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

Two cases of olfactory neuroblastoma in women in northern Thailand are described. Original complaints were severe headaches and eye pain; death occurred from intracranial extensions 6 months and 1 year after diagnosis. Results of study with light microscopy, immunohistopathology, and electron microscopy are reviewed, and several management recommendations are discussed.
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PMID:Olfactory neuroblastoma in northern Thailand. 914 85

The delivery of sumatriptan doses intranasally could add greater flexibility in the treatment of migraine than is possible with the currently available subcutaneous and oral sumatriptan preparations. Two independent double-blind, randomized, placebo-controlled clinical studies were conducted to evaluate the safety, tolerability and pharmacokinetics of intranasally administered sumatriptan following ascending single doses (three different dose levels) and multiple doses. In the four-way, crossover, ascending-dose study, 20 healthy female subjects were randomized to receive on separate occasions single intranasal spray doses of 5, 10, or 20 mg sumatriptan (as the hemisulphate salt) or placebo into one nostril. Adverse events were mild and consisted mainly of bitter taste at the back of the throat and events typical of sumatriptan administered by other routes (headache, lightheadedness and tingling). Area under the plasma sumatriptan concentration versus time curve (AUC infinity) and peak plasma concentration (Cmax) increased with the dose. Dose proportionality was demonstrated between 5 and 10 mg but not across the dose range 5-20 mg. Time to maximum plasma concentration (tmax) was variable due to multiple peaking. The elimination half-life (t1/2), approximately 2 h, was unaffected by the magnitude of dose. In the two-period, multiple-dose, crossover study, 12 healthy adult male and female subjects were randomized to receive either sumatriptan hemisulphate 20 mg or placebo, administered intranasally as a spray three times a day for 4 days. The two dosing periods were separated by 3 to 14 days. Multiple doses of sumatriptan were well tolerated, with no serious adverse events occurring or withdrawals due to adverse events. All patients reported a mild to moderate drug-related disturbance of taste. Nasal examinations remained normal, and olfactory function was unaffected. The AUC over the first 8 h following dosing (AUC8) and fraction of the dose excreted in the urine (fe; 6.2% vs 3.6%) were similar on Days 1 and 4. Day 4 values were significantly higher (p < or = 0.05) for Cmax (16.9 ng/ml vs 13.1 ng/ml), renal clearance (Clr; 19.0 l/h vs 14.2 l/h), and t1/2 (2.18 h vs 1.93 h), and shorter for tmax (0.88 h vs 1.75 h). Some accumulation (22%) occurred over the 4 days of dosing. Serum concentrations of the pharmacologically inactive indole acetic acid metabolite of sumatriptan were fourfold to fivefold higher than corresponding sumatriptan concentrations. Overall, these studies show that the sumatriptan intranasal spray formulation is well tolerated, allows rapid absorption of sumatriptan, and results in only a clinically insignificant degree of sumatriptan accumulation upon repeated dosing.
Cephalalgia 1997 Jun
PMID:Safety, tolerability, and pharmacokinetics of sumatriptan in healthy subjects following ascending single intranasal doses and multiple intranasal doses. 920 76

