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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 intracerebral hemorrhage which probably had been caused by a rupture of abnormal "moyamoya vessels" due to tuberculous arteritis was reported. A 42-year-old female had a history of tuberculous meningitis at the age of 2 years and suffered from a sudden onset of severe headache in January of 1998. CT scan disclosed a medium-sized intracerebral hematoma in the left frontal base and many calcifications in the basal cistern. Subsequent angiography demonstrated high-grade stenosis in the terminal portion of the right internal carotid artery and near-by "moyamoya vessels". No surgery was performed on the patient. A second angiography was carried out two months later and it newly disclosed ophthalmic artery-feeding "moyamoya vessels" in the place where the intracerebral hematoma had been located. This led us to conclude that a rupture of "moyamoya vessels" was the cause of the intracerebral hemorrhage and "moyamoya vessels" were not visible in the first angiograms because they had been compressed by the hematoma. Although cerebral infarction is common in tuberculous arteritis, cerebral hemorrhage is uncommon. The pathogenesis of cerebral hemorrhage due to tuberculous arteritis and its difference from that of hemorrhage caused by moyamoya disease is discussed.
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PMID:[Intracerebral hemorrhage in a patient with moyamoya phenomenon caused by tuberculous arteritis: a case report]. 1045 40

A 42-year-old house wife presented with worsening headaches over 6 months in the absence of visual symptoms or symptoms suggestive of focal neurology. She was a life-long smoker. Systems review was unremarkable apart from secondary amenorrhoea and galactorrhoea of 6 months duration. Her serum prolactin was found to be 620 mU/l (60-400), FT4 12.6 nmol/l (9.8-23.1), TSH 1.38 mU/l (0.35-5.5), oestradiol < 73 pmol/l, LH and FSH of 4.4 and 12.6 mIU/l, respectively. She was on bromocriptine. A presumptive diagnosis of pneumonia, based on pyrexia and CXR findings, was made and she was started on IV antibiotics. Two days later she developed meningism and deterioration of conscious level. (Lumbar puncture results: no organisms, 312 neutrophils and 164 lymphocytes). CT scan revealed a 2.5-cm pituitary adenoma, with suprasellar extension. A repeat hormonal profile revealed FSH 1.4, LH < 0.3 mU/l, oestradiol < 73 pmol/l, prolactin 488 mU/l (60-400), and low random cortisol at 29 nmol/l. T1-weighted MRI revealed a large pituitary mass with evidence of haemorrhage. The patient subsequently underwent a transsphenoidal exploration with resection of the pituitary lesion. Whilst awaiting the histopathology results, CT of chest revealed a 1. 5-cm diameter rounded well defined density in the right lower lobe associated with hilar, pre- and right para-tracheal lymphadenopathy. The histopathology of the pituitary lesion, obtained piecemeal, revealed fragments of fibrous tissue infiltrated by sheets of acidophilic prolactin-positive cells, in keeping with a prolactinoma. In addition, other fragments with blood clot included highly atypical epithelial cells with mitotic figures. These were negative for prolactin but showed HMFG-and CEA-positivity, excluding them from a pituitary lineage. Transbronchial biopsy revealed moderately differentiated adenocarcinoma, with evidence of lymphatic spread. The overall conclusion was of bronchogenic adenocarcinoma, metastasizing to a prolactinoma and complicated by apoplexy.
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PMID:Pituitary apoplexy following metastasis of bronchogenic adenocarcinoma to a prolactinoma. 1046 19

Subarachnoid hemorrhage secondary to ruptured intracranial arteriovenous malformation (AVM) during pregnancy, although rare, is a grave complication. We experienced 3 patients with AVM for cesarean section. Case 1: A 24-year-old woman suffered sudden vomiting and headache during the 22nd week of her first pregnancy. She was diagnosed as having the intracranial hemorrhage due to AVM. Because the patient was bleeding again at 29th week of pregnancy, emergency operation was performed. Her neurological symptom improved. Cesarean section was performed under general anesthesia at 34th week of pregnancy. Case 2: A 42-year-old woman of her first pregnancy had past history of subarachnoid hemorrhage due to AVM at the ages of 23, 28, 29 and 36. The malformation was not corrected surgically. Her neurological status was normal. Cesarean section was performed under spinal anesthesia. Case 3: A 29-year-old woman suffered sudden hemiplegia, vomiting and headache during the 40th week of her first pregnancy. She was diagnosed as having intracranial hemorrhage. Cesarean section immediately followed by the removal of an intra cranial hematoma under general anesthesia. Better perinatal outcome is expected when AVM rerupture is prevented by first performing cesarean section.
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PMID:[The anesthetic management for elective or emergent cesarean section in patients with intracranial arteriovenous malformation]. 1068 40

A 42-year-old man came to our headache unit in October 1995 complaining of recurrent attacks of headache, which had begun in February 1991. Chronic cluster headache was diagnosed, and he was given verapamil, 360 mg per day. The attacks ceased in the following months and verapamil was stopped in March 1996. In May 1997, a recurrence of the attacks required the readministration of verapamil, 360 mg per day. The attacks decreased (one to three per week), but after 2 months the patient reported a worsening in his condition due to the appearance of shorter attacks, which were diagnosed as chronic paroxysmal hemicrania. The administration of indomethacin, 225 mg per day, resulted in the disappearance of the short attacks. The concomitant occurrence of attacks of cluster headache and chronic paroxysmal hemicrania suggests the presence of shared factors in the pathophysiology of the two forms of headache. This hypothesis is supported by previous reports in the literature.
Headache 2000 Jan
PMID:Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: a case report. 1075 6

