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)

Intranasal or paranasal sinus olfactory neuroblastoma is a rare malignant neoplasm of olfactory neuroepithelial origin, accounting for approximately 5% of paranasal sinus cancers. Most of the presenting symptoms include nasal obstruction, nasal bleeding, anosmia, rhinorrhea, and headache. In this present report, we describe a 79-year-old man who presented with bilateral nasal congestion for more than 1 year. Nasoendoscopy showed a huge, smooth, mucosal tumor in the nasopharynx with extension to the posterior nasal septum. The tumor was completely resected under endonasal endoscopy and the pathology revealed olfactory neuroblastoma. Olfactory neuroblastomas usually arise in the cribriform plate and superior turbinate. However, the origin and isolation of olfactory neuroblastomas to the sphenoid sinus is exceedingly rare. Only four cases of olfactory neuroblastoma isolated in the sphenoid sinus have been described in English literature and the frequency of presenting symptoms with cranial neuropathies and headache. We report a case of primary sphenoid sinus olfactory neuroblastoma with the greatest enlargement reported to date.
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PMID:Huge sphenoid sinus olfactory neuroblastoma: a case report. 1932 12

We report the case of a 54-year-old man who presented at the Emergency Department with intense headache of 6-days duration and sporadic nominal dysphasia. He did not present anosmia and the rest of the examination was normal. The emergency CT and the posterior cerebral MR showed a great subfrontal extra-axial mass of 7 x 6 x 5 cm, over the right side of the cribiform plate, hetereogeneously enhancing after gadolinium administration. Preoperative diagnosis was olfactory groove meningioma. After total removal by bifrontal craniotomy the histopathological diagnosis was schwannoma of the conventional type. Owing to the unusual frequency of this kind of tumors (26 to the date), we review the literature, the possible radiological differences with olfactory groove meningiomas and the different theories about their origin.
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PMID:[A new case of "olfactory schwannoma"; presentation and literature review]. 1957 36

Functional imaging of human trigemino-nociceptive processing provides meaningful insights into altered pain processing in head and face pain diseases. Although functional magnetic resonance imaging (fMRI) offers high temporal and spatial resolution, most studies available were done with radioligand-positron emission tomography, as fMRI requires non-magnetic stimulus equipment and fast on-off conditions. We developed a new approach for painful stimulation of the trigeminal nerve that can be implemented within an event-related design using fMRI and aimed to detect increased blood-oxygen-level-dependent (BOLD) signals as surrogate markers of trigeminal pain processing. Using an olfactometer, 20 healthy volunteers received intranasally standardized trigeminal nociceptive stimuli (ammonia gas) as well as olfactory (rose odour) and odorless control stimuli (air puffs). Imaging revealed robust BOLD responses to the trigeminal nociceptive stimulation in cortical and subcortical brain areas known to be involved in pain processing. Focusing on the trigeminal pain pathway, significant activations were observed bilaterally in brainstem areas at the trigeminal nerve entry zone, which are agreeable with the principal trigeminal nuclei. Furthermore, increased signal changes could be detected ipsilaterally at anatomical localization of the trigeminal ganglion and bilaterally in the rostral medulla, which probably represents the spinal trigeminal nuclei. However, brainstem areas involved in the endogenous pain control system that are close to this anatomical localization, such as raphe nuclei, have to be discussed. Our findings suggest that mapping trigeminal pain processing using fMRI with this non-invasive experimental design is feasible and capable of evoking specific activations in the trigeminal nociceptive system. This method will provide an ideal opportunity to study the trigeminal pain system in both health and pathological conditions such as idiopathic headache disorders.
Cephalalgia 2010 Apr
PMID:A new trigemino-nociceptive stimulation model for event-related fMRI. 1967 14

