Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 42-year-old man presented with a three-day history of progressive bilateral blurred vision, photophobia and headaches. There was no history of trauma. He was emmetropic with visual acuity of 6/60 (pinhole 6/24) in both eyes, no ptosis and full range of eye movements. His pupils were in fixed mydriasis. The pupils were unreactive to light or accommodation. His optic discs and fundi were normal. Pilocarpine failed to constrict his pupils. Initially, he strongly denied using any topical ocular medications but later remembered that 10 days previously his eyes had felt 'gritty' and his wife had instilled their son's old atropine penalisation drops into both his eyes. His signs and symptoms had resolved over the next two days.
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PMID:A case of accidental mydriasis. 1731 76

A 42-year-old woman presents with headache and anisocoria. Gonioscopy suggested narrow angles. Ultrasound biomicroscopy confirmed the diagnosis. The patient underwent bilateral peripheral iridotomies with resolution of her symptoms. The differential diagnosis of headache and anisocoria are reviewed. Plateau iris syndrome and subacute angle closure are discussed.
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PMID:Migraine and anisocoria. 1735 58

Cerebral venous thromboses are uncommon in cancer, and rarely presents as a paraneoplastic syndrome. A 42-year-old patient presented with headache and a bilateral papillar edema. Cerebral computed tomographic (CT) scan did not find a tumoral process. Biological tests disclosed increased acute phase reactants and liver cytolysis and cholestasis. Cerebral magnetic resonance angiogram showed superior longitudinal venous thrombosis. Thoracoabdominal CT scan was performed and disclosed multiple secondary liver nodules. CA 19-9 serum level was increased to 7648 UI/ml. Liver biopsy revealed a slightly differentiated mucinous adenocarcinoma compatible with a biliary tract or a pancreatic neoplasia. Chemotherapy with cisplatin and 5-fluorouracil was instituted but disease outcome was rapidly unfavourable.
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PMID:[A rarely diagnosed paraneoplastic syndrome: cerebral venous thrombosis]. 1758 66

A 42-year-old man presented with a ruptured fusiform aneurysm of the proximal anterior cerebral artery (A(1) segment) manifesting as sudden onset of severe headache. Brain computed tomography revealed subarachnoid hemorrhage in the basal cisterns, and left carotid angiography demonstrated a fusiform aneurysm of the left A(1) segment. He underwent surgery via the left pterional approach. The left A(1) segment exhibited a fusiform configuration. Adequate development of the anterior communicating artery was confirmed. Trapping of the aneurysm was performed. The aneurysm was associated with atherosclerotic changes. The postoperative course was uneventful, and the patient was discharged without neurological deficits 1 month after surgery. Fusiform aneurysm of the A(1) segment is quite rare, and tends to bleed, so must be treated. The atherosclerotic origin indicates long-term follow up to identify subsequent lesions.
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PMID:Ruptured fusiform aneurysm of the proximal anterior cerebral artery (A1 segment). 1772 Oct 50

Endoscopic third ventriculostomy (ETV) is an effective and rather safe treatment for noncommunicating hydrocephalus secondary to aqueductal stenosis and other obstructive pathologies. It has become a popular alternative to ventricular shunts for noncommunicating hydrocephalus. Although it is a safe procedure, several complications related to this procedure have been reported in the literature. We report a rare case of a large chronic subdural hematoma (ChSDH) after ETV in a patient with aqueductal stenosis. A 42-year-old female patient presented with acute symptoms of obstructive hydrocephalus, headaches and blurring of consciousness. A computerized tomogram (CT) of the patient's brain revealed marked triventricular supratentorial hydrocephalus and an external ventricular drainage (EVD) was performed first. After this procedure, magnetic resonance imaging (MRI) demonstrated hydrocephalus secondary to aqueductal stenosis. ETV was performed and the EVD removed uneventfully. The patient was discharged home after a few days without any complications. She then presented with headaches 4 weeks following ETV. A CT demonstrated chronic subdural hematoma on the contralateral side. This was treated with burr-hole evacuation. Postoperatively, her headaches improved. During the follow-up period, she remains symptom-free and has radiographic evidence of a patent ventriculostomy. This case confirms chronic subdural hematoma formation is a possible complication following endoscopic third ventriculostomy.
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PMID:Chronic subdural hematoma after endoscopic third ventriculostomy: case report. 1805 76

A 42-year-old woman presented with a rare case of fenestration of the supraclinoid internal carotid artery (ICA) with associated aneurysm manifesting as headache. Computed tomography (CT) found no abnormalities. Three-dimensional CT angiography showed fenestration of the left ICA with an associated aneurysm. Direct surgery was performed for the aneurysm, and the patient's postoperative course was uneventful. The present case of ICA fenestration associated with aneurysm indicates that surgical treatment should be considered for even small unruptured aneurysms arising from this location, because of the high risk of rupture.
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PMID:Fenestration of the supraclinoid internal carotid artery with associated aneurysm. 1836 58