A 42-year-old man noted pain on the left side of his forehead and left ptosis. On examination, he showed conjunctival hyperemia, ptosis and miosis in the left side, as well as hyperesthesia in the first branch of left trigeminal nerve. An MRI of his brain showed a retension cyst in the left ethmoid sinus. There was neither abnormalities in the parasellar lesion nor in the neck. We diagnosed him with pericarotid syndrome rather than cluster headache or Raeder syndrome. Five cases who had paranasal sinus lesions as a cause of cluster headache or Raeder syndrome have been reported. More cases are needed to clarify the association of retension cyst in ethmoid sinus and pericarotid syndrome.
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PMID:[A case of pericarotid syndrome with retention cyst in ethmoid sinus]. 1082 99

Acromegaly is usually caused by a growth hormone (GH)-secreting pituitary adenoma, and hypersecretion of GH-releasing hormone (GHRH) from a hypothalamic or neuroendocrine tumor accounts for other cases. The authors report on the unusual association of acromegaly with a granular cell tumor of the neurohypophysis. A 42-year-old woman with a 10-year history of acral enlargement, headache, and menstrual abnormalities was referred to our department for a suspected GH-secreting pituitary adenoma. The patient's basal GH levels were mildly elevated at 4.8 microg/L, were not suppressed in response to an oral glucose tolerance test, and increased paradoxically after administration of thyrotropin-releasing hormone. The patient's insulin-like growth factor-1 (IGF-1) level was elevated at 462 microg/L, whereas a magnetic resonance image of the sella turcica revealed an intra- and suprasellar lesion that was compatible with a diagnosis of pituitary adenoma. A transsphenoidal approach to remove the lesion, which was mainly suprasellar, was successful during a second operative attempt, resulting in the clinical and biochemical regression of the patient's acromegaly. Four months postoperatively, the patient's basal GH level was 0.9 microg/L and her IGF-1 level was 140 microg/L. Histological analysis of the operative specimen demonstrated a granular cell tumor of the neurohypophysis, which when stained proved negative for pituitary hormones and GHRH. This case represents the first reported association between a granular cell tumor of the neurohypophysis and acromegaly. Granular cell tumor of the neurohypophysis could be added to the restricted list of neoplastic causes of acromegaly secondary to hypersecretion of a GH-releasing substance.
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PMID:Acromegaly associated with a granular cell tumor of the neurohypophysis: a clinical and histological study. Case report. 1111 61

A case of a primary pineal embryonal carcinoma occurring in a middle aged man is reported. A 42-year-old man suffering from headache and nausea was referred to our department. A neurological examination revealed that he had Parinaud's sign. Head CT and MRI showed a tumor in the pineal region. He was operated on using the occipital trans-tentorial approach. The tumor was partially removed and an intra-operative specimen was used to diagnose a kind of germ cell line tumor. However, the tumor was diagnosed afterwards as a pure embryonal carcinoma. Three courses of PE chemotherapy followed by 30 Gy of whole craniospinal irradiation and 30 Gy of extended local irradiation were completed. An MRI showed the tumor to be in complete remission. Despite careful follow-up with chemotherapy every three months, a re-operation and linac radio-surgery, the tumor recurred, and disseminated. The patient died due to an intra-tumoral hemorrhage. A pure primary pineal embryonal carcinoma occurring in a middle-aged person has never been reported previously in detail.
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PMID:[Primary pineal embryonal carcinoma occurring in a middle aged man]. 1107 Sep 13

A 42 year-woman suffering from a non-small cell lung cancer, presenting initially as a mediastinal tumor, is hospitalized for fever, headaches and nausea. An aseptic meningitis is diagnosed. The patient died despite the administration of broad spectrum antibiotics and antituberculous agents. The differential diagnoses are presented.
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PMID:[Mediastinal mass, pulmonary infiltration, and meningitis]. 1191 89

Hereditary hypercoagulability has been identified as risk factor in approximately 30% of cerebral venous thrombosis cases. We report three females with this association. A 38 years old female with a history of deep venous thrombosis of the lower limb, presented with headache, vomiting and a generalized seizure. Magnetic resonance angiography showed a partial thrombosis of the left lateral and superior longitudinal venous sinuses. Coagulation study showed a resistance to activated C protein and factor V Leyden. A 42 years old woman with a history of deep venous thrombosis, presented a right hemiplegia during a hospitalization. Magnetic resonance showed a left lateral hemorrhagic infarction. Magnetic resonance angiography showed an absence of signal in three venous sinuses. Coagulation study showed a protein C deficiency. A 17 years old woman presented a right hemiparesis in the sixth day of puerperium. CAT scan showed a left frontoparietal subcortical venous infarction. Coagulation study showed an antithrombin III deficiency.
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PMID:[Status of hereditary hypercoagulability and cerebral venous thrombosis. Report of 3 cases]. 1196 66

A 42-year-old man was admitted complaining of the sudden onset of headache, vomiting, vertigo, and gait disturbance. The authors found hemiparesis of his right limbs, right Homer's syndrome, and decreased pain and temperature sensation of his right face and left limbs. Diffusion-weighted imaging (DWI) showed an acute small infarct located on the right side of the lateral lower medulla. This is the first report of Opalski's syndrome with lower medullary infarction detected by DWI.
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PMID:Ipsilateral hemiplegia in a lateral medullary infarct--Opalski's syndrome. 1259 37


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