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

A man in his mid 30s arrived for admission by ambulance to the psychiatric unit of a private hospital after transfer from a small rural hospital. His voluntary admission was the result of a suicide attempt by carbon monoxide (CO) poisoning. On arrival the patient was receiving oxygen via nasal prongs at 3 liters per minute, appeared to be extremely distressed, and complained of severe headache. The nurses became extremely concerned after reading the transfer notes--the poisoning incident had occurred 4 hours prior to arrival at the unit. Furthermore, the patient was discovered unconscious and resuscitated by paramedics. The nursing staff immediately notified the supervisor and requested that the medical registrar examine the patient. The psychiatrist was notified of the concerns of the nursing staff. Eventually, after many tests, phone calls and arrangements, the patient was transferred to a large city hospital for hyperbaric oxygen therapy.
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PMID:Carbon monoxide poisoning: nursing priorities and treatment. 796 43

A single-breath CO2 test was carried out in cluster headache patients both during bout and remission, and in matched healthy individuals (n = 10 for each group) to assess peripheral chemosensitivity. The test subjects inhaled one tidal breath of 13% CO2 in air. The response was expressed as the maximal increase in inspiratory minute ventilation (Vi) within 20 seconds from the exposure to CO2, divided by the increase in end-tidal PCO2 (PETCO2) (the difference in PCO2 between the test breath and the preceding control breaths): delta Vi/delta PETCO2. Under the initial resting condition, cluster headache patients within the bout showed a slight hyperventilation in that there was a significantly reduced PETCO2 (P < 0.05, Student's paired t-test), and during remission, higher Vi, and a lower PETCO2 (P < 0.05, Wilcoxon signed rank test), in comparison with the controls. There was no statistically significant difference as regards the peripheral chemosensitivity between cluster headache and control groups. These results indicate that cluster headache patients have an intact and properly-functioning carotid body.
Headache 1994 Feb
PMID:Cluster headache: the peripheral chemosensitivity as indicated by the single-breath CO2 test. 816 71

Acute altitude illnesses include acute mountain sickness (AMS), a benign condition involving headache, nausea, vomiting, irritability, insomnia, dizziness, lethargy, and peripheral edema, and potentially lethal high-altitude cerebral edema and pulmonary edema (HAPE). Recent evidence is summarized that AMS is related to cerebral edema secondary at least in part to hypoxic cerebral vasodilation and elevated cerebral capillary hydrostatic pressure. This results in reduced brain compliance with compression of intracranial structures in the absence of altered global brain metabolism. It is postulated that these primary intracranial events elevate peripheral sympathetic activity that acts neurogenically in the lung possibly in concert with pulmonary capillary stress failure to cause HAPE and in the kidney to promote salt and water retention. The adrenergic responses are likely modulated by striking increases of aldosterone, vasopressin and atrial natriuretic peptide. The effects of exercise on altitude-induced illness and various therapeutic regimens (acetazolamide, CO2 breathing, dexamethasone, and alpha adrenergic inhibitors) are discussed in light of this hypothesis.
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PMID:A neurogenic basis for acute altitude illness. 816 37

Among 182 episodes with ARF (PaCO2 > 50 torr) in 400 episodes of COPD patients who were admitted to Chulalongkorn Hospital during the period 1982 to 1986, despite conservative treatment, 66 developed severe acute respiratory failure requiring assisted ventilation. Patients with a history of chronic cough, pneumonia as a precipitating factor and more severe ARF on admission, as indicated by palpitation, headache, cyanosis, alteration of consciousness, cor-pulmonale and decompensated acidosis (pH < 7.30), were likely to require mechanical ventilation. Indications for mechanical ventilation were carbon dioxide narcosis (43 episodes), severe hypoxemia despite on a high FIO2 (one episode), various combination parameters of respiratory muscle fatigue, cardiovascular instability (22 episodes). The major complications of mechanical ventilation were pneumonia, sepsis, pneumothorax, UGI bleeding of 16, 8, 5 and 9 episodes, respectively. The average duration of assisted ventilation and hospitalization were 15.8 and 19.02 days, respectively. The mortality rate was 50 per cent in the mechanical ventilation group compared with 9.8 per cent in the non-mechanical ventilation group. Increased mortality rate was found in those with pneumonia as the precipitating factor (68.4 vs 14.3%, respectively, in comparing the two groups). Complications of mechanical ventilation, which included pneumonia, sepsis, fluid overload, hyponatremia and persistent acidosis, were high-risk factors for the non-surviving group.
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PMID:Mechanical and non-mechanical ventilation of respiratory failure in chronic obstructive pulmonary disease. 822 88

Workers exposed to carbon monoxide (CO) at a concentration of 26.8mg/m3 at an altitude of 2,300 metres above sea level were compared with a control group of local inhabitants. There were significant differences in symptoms of headache, vertige fatigue and weakness memory impairment, insomnia, palpitation and neurobehavioral functions. CO concentration in respiratory air and HbCO in blood was higher but partial pressure of oxygen (PO2) and saturation of oxygen (SaO2) in blood was lower in the exposed group than the control group. Self-comparison of CO in respiratory air and HbCO in blood was higher after work than before work. Neurasthenia rate was significantly higher but PO2 and SaO2 significantly lower at high altitude than in the plain. The results indicated that under same CO concentrations the hazards to workers at high altitude were greater than to those working in the plain. The author recommends that at high altitude the CO permissible level should be appropriately lowered.
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PMID:[Health effects on workers exposed to low concentration carbon monoxide at high altitude]. 835 10

