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

The purpose of this study was to compare hearing and understanding with a bone conduction hearing aid of a new type and with conventional models. The new instrument, BAHA (bone anchored hearing aid) is connected with the skull percutaneously rather than transcutaneously as with the conventional instruments. In the ENT department of Nijmegen University Hospital the understanding of speech with both types of hearing aid was evaluated thoroughly. The patients had a middle-ear loss with in addition an inner-ear loss of 60 dBHL at most. A conventional air conduction hearing aid (behind or inside the ear) was unsuitable for them because of, for instance, chronic runny ears or anomalies of the auditory meatus. A conventional bone conduction hearing aid containing a transducer pressing on the skin was rejected because of poor understanding or serious side effects such as headache and pressure pains. At the first session a titanium screw was implanted in the skull behind the ear. The percutaneous superstructure was put into place a few months later at a second session. In none of the patients were there peroperative problems or postoperative infections of any importance. Understanding of speech in silence and in noise was evaluated with the BAHA and with the conventional aid. Differences in understanding of speech were regarded as significant if they amounted to more than twice the known intra-individual standard deviation. As to understanding of speech in silence, 7 of the 15 patients were found to understand significantly better with the BAHA than with a conventional aid. In the other patients no difference was found.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A hearing aid anchored in the cranial bone for amplification of bone conduction]. 202 52

Rigid fixation has been used over the past 20 years for the long-lasting correction of traumatic and congenital craniofacial defects. It has been noted that the use of plates and screws can result in the migration of the hardware through the skull to the inner cerebral cortex where it embeds in the dura. In addition, there is controversy concerning the safety of using titanium plates in the pediatric population. We report here on an 8-year-old boy who presented to our clinic with a chronic headache after rigid craniofacial fixation using titanium plates 7 years before.
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PMID:Chronic headache as a sequela of rigid fixation for craniosynostosis. 1200 Aug 98

Vascular closure staple clips made of titanium were originally developed for microvascular anastomosis. Clinical applications for these clips include arteriotomy closure for carotid endarterectomy, extracranial-intracranial bypass, and dural closure. This is the first report in which vascular closure staple clips have been used successfully for direct repair of a tear on the internal carotid artery (ICA). This report involves a 65-year-old man who presented with sudden onset of headache. Admission computerized tomography scans demonstrated a diffuse and thick subarachnoid hemorrhage in the basal cisterns. Cerebral angiograms demonstrated a broad-based, small bulge on the superomedial wall of the left ICA. Intraoperatively, an extremely thin-walled aneurysm was seen on the segment of the ICA at the C-2 vertebral level. The aneurysm ruptured abruptly, although no surgical manipulation was being performed on the aneurysm itself. After temporary clips were applied on the vessel, a large tear of the ICA was repaired with vascular closure staple clips. Reconstruction with the vascular closure staple clips required only a short period of temporary occlusion of the ICA. Postoperative angiograms revealed reduction of the aneurysm bulge and good patency of the ICA. The postoperative course was uneventful, and the patient has been free of symptoms. The vascular closure staple clipping procedure is useful for urgent repair of an aneurysm tear. This method is a new treatment option for these fragile aneurysms in cases in which other options, such as encircling clips or bypass procedures, may have drawbacks or be impossible.
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PMID:Direct repair of a blisterlike aneurysm on the internal carotid artery with vascular closure staple clips. Technical note. 1474 28

A 53-year-old woman presented with a rare case of cavernous hemangioma of the frontal bone manifesting as right frontal stabbing headache and local swelling. Computed tomography revealed an extensive, well-defined, radiolucent, osteolytic lesion in the right frontal bone. The inner and outer tables of the skull were eroded and the lesion had compressed the brain parenchyma. Right frontal craniotomy was performed, and the lesion with a 1 cm-wide margin of surrounding uninvolved bone was removed. The defect was reconstructed with titanium mesh. The patient did well after the operation. The cosmetic results were satisfactory and follow up at 6 months post-surgery revealed no recurrence.
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PMID:Large cavernous hemangioma of the frontal bone. 1591 68

Tension pneumocephalus is an unusual, potentially life-threatening complication of frontal fossa tumors. We present an uncommon case of a frontoethmoidal osteoma causing a tension pneumocephalus and neurological deterioration prompting a combined endonasal ethmoidectomy and bifrontal craniotomy with craniofacial approach for resection. A 68-year-old man presented with a 1-week history of worsening headache, slowness of speech, and increasing confusion. Standard computed tomography scan revealed a marked tension pneumocephalus with ventricular air and 1-cm midline shift to the right. Further studies showed a calcified left ethmoid mass and a left anterior cranial-base defect. A team composed of neurosurgery and otolaryngology performed a combined endonasal ethmoidectomy and bifrontal craniotomy with craniofacial approach to resect a large frontoethmoid bony tumor. No abscess or mucocele was identified. The skull base defect was repaired with the aid of a transnasal endoscopy, a titanium mesh, and a pedunculated pericranial flap. Postoperatively, the pneumocephalus and the patient's symptoms completely resolved. Pathology was consistent with a benign osteoma. This is an uncommon case of a frontoethmoidal osteoma associated with tension pneumocephalus. Recognition of this entity and timely diagnosis and treatment, consisting of an endonasal ethmoidectomy and a bifrontal craniotomy with craniofacial approach, may prevent potential life-threatening complications.
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PMID:Endonasal ethmoidectomy and bifrontal craniotomy with craniofacial approach for resection of frontoethmoidal osteoma causing tension pneumocephalus. 1859 21

