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

Eosinophilic meningitis is due to infestation of the nervous system by the larvae of Angiostrongylus cantonensis. The infection is from infected prawns and slugs. In a study of 54 patients from Tahiti the leading symptoms were headaches, neck stiffness, limb pains and sometimes a facial palsy. The diagnosis is made by examination of the CSF when the leucocytes are usually over 100/mm3 and over half are eosinophilic cells. The blood eosinophil count is often raised, above 400/mm3. The disease is self-limiting and there is no known specific treatment.
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PMID:Eosinophilic meningitis in Tahiti: clinical study of 54 patients. 28 29

Twenty pediatric and 180 adult patients underwent myelography using metrizamide (Amipaque). All patients were examined and interviewed before and after the studies. New or exacerbated symptoms attributed to metrizamide myelography were graded according to severity. After the procedure, 51 of 200 patients were unchanged from baseline. Headache was the most common complaint, with an overall incidence of 62%. Nausea and/or vomiting occurred in 38%. Back or leg pain, neck stiffness, temperature elevation, and a variety of less common manifestations were also observed. The incidence of sequelae was higher than in comparable Scandinavian studies with this contrast medium.
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PMID:Sequelae of metrizamide myelography in 200 examinations. 41 57

A patient with eosinophilic meningitis in Shizuoka Prefecture, Honshu, Japan had nausea, vomiting and headache on admission; laboratory examinations revealed leukocytosis with eosinophilia. Eight days later neck stiffness appeared. Lumbar puncture showed an increase of the initial pressure in association with eosinophilic pleocytosis in the spinal fluid. The possibility of angiostrongylosis was considered because the patient had eaten raw slugs for 4 years as a remedy for lumbago. Although the serum contained cross-reactive antibodies against Toxocara canis, positive reactions to Angiostrongylus cantonensis antigens were observed in all of the immunological tests made. These observations, together with results of epidemiological studies in Honshu carried out by other investigators, suggest that the present case of eosinophilic meningitis may have been caused by A. cantonensis. One previous case has been reported from Honshu Island, Japan.
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PMID:Eosinophilic meningitis: a suspected case of angiostrongylosis found in Shizuoka Prefecture, Honshu, Japan. 43 13

Between 1959 and 1976, 34 patients were seen in Hawaii with eosinophilic meningitis. Angiostrongylus cantonensis was recovered from two of these patients. The remaining cases were presumed to be due to this parasite because of clinical and epidemiologic findings. The most likely source of infection for eight patients was ingesting raw terrestrial snails or slugs, and for six patients eating raw or poorly cooked crustaceans. Patients typically presented with severe headache; neck stiffness and fever were usually mild or absent. Paresthesias were noted by most adults. The cerebrospinal fluid (CSF) cell count ranged from 150 to 1500 leukocytes per cubic millimeter, with a mean eosinophil percentage of 38. CSF IgE levels were not abnormal in four patients so studied. Although two deaths occurred, the illness was typically self-limited, resolving completely with no specific treatment.
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PMID:Clinical manifestations of eosinophilic memingitis due to Angiostrongylus cantonensis. 57 19

A case of aneurysm of the left internal acoustic meatus has been reported. The patient was 53-year-old man who was admitted with the history of sudden onset of a severe occipital headache 18 days previously. He also noted nausea, vomiting and became drowsy at that time. He was seen at a local clinic and a lumbar puncture showed bloody fluid. The next day his level of consciousness improved but he noted left tinnitus and neck stiffness. On admission, he only complained of a left tinnitus. The rest of the neurological examination was normal. Craniogram was of no abnormal findings. Cerebral angiogram showed an aneurysm at the left internal acoustic meatus fed by the left internal auditory artery. At operation, the aneurysm was clipped at the entrance of its feeding artery via retroauricural-retromastoidal craniectomy. The postoperative course was satisfactory except for the decrease of the left auditory acuity to 50dB. Postoperative angiogram revealed a complete disappearance of the aneurysm. In the literature only six cases have been reported, which were summarized in Figure 1. Clinical features of such an aneurysm are subarachnoid hemorrhage and symptoms of cerebello-pontine angle, namely tinnitus, hearing disturbance and facial palsy etc. Besides, on skull x-ray film, sometimes enlargement of the internal acoustic meatus has been found.
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PMID:[A case of aneurysm of the left internal acoustic meatus (author's transl)]. 65 16

The records of 24 patients with cryptococcal meningitis, admitted to King Edward VIII Hospital in Durban, were reviewed. There were 21 adults and 3 children over periods of 10 and 18 years, respectively. Slightly more males were affected. The age distribution was fairly even. The common clinical presentations were headache, neck stiffness, mental changes, cranial nerve palsies and papilloedema. The diagnosis was proved by the presense of Cryptococcus neoformans in the cerebrospinal fluid (CSF) in 21 of the patients, and in pathological tissue in the remaining 3 patients. A significant percentage of patients presented with an initial polymorphonuclear leucocyte predominance in the CSF. The other CSF findings were elevated protein and low sugar levels. Tuberculosis was the common coexisting disease. We found the mortality rate of 58% to be very high and a significant number of patients died even after adequate treatment with amphotericin B either singly or in combination with 5-fluorocytosine.
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PMID:Cryptococcal meningitis: our experience in 24 black patients. 98 16

