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

We describe three patients with unilateral facial pain due to non-metastatic lung cancer and review 11 published cases. Pain, most frequently located on the right side and around the ear, as well as digital clubbing can be clues to an early diagnosis. Compression of the vagus nerve by the tumour or by mediastinal adenopathy is most likely responsible for the facial pain and could play a role in pulmonary osteoarthropathy.
Cephalalgia 1992 Jun
PMID:Unilateral facial pain as the first symptom of lung cancer: are there diagnostic clues? 162 15

We have studied the clinical presentation and course of a chronic inflammatory disease occurring in childhood and observed in 30 patients. The first symptoms were generally present at birth, except in a few patients where they were first noticed in early infancy. All the patients had the association of three main symptoms: neurological, cutaneous and articular. The skin rash was the first symptom observed in all the patients and looked like a chronic non pruritic urticaria varying during the day. The articular manifestations involved knees, ankles and feet, elbows, wrists and hands unaffecting the other joints. They could be mild giving arthritis during flare-ups or severe with major radiological modifications affecting the epiphysis, metaphysis and growth cartilage. The neurological manifestations were characterized by a chronic meningitis and symptoms indicating meningeal irritation: headaches, seizures, spasticity of legs. Most patients had a cerebral atrophy and a low IQ. Sensory organ involvement occurred progressively during the follow-up: ocular inflammation with optic atrophy, deafness and hoarseness. Common morphological features characterized these patients with short stature, head enlargement, saddle back nose and short and thick extremities with clubbing of fingers. The course was that of a chronic inflammatory disease with numerous flare-ups associating fever, splenomegaly and adenomegaly. Except for a high level of eosinophils in blood, CSF and tissues, the biology was non specific and only exhibited features of inflammation. Except for two families, the disease was sporadic. A high frequency of prematurity with features resembling a foetal infection was observed but no proof of a possible causal virus has so far been found so that etiology remains unknown.
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PMID:A chronic, infantile, neurological, cutaneous and articular (CINCA) syndrome. A specific entity analysed in 30 patients. 348 35

The clinical courses of 31 episodes of brain abscess and one episode of meningitis occurring in patients with hereditary hemorrhagic telangiectasia are reviewed. Pulmonary arteriovenous malformations were demonstrable in all but two patients and presumably permitted septic microemboli to evade the normal pulmonary capillary filter and lodge in the brain. Obtundation, headache, visual disturbances, hemiplegia, and seizures were the most common presenting features. Cyanosis, clubbing, polycythemia, and hypoxemia were routinely encountered, but leukocytosis and fever were present in a minority of cases, and all blood cultures were sterile. Anaerobic and microaerophilic streptococci were the commonest pathogens found in the brain abscesses. Thirteen patients died, and patients without abscess drainage or with delayed diagnosis had a higher mortality rate. A brain abscess may develop in approximately 1 percent of patients with hereditary hemorrhagic telangiectasia, and awareness of this risk should lead to early investigation of any patient with hereditary hemorrhagic telangiectasia who has neurologic symptoms.
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PMID:Central nervous system infections associated with hereditary hemorrhagic telangiectasia. 637 93

Liz... Josiane, a 9 year old girl, was admitted with a 24 hours history of severe headache and vomiting. On admission she was conscious, irritable and complained of a severe headache. Clinical examination revealed a right hemiparesis with cyanosis of the lips and extremities and clubbing of the fingers, all consistent with chronic hypoxia. Cardiovascular examination was normal apart from a systolic murmur which could be heard posteriorly under the left scapula. There were no angiomatous or telangiectatic lesions of the skin. A blood examination revealed a raised ESR, a marked polycythaemia with a decreased arterial oxygen tension. Chest x-rays showed the presence of an irregular well delineated opacity in the posterior basal segment of the left lower lobe. This opacity was confluent with the ipsilateral hilum and was suggestive of a pulmonary arteriovenous fistula. An intracranial space occupying lesion in the left temporal region of the brain was revealed by electroencephalographic and CT scan investigations; this proved to be an abscess which was surgically removed with no subsequent complications. Further radiological investigations of the chest revealed the pulmonary lesion was an arteriovenous aneurysm occupying the whole left inferior lobe. This was removed at thoracotomy three months after the acute neurological event. The results of respiratory function and regional isotopic investigations before and after surgery will be discussed.
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PMID:[Cerebral abscess and pulmonary arteriovenous fistula. A clinical and respiratory function study]. 685 38

