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

To study the types of patients with climacteric syndrome who respond to conjugated estrogen therapy, we investigated the results of 1- to 2-month therapy in 52 patients by comparing their pre- and post-drug level of blood estradiol (E2), FSH and LH as well as comparing information through a questionnaire on menopausal complaints listed according to Kupperman. Predrug E2 in the patients studied was lower than normal, but the lowering was not significantly specific to any particular climacteric symptom. Blood FSH was higher in the patients complaining of hot flushing, sweating, depression, feeling of something sticking in the throat, and decreased sexual desire, whereas blood LH was higher in the patients with hot flushing and sweating. Changes in various symptom were investigated in relation to hormonal changes found after conjugated estrogen therapy. In the patients whose E2 was increased and FSH and LH were decreased after the therapy, hot flushing, cold sensation, excitability and insomnia were ameliorated at a high rate. Numbness was favorably treated in the patients responding with increased E2, whereas shoulder stiffness, fatigability and headache was reduced in those responding with decreased LH.
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PMID:[Blood levels of estradiol, FSH and LH in women with climacteric syndrome--conjugated estrogen therapy]. 642 67

A 50-year-old fisherman presented with numbness of the left hand and headache after a fall on the deck of a boat. Myelography revealed protrusions of the disks of C-7 and L-4. Computed tomography of the brain incidentally disclosed moderate hydrocephalus and hypoplasia of the inferior cerebellar vermis without cystic formation in the posterior fossa. The patient never developed evidence of cerebral involvement. Several entities associated with agenesis or hypoplasia of the cerebellar vermis have been described, all of which accompany abnormal clinical symptoms or signs attributable to cerebral involvement. This case is unique in that the patient has been entirely asymptomatic with this abnormality since birth.
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PMID:Asymptomatic Dandy-Walker variant in an adult. 646 32

Two patients who developed intraspinal hematomas associated with anticoagulation therapy are described, and the pathology, clinical presentation, risks, evaluation and management of this rare hemorrhagic consequence, which results in spinal cord injury (SCI), are discussed. A 49-year-old man was taking warfarin sodium 7.5 mg orally every day for two weeks for thrombophlebitis. Prothrombin time (PT) was 24 sec (control = 17 sec). Two days after a dosage reduction for a PT of 36.5 sec (control = 11 sec), he developed severe neck pain, numbness and weakness of the legs, and then quadriplegia. Warfarin therapy was discontinued, and 25 mg of phytonadione was administered intravenously. An epidural hematoma was removed via a C3-C6 laminectomy, and the patient remains a C3 complete quadriplegic. The second patient was a 64-year-old man who was taking warfarin sodium 5 mg and 7.5 mg orally on alternate days following an aortic-valve replacement. PT was maintained at 1.5 times the control value. Four years later, he fell and sustained flexion distraction and compression injuries of the spine at the L1-L2 level. He complained of severe neck pain and headache. Warfarin therapy was stopped, and 10 mg of phytonadione was administered i.v. During a hospital transfer he developed complete paraplegia. PT was 12.4 sec (control = 10.8 sec). Twelve days later, a laminectomy was performed to remove the T6-L1 subdural hematoma revealed by computed tomography (CT). The patient remains a T5 complete paraplegic. Unlike intracranial hemorrhage, intraspinal hemorrhage usually occurs in the epidural space, most often in the dorsal thoracic spine.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Intraspinal hematoma as a complication of anticoagulant therapy. 650 81

Herein we review the symptoms, physical findings, and test results in 131 patients with acoustic neurinoma. The earliest symptoms are unilateral hearing loss, tinnitus, and dysequilibrium. As the disease progresses, facial numbness, facial weakness, and headaches become more prominent. Physical findings other than hearing loss are uncommon; the most frequently observed are a decreased corneal reflex, nystagmus, and facial hypoesthesia. Routine audiometry provides objective information about the hearing loss. Some degree of asymmetry is found in the pure-tone tests. In addition, the speech discrimination scores are frequently lower than expected. Special audiometric tests should be performed on those patients with residual hearing; at the present time, acoustic reflex tests and the brainstem-evoked response yield the most information. Computed tomography with dye enhancement with or without the use of air contrast has become the most accurate roentgenographic test. Our goal is to identify acoustic neurinomas sufficiently early so that surgical removal is safe and leaves minimal deficit.
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PMID:Clinical findings in patients with acoustic neurinoma. 663 70

A giant aneurysm of the left vertebral artery which was nearly completely thrombosed and very difficult to diagnose, was successfully treated by a complete surgical excision. The patient had been hospitalized eight times because of brief episodes of headache associated with neck stiffness, nausea, vomiting and numbness of the left hand. On the ninth admission, the diagnosis of a "tumour" involving the posterior fossa was established. At operation an aneurysm of the left vertebral artery was found and resected. At discharge, one week after surgery, the patient was free of neurologic deficits.
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PMID:A tumor-simulating giant aneurysm of the vertebral artery. Case report. 663 54