Cortical venous drainage has been described as one of the major risk factors for dural arteriovenous fistula, which may induce venous hypertension leading to venous ischemia or intracerebral hemorrhage. However, it is rather rare to observe cortical venous drainage manifesting in this way in the cavernous sinus region. We report a case of a 55-year-old gentleman with a right cavernous dural arteriovenous fistula, presenting with conjunctival chemosis, exophthalmus and ocular hypertension on the affected side. Magnetic resonance imaging showed a small intracerebral hemorrhage in the right frontal lobe. Cerebral angiography revealed a dural arteriovenous fistula in the right cavernous sinus draining into the right olfactory vein via the uncal vein, as well as into the superior and inferior ophthalmic veins. This unusual cortical venous reflux was thought to be consistent with the intracerebral hemorrhage found on the magnetic resonance imaging. The patient underwent transvenous embolization for the dural arteriovenous fistula using an inferior petrosal catheterization into the uncal vein was difficult, and the cortical venous reflux through the vein seemed to be slight. However, extravasation of the contrast material occurred in the right frontal lobe after obliteration of the ophthalmic veins during the procedure. The cause of the extravasation was suspected to be the same olfactory vein that had been involved in the previous intracerebral hemorrhage. The obliteration of the dural fistula was continued rapidly, and the fistula disappeared after the embolization. Neurologically, the patient had no noticeable troubles, except for a mild headache. The pretreatment symptoms were alleviated within several days, and the patient was discharged in a week. We emphasize the following points from this rare case in order to facilitate a safer procedure during transvenous embolization for cavernous dural arteriovenous fistula. It is important to obliterate the cortical venous drainage as early as possible, even if the reflux is small or the catheterization is difficult. Repeated, careful sinography is useful for the evaluation of the drainage pattern at certain stages during the transvenous embolization procedure.
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PMID:[A case of cavernous dural arteriovenous fistula resulting in intracerebral extravasation during transvenous embolization]. 926 67

A case of primary amebic meningoencephalitis (PAM) with severe spinal cord involvement was documented in a 12 year-old boy from Samut Prakan Province, Thailand. This is the first reported case of Naegleria meningomyeloencephalitis in Thailand. He had a history of swimming in the canal nearby his house prior to the fever, headache and convulsion which rapidly progressed into a comatose state. PAM was only detected at post-mortem. The findings included suppurative exudates and necrosis of the olfactory bulbs and the basal parts of the frontal, temporal lobes, pons, cerebellum, medulla and the spinal cord. Numerous Naegleria trophozoites were present in the brain and spinal cord. Foci of neuronal degeneration and demyelination were noted.
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PMID:Naegleria meningomyeloencephalitis. 932 14

Olfactory thresholds for acetone and vanillin and the unpleasantness rating of concentrated acetone were measured in 20 migraine sufferers and 21 controls. The olfactory threshold for vanillin was lower in migraine sufferers than in controls. In addition, patients who reported that odours frequently seemed stronger during attacks of migraine were able to detect acetone at a lower concentration than most other patients. No differences were found between migraine sufferers and controls for ratings of the unpleasantness of concentrated acetone. These findings suggest that hyperacuity to odours persists between episodes of migraine. Sensitivity to odours could contribute to the migraine predisposition.
Cephalalgia 1997 Nov
PMID:Olfaction in migraine. 973 44

Individuals who report illness (e.g. nausea, headache) from common chemical odors tend to report CNS symptoms suggestive of olfactory-limbic system involvement. This study compared the resting quantitative electroencephalographic (qEEG) patterns of young adult college students reporting subjectively elevated chemical odor intolerance ratings (HICI) with those of controls reporting little or no odor intolerance (LOCI). Each group was subdivided into those with higher (HIDEP) vs. lower (LODEP) ratings of concomitant depression. Nineteen channels of EEG were recorded during a single session over four separate rest periods, respectively, following baseline, cognitive, chemical exposure and olfactory identification tests. Each recording involved two 30-s, eyes-closed, filtered room air breathing conditions: (1) nose inhalation followed by mouth exhalation and (2) mouth inhalation followed by mouth exhalation. HICI showed significantly less beta 1 (beta 1) over the temporal-central region during nose than during mouth inhalation. Over some temporal and central leads, task, DEP and CI interacted to influence beta 1 as well. For theta (theta), CI differences emerged during nose inhalation after the cognitive task at Cz, after chemical exposures at C3, Cz and C4 and after the olfactory ID task at C4. CI differences emerged during mouth breathing after the olfactory ID task at Cz, C4 and T4. The T5-T6 coronal array showed significant CI differences after chemical exposures during nose breathing and during mouth breathing after the cognitive and olfactory ID tasks. The theta findings in the HICI may be related to reports of disturbed attention in CI.
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PMID:Quantitative EEG patterns during nose versus mouth inhalation of filtered room air in young adults with and without self-reported chemical odor intolerances. 950 9

