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Query: UMLS:C0018681 (headache)
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The premenstrual symptom complex many women experience in a moderate to severe form can be divided into four subgroups. Because there is more than one syndrome and nervous tension is one of the most common symptoms, the term premenstrual tension syndromes (PMTS) is used. The most common subgroup, PMT-A, consists of premenstrual anxiety, irritability and nervous tension, sometimes expressed in behavior patterns detrimental to self, family and society. Elevated blood estrogen and low progesterone have been observed in this subgroup. Administration of vitamin B6 at doses of 200-800 mg/day reduces blood estrogen, increases progesterone and results in improved symptoms under double-blind conditions. Women in this subgroup consume an excessive amount of dairy products and refined sugar, and progesterone may be of value in them. The second-most-common subgroup, PMT-H, is associated with symptoms of water and salt retention, abdominal bloating, mastalgia and weight gain. The severe form of PMT-H is associated with elevated serum aldosterone. Vitamin B6 at high dosage suppresses aldosterone and results in diuresis and clinical improvement. Vitamin E helps the breast symptoms. Methylxanthines and nicotine should be curtailed and sodium limited to 3 gm/day. PMT-C is characterized by premenstrual craving for sweets, increased appetite and indulgence in eating refined sugar followed by palpitation, fatigue, fainting spells, headache and sometimes the shakes. PMT-C patients have increased carbohydrate tolerance and low red-cell magnesium. Adequate magnesium replacement results in improved glucose tolerance tests and decreased PMT-C symptoms. Deficiency of the prostaglandin PGE1 may also be involved in PMT-C. PMT-D is the least common but most dangerous because suicide is most frequent in this subgroup. The symptoms are depression, withdrawal, insomnia, forgetfulness and confusion. In ten PMT-D patients the mean blood estrogen was lower and the mean blood progesterone higher than normal during the midluteal phase. Elevated adrenal androgens are observed in some hirsute PMT-D patients. Two PMT-D patients with normal blood progesterone and estrogens had high lead levels in hair tissue and chronic lead intoxication. This subgroups needs careful medical attention when the symptoms are severe. Therapy should be individualized according to the results of the evaluation.
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PMID:Nutritional factors in the etiology of the premenstrual tension syndromes. 668 67

A menstrual symptom questionnaire was used to assess the incidence of premenstrual tension (PMT) in 1,395 regularly menstruating women not on hormonal contraceptives or any other hormonal therapy during routine visits to a gynecologic clinic. Nineteen symptoms were divided into four PMT subgroups: PMT-A (anxiety, irritability, mood swings, nervous tension), PMT-H (weight gain, swelling of extremities, breast tenderness, abdominal bloating), PMT-C (headache, craving for sweets, increased appetite, heart pounding, fatigue and dizziness or fainting) and PMT-D (depression, forgetfulness, crying, confusion, insomnia). The ages of the patients ranged from 13 to 54 years, with a mean +/- S.D. of 32 +/- 8.5 years. Using strict criteria for PMT, 702 patients scored positive for at least one subgroup of PMT, giving an incidence of 50%. When the patients were divided into five-year age groups, a peak incidence of 60% was observed in the third decade of life. The most common PMT subgroups were PMT-A and PMT-H, occurring either alone or in combination. The least common subgroup was PMT-D, occurring in only 12 patients and by itself. The mean cycle length in pure PMT-D patients was significantly shorter (p less than 0.05) than in patients without PMT.
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PMID:The incidence of premenstrual tension in a gynecologic clinic. 689 20

We report a 71-year-old woman with progressive gait disturbance and dementia. The patient was well until 61 years of age (1980) when she noted a gradual onset of gait disturbance. A year later, she noted slurring of the speech and forgetfulness. In 1982, she noted difficulty in looking down and progression of her gait disturbance. In 1983, she became unable to walk alone unless supported. She was admitted to our service in 1984; neurological examination at that time revealed moderate dementia, limitation in the vertical gaze, slurred speech, and wide based ataxic gait. She was discharged for out patient follow up. Cranial CT scan in 1989 revealed cortical, brain stem, and cerebellar atrophies. On March 10, 1990, she fell down and hit her head. She developed headache on April 1, vomited on April 8, and was admitted to our service again. On admission, she was somnolent, she was unable to follow an object to any direction; oculocephalic response was elicited to horizontal directions, however, it was difficult to induce in the vertical direction. Rigidity was noted in the extremities except in the left lower extremity. Rapid alternating movement was difficult and dysmetria was noted in the finger-to nose test. Deep reflexes were exaggerated without clonus; the plantar response was extensor bilaterally. Cranial CT scan revealed bilateral subdural hematoma. She was treated with intravenous infusion of glycerol, and she became alert after this treatment; however, she was markedly demented. She was unable to walk alone. She was discharged to home, but she showed progressive loss of activities, and became bed ridden in December 1992. In January of 1993, she developed fever, dyspnea, and disturbance of consciousness, and was admitted again on January 26, 1993. On admission, her blood pressure was 70 mmHg by palpation and body temperature 38.5 degrees C. The lungs were clear. On neurologic examination, she was semicomatose; the optic fundi were unremarkable; only incomplete eye movements elicited by the oculocephalic reflex. She was passive supine in position; some spontaneous movements were observed in the extremities. Lead-pipe rigidity was noted in both upper extremities, but the muscle tone was decreased in the lower extremities. No abnormal involuntary movements were seen. Deep reflexes were exaggerated except for the ankle jerk which was diminished bilaterally. The plantar response was extensor on both sides.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 71-year-old woman with progressive gait disturbance and dementia]. 766 34