Four cases of venous angioma, one cerebral and three in the cerebellum, are reported. Case 1. A 50-year-old woman who had a sudden attack of headache and disorientation was admitted to the Mitsui Memorial Hospital. Neurological examination revealed slight disorientation, mild motor aphasis and right hemiparesis. Plain CT scan on admission showed a left frontal hematoma. Left cerebral angiomas demonstrated a caput-Medusae-like lesion which consisted of numerous small veins and drained into one single enlarged vein. Enhanced CT scan taken 12 days after the attack demonstrated a linear enhancement next ot the hematoma. Left frontal craniotomy was performed, and the hematoma was evacuated. In the next step, coagulation and resection of the major part of the angioma was attempted. However, this caused significant swelling of the adjacent brain and the angioma had to be resected totally including intervening normal cerebral tissue. Postoperatively, the patient became worse with significant hemiparesis and severe motor aphasia. After intensive rehabilitation treatment, she recovered gradually and was discharged on foot with moderate speech disturbances. Histological examination revealed a typical venous angioma with hyalinization of vessel wall. Case 2. A 55-year-old woman with a 9 year history of vertigo and headache was admitted to our hospital because of sudden onset of numbness in her right lower limb. Enhanced CT scan revealed a small nodular high density lesion and an old hematoma in the right cerebellar hemisphere. Vertebral angiograms demonstrated a single abnormal vein with some small veins in the right cerebellum. Right suboccipital craniectomy was performed and the blood clot was removed. The abnormal veins were electro-coagulated. The postoperative course was uneventful and the patient was discharged with no neurological deficit. Case 3. A 31-year-old man was admitted to our department with 9 month history of nausea and vertigo attack. Enhanced CT scan demonstrated a large nodular high density lesion in the left cerebellar hemisphere. Vertebral angiograms showed a typical caput-Medusae-like venous angioma. The patient had no evidence of hemorrhage and was discharged without surgery. Case 4. A 36-year-old man who had two attacks of nausea and headache was admitted to the Mitsui Memorial Hospital. Enhanced CT scan showed a linear high density lesion in the right cerebellar hemisphere. Vertebral angiograms disclosed a typical venous angioma in the right cerebellum. This patient also had no attack of bleeding and was discharged without operation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Four cases of cerebral venous angioma--with special reference to its surgical indication and CT diagnosis]. 666 47

Paroxysmal symptoms caused by phaeochromocytoma, headaches associated with sexual activity, numbness of one half of the tongue on sudden neck movement, visual hallucinations, drop attacks, episodic involuntary movements, and various genital sensations are described. At first encounter, some of these and other unusual syndromes may be mistaken for psychological disorders, but can usually be distinguished by their characteristic pattern and evolution of symptoms.
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PMID:Unusual syndromes in neurological practice. 670 May 12

We investigated an outbreak of illness in electronics plant workers. Questionnaire data revealed that 98 employees experienced symptoms, including light- headedness , headache, sleepiness, and numbness/tingling of the face or extremities. Attack rates by work station followed no apparent pattern. Extensive medical and environmental evaluation, including air sampling for numerous solvents and gases, provided no physical or chemical explanation for the epidemic. Compared with well employees, ill employees were more commonly female, complained more frequently of bothersome odors, and believed that greater danger existed of the illness recurring. Blood gas analyses of seven of 11 ill workers showed respiratory alkalosis, consistent with hyperventilation. The poorly defined nature of this illness, the absence of exposures to environmental contaminants in concentrations exceeding recommended limits, and the evidence of hyperventilation suggest that this outbreak was an incident of industrial psychogenic illness.
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PMID:An epidemic of psychogenic illness in an electronics plant. 672 87

A computerized headache interview was completed by 255 children, adolescents, and adults. Children did not differ from adults in the frequency of auras or prodromes. Young children were more likely than older patients to have brief headaches and headaches that tended to occur on weekdays, and to feel "great" after a headache. They were less likely than older patients to acknowledge multiple kinds of headaches, headaches located on one side of the head or posteriorly, and such concomitant occurrences as blurring, photophobia, irritability, frustration-anger, light-headedness, trouble with concentration, numbness-tingling, and lack of appetite. We do not know how much these differences can be attributed to age-related differences in language, physiology, or medical care selection factors.
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PMID:Age-related headache characteristics. 674 68

Detailed clinical study of 50 patients with primary fibromyalgia and 50 normal matched controls has shown a characteristic syndrome. Primary fibromyalgia patients are usually females, aged 25-40 yr, who complain of diffuse musculoskeletal aches, pains or stiffness associated with tiredness, anxiety, poor sleep, headaches, irritable bowel syndrome, subjective swelling in the articular and periarticular areas and numbness. Physical examination is characterized by presence of multiple tender points at specific sites and absence of joint swelling. Symptoms are influenced by weather and activities, as well as by time of day(worse in the morning and the evening). In contrast, symptoms of psychogenic rheumatism patients have little fluctuation, if any, and are modulated by emotional rather than physical factors. In psychogenic rheumatism, there is diffuse tenderness rather than tender points at specific sites. Laboratory tests and roentgenologic findings in primary fibromyalgia are normal or negative. Primary fibromyalgia should be suspected by the presence of its own characteristic features, and not diagnosed just by the absence of other recognizable conditions. This study has also shown that primary fibromyalgia is a poorly recognized condition. Patients were usually seen by many physicians who failed to provide a definite diagnosis despite frequent unnecessary investigations. A guideline for diagnosis of primary fibromyalgia, based upon our observations, is suggested. Management is usually gratifying in these frustrated patients. The most important aspects are a definite diagnosis, explanation of the various possible mechanisms responsible for the symptoms, and reassurance regarding the benign nature of this condition. A combination of reassurance, nonsteroidal antiinflammatory drugs, good sleep, local tender point injections, and various modes of physical therapy is successful in most cases.
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PMID:Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. 694 96


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