A 42-year-old previously healthy woman presented with a 5-week history of headache, facial numbness, proptosis, motility restriction, and visual loss. CT showed soft-tissue infiltration involving the posterior ethmoids, pterygopalatine fossa, and posterior inferior orbit. Histopathologic analysis of a biopsy specimen disclosed a highly aggressive and undifferentiated neoplasm with an immunophenotype and ultrastructural features consistent with an epithelial origin, which was most consistent with a diagnosis of sinonasal indifferentiated carcinoma. The tumor was unresectable and the patient was started on a course of radiation and chemotherapy.
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PMID:Sinonasal undifferentiated carcinoma with a frozen globe. 1852 Aug 42

A 42-year-old man presented with fever, photosensitivity, headaches, myalgia, hyperhidrosis, muscle weakness, alopecia, nasal crustae, weight loss, painful nails, arthritis, oral ulcers, erythema, discoid cutaneous lesions, and painful subcutaneous nodes. We made a diagnosis of systemic lupus erythematosus (SLE), type II cryoglobulinemia, and nodular vasculitis. In the skin, different types of vasculitis may be observed. Typically, histology shows leukocytoclastic vasculitis of superficial vessels both in SLE and mixed cryoglobulinemia, which clinically results in palpable purpura. In our patient, however, histopathological examination of the subcutaneous nodes not only revealed leukocytoclastic vasculitis of the superficial vasculature but also showed even more extensive involvement of dermal and subdermal small and medium sized vessels, giving rise to a nodular vasculitis.
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PMID:Nodular vasculitis in systemic lupus erythematosus. 1898 75

We report a case of Vogt-Koyanagi-Harada (VKH) disease associated with non-herpetic acute limbic encephalitis with autoantibodies against glutamate receptor epsilon2 in the cerebrospinal fluid. A 42-year-old woman developed a complaint of visual distortion, visual disturbance, headache and mild psychiatric symptoms, such as anxiety and depression. She was diagnosed as VKH through the fidings of fluorescein fundus angiography, which revealed patchy hypofluorescence associated with delayed choroidal filling at early fluorescein angiographic phase, and spotted choroidal hyperfluorescence and pooling of dye at late phase. Analysis of the cerebrospinal fluid (CSF) showed slight increase of leukocyte count (49/microl, mononuclear cells) and immunoglobulin (Ig) G index. An anti-GluRepsilon2 IgM antibody was positive in CSF. Brain magnetic resonance imaging (MRI) showed a monofocal hyperintensity lesion in the left parahippocampal gyrus on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. We diagnosed her VKH disease associated with non-herpetic acute limbic encephalitis. She was treated with oral prednisone, 70 mg day and her symptoms have gradually improved. To our knowledge, meningoencephalitis in VKH disease is extremely rare and the analysis of anti-GluRepsilon2 IgM antibody in CSF has not been reported. We speculate that a certain immunologic mechanism, including the anti-GluRepsilon2 IgM antibody, contributes to the pathogenesis of the VKH disease with non-herpetic acute limbic encephalitis.
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PMID:[Case of Vogt-Koyanagi-Harada disease associated with non-herpetic acute limbic encephalitis with autoantibodies against glutamate receptor epsilon2 in the cerebrospinal fluid]. 1982 98

We describe a case of bilateral exudative retinal detachment associated with prodromal symptoms simulating the presentation of acute Vogt-Koyanagi-Harada disease that was eventually diagnosed as acute lymphoblastic leukemia. A 42-year-old man presented with sudden visual loss in both eyes for two weeks. He complained of intermittent headache, neck stiffness and tinnitus for a month. His best-corrected visual acuities were 20/200 in both eyes. Fluorescein angiography, optical coherence topography and indocyanine green angiography featured bilateral serous retinal detachments. A clinical diagnosis of incomplete type Vogt-Koyanagi-Harada disease was considered. However, complete blood cell count showed a marked increase in the number of white blood cells and bone marrow examination revealed precursor B cell lymphoblastic leukemia. The patient started on induction chemotherapy. A week later, his best-corrected visual acuities were 20/25 and the serous retinal detachments were nearly absorbed in both eyes. Bilateral exudative retinal detachment associated with neurologic and auditory abnormalities may be a presenting sign of acute lymphoblastic leukemia. Clinicians should be aware of the possibility of leukemia in such patients.
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PMID:Acute lymphoblastic leukemia manifesting as acute Vogt-Koyanagi-Harada disease. 2004


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