Between August 1990 and March 1991, the United States deployed 697,000 troops to the Persian Gulf to liberate Kuwait from Iraqi occupation. Since the Gulf War, most veterans seeking medical care at Departments of Veterans Affairs and Defense medical facilities have had diagnosable conditions, but the symptoms of several thousand veterans have not been readily explained. The most commonly reported, unexplained complaints have been chronic fatigue, rash, headache, arthralgias/myalgias, difficulty concentrating, forgetfulness, and irritability. These symptoms have not been localized to any one organ system, and there has been no consistent physical sign or laboratory abnormality that indicates a single specific disease. Because of the unexplained illnesses being experienced by some Gulf War troops, a comprehensive clinical and research effort has been organized by the Departments of Veterans Affairs, Defense, and Health and Human Services to provide care for veterans and to evaluate their medical problems. To determine the causes and most effective treatments of illnesses among Gulf War veterans, a thorough understanding of all potential health risks associated with service in the Persian Gulf is necessary. These risks are reviewed in this article and include possible reactions to prophylactic drugs and vaccines, infectious diseases, and exposures to chemicals, radiation, and smoke from oil fires.
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PMID:Unexplained illnesses among Desert Storm veterans. A search for causes, treatment, and cooperation. Persian Gulf Veterans Coordinating Board. 854 60

The neuropsychological functioning of five men suffering alleged physical, cognitive and behavioural changes following exposure to methylene diphenyl diisocyanate (MDI), an industrial chemical, was investigated in the present study. At the time of assessment, four of the five patients remained symptomatic despite having no contact with MDI for periods ranging from 5 to 9 months. All patients reported experiencing subjective symptoms consisting of respiratory distress, headaches, depression, irritability, forgetfulness, decreased calculating ability, word-finding problems and reduced concentration. While the pattern of neuropsychological deficits varied among the patients, common findings for the group included intact psychomotor, psychosensory, visuographic and language functions accompanied by deceased concentration, mental efficiency, rate of information processing, learning ability and abstract reasoning. All five patients also revealed significant emotional distress on an objective personality measure. In general, the neuropsychological test data support the presence of behavioural and cognitive correlates of CNS injury following exposure to MDI.
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PMID:Neuropsychological toxicology of methylene diphenyl diisocyanate: a report of five cases. 800 86

We present a 81-year old male who developed dementia, gait disturbance and right hemiparesis. He was well until the age of 74 when he developed a hemorrhagic infarction in the right occipital region, which left him left homonymous hemianopsia. One year later he had one TIA attack consisting of dizziness, headache, and some clouding of consciousness. At that time, atrial fibrillation was found. At age 79, he was attacked by right hemiparesis. Cranial CT scans revealed a lesion consistent with a hemorrhagic infarct in the left middle cerebral artery territory. Two months prior to his final admission, he had a gradual onset of forgetfulness, labile affect, nocturnal agitation and hallucination which were followed by gait disturbance and urinary incontinence. On admission, he was alert but moderately demented. In addition he showed difficulty in repetition, limb kinetic and ideomotor apraxia of the left hand indicative of sympathetic apraxia, and constructional apraxia bilaterally. Granial nerves appeared intact except for left homonymous hemianopsia. His gait was wide-based and small stepped. No weakness or ataxia was noted. Deep reflexes were diminished on the left side. Plantar reflex was equivocally extensor of the left. Light touch and pain was slightly diminished on the right side. Cranial CT scans revealed a large low density area in the left fronto-temporo-parietal region. Also ventricular dilatation, diffuse low density change in the subcortical white matter, and diffuse cortical atrophy were seen. His clinical course was complicated by melena, anemia, pneumonia, cardiac failure and renal failure. He expired 2 months after his admission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A 81-year-old man with dementia, gait disturbance, hemiparesis, and sympathetic apraxia]. 833 25

