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)

A 50-year-old woman with migraine was admitted to hospital shortly after having abruptly developed hemiparesis. CT scan revealed infarction in the territory of the right middle cerebral artery. Death ensued after three days due to cerebral edema with herniation. Autopsy revealed no pathologic findings in the heart or in the extra- or intracranial arteries. It is suggested that the fatal stroke may have resulted from arterial spasm caused by ergotamine overdosage and possibly complicated by thrombosis.
Cephalalgia 1989 Dec
PMID:Fatal stroke in migraine: a case report with autopsy findings. 261 86

Oral Mydocalm intermittent therapy was used in 113 patients suffering from myogenous cephalalgia. Daily 3 +/- 150 mg tolperisonum doses relieved, within 3-7 days, spasm, hypertonicity, rigidity of occipital, cervical, and shoulder muscles, and resulted in functional improvement and successfully controlled myogenous cephalalgias.
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PMID:High-dose Mydocalm therapy in certain myogenous headaches. 268 81

It has long been assumed that the origin of pain in 'muscle-contraction headache' lies in the peri-cranial muscles, especially in the frontales. Pain, it is assumed, is experienced when the muscles are in spasm. It is further assumed that learned reductions in muscle tone between headache episodes will reduce the probability of future pain episodes. In this experiment, details are given of EMG measures made on the frontal, occipital, and neck muscles of separate groups of migraine and tension headache subjects. The measures were made before the onset of head pain and later when the same subjects reported pain. As part of the experiment, subjects were exposed to an experimental stressor during the pain-free period, and these results were compared with those of a group of non-headache subjects. Results showed that the headache groups did not differ on any of the pre-headache measures. Neck muscle levels varied markedly when compared with control subjects who had comparatively low levels reactive to an experimental stressor. When the data taken during the headache phase were analysed according to diagnosis, the occipital muscle output was found to be significantly lower in the migraine group and higher in the tension group.
Headache 1989 Feb
PMID:EMG cranial muscle levels in headache sufferers before and during headache. 270 38

Both miners exposed to high temperature and excess heat and miners working under permissible temperature conditions (a control group) had similar nonspecific signs, i. e., complaints of heartache and headache, erethism, flaccidity, hydrosis, degradation of appetite and sleep, vertigo, dimness, the sense of air shortage, palpitation in rest, uncertain gait, muscle spasm. There were also presented the following objective data: tremor of close eyelids, asymmetry of tendon reflex, convergence weakness, emotional lability, changes in orthostatic test results, higher Kerdau index, instability of sensitizing Romberg's test. The above signs were more pronounced in miners exposed to high temperature, thus it was possible to regard them as indicators of miners' chronic overheating.
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PMID:[Signs of chronic overheating in miners of deep coal mines]. 276 95

We investigated the adjunctive use of physical therapy, with the more standard modalities of medication and/or biofeedback-enhanced neuromuscular re-education, in patients with chronic daily headaches who had palpable muscle spasm in the neck and shoulder regions. Patients in group one received medication detoxification (when necessary), amitriptyline and (in some cases), biofeedback. Patients in group two received detoxification (when necessary), amitriptyline (in some cases) and physical therapy, including TENS (transcutaneous electrical nerve stimulation). Patients in group three received detoxification (when necessary), amitriptyline in (some cases), and TENS without other modalities of physical therapy. Patients in groups two and three, as judged by changes in Headache Index, showed a significantly faster and greater decline in headaches than patients in group one, and maintained this excellent relief through the six month follow-up period. From a biochemical perspective, this improvement may be related to the demonstrable increase in serotonin levels that attends TENS. From a behavioural perspective, improvement may be related to the change in "locus of control" from the headache to the patient that attends the more "active" modalities of TENS and physical therapy, as opposed to the more "passive" modality of medication alone.
Headache 1989 Mar
PMID:The effectiveness of physical therapy in the treatment of chronic daily headaches. 278 94