Bilateral putaminal necrosis is characteristic of methanol poisoning. A 31-year-old male alcoholic had headache, impaired consciousness, neck stiffness, roving eyes with dilated unreactive pupils, papilloedema, abdominal pain, vomiting, and severe metabolic acidosis after a binge. Abnormalities of the cerebrospinal fluid included an initial pressure of 240 mmH2 O, RBC 286/mm3, WBC 8/mm3, and protein 179 mg/dl. Peritoneal dialysis was performed on the 2nd day after drinking. A blood test for methanol was not performed until the 5th day, and its results was negative. However, computed tomography (CT) on the 3rd day showed necrosis and hemorrhage of bilateral putamina and the cerebral cortex, and post-contrast enhancement of meninges. On the 22nd day, a CT revealed further changes: necrosis of bilateral subcortical white matter, and post-contrast gyral enhancement at the otherwise normal-looking areas of the cerebral cortex. We suggest that, in certain situations, the characteristic CT findings are helpful in the diagnosis of methanol poisoning.
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PMID:Bilateral putaminal necrosis caused by methanol poisoning: a case report. 131 54

Among 504 cases of AIDS diagnosed between 1983 and 1990, there were 86 patients (17%) with toxoplasma encephalitis (TE). All were symptomatic at the time of diagnosis. General signs such as fever, neck stiffness, or headache were present in 87.2%, and 75.6% had focal signs. The primary means of diagnosis was computerized tomographic scanning, revealing 169 lesions of which 80% were immediately contrast-enhancing. All patients had IgG antibodies against Toxoplasma gondii either before (74 of 75 evaluable patients) or at the time of diagnosis of TE (73 of 75). Elevated antibody titers were present in 44% of evaluable patients, compared to 11% of patients with AIDS and other opportunistic infections. Initial treatment was pyrimethamine plus sulfonamides in 65 patients, and pyrimethamine plus clindamycin in 12 patients, with other combinations or no treatment accounting for the remainder. Life-table analysis of the time to discontinuation of treatment because of suspected side effects suggested that sulfadiazine was significantly more toxic, with 48% of patients experiencing an interruption in treatment after 30 days, than pyrimethamine (12%) or clindamycin (24%). The 30-day mortality rate was 12%, and median survival was 310 days after diagnosis, 530 in patients treated with zidovudine and 190 days in those not so treated. Of 82 evaluable patients, 16 relapsed once and 4 of these more than once. The risk of relapse was 27% 1 year after diagnosis of a first episode of TE.
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PMID:Toxoplasma encephalitis in patients with the acquired immunodeficiency syndrome. 135 79

This is the first report from Ethiopia of a case of cryptococcal meningitis in a patient with AIDS. A 20-year-old woman was admitted to Tikur Anbessa Hospital in January 1990 with complaints of generalized pruritic skin lesions of six months, and headache, fever, and poor appetite of three months duration. The headache and low-grade intermittent fever were accompanied by nausea, vomiting, anorexia, and progressive weight loss, without diarrhea. She had had multiple sex partners. Upon admission, after being bedridden for two weeks, she appeared acutely ill and restless. Her temperature was 39.5 degrees Celsius, and she had oral thrush. There was no lymphadenopathy. Widespread, irregular erythematous and whitish macular patches (3 x 5 to 8 x 10 sq. cm in size) with peripheral scaling and tiny vesicles were found on the skin, pubic and perineal regions. She had neck stiffness, but was conscious and well-oriented. Hemoglobin (Hb) was 10.5 g%; the white cell count (WBC) was 3400/cu. mm; the erythrocyte sedimentation rate (ESR) was 92 mm/hr; the platelet count was 175,000/mm; and blood films were negative for hemoparasites. Urinalysis showed 3+ albumin and many pus cells and red cells/HPF. Urine culture was negative, and the VDRL test was nonreactive. Lumbar puncture, which was performed upon arrival, showed clear cerebrospinal fluid (CSF), with normal protein and glucose levels and no cells. CSF culture showed yeast cells, and an India ink preparation was positive for Cryptococcus neoformans. Blood taken for bacterial culture grew yeast cells. Renal and liver function tests, and chest x-rays were normal. A potassium hydroxide (KOH) preparation from a skin snip showed rounded yeast cells. ELISA and Western blot tests were both positive. The patient was given supportive treatment and amphotericin B (0.6 mg/kg daily). Although the fever decreased, the patient's general condition did not improve. She complained of headache, photophobia, nausea, and vomiting. Lumbar puncture was repeated eight days after the start of treatment; CSF culture and India ink preparations were negative. Urea nitrogen (BUN) repeated two weeks later was normal. Four weeks after admission, the patient suddenly vomited massive amounts of fresh blood and died before transfusion could be given. A discussion follows regarding the clinical manifestations, diagnosis, and treatment of this disease, particularly in AIDS patients, with a review of the literature.
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PMID:Cryptococcal meningitis in a young Ethiopian woman with AIDS. 139 20

A 52 year old, right handed, hearing impaired woman was admitted with headache and neck stiffness. The only neuropsychological symptom was transient auditory perceptions in the left ear, which were musical, seemed familiar and were not influenced by verbal communication. CT and MRI showed a right subarachnoid haemorrhage, while brainstem auditory evoked potentials failed to reveal a brainstem lesion. In patients with organic cerebral disease, unilateral auditory hallucinations (AHs) may indicate a lesion in the contralateral hemisphere. However, according to this review the type of AHs (verbal versus musical) is not consistently associated with a cerebral lesion on either side.
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PMID:Transient musical hallucinosis of central origin: a review and clinical study. 146 4


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