A female patient is described who had a four year long period of unilateral chronic paroxysmal hemicrania (CPH) which then became bilateral. For some years before the CPH started she suffered from periods of about one month with chronic hemicrania without nerve involvement. She also suffered from chronic fatigue, back pain, arthralgia, vertigo, chronic constipation and spontaneous ecchymoses. Blood tests showed chronic leukocytosis, low serum iron, and signs of inflammation in serum electrophoresis during the five years she was studied. CPH attacks could be provoked by breathing 6% carbon dioxide in air. Lumbar cerebrospinal fluid pressure was pathologically increased (30 cm water). The attacks decreased during indomethacin treatment but 275 mg was needed for satisfactory control of the attacks, i.e., more than the 150 mg which, according to the criteria for CPH, should be absolutely effective. Sumatriptan was found to suppress the CPH attacks as well as indomethacin. Due to these findings CPH is considered to be another manifestation of venous vasculitis. The beneficiary mechanism of indomethacin in CPH is considered to be due partly to its anti-inflammatory effects and partly to its reduction of the intracranial blood flow.
Headache 1993 Jun
PMID:Intracranial hypertension and sumatriptan efficacy in a case of chronic paroxysmal hemicrania which became bilateral. (The mechanism of indomethacin in CPH). 839 1

The effects of acute exposure to methylene chloride (dichloromethane) are due to its central nervous system depressant properties, which have resulted in fatalities. Manifestations of acute exposure include mental confusion, fatigue, lethargy, headache and chest pain. Metabolic conversion of methylene chloride to carbon monoxide may place persons with preexisting coronary artery disease at increased risk. Sequelae following chronic exposure are unknown, but data suggest serious long-term effects. The Environmental Protection Agency considers methylene chloride to be a probable human carcinogen.
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PMID:Methylene chloride toxicity. 846 11

Eighteen cluster headache patients and five controls were studied using ultrasound duplex techniques to measure blood flow in the common carotid arteries after nitroglycerin and placebo administration. Vessel diameter and blood flow tended to be greater before nitroglycerin in patients in the cluster headache period than in patients out of period and controls. Nitroglycerin tended to increase blood flow only in patients not in the cluster period and in controls. There was a significant decrease in common carotid blood flow and increase in vascular resistance related to maximum pain in both nitroglycerin-induced and spontaneous cluster headache attacks. Blood flow did not reach the initial flow values after the attack was over. In one patient a hyperventilation attack only temporarily decreased the pain. We suggest that the decrease in blood flow and increase in vascular resistance may be due to constriction of intracranial arteries by reflex activation of sympathetic efferents, rather than to decrease of arterial CO2 tension.
Cephalalgia 1993 Apr
PMID:Pain induces decrease of blood flow in the common carotid arteries in cluster headache attacks. 849 50

Headache often accompanies treatment with nitroglycerin, but the cerebral hemodynamic effects and the exact mechanism of the headache are incompletely understood. Transcranial Doppler monitoring allows evaluation and monitoring of changes in blood flow velocity in the large intracranial arteries. The objective of this study was to assess middle cerebral artery (MCA) blood flow velocities with transcranial Doppler monitoring in subjects receiving continuous low-dose nitroglycerin intravenously or by patch, and correlate these with clinical headache. Twenty-eight normal adult men received nitroglycerin (0.12 micrograms/kg/min intravenously [n = 14] or 0.6 mg/min by transdermal patch [n = 14]), for up to 120 minutes, with monitoring of clinical headache status (standard 4-point scale), blood pressure, heart rate, end-expiratory PCO2 (CO2), and right MCA velocity. All subjects developed headache (mean time to onset, 34 min), reaching moderate or severe levels in 20. There were no differences in age, weight, mean blood pressure, mean heart rate, or resting end-tidal CO2 between those whose headache reached a moderate to severe level and those whose headache remained mild. MCA velocity decreased from baseline values at all levels of clinical headache (onset, -17%; moderate, -18%; severe, -16%; nitroglycerin stopped, -19%) (p, 0.0001 by t test for each stage of headache). MCA velocity remained decreased at the time of headache resolution (-14%; p < 0.001). Blood pressure, heart rate, and CO2 did not change significantly. There were no differences related to route of nitroglycerin dosing. These data show that continuous low doses of nitroglycerin by patch or intravenously produce headache in normal male subjects. MCA velocities were significantly decreased at headache onset and at all levels of headache severity. Changes in MCA velocity persisted beyond the clinical headache. These results suggest a direct MCA vasodilatory effect of nitroglycerin. This method may also be used to evaluate the intracranial hemodynamic effects of other vasoactive drugs, even in clinical settings.
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PMID:Middle cerebral artery velocity correlates with nitroglycerin-induced headache onset. 863 92

The aim of this study was to clarify a possible relationship between pollution and worsening of headache in the industrial city of Turin. From October 1992 to June 1993, we examined a group of 32 patients suffering from various headache types. During these months, they kept a daily record of their headaches and associated disturbances. Changes in pain frequency and severity were recorded every hour of the day and compared hour to hour with the various degrees of pollution recorded in the main streets by a monitoring station. The influence of meteorological parameters was also taken into consideration. During winter, carbon monoxide and nitrogen dioxide showed a simultaneous hyperconcentration on the same days and the same hours. Increased incidence of headache attacks and increase in severity corresponded to the same hours, days, and months. The findings were statistically significant (P = 0.008, Student's t-test). An isolated increase in nitrogen dioxide only (without an increase in carbon monoxide which was only recorded once) induced headache a couple of hours after the peak concentration was reached. Among the meteorological factors, only the highest values in wind velocity were shown to exert a significant influence on worsening headache frequency and severity.
Headache 1996 Apr
PMID:Outdoor pollution and headache. 867 30


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