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

A case of primary interhemispheric subdural abscess was reported, which was not accompanied by abscess formation in other places such as subdural spaces of the convexity or in the brain. A 13-year-old school boy was admitted with 8 days' history of fever, headache and progressive weakness of the left lower extremity. Prior to admission he developed 2 spells of jacksonian seizure initiating from the left leg. Right carotid angiography was performed on admission and separation of the pericallosal and callosomarginal arteries with small avascular area was shown indicating possible abscess formation in the interhemispheric fissure. There was no evidence of purulent infection in the laboratory findings including the CSF and EEG showed diffuse slow wave discharge, more in the right frontocentral leads. He was placed on the vigorous treatment with antibiotics and steroids, and one month later the left lower weakness as well as the EEG abnormality showed some improvement. However, the separation of the anterior cerebral arterial branches became more prominent and formed a lens shaped avascular area, although the pericallosal artery was in the midline. A diagnosis of interhemispheric subdural abscess was made and was confirmed by surgery. Patient showed progressive recovery of the left lower paralysis, and the abscess was totally collapsed in the repeated angiographic follow-up study. Angiographic characteristics of the interhemispheric subdural abscess were described and particular emphasis was placed on the peculiar neurological symptoms referring to the previous reports in the literature.
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PMID:[Primary interhemispheric subdural abscess--case report (author's transl)]. 41 51

Two children are reported who had recurrent attacks of impairment of time sense, body image, and visual analysis of the environment. These occurred with a clear state of consciousness and in the absence of any evidence of an encephalitic process, seizures, drug ingestion, or psychiatric illness. Both children had recurrent headaches; one was clearly migrainous. There was a family history of migraine in both cases. These children represent examples of the Alice in Wonderland syndrome in juvenile migraine.
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PMID:The Alice in Wonderland syndrome in juvenile migraine. 44 Aug 58

The author has operated on 40 patients with giant intracranial aneurysms, using various surgical approaches. Giant aneurysms predominated in females (3:1) and were most common in the age group 30 to 60 years. Patients presented with subarachnoid hemorrhage (17), visual disturbance (18), chronic headache (14), transient or progressive hemispheric deficit (6), seizure (2), dementia (2), and cerebrospinal fluid rhinorrhea (1). Giant aneurysms were located at the carotid artery (25), the basovertebral artery (8), the anterior communicating artery (5), and the middle cerebral artery (2). Eight of 40 patients had one or more other aneurysms and/or associated arteriovenous malformations. Aneurysms were treated with intramural thrombosis (21), neck occlusion (7), trapping (10), proximal parent artery ligation (1), and aneurysmorrhaphy (1). After as much as 8 years of follow-up, 32 patients (80%) showed complete or marked improvement in signs and symptoms; two patients (5%) had a poor recovery. There were six surgical mortalities (15%). Giant aneurysms can be treated with respectable results if the surgeon selects the technique best suited to the particular aneurysm. In general, neck occlusion, trapping, and aneurysmorrhaphy are best for giant aneurysms of the anterior circulation, and intramural thrombosis is best for those of the posterior circulation. Extra- and intracranial vascular anastomotic techniques are also of value. For success, a flexible approach is essential.
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PMID:Direct surgical treatment of giant intracranial aneurysms. 50 18

Three cases of angiographically cryptic cerebrovascular malformations are presented and a review of the cases in the English literature is tabulated. The typical patient is a 30- to 40-year-old woman with a history of seizures and headache. There is no antecedent history suggesting hemorrhage. On nonenhanced computerized tomographic scans, these lesions are denser than normal brain. They enhance with contrast administration. The angiogram demonstrates an avascular mass. The history, physical findings, and radiographic studies suggest brain tumor. An accurate diagnosis requires operation and pathological examination of the lesion.
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PMID:Angiographically cryptic cerebrovascular malformations. 53 54