A 59-year-old male presented with generalized seizure. The patient had not been aware of any traumatic head injuries or preceding infection, and had no contributory medical history. On admission, he was alert and well oriented, without neurological impairment or headache. He was afebrile and blood examination showed no abnormal findings. Computed tomography revealed an irregular intracerebral hematoma, 3 x 1.5 cm in diameter, in the left rectal gyrus. Cerebral angiography showed an arteriovenous fistula (AVF) in the anterior cranial fossa supplied only by the persistent primitive olfactory artery (PPOA) originating from the anterior cerebral artery, forming a shunt to an ascending cortical vein, and drained by the superior sagittal sinus. The patient underwent endovascular obliteration of the AVF via the transarterial route. Immediately after successful isolation, angiography showed that the bilateral anterior ethmoidal arteries supplied the AVF. The feeding branches from the left anterior ethmoidal artery were completely occluded via the ophthalmic artery, but introduction of the catheter into the right ophthalmic artery markedly decreased the stump pressure. Follow-up angiography performed at 3 and 8 weeks following embolization showed spontaneous resolution of the residual AVF without findings of recanalization or new abnormal channels. AVF arising in the anterior cranial fossa may be associated with an unusual pattern of the blood supply when including the PPOA.
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PMID:Arteriovenous fistula arising from the persistent primitive olfactory artery with dual supply from the bilateral anterior ethmoidal arteries. 1977 85

Intranasal lidocaine hydrochloride (LID, CAS 73-78-9) has been widely and commonly used in the treatment of a series of symptoms such as migraine, cluster headache and trigeminal neuralgia in clinical studies. Nevertheless, rapid nasal mucociliary clearance of intranasal solution presents the predominant obstacle impacting its efficiency. In order to prolong the residence time of LID in the nasal cavity and increase its absorption, a LID nasal gel had been developed previously using hydroxypropyl methyl cellulose (HPMC) as base material. The LID nasal gel formulation has been optimized through central composite design and its in vitro release behavior has been investigated. In the present study, safety studies employing in situ toad palate model and in vivo rat nasal mucosa model showed that compared with LID nasal spray, LID nasal gel was less toxic to mucocilia. The pharmacokinetic parameters, along with olfactory and ventricle delivery of LID from nasal gel were compared with those of LID from nasal spray, intravenous injections and oral solutions in rats using microdialysis, and the drug targeting index (DTI) was used to evaluate their brain delivery. The absolute bioavailability of the optimized LID nasal gel was about 1.5 times of that of LID nasal spray which suggested a better absorption of LID from nasal gel. Moreover, the drug targeting index (DTI) of olfactory/ventricle after nasal gel and spray administration was 2.15/1.51 and 1.66/1.26, respectively. This suggested that a fraction of the LID dose could be transported directly from the nasal cavity into the central nervous system (CNS), and the brain delivery of LID can be enhanced by nasal gel.
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PMID:Hydrophilic nasal gel of lidocaine hydrochloride. 2nd communication: Improved bioavailability and brain delivery in rats with low ciliotoxicity. 2010 49

A rare case of simultaneous occurrence of three entirely distinct intracranial tumors is described. A 55-year-old male with no evidence of phacomatoses or history of radiation therapy presented with complaints of increased drowsiness, headaches, and dysarthria. Investigations revealed an olfactory groove meningioma, a glioblastoma multiforme in the left medial temporal lobe, and a diffuse glioma in the brain stem. Occurrence of multiple varieties of tumors at the same time is extremely rare. Theories that explain their occurrences including the role of common carcinogens, autocrine growth factors, and tumor suppressor genes are discussed.
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PMID:Three distinct co-existent primary brain tumors in a patient. 2016 Mar 65

Intranasal delivery has been shown to noninvasively deliver drugs from the nose to the brain in minutes along the olfactory and trigeminal nerve pathways, bypassing the blood-brain barrier. However, no one has investigated whether nasally applied drugs target orofacial structures, despite high concentrations observed in the trigeminal nerve innervating these tissues. Following intranasal administration of lidocaine to rats, trigeminally innervated structures (teeth, temporomandibular joint (TMJ), and masseter muscle) were found to have up to 20-fold higher tissue concentrations of lidocaine than the brain and blood as measured by ELISA. This concentration difference could allow intranasally administered therapeutics to treat disorders of orofacial structures (i.e., teeth, TMJ, and masseter muscle) without causing unwanted side effects in the brain and the rest of the body. In this study, an intranasally administered infrared dye reached the brain within 10 minutes. Distribution of dye is consistent with dye entering the trigeminal nerve after intranasal administration through three regions with high drug concentrations in the nasal cavity: the middle concha, the maxillary sinus, and the choana. In humans the trigeminal nerve passes through the maxillary sinus to innervate the maxillary teeth. Delivering lidocaine intranasally may provide an effective anesthetic technique for a noninvasive maxillary nerve block. Intranasal delivery could be used to target vaccinations and treat disorders with fewer side effects such as tooth pain, TMJ disorder, trigeminal neuralgia, headache, and brain diseases.
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PMID:Trigeminal pathways deliver a low molecular weight drug from the nose to the brain and orofacial structures. 2042 Apr 46

