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)

The pharmacokinetics and urinary excretion of a single dyphylline dose were studied in five normal volunteers. The mean dyphylline half-life was 1.8 +/- 0.2 hr; the mean total body clearance rate and mean renal clearance rate were 333 +/- 62 and 276 +/- 52 ml/min, respectively; and the mean volume of distribution was 0.8 +/- 0.2 liter/kg. In the urine, 83 +/- 5% of the dose was excreted as unchanged drug, and theophylline was not detected. Dyphylline doses of 19--27 mg/kg, resulting in peak serum dyphylline concentrations of 19.3--23.5 micrograms/ml, were tolerated well by four subjects. One subject had a severe headache following a 28-mg/kg dose, associated with a peak serum dyphylline concentration of 36.4 micrograms/ml. This study confirms speculation that dyphylline is not metabolized to theophylline in vivo.
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PMID:Urinary excretion of dyphylline in humans. 51 73

Interhemispheric subdural hematoma (ISDH), although not infrequent in children, has been rarely encountered in adults. Spread of CT, ISDH has been reported sporadically, and so far more than 40 cases have been reported. But bilateral ISDH is an extremely rare lesion, with only 5 cases reported in the literature. We report a sixth case of bilateral ISDH in adults. A 68-year-old woman was admitted because of headache and vomiting. Two days before admission she had fallen, striking her occiput, and had lost consciousness for a few minutes. Neurological examination on admission revealed hyperreflexia of her extremities, especially in her left leg. However, motor weakness was not recognized. There was no fracture visible on the plain X ray films of the skull. Axial CT scan demonstrated a high density lesion along the falx and its extension down over the tentorium. Coronal CT scan also demonstrated a convexo-convex high density lesion beside the falx, and its extension onto the tentorium. Cerebral angiogram showed lateral displacement of the callosomarginal artery, and an avascular area beside the falx and onto the tentorium. After admission she was managed conservatively, but on the 14th day after head trauma, paraparesis and left arm paresis were recognized. This condition deteriorated and she developed an inability to stand. On the 19th day parasagittal craniotomy and evacuation of the hematoma were performed. Her postoperative course was uneventful and she was discharged with no neurological deficits.
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PMID:[A case of bilateral interhemispheric subdural hematoma]. 235 80

To demonstrate the typical clinical and CT features of sinonasal polyposis, we reviewed the clinical records and preoperative direct coronal CT scans of 35 patients with surgically proven disease. Symptoms included progressive nasal stuffiness (100%), rhinorrhea (69%), facial pain (60%), headache (43%) and anosmia (17%). We found associations with rhinitis (46%), asthma (29%) and aspirin sensitivity (9%). Coronal CT features included polypoid masses in the nasal cavity (91%), partial or complete pansinus opacification (90%), enlargement of infundibula (89%), bony attenuation of the ethmoid trabeculae (63%) and nasal septum (37%), opacified ethmoid sinuses with convex lateral walls (51%) and air-fluid levels (43%). The latter feature correlated with symptoms and signs of acute sinusitis in only 40% of patients. Recognition of sinonasal polyposis is important to the endoscopic surgeon since it can be the most troubling sinonasal inflammatory disease to manage due to its aggressive nature and tendency to recur despite appropriate treatment.
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PMID:Sinonasal polyposis: investigation by direct coronal CT. 799 Oct 94

