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

Since October 1967 we have performed 76 microsurgical STA--cortical MCA bypass operations. Recently we have had two cases, who died from intracerebellar hematoma following bypass operation. Intracerebellar hematoma is reported primarily due to hypertension (50-80%), and to comprise 10% of all spontaneous intracranial hematomas. Diagnosis of this lesion is frequently missed but can be made by the typical clinical picture (respiratory irregularity, pinpoint pupils, absence of oculovestibular responses, loss of consciousness), and the CT-Scan. If the correct diagnosis is made and operation promptly performed, many patients with subacute or acute intracerebellar hematoma can be saved. The 2 cases presented here had a history of hypertension and anticoagulation (including Colfarit), but had sustained the bypass operation well and showed no neurological deficit immediately after the operation. They had received Rheomacrodex intra- and postoperatively. Quite soon postoperatively, however, the systolic blood pressure rose to 210 mmHg and the patients complained of severe headache. They were treated symptomatically with analgesics and antihypertensive drugs. A short time later they became comatose and died. In order to prevent this complication after bypass surgery, postoperative management of hypertension is mandatory. The combination of antithrombic agents, Colfarit and Rheomacrodox, might have played a role in inducing the hemorrhages. Furthermore strong analgesics should be withheld to prevent their masking neurological deterioration. Intracerebellar hematoma must always be considered in hypertensive or anticoagulated patients, especially because it can be cured with prompt diagnosis and operative treatment.
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PMID:[Intracerebellar Hematoma following microsurgical STA-cortical MCA bypass surgery (author's transl)]. 90 21

Transcranial Doppler sonography examination was performed on 44 patients with migraine with aura and 88 controls. All patients were investigated in headache-free periods and 10 of them also during a migraine attack. During the headache-free period a not significant increase of mean flow velocity in patients compared to controls was obtained. The pulsatility index (PI) mean values were also higher in patients than in controls and the differences were significant in the MCA (p < 0.05). No difference between right and left side was observed. During the attack the mean flow velocity (MFV) decreased in all arteries but the decrease was significant only in MCA and ACA (p < 0.05). The mean PI increased in all arteries but not significantly. These variations were observed both on the headache and contralateral side. Nevertheless, the MFV decrease in all arteries was observed in four patients only. In four patients the MFV decrease was found in the anterior arteries and the MFV increase in the posterior arteries, while in two patients the MFV increase was observed both in the anterior and posterior arteries. The correlation between the variations of MFV values during the attacks and the time interval from the onset of attacks showed that the PCA and BA flow velocities were increased in patients examined between 0.5 and 3 hours, while an increase in MCA and ACA flow velocities were observed only in patients examined after 1.5 hours.
Headache 1992 Oct
PMID:Cerebral blood flow in migraine with aura: a transcranial Doppler sonography study. 144 88

A case of fibromuscular dysplasia (FMD) with intra- and extracranial multiple aneurysms is reported. A 42-year-old woman was admitted to Kagawa Central Hospital with severe headache and stiffness of the neck. CT scan showed subarachnoid hemorrhage predominantly in the left side of the basal cisterns and hydrocephalus. Angiography at admission revealed marked stenosis and dilatation of the extracranial major arteries and multiple aneurysms in the lt. PCA, lt. ICA, bil. VA, and the lt. renal artery. String-of-beads appearance was also seen in the branches of the lt. external carotid artery. During the operation, the PCA aneurysm which has been diagnosed as the ruptured one, was found to arise from the posterior communicating artery itself. It was thus a so-called true posterior communicating aneurysm. The aneurysm was trapped by clipping the artery on both the ICA and the PCA sides. The giant aneurysm of the lt. ICA was successfully treated by lt. STA-MCA anastomosis and ligation of the lt. ICA. Postoperative angiography demonstrated no visualization of the aneurysm and total occlusion at the origin of the lt. VA that had been patent preoperatively. On histological examination, intimal and medial hyperplasia was seen in the aneurysmal wall and occipital artery biopsied at operation. There has been no report of FMD associated with multiple and very rare posterior communicating aneurysms. Wide involvement of vascular change and advance of arterial occlusion noted by serial angiography indicates that FMD is a disease in which pathology would be progressive in some cases.
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PMID:[A case of fibromuscular dysplasia associated with intra- and extracranial multiple aneurysms]. 159 38