The clinical and pathologic findings in 20 patients with hypertensive encephalopathy were reviewed. The dominant central nervous system (CNS) symptoms were altered state of consciousness and severe headache. Nausea, vomiting, and visual disturbances were less common. Seizures and focal signs were infrequent. The changes seen were invariably accompanied both by the characteristic ophthalmoscopic alterations of malignant hypertension and by uremia. The neuropathologic changes consisted of severe vascular alterations (fibrinoid necrosis of arterioles, thrombosis of arterioles and capillaries), and of parenchymal lesions (microinfarcts, petechial hemorrhages) secondary to the vascular lesions. The vascular changes were not confined to the brain but were diffuse, affecting the eyes, kidneys, and other organs. In the CNS the brainstem was most severely affected. Cerebral edema was not observed, even in those patients who had increased cerebrospinal fluid pressure and papilledema.
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PMID:Hypertensive encephalopathy: a clinicopathologic study of 20 cases. 56 64

We here enumerate criteria that we believe are suitable for the diagnosis of migraine in children. Using these criteria, we identified 84 children retrospectively, and studied their illness for 3 to 9 years thereafter. The majority were male, and 47 patients had frontal headaches. EEGs were performed in 64 children: 17 were paroxysmal, but 7 patients never developed seizures. Referral to a neurologist occurred when there was a marked increase in the frequency or severity of headaches. Irrespective of the form of treatment, about one-half of all patients had more than a 50% reduction in headache frequency in the 6 months following their initial visit to a neurologist.
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PMID:Diagnosis and treatment of migraine in children. 57 49

A 11-year-old boy of short stature had recurrent right temporal pounding headaches of 7 months' duration, and progressive visual loss for 3 days. There was a left hemianopia, alexia without agraphia, and diffuse muscle weakness. Investigation established the presence of a mitochondrial myopathy with pyruvate and lactic acidemia and increased serum content of sarcoplasmic enzymes. On treatment with prednisone, the patient's strength and reading skill improved, symptoms resolved, and muscle enzymes returned to normal. Three attempts to reduce steroids resulted in accentuation of symptoms, seizures, weakness, regression of reading skills, and elevation of serum enzymes. The alexia was also reversible.
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PMID:Reversible alexia, mitochondrial myopathy, and lactic acidemia. 57 70

Brain abscess can develop at the site of retained intracranial foreign bodies many years after the injury. This report describes a 6 1/2-year-old child who presented with recurrent severe headaches and a focal seizure of the right upper extremity. Skull X-ray was normal. Computed tomography of the head showed a mass in the left temporoparietal region with a central area of high density and contrast enhancement, thought to be a neoplasm. The mass was seen on the radionuclide brain scan and was avascular on angiography. Craniotomy revealed a foreign body granuloma with a small abscess cavity and a retained piece of pencil graphite. No one in the family could recall if the child had had such an injury.
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PMID:Case report: chronic graphite granulomatous abscess simulating a brain tumor. 61 34

Three cases presenting with hemiparesis, headache, or seizures gave no history suggestive of subarachnoid or intracerebral hemorrhage. Carotid arteriograms were performed, and in each case failed to demonstrate a vascular malformation. In all three cases cerebral lesions were shown by either computerized tomographic (CT) scan, radionuclide scan, or both. Surgical exploration and biopsy revealed a vascular malformation in each case. The CT scans in two of the cases showed dense lesions that could suggest vascular malformation as a diagnostic possibility.
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PMID:The angiographically occult cerebrovascular malformation. Report of three cases. 62 78

Blood pressure should be routinely measured in all infants and children. Measurements should be performed with an appropriate size cuff and observed pressures compared to normal values for age. Elevated blood pressure is seen in one to ten percent of children, depending on the age group surveyed and the definition of hypertension selected. Thirty to fifty percent of children with elevated blood pressures are asymptomatic. The remainder have symptoms which are nonspecific, including headaches, visual disturbances, seizures, congestive heart failure, and facial palsy. Hypertension in children, unlike hypertension in the adult, usually has a definite cause which often responds to adequate medical and/or surgical treatment. For this reason, children with well-confirmed hypertension should be thoroughly evaluated. The most common causes of hypertension found in children are renal disease (pyelonephritis, vascular disease, structural malformations) and coarctation of the aorta. An approach to the child with transient or persistent hypertension is described. Diagnostic studies should be individualized and should follow clinical clues where possible. Medical management of the child with acute hypertension is discussed.
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PMID:Elevated blood pressures in infants and children. 62 65


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