We report a case of intraorbital conjunctival cyst following a penetrating orbitocranial injury. The patient was a 28-year-old male who was hospitalized with exophthalmos, retrobulbar pain and upper gaze disturbance of his left eye. When he was 4 years old, a thin iron rod had penetrated intracranially through the inner angle of his left orbit. He was hospitalized and treated conservatively for about two weeks. The left eye ball was intact and visual acuity was normal, although bloody fluid had continuously flowed out from the left inner angle of the conjunctival wound for a few days. He had been febrile to 39 degrees C and complained of headache for one week. Subsequentry, the symptoms gradually improved through conservative therapy. When he was a junior high school student, he noticed exophthalmos of his left eye. However, he had never been examined closely, until he was 28 years old. We suspect that he had suffered from meningitis caused by the penetrating orbitocranial injury, and had fortunately improved under the conservative therapy. On admission to our hospital, a craniogram showed fracture of the left orbital roof, and coronal and three-dimensional computed tomography (CT) scans clearly demonstrated the orbital fracture. CT revealed a cystic mass in the retrobulbar space, and a porencephalic cyst in the medial basal frontal lobe. On magnetic resonance imaging (MRI) scans, both cysts were of low intensity on T1-weighted imaging, and of high intensity on T2-weighted images. Coronal and sagittal MRI scans showed that the two cysts were connected with each other through the fracture in the orbital roof. We diagnosed therefore that the orbital cyst was a herniated porencephalic cyst of the frontal lobe. Surgery was performed by a transcranial approach. The porencephalic cyst adhered to the fractured lesion of the frontal base but did not extend into the orbita. The intraorbital cyst was totally removed by opening the orbital roof including the fractured lesion. The cyst contained milky fluid. Postoperatively, the exophthalmos, retrobulbar pain and upper gaze disturbance showed gradual improvement. On histological examination, the cyst was found to be lined by non-keratinized stratified squamous epithelium and was diagnosed as a conjunctival cyst. This case was considered to be one of traumatic conjunctival cysts caused by a penetrating orbitocranial injury. Orbital conjunctival cysts have been reported to comprise about 10% of orbital epidermoid and dermoid cysts. Of these cysts, traumatic conjunctival cysts are rare, and only a few cases have been described. The etiology and therapy of orbital conjunctival cysts are discussed.
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PMID:[Intraorbital conjunctival cyst after a penetrating orbital injury: a case report]. 875 79

Optic nerve fenestration is carried out in cases of severe benign intracranial hypertension. This study aimed to monitor the optic nerve sheath appearances and orbital changes that occur following this procedure. The eight patients were all female with an average age of 37.3 years and a range of 20-58 years. The duration of symptoms was 2-6 years. Symptoms included headaches, diplopia and visual obscurations. Examination revealed severe papilledema. All investigations, including MRI, biochemical and immunological tests, were negative. Patients had fenestration of a 2 mm x 3 mm segment of the medial aspect of the optic nerve sheath. Imaging was obtained with a 1 T MRI machine using a head coil. Coronal, axial and sagittal 3 mm contiguous sections using STIR sequences with TR 4900 ms, IT 150 ms and TE 60 ms were obtained. Five patients showed clinical improvement. The post-operative MRI findings in four of these included a decreased volume of cerebrospinal fluid (CSF) around the optic nerve sheaths and a localized collection of fluid within the orbit. There were no MRI changes in the three patients with no clinical improvement. Decreased CSF volume around the optic nerve and a fluid collection within the orbit may indicate a favorable outcome in optic nerve fenestration.
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PMID:The MRI appearance of the optic nerve sheath following fenestration for benign intracranial hypertension. 972 37

The authors report a case of a 53-year-old woman who developed symptoms and signs of compression of the left medulla oblongata by the elongated and curved left vertebral artery with normal diameter. Twelve days before admission to the hospital, the patient suddenly noticed severe occipital-nuchal headache and nausea with vomiting, while she was unloading a burden. Neurological examination revealed left facial hyperalgesia, right hemihypesthesia and mild right hemiparesis. Hoarseness was observed, but the movement of the uvula and tongue was normal. Hypertension was noticed (180/100). Cerebral and vertebral angiography revealed no aneurysm, but demonstrated an elongated and curved V4 portion of the left vertebral artery with normal diameter. Coronal plain of T2 weighted image of MRI and CT scan with metrizamide administered into the CSF, clearly demonstrated an elongated and curved left vertebral artery compressing the ventro-lateral portion of the left medulla oblongata, neurovascular decompression of the V4 from the medulla oblongata was performed. Through the operating microscope, it was observed that the elongated and curved V4 portion of the left vertebral artery with normal configuration was compressing the left medulla oblongata ventro-laterally, making a compression notch at the outlets of the cranial nerves IX and X. Transposition of the V4 portion was impossible. Some pieces of Taflon felt, thick enough to prevent the pulsatile movement of the V4 from compressing the medulla oblongata, were inserted between the V4 and the medulla oblongata. Two months after the operation, the patient's right hemiparesis and sensory disturbances were gradually improving and her blood pressure had become normal. The authors emphasize that, among patients with symptoms and signs of compression of the medulla oblongata, there is at least one patient for whom neurovascular decompression was an effective treatment.
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PMID:[A case report of hemiparesis due to compression of the medulla oblongata by an elongated vertebral artery]. 1132 94