To clarify the relationship between non-specific neurological complaints and silent cerebral infarction (SCI), we studied 82 patients (56 +/- 8 years old; mean +/- SD) who presented with at least one complaint (headache, dizziness, forgetfulness) and 76 normal volunteers with no complaints (55 +/- 7 years old). All subjects were evaluated with a questionnaire for complaints and with 0.5 T magnetic resonance imaging of the brain for the presence of SCI. Several risk factors for stroke were also studied. SCI was significantly more common in the patients (18%) than in the normal subjects (7%, p < 0.05). SCI was more common in subjects with dizziness (40%) and in those with headache (18%) than in those with no complaints (p < 0.01, p < 0.05, respectively). Dizziness and forgetfulness were closely associated with SCI (p < 0.05). Two risk factors for stroke, age and hypertension, correlated with SCI. These results clearly show that non-specific neurological complaints are closely related to SCI.
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PMID:[Non-specific neurological complaints and silent cerebral infarction]. 879 60

The term "chordoid glioma" was recently introduced to denote a circumscribed, apparently low-grade neoplasm arising in or preferentially involving the third ventricle of middle-aged women. We report biopsy and postmortem findings in a 60-year-old woman with symptoms of forgetfulness, headache, and lethargy. Neuroimaging showed a contrast-enhancing third ventricular mass with obstructive hydrocephalus. The tumor was subtotally resected. Microscopically, it consisted of clusters and strands of epithelioid cells in a mucoid matrix. Its margins were remarkably discrete and showed little tendency to infiltrate surrounding brain parenchyma. The majority of neoplastic cells were glial fibrillary acidic protein (GFAP) and vimentin positive, whereas S100 protein labeled only individual cells. Stains for epithelial membrane antigen (EMA) and cytokeratin were nonreactive. There was no evidence of neuroendocrine differentiation or expression of estrogen and progesteron receptors. Lymphoplasmacellular infiltrates were noted throughout the lesion and at the tumor-brain interface. The MIB-1 labeling index averaged 1.5%. At present, chordoid glioma is considered a glial neoplasm of uncertain histogenesis with distinct clinicopathologic features.
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PMID:Chordoid glioma of the third ventricle: confirmatory report of a new entity. 1037 85

Our purpose in conducting this study was to examine the relationship between physical activity and symptoms associated with perimenopause. A group of 214 perimenopausal women aged 40-55 years (mean = 47 years) completed the Women's Health Assessment Scale (assesses symptoms associated with perimenopause: vasomotor, psychosomatic, menstrual, and sexual symptoms) and the physical activity questionnaire. These women were categorized into three groups based on their levels of physical activity: inactive, relatively active, and active. Analyses of covariance (ANCOVA) revealed significant differences between groups in frequency and distress of overall symptoms associated with perimenopause (F = 8.86, p = .00, F = 6.25, p = .00, respectively). Further analyses indicated that relatively active and active women had significantly fewer and less distressful psychosomatic symptoms (F = 8.05, p = .00, F = 5.80, p = .00, respectively), such as irritability, forgetfulness, and headache as well as fewer and less distressful sexual symptoms (F = 3.42, p = .03, F = 3.73, p = .03, respectively), such as vaginal dryness and decreased sexual desire than inactive women. No significant differences were found among groups on vasomotor and menstrual symptoms. In conclusion, physical activity may be an important alternative/adjunct to hormone therapy particularly for psychosomatic and sexual symptom management at perimenopause.
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PMID:The relationship between physical activity and perimenopause. 1040 86

Patients who suffered a closed head injury (CHI) are frequently with various subjective complaints: headache, forgetfulness, irritability, poor concentration, etc. Such complaints were observed in patients with both severe and mild CHI. The aim of this study was to establish the degree of the subjective complaints in the group of 40 patients who continuously expressed the complaints even in the follow-up period from 6 to 47 months after the injury. Special questionnaire adopted for this category of patients was used for the registration of their complaints. The severity of CHI was estimated upon the classification of the initial impaired consciousness by Glasgow Coma Scale (GCS) and upon the duration of post-traumatic amnesia (PTA), while the recovery was estimated upon the five-levels scale of return to work (RTW). The most frequent disturbances were: forgetfulness (4%), irritability (40%) and poor concentration (35%). The analyses indicated the occurrence of two groups of symptoms, and the explanation for their most probable genesis was given.
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PMID:[Subjective complaints in patients after a closed head injury]. 1043 18


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