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

The arterio-venous malformations of the corpus callosum are distinct clinical and surgical entities. Review of literature reveals 45 documented cases of which 32 were treated surgically. The authors (M.G.Y.) had 18 such patients of which eight involved the anterior and the middle portions of the corpus callosum. (No. 8 involved the whole callosum). The patients were in the younger age group. Headache and stiffness of the neck were the common presenting features. Seizures were rare and there was a paucity of localizing neurological signs. These AVMs are supplied mainly by the pericallosal arteries and occasionally by branches of the posterior cerebral artery. The drainage is by septal veins, the inferior sagittal sinus and the superior sagittal sinus. Radical excision of these AVMs in the anterior and the middle portions of the corpus callosum was accomplished without operative mortality and with minimal morbidity. Radical removal of these anomalies with microsurgical techniques is the treatment of choice.
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PMID:Arteriovenous malformations of the anterior and the middle portions of the corpus callosum: microsurgical treatment. 125 78

Two cases of cerebral abscesses caused by Pseudomonas pseudomallei are reported. The first case, a 51-year-old women had a sudden onset of progressive right hemiparesis and right facial palsy and died within 7 days. Postmortem examination disclosed brain abscess in association with disseminated infection outside the central nervous system. The second case, a 9-year-old boy displayed cerebral abscesses as an isolated manifestation. Recovery occurred after treatment with ceftazidime. Review of the ten case reports of cerebral melioidosis revealed that the lesion occurred in patients of all ages and was more common in men than in women. The frontoparietal lobe was the most common location. Fever, headache, and hemiparesis were frequent clinical manifestations while seizures, ataxia were uncommon. CT scanning, serum antibody titer along with hemoculture were useful investigate tools. The importance of early diagnosis and prompt treatment is emphasized for this fatal but treatable disease.
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PMID:Cerebral abscesses due to Pseudomonas pseudomallei. 128 75

Clinical and neuroimaging studies were made in twenty-one patients during the attack of eclampsia. Most frequent neurological signs and symptoms were the impairment of consciousness, headache, seizure and visual disturbance. Mean arterial blood pressure increased by 46 mmHg (n = 21) during the attacks. Eight of 9 patients studied by CT and/or MRI showed transient abnormalities on brain images during the attack in the occipital cortex, basal ganglia, and internal and external capsule. The findings were compatible with brain edema and were seen mainly in the white matter. Cerebral blood flow measured by SPECT method in one patient during an attack with visual disturbance showed increased blood flow in the occipital cortex. Acute increase in blood pressure, cerebral hyperperfusion and edema, similar to the pathophysiology of hypertensive encephalopathy, were considered to play an important role in the pathogenesis of eclampsia.
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PMID:[Neurological and neuroimaging studies of eclampsia]. 129 Nov 59

12 cases of cerebral "venous angioma" are reported; pathological, clinical and radiological features of the lesion are reviewed. "Venous angioma" should be regarded as a developmental anatomic variation of the venous drainage system of the white matter. Its clinical significance is controversial, although it has been reported to cause hemorrhage, seizures, progressive neurological deficits, headaches. The clinical presentation of our patients was variable and, in some of them, dependent also on associated lesions. An hematoma was found in three patients, infarction in one and tumor in one. Angiography, CT and MRI demonstrated the typical appearance of the anomaly. Surgery was performed in one patient harboring a significant cerebellar hematoma and the coexistence of a cavernoma was pathologically confirmed. Venous developmental anomalies are often identified as the source of symptoms due to other conditions, that should be treated independently sparing the anomaly.
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PMID:Cavernous angioma does not exist? 129 92

Cerebral sparganosis is caused by migrating larvae of Spirometra mansonoides. This condition is rare. The presenting symptoms include headache, seizures and focal neurological deficit, which are due to a parasitic granulomatous space-occupying lesion. The authors report a case of intracerebral hematoma, which has never been reported as a presenting symptom of cerebral sparganosis. The surgical treatment of this complicated condition yielded poor results when compared to previous reports of the uncomplicated condition.
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PMID:Intracerebral hematoma caused by sparganum: a case report. 130 98

It was reviewed a series of 2860 cerebral computed tomography (CCT) in order to compare the main reasons at referral to investigation with the CCT results and the costs with normal and abnormal CCT. It was also studied the age and sex of the patients. Data were collected from one out of three diagnostic centers in Salvador, Brasil, for a three years period. The 2860 CCT exclude all investigation carried out for the follow-up of a previously diagnosed abnormality. CCT abnormalities were detected in 1152 (40.3%). The following reasons showed the highest proportion of abnormal CCT, for males and females respectively: demential syndrome (91.7 and 83.3%); cerebrovascular accidents (85.1 and 73.6%); infectious and parasitary diseases (76.5 and 78.6%); tumors (65.8 and 55.4%); and head injuries, 63.6% for males. In the female group, 65.0% of the CCT were normal, in a range of 65.0 to 80.0% for the age groups under 54 years old. In the male group, the highest proportion of normal CCT was found in the age groups: 25-34 (68.4%), < 15 (62.9%) and 35-44 (62.7%). The most common reasons for normal CCT for males and females were: headache (81.3 and 87.5%); dizziness/vertigo (79.3 and 78.6%); seizures (67.3 and 70.0%); psychomotor deficiency (72.0 and 67.7%) and "endocrine disorders", 75.0% for each sex. The highest proportion of normal CCT (65.3%) was requested by medical "convenios". The cost with normal CCT reached US$565,225 and with the abnormal ones, US$381,247. Costs with normal CCT were 2.2 higher for medical "convenios" as compared to those of the National Institute of Security requests and 2.8 more than those of private medicine.
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PMID:[Characteristics of the demand for cranial computerized tomography: reasons and costs of the exam]. 130 85