Intracranial meningiomas account for 18.2% of all intracranial tumors. During Jan. 1982-Dec. 1986, 65 cases of intracranial meningiomas were diagnosed after operations and pathologic examinations at Taichung Veterans General Hospital. There were 36 females and 29 males, aged from 18 to 80 with a mean of 52 years. Average period of follow-up was 23.7 months. All patients received craniotomy or craniectomy with or without microscopic technique to remove the tumors & 3 cases received postoperative radiotherapy. The most common sites of meningiomas were the posterior fossa, convexity, parasagittal area and falx. The complete removal rate was 84.8%, the mortality rate 9.1% and the morbidity rate 33%. The major complications were intracerebral hemorrhage, infection of central nerve system, and hydrocephalus. There were 3 cases (4.6%) of multiple meningiomas. The most common symptoms and signs in order were headache, hemiparesis, seizure, nausea and vomiting, conscious disturbance & trigeminal neuralgia. The average duration of symptoms was 18.5 months. There were 9 cases of trigeminal neuralgia and 2 cases of hemifacial spasm. There were 3 cases (5.6%) of recurrence and 4 cases (6.1%) of malignancy. The most frequently found subtypes of meningiomas were the meningotheliomatous type and the transitional type. Mean size of the tumors was 5 cm. Tumor location and its biological behavior were closely related to the removal rate, prognosis and recurrence, while tumor size was of less importance. Ability of daily life was improved and seizure was better controlled by antiepileptic drugs in postoperative days.
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PMID:[Intracranial meningiomas--5 year analysis]. 280 87

Heroin, cocaine, amphetamines, sympathomimetic drugs can cause cerebral angiopathy. We report 2 patients with cerebrovascular disorders after ingestion of a nasal vasoconstrictor containing phenylpropanolamine (P.P.A.). The first patient had two acute repetitive attacks of severe headache and vomiting, occurring after a daily treatment with 180 mg of P.P.A. during 6 weeks. The second patient had an intracerebral hemorrhage, occurring some hours after taking for the first time 120 mg of P.P.A. In both cases, cerebral angiography, performed in the next week, demonstrated segmental narrowing and dilatations of medium-size intracranial arteries. None of the usual causes of cerebral vasculitis were present. The outcome was favorable and follow-up angiograms showed the disappearance of the beading pattern. P.P.A. is widely used over the counter in diet pills and stimulants. Cerebral vascular complications have been rarely reported, always hemorrhagic and often associated with cerebral vasculitis. They are unrelated to duration or dosage of treatment. The mechanism is unclear but could result from several factors: chronic or paroxystic high blood pressure, immuno-allergic vasculitis, arterial spasm, direct "toxic" effect of the P.P.A. on the arterial wall may be increased by other drugs and caffeine.
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PMID:[Benign cerebral angiopathies and phenylpropanolamine]. 304 37

2 cases reports are described of patients with renal artery stenosis who presented with hypertensive encephalopathy, normal blood pressures having been recorded within the previous 6 months while taking oral contraceptives (OCs). A 27-year-old woman, admitted to the hospital following 2 grand mal fits, had suffered from increasing headaches, nausea, and vomiting over the previous month. Her blood pressure had been elevated at 160/110 mmHg 1 week prior to admission but had been normal over previous 11 years while taking OCs (various formulations of combined estrogen and progestogen) which she had stopped taking 2 months previously. She was a nonsmoker. Her blood pressure was controlled with atenolol, nifedipine, and bendrofluazide, and her conscious level returned to normal with no further fits. An intravenous urogram revealed a small left kidney with a delayed nephrogram, and subsequent arteriography showed bilateral medial fibromuscular dysplasia with a narrow stenosis of the left renal artery. Attempted balloon angioplasty was unsuccessful due to arterial spasm. 4 months after presentation she became pregnant. Blood pressure was controlled with methyl dopa during pregnancy which progressed uneventfully to full term. In the 2nd case, a 19-year old girl became confused and suffered a grand mal convulsion. She had complained of headaches over the previous 3 days. Her blood pressure had been normal over the previous 6 months while taking Logynon (phased formulation of ethinylestradiol and levonorgestrel). She was a nonsmoker. On admission to the hospital, she suffered further generalized convulsions. Despite control of her convulsions with intravenous chlormethiazole, her blood pressure rose to 220/140 mmHg, and this was controlled with intravenous hydralazine and propranolol. The following day she was conscious and was changed to oral therapy. A renogram and DMSA scan showed normal sized kidneys, but there was evidence of decreased blood flow to the left kidney with an increased transit time. Renal arteriography showed a stenosis of the left renal artery, typical of intimal fibromuscular dysplasia, which was dilated by balloon angioplasty. Anti-hypertensive medication was withdrawn postoperatively, and her blood pressure has remained well controlled. In both of the cases the onset of hypertension was rapid with encephalopathy being the presenting feature. Hypertensive encephalopathy is well recognized as a presenting feature of renal transplant artery stenosis but not in cases of native renal artery stenosis. 1 of the patients had stopped using OCs 2 months before presentation, suggesting that although there may have been an association between OC use and the development of fibromuscular dysplasia, it could not be implicated in the mode of presentation.
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PMID:Encephalopathy in renovascular hypertension associated with the use of oral contraceptives. 311 27