A retrospective study of the records of 392 consecutive patients prospectively operated for non-vasomotor nasal obstruction, has allowed us to identify a syndrome that we would call morphological syndrome. This is caused by anatomical deformities of the nasal septum, inferior turbinate hypertrophy frequently found being the most often only a compensation for the septal deviation. This endonasal abnormality, which can be congenital or post-traumatic, is most frequently of developmental origin and therefore most often found in Caucasian men, whose facial and septal growth is considerable. This morphological syndrome comprises unilateral or bilateral nasal obstruction, noisy nocturnal breathing (20% of patients), a posterior nasal drip (38% of patients), frontal headaches (49% of patients) and recurrent viral or bacterial rhinosinusitis (36% of patients). Other associated symptoms include epistaxis, olfactory dysfunction (hyposmia) and the manifestations of eustachian tube dysfunction. That this syndrome exists is confirmed by the effectiveness of septoplastic operation, performed in our hospital according to the method of Cottle, but without any surgical associated intervention on the inferior turbinates. This operation is an effective treatment both in a global fashion (95% of good results) and in relation to each of the symptoms (except postnasal drip) and is stable in the longterm and well tolerated (minor associated morbidity). This study allow us to re-establish the almost exclusive role of the nasal septum in the genesis of morphological nasal obstruction.
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PMID:[Anatomy of nasal obstruction. The recognition of the role of septum. Its application to the surgical treatment of nasal obstruction]. 977 41

A 45-year-old man presented with headaches of 6 months' duration and generalized seizures in a cluster 2 days prior to admission. Examination revealed bilateral papilloedema and no focal deficits. CT scan showed an isodense enhancing mass lesion in the right frontobasal region with perilesional edema. Bifrontal craniotomy (with total excision of the tumor) revealed a tumor in the region of the right olfactory groove attached to the cribriform plate. Histopathological examination disclosed it to be a hyalinised schwannoma. Solitary schwannomas arising from the olfactory groove are extremely rare. Only six other cases have been reported so far. The presentation. CT scan findings and histogenesis of the tumor are discussed along with a review of the literature.
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PMID:Solitary olfactory groove schwannoma: case report with review of the literature. 1035 Feb

Complaints about unpleasant environmental odorants, both outdoor and indoor, are increasingly being reported. The main complaints of health symptoms from environmental odorants are eye, nose and throat irritation, headache and drowsiness. Complaints may arise from the stimulation of olfactory receptors or trigeminal chemoreceptors. Stimulation of cerebrovascular nociceptors originating from a branch of the trigeminal nerve may be associated with an increase in cortical blood flow which is thought to be related to headache. Since odorants are reported to elicit headaches, the possibility that odorants may increase cortical blood flow was examined. Cortical blood flow was monitored in rats using a laser-Doppler flowmeter. The flowmeter probe was placed over the left frontal cortex while propionic acid, cyclohexanone, amyl acetate or butanol was delivered to the nasal cavity via an olfactometer. Cortical blood flow increased as the concentration increased for three of the odorants tested. The greatest increase in blood flow occurred to the presentation of propionic acid, followed by cyclohexanone and amyl acetate. There was no response to butanol. These data demonstrate that odorants can alter cerebrovascular blood flow, which may account, in part, for one of the health symptoms reported for odorants.
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PMID:Odorants presented to the rat nasal cavity increase cortical blood flow. 1058 99

Olfactory groove meningioma is a rare clinical entity. The principal symptoms associated with olfactory groove meningiomas are anosmia and headache which lead the patient to the ENT specialist. Frontal sinusitis, migraine and neuralgia are most frequent incorrect diagnoses. This retrospective study of 13 consecutive patients who underwent excision of Olfactory Groove meningiomas in the North Staffordshire Royal Infirmary, Department of Neurosurgery over a 20-year period was undertaken to study the presenting features, duration of symptoms, results of surgery, and long-term follow-up. Symptoms were present for less than 6 months to 3 years. Although excision was thought to be complete reoccurrences occurred in four patients. The morbidity of surgery was significant.
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PMID:Olfactory groove meningiomas. 1060 98


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