One familial case of "moyamoya" disease affecting three patients is reported. The patient in Case 1 was a 28-year-old female. She had suffered from motor weakness of the right limbs in her infantile period. She visited our hospital because of sudden headache and left motor weakness associated with nausea and vomiting. On admission, CT scan revealed cerebral hemorrhage in the right caudate nucleus with intraventricular clots and infarction in the left parietal lobe. Angiography showed stenosis of the left ICA terminal portion and occlusion of the right side, with moyamoya vessels in the basal area. The patient in Case 2 was a 54-year-old female, who was the mother of Case 1. After an operation for acute upper intestinal bleeding, she suffered from cerebral infarction. CT scan revealed large low density areas in the territory of the bilateral MCA. Angiography showed stenosis of the bilateral ICA terminal portions, occlusion of the right MCA, stenosis of the left MCA, and moyamoya vessels in the basal area. The patient in Case 3 was a 40-year-old female, who was a younger sister of Case 2. She had a convulsive attack in her infantile period. She visited our hospital because of gradually worsening headache. CT scan revealed multiple infarctions in the left paraventricle, the right parieto-occipital and occipital lobe. Angiography showed occlusion of the bilateral ICA terminals with moyamoya vessels in the basal and the ethmoidal areas. The patient in Case 2 died immediately. Surgery for reconstruction of hemodynamics was performed in Case 1 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[One pedigree of "moyamoya" disease]. 189 26

We report a very rare case of subarachnoid hemorrhage associated with fenestration of the anterior cerebral artery (ACA), the accessory middle cerebral artery (A-MCA) and the duplication of the middle cerebral artery (D-MCA). It seems that this is the first report of these combined intracranial vascular anomalies, although many authors have reported each anomaly in isolation. A 50-year-old male visited a local physician complaining of the sudden onset of a severe pulsating headache. A lumbar puncture showed bloody cerebrospinal fluid, and he was transferred to our institution. An emergency CT scan showed no apparent subarachnoid hemorrhage, but the left internal carotid angiography showed a saccular aneurysm at the origin of the D-MCA. Other anomalies, such as the fenestration of the ACA and the A-MCA, were also apparent during angiography. The ruptured aneurysm was safely clipped on the next day and the patient was discharged with no neurological deficits three weeks after the operation. The incidence of fenestration of the ACA is 0.2% in the angiographic series, and 0.1-7.2% at autopsy. Fenestration of the ACA is thought to be less than that of the vertebral artery. Ever since it was proposed by Teal et al, the term A-MCA has been restricted to an artery that arises from the ACA, and a branch arising from the internal carotid artery has been termed as the D-MCA. These anomalous vessels supply the cortex in the distribution of the middle cerebral artery. The angiographic incidence of A-MCA is about 4%, and six cases of aneurysm located at the origin of the A-MCA have been reported so far.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Ruptured intracranial aneurysm combined with multiple cerebral vessel anomalies; a case report]. 194 84

The authors report a case of spontaneous occlusion of an arteriovenous malformation (AVM) verified by the second angiography performed 3 days after the initial one. This 65-year-old man had a sudden attack of headache, nausea, and vomiting and was admitted to our hospital next day. On admission, CT scan showed subcortical hemorrhage in the right temporo-parietal area and right CAG showed a small AVM in the same area. The main feeder was a MCA distal branch and the drainer joined Labbe's vein. Repeated angiography 3 days after initial one failed to demonstrate the AVM. Craniotomy was performed and thrombosed AVM was totally removed. Mechanism for disappearance of the malformation is assumed to be acute thrombosis due to intracranial hemorrhage and arteriosclerotic change. The literature is reviewed.
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PMID:[Spontaneous occlusion of a cerebral arteriovenous malformation--report of a case]. 332 Aug 5

