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

A case of an extra-axial cavernous angioma of the cisterna magna is described. The clinical presentation, radiographic features, treatment of that unusual location in the posterior fossa are discussed. The patient is a 31 years old man admitted for the sudden onset of occipital headache and instability. A CT scan demonstrated a slightly calcified lesion, minimally enhanced after intravenous injection of a contrast agent, located within the posterior fossa. A T2-weighted MR image showed a well circumscribed mass, located between medulla oblongata and left cerebellar tonsil, of mixed signal intensity surrounded by a rim of decreased signal intensity related to the presence of hemosiderin. Cerebral arteriography was normal. A medial suboccipital craniectomy was performed, with the patient in the ventral position, in which a 1.5 x 1 cm solid dark-red mass was encountered arising from the cisterna magna and was easily removed "en bloc". The operative extra-axial aspect of that lesion was evident excluding a medulla oblongata tumor protruding into the cisterna magna. Histologically, the lesion was a cavernous angioma consisting of numerous vascular channels with collagen fibrous walls filled with fibrin thrombi and hemosiderin. Few elastic fibers were found in vascular walls. The patient's post-operative course was unremarkable.
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PMID:[Unusual extra-axial infra-tentorial localization of a cavernoma in the cisterna magna]. 763 Apr 63

An extremely rare case of ruptured cerebral aneurysm associated with a fenestrated vertebral artery in osteogenesis imperfecta (OI) is presented. A 33-year-old female suffering from OI was admitted to our hospital with severe headache and vomiting. A CT scan revealed subarachnoid hemorrhage. Cerebral angiography with four vessel study showed a fenestration in the V3 portion of the left vertebral artery and a dilatation in its V4 portion, but no cerebral aneurysm was detected. After conservative treatment for three weeks, repeated angiography demonstrated an aneurysm of the anterior communicating artery. A neck clipping of the aneurysm was performed successfully. The patient was discharged with no neurological deficits. OI is a hereditary connective tissue disease characterized by bone fragility. From her family history and clinical findings, the patient was suspected to have OI type I of Sillence's classification. Among the connective tissue diseases, OI does not have complications in the cerebrovascular system as frequently as other connective tissue diseases do, for example, Marfan's syndrome, Ehlers-Danlos syndrome, or pseudoxanthoma elasticum. Carotid-cavernous fistula and moyamoya disease have been the only complications reported in OI. However, dilatation of the aortic root and increased vascular fragility have been reported recently in OI. Although this is the first reported case of a ruptured aneurysm accompanied by a fenestration and a dilatation of the vertebral artery associated with OI, it was suggested that vascular fragility caused by collagen abnormality might affect the cerebral vasculature.
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PMID:[A case of ruptured cerebral aneurysm associated with fenestrated vertebral artery in osteogenesis imperfecta]. 775 27

We report the case of a 41-year-old man infected with human immunodeficiency virus who had two episodes of aseptic meningitis that occurred 2 weeks apart; the first was associated with ingestion of trimethoprim-sulfamethoxazole (TMP-SMZ) and the second was associated with ingestion of TMP alone. Onset of fever, headache, and flushing was abrupt, followed by somnolence, hearing loss, and aphasia. Analysis of the CSF showed pleocytosis and an elevated protein level. The findings resolved within 48 hours after withdrawal of the drug. We also review 18 previously reported cases of TMP-SMZ- or TMP-induced meningitis, 17 of which occurred in women. In all of these cases, a similar abrupt onset and resolution were noted. Six of the 18 patients had collagen-vascular diseases. All but two of these patients had multiple recurrent episodes of meningitis before the diagnosis was made. We conclude that the diagnosis of TMP-SMZ- or TMP-induced meningitis should be considered when a patient receiving these drugs has recurrent episodes of aseptic meningitis.
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PMID:Trimethoprim-induced aseptic meningitis in a patient with AIDS: case report and review. 781 61

Reported here is a rare case of intracranial foreign body granuloma caused by fine cotton fibers originating from the cotton sheet, which was used in the previous operation. The patient was a 54-year-old woman who presented with headache and right hemiparesis. CT scan demonstrated a large enhanced tumor in the left temporal lobe. During the operation, the tumor bled easily and was hard to remove. The brain surface was covered with oxidized cellulose (Oxycell) after the tumor was subtotally removed. Cotton sheets (Surgical Patty) were also used during the operation. The microfibrillar collagen hemostat (Avitene) was not applied. The histological diagnosis was astrocytoma. Radio-chemotherapy was given. CT and MRI on the 40th day after the operation, showed a large tumor in the left temporal lobe, which led to suspicions of tumor recurrence. The second operation disclosed a mass which was harder in consistence than the previous one. The histological diagnosis was foreign body granuloma, which contained a lot of fine cotton fibers. Oxycell was not found in it. The cotton-sheet is well documented as a cause of granuloma in the literature, but it is seldom mentioned that the foreign body granuloma is caused by cotton fibers, scattered in the operative fields. This case report suggests the possibility of cotton-fiber granuloma and our simple experiment indicated that a lot of cotton fiber might be scattered in the operative fields, if dry cotton sheets are used. These results stress that washed cotton sheets should be applied to avoid the possibility of the development of cotton-fiber foreign body granuloma.
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PMID:[Intracranial foreign body granuloma caused by fine cotton fibers: a case report]. 781 82