Sydenham's chorea (chorea minor, St. Vitus dance, rheumatic encephalitis), described by Thomas Sydenham in 1686, is considered one of the major manifestations of rheumatic fever (1, 2, 3, 4). Clinically it is characterized by involuntary movements, hypotonia, dysarthria, emotional disorders, and less frequently, by other neurological manifestations such as weakness, headache, seizures and sensory abnormalities (1,4). The motor disorders may be generalized or unilateral, in this case constituting a hemichorea (3). Chorea may present associated to other rheumatic fever manifestations during an acute episode, or in isolated form, characterizing the so-called "pure" chorea (5, 6, 7). Its etiology and pathophysiological mechanisms are still unclear, although its relation with a previous pathophysiological group A Beta-hemolytic streptococcus infection is well established (8). There is also evidence of the participation of immunological mechanisms in its pathogenesis, such as the finding of serum anti-nucleus caudatus and anti-subthalamic antibodies (9) and increase in IgG levels in cerebrospinal fluid of patients with chorea (10). In developed countries due to the reduction in rheumatic fever incidence and decrease in frequency of chorea as its manifestation (3, 11), the latter has become rare. However, in developing countries rheumatic fever remains a public health problem. In Brazil, in the last years an increase in the incidence of chorea has been observed as part of the clinical picture of rheumatic fever (12). The present study reports the clinical and laboratory findings of 187 cases of Sydenham's chorea followed-up during the period of January 1980 to December 1990 in two university centers in the city of Sao Paulo, Brazil.
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PMID:Sydenham chorea: clinical and laboratory findings. Analysis of 187 cases. 134 Oct 4

The clinical and computed tomography (CT) features of 25 patients with peripartum CVT are described. Majority of the patients presented in postpartum period and did not receive proper antenatal care. Headache (92%), altered sensorium (80%, seizures (76%), papilloedema (80%) and hemiplegia (52%) were the common modes of presentation. CT findings included diffuse brain oedema (52%), haemorrhagic or nonhaemorrhagic infarctions on one or both sides of brain (48%), gyral enhancement (40%) and tentorial enhancement (16%). While 15 patients made good recovery, 3 cases (12%) died during acute stage of illness.
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PMID:Peripartum cerebral venous thrombosis. 830 May 9

Nervous system opportunistic infections are seen in about one fifth of AIDS cases and account for over 40% of the patients with neurological manifestations. Serious infections are seen in severely immunosuppressed patients, usually with CD4 counts of 200 ml-1 or less. The commonest is CMV, which can produce acute encephalitis, sometimes with focal hemisphere or brain-stem signs, dementia, retinitis, optic neuritis and an ascending radiculomyeloencephalitis. Cryptococcal meningitis is the most frequent fungal disease; a high degree of clinical suspicion is required in patients with fever, malaise, headache or seizures. Only CSF cultures are always positive; both serum and CSF cryptococcal antigen tests are highly sensitive and specific. Treatment with amphotericin B and flucytosine is successful in at least 70% of first episodes but side-effects are common. Without maintenance therapy 50% of patients relapse; fluconazole is recommended. Cerebral toxoplasmosis can present with focal cerebral or spinal cord signs but also as a diffuse encephalopathy; negative T. gondii serology is exceptional but positive serum titres are usually unhelpful. Treatment with sulfadiazine, pyrimethamine and folinic acid achieves good results in 90% of the first episodes, but side-effects are common. Appearances on CT scan or MRI may take several weeks to improve. The value of an empirical approach to treatment is well-established; an initial cerebral biopsy is difficult to justify. Without maintenance therapy a relapse rate of 50% can be expected; therapy with sulfadiazine and pyrimethamine may also prevent pneumocystosis. HIV disease appears to increase the likelihood of neurosyphilis, and the risk of relapse after conventional penicillin doses, in patients with syphilis; at least 3-4 weeks of appropriate therapy are recommended. A number of other diseases caused by viruses, fungi, bacteria and parasites are less common; these include progressive multifocal leukoencephalopathy, herpes simplex and zoster infections and tuberculosis.
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PMID:Central nervous system opportunistic infections in HIV disease: clinical aspects. 134 47

Arteriovenous malformations (AVM) are usually located superficially in the subcortical white matter, and seizures are one of the frequently seen presenting features of AVM. The diagnosis of AVM is confirmed with various neuroimaging techniques. The present study comprised six patients presenting with seizures and headaches, referred to the neurodiagnostic unit to rule out/confirm epilepsy. All patients showed epileptiform activity on electroencephalography (EEG). Further investigations, such as angiography supplemented with computed tomography (CT) showed AVM. EEG is usually not considered a valuable diagnostic tool in AVM, but our results support the finding that EEG is an extremely reliable investigative tool, and should be supplemented with angiography and CT scan for better localization of AVM.
Seizure 1992 Dec
PMID:Diagnostic value of electroencephalography in arteriovenous malformations. 134 80


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