A rare case of duplication of the middle cerebral artery associated with an arteriovenous malformation of the left temporal lobe is reported. A 45-year-old man was admitted to our clinic on January 7, 1985 with a history of sudden onset of headache and nausea, followed by loss of consciousness for 20 minutes. Neurological signs were negative on admission. An arteriovenous malformation of the left temporal lobe fed by a duplicated middle cerebral artery and the original MCA were demonstrated on left carotid angiography. No other vascular lesion was observed on the angiograms. The arteriovenous malformation was successfully removed on January 17, 1985. Postoperative course was uneventful. Embryological relation of duplication of the middle cerebral artery to other cerebrovascular anomalies is briefly discussed.
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PMID:[A case of duplication of the middle cerebral artery associated with arteriovenous malformation of the temporal lobe]. 336

This paper reports a case of meningioma associated with AVM. A 67 years old lady showed transient rt. lower hemiparesis with severe headache, nausea and consciousness disorder. Bilateral carotid angiogram and CT scan revealed lt. convexity meningioma and AVM. Lt MCA and ACA entered into the AVM from which several draining vessels entered into the deep venous system. These two lesions were removed by one stage. It is quite rare that cerebral tumor associates with intracranial AVM. Only two cases of meningioma associated with AVM have been reported.
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PMID:[A meningioma associated with AVM: a case report]. 370 19

Seventeen patients with basal occlusive disease have been seen over the past 4 years. Nine of these had a classical moyamoya appearance on angiography. Of these nine, seven were adults and two were children. Eight had ischemic episodes, and one had a hemorrhage. One had neurofibromatosis with a chiasmal glioma and had received radiotherapy. Eight patients underwent superficial temporal-middle cerebral artery (STA-MCA) bypass, and one refused operation. Six patients improved, one had a stroke on the opposite side, and one died. Eight patients had unilateral basal arterial occlusive disease. Of these, three had ischemic episodes, four had hemorrhages, and one had only headaches. Four were adults, and four were children. Five underwent STA-MCA bypass with improvement, one with headaches had an aneurysm treated, and two were not operated upon. Considerations regarding the cause, therapeutic options, and disease course in these patients are discussed.
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PMID:Basal arterial occlusive disease. 408 Jan 27

Two cases of the spontaneous dissecting aneurysm (SDA) of the cervical carotid artery (ICA) were reported. Case 1: A 36 years old man was admitted with a sudden onset of right hemiparesis, aphasia and a one-week history of headache and neck pain. Serological examinations were normal. Angiography showed a severe stenosis with two intimal flaps of the left cervical ICA. Four weeks later, left STA-MCA anastomosis was performed. After six weeks from the onset, re-angiography showed the resolution of the left cervical ICA stenosis. Case 2: A 26 years old man experienced the transient monoocular blindness a week before admission. He was admitted with a sudden onset of right hemiparesis and aphasia. Serological examinations were normal. Angiography showed a postsinus tapering occlusion of the left cervical ICA. Four weeks later, left STA-MCA anastmosis was performed. After the operation, left hemiparesis improved remarkably. After two weeks from the operation, re-angiography showed the complete resolution of the left cervical ICA stenosis. As the differential diagnoses, spasm, arteritis, embolism and thrombosis with atherosclerosis were listed. But from the reason reported, we diagnosed the two cases as the resolution of the SDA of the ICA. From the previous literature, 129 cases of SDA of the ICA were reviewed and discussed about the symptom, angiographic findings and treatment. Some specific findings (high frequency of resolution, 87%, etc.) were found. SDA of the ICA occurs in the non-atherosclerotic age and causes the ischemic brain damage. SDA of the ICA should be paid more attention and will probably be identified more frequently.
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PMID:[Spontaneous dissecting aneurysm of the cervical internal carotid artery. Report of 2 cases and review of literature]. 652 29


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