Inflammatory pseudotumors (IPT) are rare lesions composed of inflammatory cells admixed with collagen tissue. Although IPT are ubiquitous, intracranial locations are rare. In this study, four intracranial IPT of the plasma-cell-granuloma (PCG) type are reported. Four patients presented with lesions located, respectively, in the right cavernous sinus, the left cavernous sinus with extension to the tentorium cerebelli, the vermis cerebelli, and the pituitary stalk. All patients were operated on, but complete resection could not be achieved in cases 1 and 2. Follow-up was favorable in all cases, although case 1 still complained of headaches 2 years after operation. All cases were studied on histologic and immunohistochemical bases, and ultrastructural analysis was performed on two cases. In cases 1, 2, and 4, IPT were made up of plasma cells admixed with lymphocytes and rare histiocytes in a fibrous tissue-the density of which varied from case to case. In case 3, the mass was composed of plasma cells associated with numerous foamy histiocytes and polymorphonuclear cells. No light chain restriction could be demonstrated when immunohistochemistry was performed, and ultrastructural study did not disclose features reminiscent of meningioma or histiocytosis X. Intracranial IPT should not be confused with other diseases such as meningioma, lymphoproliferative disorders, or histiocytosis X. Although intracranial locations are much rarer than pulmonary ones, histology is identical in both sites and shows different patterns in its evolution. This is in agreement with the inflammatory origin of this lesion.
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PMID:Intracranial plasma cell granuloma: a report of four cases. 782 2

We studied whole blood platelet aggregation induced by collagen, platelet activating factor (PAF) and measured basal platelet L-arginine (L-arg) levels, as an indirect index of the nitric oxide (NO) pathway in migraine. Migraine, both with and without aura groups, showed a reduced aggregation to collagen, but not to PAF, compared with control subjects. Platelet L-arg levels were significantly increased in migraine with aura sufferers, whereas the plasma levels were in the same range in migraineurs and controls. Platelet hyperesponsiveness to collagen stimulation in migraine may be linked to an increased availability of the amino acid precursor and an abnormal NO synthesis.
Cephalalgia 1994 Oct
PMID:Decreased collagen-induced platelet aggregation and increased platelet arginine levels in migraine: a possible link with the NO pathway. 782 94

The authors report a rare complication during aspiration of a brain abscess. A 23 year-old man who had undergone surgery for empyema two months previously presented himself at our hospital complaining of headache, deterioration of activity and conscious level. An emergency computed tomography demonstrated a left frontal brain abscess. Aspiration and drainage were performed. However, this resulted in massive hematoma in and around the abscess capsule. Following craniotomy and excision of the abscess, the patient was cured. Microscopic examination of the abscess revealed the formation of a complete capsule consisting of fibroblasts and collagen fiber. In addition to this, significant neovascularization with inflammatory cells was apparent around the capsule. These findings suggest that profuse hemorrhage may occur in aspiration and drainage surgery.
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PMID:[Aspiration and drainage for brain abscess causing massive bleeding from abscess capsule: case report]. 816 3

Several studies in vivo indicate platelet activation in migraine, as reflected by increased plasma concentrations of platelet secretory products. In vitro data on platelet secretion are scant, which prompted an investigation into agonist-induced platelet aggregation and secretion in platelets from patients with migraine. Sixty two patients with migraine with aura (MA) and 41 with migraine without aura (MwA) were studied during a headache-free phase, together with 26 healthy controls. Platelet aggregation and secretion in platelet-rich plasma were induced by collagen and platelet activating factor (PAF). Serotonin was measured by high performance liquid chromatography and platelet factor 4 (PF4) with an enzyme immunoassay kit. There were no significant aberrations in platelet aggregation in those with migraine compared with healthy controls. The platelet PF4 secretion induced by PAF (1.0 and 0.1 microM) was increased in MwA (p < 0.05, p < 0.0001) compared with controls, and there was a similar trend in MA (NS, p < 0.01). By contrast, the PF4 secretion induced by collagen (0.5 and 2.0 micrograms/ml) was reduced in MA (p < 0.01 and p < 0.05). Further, the MA group exhibited increased basal intraplatelet serotonin concentrations (p < 0.0001) and increased serotonin secretion induced by both concentrations of collagen (p < 0.0001) and PAF (p < 0.001). The data indicate an abnormal platelet a-granule secretion in those with migraine, and focus attention on PAF as a possible factor contributing to the platelet activation associated with migraine. The increased platelet content and secretion of serotonin was specific to MA, and may reflect different serotonin turnover in the two clinical migraine types.
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PMID:Platelet secretion from dense and alpha-granules in vitro in migraine with or without aura. 820 23

We investigated platelet aggregation and secretion from dense and alpha-granules in vitro in 28 tension-type headache (TH) patients and 26 healthy controls. We also measured basal platelet serotonin levels. Platelet aggregation was normal in TH, but the secretion of serotonin and platelet factor 4 (PF4) was significantly increased in response to 0.5 and 2.0 micrograms/ml collagen and to 1.0 mumol/l PAF. The basal platelet serotonin levels were also higher in patients than in controls. The mechanisms of platelet hypersecretion remain to be determined, but the increased secretion of serotonin is probably in part related to the increased basal levels. The increased platelet serotonin in TH patients may reflect an enhanced serotonin turnover.
Cephalalgia 1993 Oct
PMID:Increased platelet serotonin content and hypersecretion from dense and alpha-granules in vitro in tension-type headache. 824 29

A case of giant saccular aneurysm in early childhood is reported. An internal carotid aneurysm presenting with episodic headache was successfully clipped with complete relief of symptoms. The patient was also investigated for a possible collagen deficiency which proved negative. Clinical features and pathogenesis of this rare lesion are discussed.
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PMID:Giant aneurysm of internal carotid artery in a four-year-old child: a case report. 836 50


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