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

In a double-blind 3-month study in mild-to-moderate essential hypertensive patients over 50 years of age, ketanserin, a selective S2-serotoninergic antagonist with additional alpha 1-adrenergic blocking properties, has been compared with enalapril, an angiotensin-converting enzyme inhibitor. Supine and upright blood pressures and heart rates were recorded for placebo and during active treatment (-4, -2, 0, 2, 4, 6, 8, 10, and 12 weeks). Metabolic profile (plasma glucose, creatinine, sodium, potassium, total and HDL-cholesterol, triglycerides, uric acid) was monitored during treatment with placebo and at the end of the study. Mean blood pressure was equally and significantly (p less than 0.001) lowered by both drugs from 2 weeks of treatment, whereas no changes occurred in mean heart rate or in biochemical variables. Dizziness was observed in three patients on ketanserin and in one patient on enalapril, whereas headache occurred in only one patient on enalapril. These data indicate that ketanserin is as effective and well tolerated as enalapril in hypertensive patients over 50 years of age.
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PMID:Comparison of ketanserin and enalapril in the treatment of mild-to-moderate essential hypertension. 228 42

Cerebral infarction, headache, and hypertension are well-known complications of carotid endarectomy (CEA). Seizures are a less frequent, but important complication. We describe eight patients with focal and generalized seizures following CEA. Seizures occurred 6 to 13 days after CEA. All began as focal motor seizures contralateral to the side of the CEA, and six patients developed generalized tonoclonic seizures. Lorazepam and phenytoin sodium controlled the seizures. Five patients without evidence of stroke on computed tomographic scan were normal in follow-up and had no further seizures. The other three patients had mild deficits. One developed a chronic seizure disorder. The pathogenesis of this syndrome following CEA remains unclear, but may involve cerebral hyperperfusion, cerebral embolization, or both.
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PMID:Seizures following carotid endarterectomy. 199 2

The authors report two cases of pseudotumor cerebri in patients taking lithium for treatment of bipolar disorder. Pseudotumor cerebri is a poorly understood syndrome characterized by chronic headaches, bilateral papilledema, and increased intracranial pressure without localized neurologic signs or symptoms, intracranial mass, or hydrocephalus. Ventriculography, computed tomography, and nuclear magnetic resonance imaging reveal normal or small ventricles. Multiple etiologies may include Vitamin A toxicity, obesity, head trauma, hypothyroidism or hyperthyroidism, prolonged steroid therapy or its withdrawal, Addison's disease, Cushing's disease, pituitary insufficiency, and lithium therapy. Patients treated with lithium whose antidiuretic hormone-cyclic adenosine monophosphate mechanism is disturbed are most likely to develop pseudotumor cerebri via disregulation of sodium balance, thyroid-stimulating hormone production, and glucose metabolism. The authors recommend careful medical monitoring to avoid iatrogenic effects of lithium, including pseudotumor cerebri.
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PMID:Pseudotumor cerebri associated with lithium therapy in two patients. 203 32

It was observed that in hypertension hearing is severely damaged. By analysis of the otological symptomatology in 50 hypertonic patients (42 women, 8 men) a bilateral hearing disorder was revealed in 47 subjects, a unilateral one in three subjects, otoscopy revealed dilatation of the artery supplying the handle of the malleus or even hyperaemia of Schrapnell's membrane. The patients reported low-frequency tinnitus, vertigo, pressure in the ears pain in the ears, headache, weather-dependence of complaints. In the initial stages roof-shaped type of audiometric curve was found, in the group were 45% mixed types of deafness. If during hypertension sodium is retained and the extracellular volume is enlarged, then in the inner ear the volume of perilymph increases in particular and this leads to impaired conduction through the inner ear fluids with affection of high and low frequencies, disorders of the conduction function of the fenestrae with the conduction component on the audiogram. Hypertension is for the organ of hearing an important risk factor in pre-disposed subjects with and affection of the inner ear is equally malignant and has a similar pathological background as glaucoma.
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PMID:[The cochleovestibular syndrome in hypertension]. 235 Aug 10

Seven patients (five boys, two girls) with video-game epilepsy (VGE) are reported, which reflects the fact that these games have increased in popularity recently among Japanese children. Their ages at onset ranged from four to 13 years. The seizure phenomena were of three types: generalised tonic-clonic, partial seizure and headache. Interictal physical and neurological examinations were within normal limits. EEGs taken while they played video-games confirmed the diagnosis of VGE and revealed three triggers of seizures: flashing lights, special figure patterns and scene-changing. They were recommended to avoid playing video-games, but sodium valproate was effective if seizures persisted even after such avoidance.
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PMID:Electroclinical study of video-game epilepsy. 236 42

