiarized with the regional anatomy and its various surgical approaches. The link to the video can be found at: https://youtu.be/gA_ckwFq_9c .
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PMID:Microsurgical Resection of Multiple Giant Glomus Tumors. 3175 72

Superior vena cava(SVC)syndrome is a syndrome caused by impaired venous return due to stenosis of the SVC. Most of such cases are due to tumors(non-small cell lungcancer, small cell lungcancer, malignant lymphoma, etc), and the most common cause of SVC syndrome is lungcancer. Symptoms of SVC syndrome are caused by external compression of the SVC, direct invasion, internal thrombus or embolization. Increased venous pressure results in objective findings including edema of the face and neck, edema of the upper limbs, superficial precordial vein distension due to collateral circulation, and hoarseness and subjective symptoms includingcoug h, dyspnea, syncope, headache, and dizziness. SVC syndrome impair the patient's quality of life(QOL). Although there are cases of spontaneous remission, SVC syndrome is recognized as one of the oncologic emergencies because brain and laryngeal edema can be fatal and urgent care should be provided. Therapeutic modalities include radiotherapy, chemotherapy, stent placement and surgery. Treatment should be determined comprehensively based on the severity, histological type, standard therapy for the histological type and its sensitivity. It is necessary to make a definitive histopathological diagnosis as soon as possible and to cooperate with other departments to promptly select the most appropriate treatment.
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PMID:[Superior Vena Cava Syndrome]. 3254 Nov 58

We present the case of a 42-year-old woman with a 5-week history of headache, progressive dysphagia, dysphonia, and hoarseness. A brain magnetic resonance imaging revealed an extra-axial cyst of the left lateral cerebellomedullary cistern. The subsequent histopathologic examination diagnosed a neuroenteric cyst. This case sheds light on the pivotal role of histologic identification of neuroenteric cyst, which could be crucial for further diagnostic investigations, especially in pediatric patients.
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PMID:An Uncommon Case of Neuroenteric Cyst Located at the Lateral Cerebellomedullary Cistern. 3298 May 69


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