Migraine patients often report intolerance to odours. Migraineurs report odours may trigger attacks, that they experience osmophobia during attacks, and olfactory hypersensitivity between attacks. In this paper we discuss olfactory mechanisms in migraine. We also present data from a pilot questionnaire study in a group of young women diagnosed with migraine. The study results confirm that hypersensitivity to odour is a common feature in women with migraine. Migraine pathophysiology likely explains this particular vulnerability. We discuss these pathophysiologic mechanisms and hypotheses relating odour intolerances and migraine.
Curr Pain Headache Rep 2010 Jun
PMID:Migraine and olfactory stimuli. 2049 Jul 44

Fungal rhinosinusitis is an important clinical problem with diverse manifestations. Although many literatures had found low recurrence rate after surgical treatment of fungus ball rhinosinusitis, patient satisfaction and treatment outcomes (symptom-free and symptom improvement rate, etc.) for fungus ball sinusitis are not yet well established. The purpose of this study is to estimate the patient satisfaction and treatment outcome in patients with fungus ball rhinosinusitis undergoing functional endoscopic sinus surgery (FESS). Medical records of consecutive patients with diagnosed fungus ball rhinosinusitis treated by FESS between 1995 and 2005 were reviewed retrospectively. The post-operative improvement in individual symptom was assessed by chart review and telephone visiting. Ninety consecutive patients (21 men and 69 women) were eligible for the study. Six patients (7%) presented bilateral fungus ball rhinosinusitis. Multiple paranasal sinus fungus ball involvements were found in 48 patients (53%). Complete resolution of complaints with respect to nasal discharge, postnasal drip, cough with sputum, nasal bleeding, fetid odor of nose, olfactory dysfunction, nasal obstruction, headache, and facial pain or pressure were described in 74 patients (82%). The overall patient satisfaction rate was 96%. The estimated recurrence rate of fungus ball rhinosinusitis treated with FESS was 3%, with a mean follow-up of 81 months. Treatment protocol of fungus ball rhinosinusitis with FESS and without postoperative antifungal drugs is efficient because of very low recurrence rate, high patient satisfaction, and very high symptom-free rate. Furthermore, the obvious difference of symptom-free rate between fungus ball rhinosinusitis and chronic rhinosinusitis highlights the need of further studies to discover the pathophysiology of fungal sinusitis.
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PMID:Patient satisfaction and treatment outcome of fungus ball rhinosinusitis treated by functional endoscopic sinus surgery. 2053 88

Basaloid squamous cell carcinoma (BSCC) is a distinctive variant of squamous cell carcinoma (SCC) with more aggressive behavior. It occurs preferentially in the upper aerodigestive tract. Sinonasal tract BSCC is uncommon, and only limited studies have been reported in literature. In these studies, most BSCCs arose from the nasal mucosa with or without extension to the paranasal sinuses. Rare reported cases of BSCC involved only the paranasal sinus. In this report, we present a case of a female patient with a sphenoid sinus mass. Clinically, the patient had progressively decreasing vision and headache. Magnetic resonance imaging (MRI) and computerized tomographic (CT) scan showed an infiltrating tumor mass involving the sphenoid sinus and the sella with compression of the optic nerve. Pathologic examination revealed an invasive basaloid epithelial neoplasm that was arranged in lobules, nests and cords. The tumor also showed palisading of peripheral cells, focal abrupt squamous differentiation and in situ carcinoma in the surface mucosa. In the immunohistochemical studies, this tumor revealed a strongly positive nuclear staining for p63. The morphologic and ancillary studies indicated a BSCC. To the best of our knowledge, this is the first report of sinonasal tract BSCC that mainly involved the sphenoid bone and sella. In this region, BSCC should be distinguished from benign and malignant neoplasms that more often affect sella and base of skull, such as pituitary adenoma with extensive necrosis, small cell neuroendocrine carcinoma (SCNC), olfactory neuroblastoma, malignant germ cell tumor, paranasal adenoid cystic carcinoma (ACC), and a variety of metastatic malignancies.
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PMID:Sphenoid sinus basaloid squamous cell carcinoma presenting as a sellar mass: report a case with review of the literature. 2097 44


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