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

Two cases of primary intracerebral malignant lymphoma were reported. Case 1 was a 42-year-old man who had been suffering from headache and mental disturbances for about 3 months prior to admission. These complaints progressed insidiously. He was admitted to our hospital on March 31, 1973. On neurological examinations he was in somnolence state and had neck rigidity, positive of Kernig's sign, disorientation and dyscalculia. Lumbar puncture gave a C.S.F. pressure of 240 mmH2O and the fluid contained 180 mg/dl of protein. A left vertebral angiogram via brachial artery demonstrated thalamic and cerebellar mass lesions. For the development of symptoms of increased intracranial pressure, a ventriculoperitoneal shunt operation was performed on April 7. A right carotid angiogram after ventriculoperitoneal shunt operation disclosed a frontal mass lesion. On May 2, a right frontal craniotomy was carried out and the frontal lobe was removed together with the tumors. After the operation his consciousness remained stupor. Thereafter consciousness and clinical pictures gradually worsened, and he died on May 30. Autopsy was performed, and gross examinations revealed tumors in the bilateral frontal and temporal lobes, right parietal lobe, and left cerebellar hemisphere. On coronal sections, there were neoplastic proliferation extending from the right thalamus to the putamen and a tumor in the right midbrain. No evidence of neoplastic proliferation was found outside the central nervous system. Microscopic examinations showed a diffuse proliferation of tumor cells with mitosis and polymorphism. The tumor was consisted of small lymphoid cells. Reticulin fibers were not found in the tumor with Watanabe's silver method. It was also unable to impregnate the tumor cells with silver carbonate. This case may be classified the primary interacerebral lymphosarcoma. Case 2 was a 48-year-old man, who was admitted to the hospital complaining of occipitalgia, speech disturbances and diffculty in walking. On neurological examinations, he had a right spastic hemiparesis and dyscalculia. A right carotid angiogram showed the frontal mass lesion. On April 18, a left frontal craniotomy was performed and frontal lobe was removed with the tumor. He made a good recovery from the operation and remained well for about 1 month. However, it culminated in a gradual diminution in the level of consciousness. Unfortunately, he died on June 20. No autopsy was performed. Histologically, the tumor cells had round or ovoid nuclei, mitosis and polymorphism. The perivascular arrangement of the tumor tissue showed tendency to confluence. There were reticulin fibers in the tumor tissue, particularly around the blood vessels. Microglial cells were not impregated with silver carbonate. It is supposed that this case belongs to the primary intracerebral "reticulum cells sarcoma-microglioma" described by Rubinstein or reticulum cell sarcoma. Both the case 1 and the case 2 should be filed to be malignant lymphoma in the wide category.
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PMID:[Two cases of primary intracerebral malignant lymphoma (author's transl)]. 110 27

During 1988, an endemic outbreak of aseptic meningitis was noted in the Kaohsiung area. Throughout the year, a total of 89 cases were identified by cerebrospinal fluid (CSF) examination at the Pediatric Department of Kaohsiung Medical College. The peak incidence was from June to October. Scattered cases still occurred during November and December. The male to female ratio was 1.7:1 and the age distribution ranged from 1 month to 15 years old. Two peaks of age distribution were observed; one in infancy and the other in the 4-7 year old age group. Most of them exhibited fever (94.4%), headache (68.9%), and vomiting (68.5%). Other associated symptoms and signs included neck stiffness, sore throat, cough, Brudzinski's sign, abdominal pain, seizure, dizziness, rhinorrhea, diarrhea, Kernig's sign, skin rash, hyperemic conjunctiva, apnea, and oral ulcers. Most of them had CSF white blood cell (WBC) counts less than 1000/mm3, normal or mild elevated protein, and normal CSF/plasma sugar ratio. Three patients were found to have a virus in their CSF without pleocytosis. Virus isolations from CSF throat swabs and/or rectal swabs were performed in 65 patients, half of them (35/65, 53.8%) had positive results including echovirus type 9 (sixteen), echovirus type 30 (eighteen), and adenovirus type 3 (one). Echovirus type 9 was predominant during July and August whereas echovirus type 30 became predominant after September. All patients recovered spontaneously without any sequelae.
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PMID:Clinical observations and virological study of aseptic meningitis in the Kaohsiung area. 198 74

