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

A case of acute cryptococcal cerebellar encephalitis with CT enhancement confined to the cerebellum is reported. A 46-year-old man with hepatoma was admitted with chief complaints of headache, fever and dizziness. On admission, cerebellar signs (disturbance of finger-to-nose test and of heel-to-knee test, intention tremor, and truncal ataxia) were neurologically noted. However, there were no brainstem signs. Head CT showed swelling and enhancement of the cerebellar cortex and dilatation of the cerebral ventriculi. Cryptococcus neoformans was detected in a culture of the patient's CSF. Clinical symptoms and signs, and enhancement of the cerebellum on CT gradually diminished after administration of anti-fungal drugs, and CSF became negative for cryptococcal antigen 6 months after admission.
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PMID:[A case of acute cerebellar encephalitis due to Cryptococcus neoformans]. 193 83

A 29-year-old man presented with headache, nuchal rigidity and bilateral facial paralysis. Lumbar puncture revealed eosinophilic CSF pleocytosis. Facial diplegia was improved by supportive treatment. Thus, eosinophilic meningitis is one of the etiologies of bilateral facial nerve paresis.
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PMID:Bilateral facial nerve paresis in eosinophilic meningitis. 194 Jul 9

A 41-year-old man had three episodes of acute aseptic meningitis from the age of thirty-six. With each episode he had severe occipital headache associated with a mononuclear pleocytosis and an increase in CSF protein. He had a neuroepithelial cyst originating from the choroid plexus of the right cerebellomedullary cistern. Spontaneous ruptures of the cyst probably caused recurrent chemical meningitis. A neuroepithelial cyst must be considered in the differential diagnosis of intracranial cystic tumors presenting with aseptic meningitis.
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PMID:Neuroepithelial cyst presenting as recurrent aseptic meningitis. 194 17

We analysed two of our own and 21 patients described in the literature with listeria brainstem encephalitis. The disease was characterised by a prodromal state with fever, nausea and headache followed by severe brainstem dysfunction with multiple cranial nerve palsies, ataxia, respiratory insufficiency and coma. The diagnosis was established by isolation of Listeria monocytogenes from CSF and/or serum. Serological tests are without diagnostic evidence. Cerebrospinal fluid examination may not initially point to a bacterial infection. Computed tomography and magnetic resonance imaging technique might supply evidence of brainstem involvement and contribute to an early diagnosis. There is a high percentage of lethal outcome without early antibiotic therapy.
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PMID:Listeria brainstem encephalitis: two own cases and literature review. 201 6

A 32-year-old primigravida showed signs of pre-eclampsia before delivery of a healthy boy at term. The CSF-space was accidentally punctured during epidural anaesthesia in labour. One day later hypertension was noted and the patient had a single generalized fit. For the next three weeks she had postural headaches, fluctuating hypertension, intermittent hearing loss and double-vision. On the 22nd day of postpartum, the patient had the first of a series of partial and later generalized seizures, followed by hemiparesis, alteration of consciousness, and finally slow recovery with corticosteroid therapy. Bilateral subdural effusions and generalized meningeal thickening were found on MR scans. Repeated MRI excluded sinus thrombosis and documented the response to treatment.
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PMID:Neurological cause of late postpartum seizures. 201 11

We have discussed several miscellaneous headache disorders not associated with structural brain disease. The first group included those headaches provoked by "exertional" triggers in various forms. These include benign cough headache, BEH, and headache associated with sexual activity. The IHS diagnostic criteria were discussed. Benign exertional headache and cough headache were discussed together because of their substantial similarities. In general, BEH is characterized by severe, short-lived pain after coughing, sneezing, lifting a burden, sexual activity, or other similar brief effort. Structural disease of the brain or skull was the most important differential diagnosis for these disorders, with posterior fossa mass lesions being identified as the most common organic etiology. Magnetic resonance imaging with special attention to the posterior fossa and foramen magnum is the preferred method for evaluating these patients. Indomethacin is the treatment of choice. The headache associated with sexual activity is dull in the early phases of sexual excitement and becomes intense at orgasm. This headache is unpredictable in occurrence. Like BEH, the headache associated with sexual activity can be a manifestation of structural disease. Subarachnoid hemorrhage must be excluded, by CT scanning and CSF examination, in patients with the sexual headache. Benign headache associated with sexual activity has been successfully treated with indomethacin and beta-blockers. The second miscellaneous group of headache disorders includes those provoked by eating something cold or food additives, and by environmental stimuli. Idiopathic stabbing headache does not have a known trigger and appears frequently in migraineurs. Its occurrence may also herald the termination of an attack of cluster headache. Indomethacin treatment provides significant relief. Three headaches triggered by substances that are eaten were reviewed: ingestion of a cold stimulus, nitrate/nitrite-induced headache, and MSG-induced headache. For the most part, avoidance of these stimuli can prevent the associated headache. Lastly, we reviewed headache provoked by high altitude and hypoxia. The headache is part of the syndrome of AMS during its early or benign stage and the later malignant stage of HACE. The pain can be exacerbated by exercise. The best treatment is prevention via slow ascent and avoidance of respiratory depressants. Acetazolamide and dexamethasone have proved useful in preventing this syndrome.
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PMID:Cough, exertional, and other miscellaneous headaches. 202 Feb 26