Patients with nonmetastatic lung cancer may rarely experience facial pain as a presenting symptom, during the course of the disease or upon recurrence of the disease. This study reviews a 10-year experience at Mayo Clinic. The aim of this study was to (1) further characterize the clinical features of facial pain as a symptom of nonmetastatic lung cancer, and (2) assist clinicians in recognizing this association. Ten cases were identified. All patients complained of severe, aching, facial pain typically aural-temporal in location, ipsilateral to the lung cancer. Six of the 10 cases involved the left side. Recent weight loss was present in 7 of 10 patients, with an elevated sedimentation rate in 6. Digital clubbing was documented in three. Neurologic examinations and neuroimaging were normal in all patients. Lumbar puncture, when performed, was normal. Facial pain preceded the diagnosis of lung cancer by 1 to 24 months. In three patients, facial pain was the initial symptom of tumor recurrence. Four of the 10 tumors were adenocarcinoma; radiation with or without chemotherapy appears to be the treatment of choice for the facial pain. The presumed mechanism is local invasion of the vagus nerve. In suspected cases, a chest x-ray and chest CT are indicated.
Headache
PMID:Facial pain as a symptom of nonmetastatic lung cancer. 855 Mar 57

A 19-year-old woman with congenital cyanotic heart disease (Epstein anomaly and ventricular septal defect) had persistent headaches and intermittent fever for five weeks. Physical examination revealed central cyanosis, finger clubbing and fever. The leucocyte count was elevated. Cerebral MR imaging showed the characteristic features of brain abscesses in the right frontal lobe, including multiloculation with adjacent satellite lesions, ring enhancement, T1-hyperintense and T2-hypointense signal areas within the abscess rim, as well as hypointense internal concentric rings on T2-weighted images. The diagnosis of brain abscesses was confirmed by craniotomy and pus drainage. She made a good recovery with a combination of antibiotics and surgery. Follow-up CT scans showed only changes of encephalomalacia at the healed abscess site. The aetiology, clinical features, and the role of CT and MR imaging in the diagnosis and management of brain abscess are discussed.
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PMID:Clinics in diagnostic imaging (51). Multiloculated cerebral abscesses due to paradoxical cardiac emboli. 1102 6

Facial pain can, on rare occasions, be the presenting symptom of lung cancer. This report describes a patient with non-metastatic lung cancer, which was associated with attacks of debilitating facial pain, presenting as cluster headache. Moreover, 32 reported cases of lung cancer-related facial pain (including the present one) are reviewed, and their clinical features are summarized. The facial pain is almost always unilateral, and is most commonly localized to the ear, the jaws, and the temporal region. The pain is frequently described as severe and aching, and may be continuous or intermittent. Aggravation and expansion of the pain, digital clubbing, increased erythrocyte sedimentation rate, and hypertrophic osteopathy, may contribute to the diagnosis. Referred pain, due to invasion or compression of the vagus nerve, as well as paraneoplastic syndrome secondary to the production of circulating humoral factors by the malignant tumor cells, is implicated in the pathophysiology of facial pain associated with non-metastatic lung cancer. Radiotherapy and tumor resection with vagotomy are very effective in aborting the facial pain. Thus, lung cancer should be included in the differential diagnosis of facial pain that is atypical and/or refractory to treatment.
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PMID:Facial pain as first manifestation of lung cancer: a case of lung cancer-related cluster headache and a review of the literature. 1455 96

Paracoccidioidomycosis is a systemic infection caused by a dimorphic fungus (Paracoccidioides brasiliensis). The most common lesions frequently occur in the bucopharinx mucosa. Other lesions occur in the adrenal glands, liver, bone, gastrointestinal tract, lungs and nervous system. We report here a case of neuroparacoccidioidomycosis. The patient was a 49 year-old male, who consulted due to neurological symptoms (cephalalgia, speech difficulty and one tonic clonic seizure with urinary incontinence) of eight months duration. Upon physical examination it was observed an emaciated male with nail clubbing, a skin ulcer with raised edges and a crusted bottom of 4 x 2 cm in diameter located in the right supraclavicular region and an ulcerated lesion in the left tonsil with edema. The rest of the physical examination reveled a discrete left side hemiparesis and pulmonary rales in the left hemitorax. The fungus was identified through direct examination of cerebrospinal fluid (CSF). The histopathology of suprarenal, lungs, brain and skin showed multiple paracoccidioidal granulomas. To the best of our knowledge, this is the third case reported in the literature. We review the literature on the pathogenesis and prevalence of neuroparacoccidioidomycosis.
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PMID:Central nervous system paracoccidioidomycosis: case report and review. 1546 72

A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported.
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PMID:Brain abscess associated with isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. 1636 65

Spontaneous arteriovenous communications below the diaphragm is a very rare condition. Its association with polysplenia has perhaps not yet been reported in children. We reported a case in a 9-year-old boy presenting with acute onset of fever, vomiting, headache, seizures and altered sensorium. A CT scan revealed a large occipital abscess which was drained surgically. On examination he had marked central cyanosis and grade III clubbing of fingers and toes. Further investigations led to the discovery of a very rare finding of abdominal arteriovenous malformation associated with multiple-enhancing structures around the splenic bed suggestive of polysplenia. We believe that the most likely cause of the brain abscess was paradoxical embolism through the abdominal arteriovenous communication. Unfortunately the parents did not consent to a surgical correction of the malformation, realising the risks involved in the procedure. Subsequently the boy was lost in follow-up.
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PMID:Spontaneous abdominal arteriovenous fistula and polysplenia in a child presenting with brain abscess. 2399 82


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