We report a rare case of severe facial pain and headache due to cervical spondylosis successfully treated by surgical intervention. A 48-year-old woman had been suffering from severe left side facial pain and headache since she was 44 years old. Analgesics were not effective. At 48 years of age, a magnetic resonance imaging of the cervical spine revealed a degenerated disk at the C5/6 level with encroachment on the foramina and the cord. Anesthetic blockade to the C5/6 facet joint was effective, but was temporary. After the anterior decompression and stabilization using a titanium cage, the pain disappeared completely and has not recurred through 1 year of follow up. This report indicates that lower cervical root compression may cause cervicogenic headache, which can be treated effectively by surgical intervention.
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PMID:[Cervicogenic headache caused by lower cervical spondylosis]. 1943 99

Oral allergies are underdiagnosed by dental health professionals. Patients with an oral allergy complain of various symptoms such as burning or tingling sensations, with or without oral dryness or loss of taste, or of more general symptoms such as headache, dyspepsia, asthenia, arthralgia, myalgia. The signs of oral allergy include erythema, labial oedema or purpuric patches on the palate, oral ulcers, gingivitis, geographical tongue, angular cheilitis, perioral eczematous eruption, or lichenoid reactions localized on the oral mucosa. There is an increase in the prevalence of oral allergies to metals used in dental materials. Allergy to gold included in dental prosthesis has been well documented since the years eighties. Recently, titanium, used in orthopedic devices and oral implants, considered as an inert material, can induce toxicity or allergic type I or IV reactions. These reactions to titanium could be responsible for unexplained successive failure cases of dental implants in some patients (named "cluster patients"). The risk of an allergy to titanium is increased in patients who are allergic to other metals. In these patients, an evaluation of allergy is recommended, in order to exclude any problem with titanium medical devices. We stress the importance of a multidisciplinary approach to take into account patients with an oral allergy, with participation of specialists from dental and dermatologic fields.
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PMID:[Allergies to dental metals. Titanium: a new allergen]. 2038 51

The authors report the first case of extensive craniocervical pneumocranium causing mass effect, without any associated extradural pneumatocele. The patient presented with frontal headaches and unusual sensations in his left ear. He was found to have large pneumocranium involving his left frontal, temporal, parietal, and occipital bones as well as the atlas. He underwent a craniectomy with replacement of the pneumatized bone with titanium mesh, and mastoidectomy with obliteration of the mastoid air cells. This case is discussed in the context of the literature to date. A review of the literature shows that trauma is not a common cause of pneumocranium, with most cases occurring spontaneously. The authors believe that a combined neurosurgical-otological approach is beneficial in such cases.
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PMID:Extensive craniocervical pneumocranium. 2093 96

A 73-year old man presented with a lesion inferior to his left medial canthus with discharge and headache. Fifteen years previously, the patient had undergone reduction of an orbital fracture and reconstruction of the orbit with silicone. An orbitocutaneous fistula was found to originate from the implant which was displaced in the ethmoid, obstructing frontal sinus outflow. Symptoms disappeared after explantation of the implant, reconstruction of the orbit with a titanium plate and frontal sinus surgery. Although the use of silicone in facial trauma has declined, complications have to be expected even years after implantation.
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PMID:[Orbitocutaneous fistula after orbital reconstruction]. 2273 79

The authors present a case that demonstrates the usefulness of anterior transarticular screw fixation in the treatment of instability due to rheumatoid arthritis. The surgical technique of this infrequently used procedure is presented. A 35-year-old female patient with medical history significant for rheumatoid arthritis complained of persistent headache and upper neck pain. Examination revealed a decreased range of cervical rotational motion. Magnetic resonance imaging of the cervical spine revealed anterior displacement of C1, destruction of the left lateral atlantoaxial articulation and bony erosion of the C2 vertebral body below the base of the odontoid. Dynamic radiographs showed increased C1-C2 mobility. The authors used a right anterolateral approach to the cervical spine to perform fixation of lateral atlantoaxial articulations by means of titanium cannulated compressive screws. On 4-month follow-up examination, successful C1-C2 stabilization was documented. Despite restriction of neck rotation, the patient reported satisfactory improvement and re-turned to work.
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PMID:Rheumatoid atlantoaxial instability treated by anterior transarticular C1-C2 fixation. Case report. 2382 28


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