We prospectively examined the clinical signs of 54 febrile patients associated with recent-onset headache. They underwent lumbar puncture (LP) on suspicion of meningitis. The relation of each sign to cerebrospinal fluid (CSF) pleocytosis was estimated. Among 34 patients with pleocytosis, 33 had jolt accentuation (sensitivity: 97.1%), while only 5 of them had neck stiffness or Kernig's sign. Among 20 patients without pleocytosis, 12 had no jolt accentuation (specificity: 60%). We found jolt accentuation to be the most sensitive sign of CSF pleocytosis. If jolt accentuation is noted in a febrile patient associated with recent onset headache, the CSF should be examined even in the absence of neck stiffness or Kernig's sign.
Headache 1991 Mar
PMID:Jolt accentuation of headache: the most sensitive sign of CSF pleocytosis. 207 96

A retrospective review of charts for 650 children who had lumbar puncture for suspected meningitis was undertaken to determine the characteristics of patients with and without meningitis, identify other conditions suggesting meningitis, and evaluate the predictive value of signs and symptoms of meningitis. The incidence of positive lumbar punctures increased with patient age. Younger infants did not present with classical features of meningitis. Bulging fontanel, lethargy, and irritability were nonspecific symptoms. Vomiting and headache, although not specific, proved to be more sensitive indicators of meningeal infection. Most patients with meningitis (75%) had at least one sign of meningeal irritation, but so did 25% of patients without meningitis. Brudzinski's sign was not specific. In contrast, nuchal rigidity and Kernig's sign had high predictive value. Up to age five, the diseases most often suggesting meningitis were right-sided pneumonia, gastroenteritis, otitis, tonsillitis, exanthema subitum, and urinary tract infections. Of 171 patients with febrile convulsion, one (0.5%) had bacterial meningitis and four had aseptic meningitis.
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PMID:Diseases that mimic meningitis. Analysis of 650 lumbar punctures. 220 11

A case of spinal ependymoma showing spinal subarachnoid hemorrhage with findings mimicking subacute meningitis is reported. A 33-year-old man was admitted to our hospital because of headache, low back pain and low grade fever on June 8, 1982. Ten years ago he had experienced an episode of abrupt onset lumbago and headache. Subarachnoid hemorrhage was suspected because of bloody cerebrospinal fluid, but cerebral angiography failed to demonstrate any abnormalities. On admission physical examination revealed nuchal rigidity, Kernig's sign and percussion tenderness on 5th lumbar spine. Lumbar puncture showed bloody cerebrospinal fluid. Cell counts were 217 per cubic millimeter (neutrophil: lymphocyte = 27.73), protein was 396 mg/dl and sugar level was 18 mg/dl. Myelography showed an intradural extramedullary tumor at the spinal level of L1-L2. Spinal MRI and CT scan also demonstrated a spinal tumor at the same level. Laminectomy and total resection of the spinal tumor were performed and a diagnosis of myxopapillary ependymoma was made histologically. He was discharged about a month later without any neurological deficits. The development of subarachnoid hemorrhage due to spinal tumor is rare. There are about 50 cases of spinal subarachnoid hemorrhage due to spinal tumor in the literature, including three cases in Japan. Two cases presenting CSF findings mimicking bacterial meningitis have been reported in the literature, but there is no report of subarachnoid hemorrhage due to spinal tumor that presents findings mimicking subacute meningitis similar to our case. From these results, it is suggested that subarachnoid hemorrhage due to spinal ependymoma may reveal various CSF findings. In cases suggesting bacterial or subacute meningitis with bloody CSF and acute onset, the possibility of spinal subarachnoid hemorrhage due to rupture of a spinal tumor, especially ependymoma, should be considered.
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PMID:[Spinal subarachnoid hemorrhage due to spinal ependymoma presenting findings mimicking subacute meningitis]. 235 Sep 33