A pilot study was performed to investigate the toxicity, pharmacokinetics and therapeutic effect of intrathecally administered radiolabelled monoclonal antibody (MAb) in patients with meningeal acute lymphoblastic leukaemia (ALL). Six children aged 3-16, in second or subsequent central nervous system (CNS) relapse of ALL, received between 629 and 1480 MBq of 131Iodine conjugated to either MAb HD37 (CD19, n = 2) or WCMH15.14 (CD10, n = 4). Conjugate was administered as a single injection either via an Ommaya reservoir (n = 4) or by lumbar puncture (n = 2). Acute toxicity was manifest by headache (n = 4), nausea and vomiting (n = 4) and pyrexia (n = 2). All acute symptoms resolved within 72 h. Transient myelosuppression occurred in three patients. Pharmacokinetic studies included investigation of whole body, blood and CSF clearance of isotope. 131I was seen to clear from the CSF by biexponential kinetics. Five patients responded to therapy. In four, the CSF became clear of blast cells at both 2 and 4 weeks following antibody injection, but evidence of relapse was seen at 6 weeks. The fifth patient, with blast cells present on a cytospin preparation, responded to therapy over an 8-week period but relapsed at 12 weeks. This study demonstrates the potential of targeted radiotherapy in CNS ALL, but further studies are necessary to increase the length of remission.
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PMID:A pilot study of monoclonal antibody targeted radiotherapy in the treatment of central nervous system leukaemia in children. 202 71

Mumps virus is one of the most common causes of viral meningitis. Although brain involvement has been observed in a low proportion of children with mumps meningitis, a pure form of mumps encephalitis is extremely uncommon in the adult. A 23 year-old man presented with a rapidly evolving syndrome of cephalalgia , vomiting, mutism, disorders of gait, somnolence and dystonic movements. The electroencephalogram showed a diffusely slowed background activity. The CSF contained no cells, but the total protein concentration was elevated. The patient recovered without sequelae, but severe intellectual and motor disturbances persisted during more than a month. Serological studies showed an increase of blood IgM mumps-specific antibodies. We conclude that mumps encephalitis, although infrequent, should be considered among viral diseases that mimic herpes simplex encephalitis in the adulthood.
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PMID:[Mumps encephalitis in adulthood]. 205

We reviewed 63 cases of cytologically confirmed leptomeningeal metastases (LM). 31 (49%) had solid tumors 17 (27%) had leukemia and 15 (24%) had lymphoma. The most common presenting symptom was pain (76%) with radicular discomfort (58%), headache (32%), neck or back pain (17%). The predominant neurological signs were mental status abnormalities (49%), weakness (47%), seizures (14%). The mode of presentation varied with tumor type. Patients with leukemia (18%) and lymphoma (13%) tended to present frequently with LM without systemic involvement, or during periods of apparent remission (leukemia 35%, lymphoma 27%), while patients with solid tumors had established systemic metastases (90%) at time of presentation. Laboratory studies did not vary among the groups. 71% had positive cytology on the first lumbar puncture (LP) and only 8% required more than 2 LPs. The cell count was a poor predictor of positive cytology as 29% of LP's with positive cytology and 36% of all LP's had less than 4 cells/mm. We conclude that 1) LM presents with pain and seizures more frequently than has been previously recognized; 2) LM is frequently the mode of presentation in patients with leukemia and lymphoma and; 3) cytology is positive frequently in CSF specimens with normal cell counts and chemistries.
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PMID:Leptomeningeal metastases: comparison of clinical features and laboratory data of solid tumors, lymphomas and leukemias. 208 37

We report two cases of cytomegalovirus (CMV) encephalitis in immunologically normal adults. Patient 1, a 53-year-old man: onset was acute with headache and pyrexia, followed by moderate disturbance of consciousness with meningeal signs. Repeated lumbar puncture revealed 58 CSF cells per microliters and 96 mg protein per dl. On the 11th day after onset, we started treatment with adenine arabinoside (ara-A). He recovered completely. With IgG-ELISA methods, antibody to CMV turned into positive on the third week, and into negative again on the fifth week, and these conversions were concomitant with the symptomatic aggravation and amelioration, respectively. Patient 2, a 78-year-old woman: onset was acute with general fatigue and pyrexia, followed by meningeal signs and mild disturbance of consciousness. Consciousness level was worsened and two courses of acyclovir (Acv) treatment were started on the 59th and on the 93rd day after onset, but consciousness level went down to coma and she died. Repeated lumbar puncture revealed 787 CSF cells per microliters and 229 mg protein per dl. CMV antibody titer (CF) in CSF was 1:32 and antibody index was 58 or more, suggesting antibody production in central nervous system. CMV encephalitis in immunologically normal adults is very rare, only 10 cases having been reported so far. Most patients recover spontaneously, but some may be fatal. In our view ara-A treatment should be taken in consideration in case of acute encephalitis unresponsive to Acv.
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PMID:[Cytomegalovirus encephalitis in immunologically normal adults]. 216 21


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