A 17-year-old boy with pyrexia, headache, and frequent drop attacks reported an acute onset of periorbital pain and swelling 1 month previously. Coronal computed tomography (CT) identified an ethmoid sinusitis, which was treated with functional endoscopic sinus surgery and intravenous gentamicin, prostaphylline, and metronidazone. Because of persistent symptoms, the patient returned 1 month later. The CT identified accumulation of debris in both frontal sinuses and a multilobulated lesion over the right frontal lobe. Bicoronal craniotomy was performed, and a mass located in the right frontal lobe was excised; the mass comprised chronic inflammatory tissues without evidence of malignancy. A postoperative brain CT confirmed the absence of a residual mass, and no recurrence or neurologic deficits were noted during the 3-month follow-up period. Intracranial complications cannot be prevented entirely even with the judicious use of antibiotics. Early application of the appropriate imaging modality and institution of aggressive therapy in any patient, not just pediatric patients, to prevent potential long-term disabilities and death are essential.
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PMID:Intracranial brain abscess preceded by orbital cellulitis and sinusitis. 2048 88

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.
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PMID:Monophasic epithelial synovial sarcoma accompanied by an inverted papilloma in the sphenoid sinus. 2325 Nov 73

Brain metastases generally present in the parenchyma of the brain. In the current report, a very rare case of brain metastasis, which simultaneously invaded the subgaleal region, the skull, and the dural and cavernous sinuses is presented. The patient, a 54-year-old female, complained of a progressive headache and exhibited the symptoms of intracranial hypertension. Coronal contrast-enhanced T1-weighted magnetic resonance imaging (MRI) showed high intensity signals in the subgaleal tissue of the left frontoparietal area, as well as in the dural and the cavernous sinuses. The patient was initially diagnosed with an intracranial infection, however, the administered treatment was ineffective. The patient subsequently underwent a biopsy and the pathological diagnosis was determined as a metastatic adenocarcinoma; a primary tumor was not identified during the examinations. Surgical removal of certain metastases and a decompressive craniectomy were performed to relieve the intracranial hypertension. However, the prognosis was unsatisfactory. The patient's neurological condition progressively worsened and an axial computed tomography scan with a bone window demonstrated a bulging growth in the brain tissue. The patient succumbed after one month due to the widespread metastasis. Thus, this case presents the unusual clinical development of this type of metastatic adenocarcinoma. In addition, due to the intracranial hypertension, the unusual sites of the high intensity signals in the MRI and the lack of a primary tumor, the patient was misdiagnosed with an intracranial infection. Furthermore, this case highlights the necessity for conducting a biopsy as soon as possible and demonstrates the poor prognosis associated with this type of patient.
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PMID:Rare incidence of a diffuse brain metastatic carcinoma: A case report. 2520 14

We report a case of primary sinonasal tuberculosis in a 23-year old man. He had a half-year history of headache and eye pain on the left side, and found the neoplasm of nasopharynx 15 days ago. Previously denied history of tuberculosis and contact history. After be admitted to hospital, twice biopsy from neoplasm of na- sopharynx were both of chronic inflammation. Coronal CT scan of the lesion when admission found the left parasellar region and the left sphenoid sinus soft tissue density increased, about 20 mm X 32 mm X 34 mm, left inferior wall between sella bone defects, and bone sclerosis, plain CT value was about 34 HU, the lesion protruded downward left the nasopharynx. Eight days after he was admissioned in hospital of sphenoid sinus biopsy showed granulomatous inflammation and tuberculosis diagnosis was considered. Review of the lesion is partial absorbed after 11 months of anti-tuberculosis treatment and now is still in follow-up.
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PMID:[One case report of primary sphenoid sinus tuberculosis]. 2601 6


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