The pathophysiology and treatment of acute subarachnoid hemorrhage (SAH) are reviewed. SAH occurs when blood is released into the subarachnoid space, which surrounds the brain and spinal cord. Symptoms of SAH include severe headache, nausea, vomiting, neck pain, nuchal rigidity, and photophobia. The initial hemorrhage is fatal in 20-30% of patients. Complications of SAH include rebleeding, hydrocephalus, delayed cerebral ischemia associated with cerebral vasospasm, and seizures. The likelihood of rebleeding is increased by measures that rapidly lower intracranial pressure. The risk of developing hydrocephalus is associated with the volume of blood within the subarachnoid space and ventricular system. Cerebral vasospasm develops in 20-40% of patients, and up to 50% of affected patients die or suffer permanent neurological damage. Seizures occur in 5-15% of patients with SAH. Radiologic procedures form the foundation for the diagnosis of SAH. The most commonly used rating scale classifies the severity of SAH based on the clinical presentation of the patient. Surgery is the definitive treatment for the prevention of rebleeding. Hydrocephalus can only be treated surgically, most commonly by insertion of a drain. The only measures proved to be effective for treatment of delayed cerebral ischemia are volume expansion and the induction of hypertension. The calcium-channel blocker nimodipine was recently approved for treatment of arterial spasm in SAH. Intravenous nicardipine is also being studied for the same indication. These agents may improve clinical outcome substantially by limiting fixed neurological deficits. To prevent seizures, prophylactic antiepileptic therapy with phenytoin sodium is generally accepted. The SAH complications of rebleeding, hydrocephalus, delayed cerebral ischemia, and seizures are managed by surgical, drug, and fluid therapy.
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PMID:Pathophysiology and treatment of subarachnoid hemorrhage. 240 1

The dihydropyridine calcium antagonist nitrendipine offers a pathophysiologically based antihypertensive treatment with a potent dilation of resistance vessels, increased arterial compliance, and an acute natriuretic/diuretic response. Prolonged nitrendipine treatment in essential hypertension is not associated with stimulation of the sympathetic nervous and the renin-angiotensin systems or accumulation of sodium and water. The antihypertensive effectiveness is similar to that of diuretics and beta-blockers, and the responsiveness appears to be greater in elderly and black patients. During long-term (approximately 1 year) nitrendipine treatment in mild to moderate hypertension, the blood pressure reduction is well sustained in "short-term" nitrendipine responders. In patients with severe hypertension, nitrendipine has a potent antihypertensive effect in combination with beta-blockers and/or diuretics. In mild-moderate hypertension, a single daily dose (10-40 mg) may be sufficient, whereas two daily doses (20-80 mg/day) seem necessary in severe hypertension. Common side effects are headache, flush, and palpitations (approximately 20-30%), but these are generally mild and transient. Dizziness and malaise occur in approximately 5%, often later during treatment. Peripheral edema in 5-20% of the patients is generally mild but persistent. Nitrendipine has no adverse effects on glucose and lipid metabolism or on plasma levels of electrolytes and urate. The ultimate aim of antihypertensive treatment is to prevent cardiovascular complications. As for other calcium antagonists, no study on primary prevention of cardiovascular complications in hypertension has been published. With regard to regression of left ventricular hypertrophy accompanying essential hypertension, conflicting results have been found with nitrendipine.
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PMID:Review of long-term trials with nitrendipine. 246 50

The effect of prophylactic treatment with sodium valproate in cluster headache was investigated in an open pilot study. Fifteen cluster headache patients were studied of whom two suffered from chronic cluster headache and thirteen from the episodic type. The dose used was between 600 and 2000 mg per day in two divided doses. Eleven out of the fifteen patients (73.3%) reacted favorably to the treatment. Nine reported a complete disappearance of pain and two, a marked improvement. Sodium valproate appears to be an effective drug in the treatment of cluster headache. A double-blind controlled study is needed for further evaluation.
Cephalalgia 1989 Sep
PMID:Sodium valproate in the treatment of cluster headache: an open clinical trial. 250 61

A 71-year-old man had sudden vision loss associated with headache. A temporal artery biopsy revealed a typical picture of giant cell arteritis. Subsequent steroid therapy failed to restore sight. A later blood culture contained spirochetes compatible with Borrelia species, and a silver stain of the temporal artery biopsy specimen demonstrated a similar spirochete. Treatment with i.v. ceftriaxone sodium led to some limited return of sight. To our knowledge, this is the first case report of a spirochete compatible with Borrelia found in a temporal artery biopsy specimen.
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PMID:Temporal arteritis associated with Borrelia infection. A case report. 252 42

We performed an epidemiological study on the atrial natriuretic factor pattern in a young population. Subjects were recruited in the Ospedale Militare Principale of Rome among young men liable to conscription, whose hospitalization was due either to essential hypertension or to other pathologies (not influencing our study, such as headache etc.). The recruitment lead to the formation of three different groups: normotensives, normotensives with family history of hypertension (mother and/or father) and hypertensives. On the morning of the study (after 7 days of pharmacological wash-out, under a diet containing 120 mEq of Na+/die), blood samples were taken. Plasma atrial natriuretic factor, renin activity and aldosterone were assayed by RIA. Digoxin-like immunoreactive substance was assayed by a solid-phase radioimmunoassay, following the extraction of plasma. Serum creatinine, sodium, potassium and urinary sodium and potassium (24 h before the study) were assayed by standard methods. Urinary kallikrein was assayed by chromogenic substrate S-2266. So far, we have studied 60 subjects (26 hypertensives, 21 normotensives and 13 normotensives with family history) and we wish to discuss in this article the preliminary results concerning the atrial natriuretic factor and its relationship with renin activity, aldosterone and blood pressure. Our results show that the mean plasma levels of atrial natriuretic factor in the hypertensive group were higher, although not significantly, than those of the other two groups and that the normotensives with family history had slightly higher levels as compared to normotensives (Delta % = + 7.4).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Atrial natriuretic factor: an epidemiological study. Preliminary results]. 252 19


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