Migraine is a common disease which expresses itself by paroxysmal headache, commonly accompanied by transient neurological symptoms. There are at the moment two important theories concerning the cerebral mechanisms of migraine: The vascular theory which attributes migraine to spasm of a cerebral artery causing local hypoxia and transient focal symptoms followed by neurogenically mediated extra- and/or intracranial vasodilation causing headache, i.e. migraine is understood in terms of a primary perturbation of blood vessel function. Another, but neglected viewpoint relates migraine to a paroxysmal, transient depolarization of primarily cortical neurones causing transient focal symptoms and headache, i.e. migraine is understood in terms of a primary perturbance of neuronal function. This review summarizes clinical and experimental studies concerning these two theories with special emphasis on classic migraine, i.e. paroxysmal headache accompanied by focal symptoms of short duration. At begin of the classic migraine attack regional cerebral blood flow (rCBF) declines in the posterior part of the brain. Subsequently the hypoperfused region expands anteriorly, independent of the territories of supply of the large cerebral arteries. This observation speaks clearly against reduced perfusion as consequence of arterial spasm. The rate of spread of the reduced perfusion is about 2 mm/min and the changes of perfusion appear to follow the cortex corresponding to the convexities. Tests of regulation of rCBF show normal blood pressure autoregulation, but reduced responsiveness to change of arterial carbon dioxide tension and in response to mental activation. These observations are consistent with arteriolar vasoconstriction as cause of reduced perfusion. Vascular tone at the arteriolar level is, however, mainly determined by local factors, and change of local neuronal function could therefore be the basis of increased arteriolar tone and reduced rCBF. Analysis of the time course of perfusion reduction and symptoms reveals that perfusion frequently declines before the patient experiences any focal symptoms. The focal symptoms frequently start after spread of the hypoperfusion has begun, but usually ceases altogether within another 30 minutes, while the reduced perfusion persists for a couple of hours, when the patient suffers from headache. This temporal relationship between symptoms and rCBF changes precludes that the focal symptoms are secondary to reduced rCBF. Furthermore, migraine headache is not related to increased rCBF. On this background the acute migraine attack can hardly be explained by a primary arterial vasospasm.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Cerebral blood flow in migraine and cortical spreading depression. 332 20

A rare complication of nonsteroidal antiinflammatory drug (NSAID) use, particularly in patients with collagen vascular or autoimmune diseases, is aseptic meningitis. A healthy 21-year-old man receiving naproxen for muscle spasm was admitted with a chief complaint of severe headache. Approximately one week after beginning naproxen, the patient developed headache, fever (T 38.8 degrees C), shaking chills, and nuchal rigidity with occasional nausea and vomiting resulting in a 15-lb weight loss. Findings from a cerebrospinal fluid examination revealed polymorphonuclear pleocytosis and elevated protein, but no evidence of infection with bacteria, fungi, mycobacteria, or viral agents was noted. Within 36 hours of discontinuing naproxen, the meningitis-like symptoms markedly improved. Rechallenge with naproxen was not performed. In patients exhibiting meningitis-like symptoms, a thorough drug history, including that of recent or intermittent NSAID use, should be obtained.
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PMID:Aseptic meningitis associated with naproxen. 339 Nov 11


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