A 14-year-old boy was admitted to our hospital complaining of dull headache, high fever and decreased visual acuity of his left eye. Physical examination on admission revealed nuchal rigidity, positive Kernig's sign, slight hyperreflexia of deep tendon reflex, and decreased visual acuity of his left eye to 0.1. The chest was clear to percussion and auscultation, and no abnormal findings was observed on chest x-ray examination. On laboratory examination, leukocytosis (12,800/mm3) and increased erythrocyte sedimentation rate (83mm/hr) was observed. Cerebrospinal fluid (CSF) examination showed pleocytosis (308/3, mono 286, poly 22) and slight elevation of protein without decrease of glucose content (52mg/dl). On ophthalmologic examination, characteristic anterior and posterior uveitis was found in both eyes, more on the left. Antibody titer to psittaci was significantly elevated in both serum and CSF in his clinical course, therefore, this case was diagnosed as psittacosis meningitis complicated with uveitis. Minocycline (200mg/day) was administered from the 30th hospital day. The effect of this drug was dramatic, and fever and dull headache rapidly disappeared. In addition, fundus oculi examination on the 85th hospital day, revealed no abnormality in his eyes, and his visual acuity returned to normal level (1.0). This case was considered to be extremely rare case of psittacosis, because in addition to meningitis, the patient complicated with uveitis without any respiratory signs and symptoms.
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PMID:[A case of psittacosis meningitis complicated with uveitis]. 274 82

A very rare case of peptostreptococcal meningitis associated with subarachnoid hemorrhage and subdural hematoma was reported. A 25-year-old man was admitted to St. Mary's Hospital on November 6, 1984 with a few day's history of headache and low grade fever. On admission, he had high grade fever (39.2 degrees C) and tachycardia (110/min). There were no neurological deficits other than neck stiffness and Kernig's sign. The cerebrospinal fluid (CSF) which was obtained through lumbar puncture showed watery clear appearance, white cell count of 32/3 mm3 (mononuclear: polymorphonuclear = 4:5), protein 76 mg/dl and glucose 8 mg/dl. It was found to be sterile. However, peptostreptococcus was found in his peripheral blood culture. He was diagnosed peptostreptococcal meningitis. After administration of antibiotics, laboratory test result of CSF improved gradually so as his meningeal irritation signs. After 25 days of hospitalization, he developed suddenly severe headache. CSF showed bloody and xanthochromic appearance, and CT scan revealed a subdural hematoma in the left fronto-temporal convexity. Although we suspected formation of mycotic aneurysm caused by the meningitis and its rupture, cerebral angiography revealed no abnormality except for the findings of subdural hematoma. The subdural hematoma was completely absorbed and he was discharged 79 days after admission without having any neurological deficit. We concluded that such a mycotic aneurysm was too small to be detected by the cerebral angiography.
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PMID:[A case of peptostreptococcal meningitis associated with subarachnoid hemorrhage and subdural hematoma]. 374 8

Idiopathic dural arteriovenous malformation which occurs in the posterior fossa uses predominantly transverse and sigmoid sinuses. Cavernous sinus comes next and others are rather rare. However, we have recently experienced such a rare case which was operated on and cured completely. The malformation was fed through the anterior ethmoid artery and drained to the cortical vein. The case was a 36-year-old male and admitted in our clinic for having headache and nausea as the chief complaints. He was diagnosed subarachnoid hemorrhage due to the following findings: CT scans showed a high density zone localized in the sylvian vallecula. Cerebrospinal fluid obtained by a lumbar puncture was found to be bloody. No neurological abnormality other than neck stiffness and positive Kernig's sign was observed. Under study of right carotid arteriography, dural AVM was evident. The anterior ethmoidal artery which branched out from the ophthalmic artery fed the AVM. The cortical vein which ran on the surface of the frontal base was its drainer via a small nidus. There was no abnormality seen on a left carotid arteriogram. Surgery was proceeded with the right frontal craniectomy in extra- and intradural approach. At first, anterior ethmoidal artery was cut at the cribriform plate extradurally. After dura was incised, both the nidus and drainer were coagulated intradurally. The nidus was located at inner surface of the dura. The arachnoid hemorrhage was thought to be caused by rupture of this drainer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Dural arteriovenous malformation of the anterior fossa with subarachnoid hemorrhage]. 380 1

Fifty-five patients with ECHO virus type 30 meningitis were admitted to the Infectious Diseases Unit, Edinburgh City Hospital between August and December 1980. There was a preponderance of males and patients aged 10-15 years. The peak admission rate was about two weeks earlier than that recorded for Scotland as a whole. Helpful diagnostic findings were headache, fever, photophobia, vomiting and nuchal rigidity but not Kernig's sign. Only one patient had a rash. The majority of patients were admitted within 48 hours of the onset of symptoms. The CSF pleiocytosis was high and tended to be polymorphonuclear in type. CSF glucose concentrations were all normal. There were no serious sequelae. The considerable morbidity reported after leaving hospital emphasises the importance of adequate convalescence.
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PMID:ECHO virus type 30 meningitis in Edinburgh. 686 96

We report a 65-year-old woman with progressive multiple cranial neuropathy. She had been suffered from bronchial asthma since 1979 for which prednisolone had been prescribed. She noted an onset of pain around her nose in October, 1989, which extended into the periorbital regions bilaterally. In February, 1990, she was treated with stellate ganglion block and trigeminal nerve block; these treatments partially alleviated her pain. In May of 1991, she noted a difficulty in swallowing solid foods. In November of the same year, she developed right facial paresis; two weeks later, she noted numbness in her left face, and was hospitalized to our service on December 16, 1991. On admission, she was afebrile and general physical examination was unremarkable except for piping rales in her both lung fields. On neurologic examination, she was alert and oriented to all spheres; higher cerebral functions were intact. In the cranial nerves, her olfactory sense was lost bilaterally; her vision was markedly diminished bilaterally only to recognize hand movements; the optic fundi appeared normal; the pupils were isocoric and reacted to light promptly. The extraocular muscles were moderately weak to most of the directions more on the left; no nystagmus was present. Facial sensation was diminished bilaterally; the jaw deviated to right; right facial paresis of peripheral type was present; her hearing was diminished bilaterally more on the right. The movement of the soft palate was diminished on the right side; dysphagia was present; her voice was horse; the gag reflex was diminished. The sternocleidomastoid muscle was weak bilaterally; the tongue appeared normal. Examination of gait was differed because of headache, however, no apparent motor weakness was present. No ataxia or involuntary movement was noted. Deep reflexes were normally elicited and symmetric. Plantar response was flexor. Sensation in the extremities was intact. Kernig's sign was positive at 70 degree leg extension; eyeball tenderness was also present bilaterally, however, no nuchal stiffness was noted. Following abnormalities were present in the laboratory examination: WBC 11,400/microliters, ESR 50 mm/hr, CRP 6.1 mg/dl. The lumbar CSF was under a normal pressure containing 29 WBC/microliters (neutrophils 7, lymphocytes 20, others 2), 67 mg/dl of protein, and 53 mg/dl of sugar; cultures for acid-fast bacilli as well as for other bacteria were negative; no malignant cells were found. A cranial CT scan revealed an isodensity mass in the orbit and ill-defined low density areas in the white matters of the frontal lobes.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 65-year-old woman with headache, facial pain, and progressive multiple cranial neuropathy]. 787 85


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