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

A 66-year-old woman complained of right-sided headache and was found to have progressive dysfunction of cranial nerves V and VIII through XII on the right side. At autopsy, there was a granulomatous pachymengitis involving the floor of the right middle and posterior cranial fossae due to Candida tropicalis infection. Inflammatory tissue compressed the clinically affected cranial nerves.
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PMID:Candida pachymeningitis with multiple cranial nerve pareses. 22 42

The records of 24 patients with cryptococcal meningitis, admitted to King Edward VIII Hospital in Durban, were reviewed. There were 21 adults and 3 children over periods of 10 and 18 years, respectively. Slightly more males were affected. The age distribution was fairly even. The common clinical presentations were headache, neck stiffness, mental changes, cranial nerve palsies and papilloedema. The diagnosis was proved by the presense of Cryptococcus neoformans in the cerebrospinal fluid (CSF) in 21 of the patients, and in pathological tissue in the remaining 3 patients. A significant percentage of patients presented with an initial polymorphonuclear leucocyte predominance in the CSF. The other CSF findings were elevated protein and low sugar levels. Tuberculosis was the common coexisting disease. We found the mortality rate of 58% to be very high and a significant number of patients died even after adequate treatment with amphotericin B either singly or in combination with 5-fluorocytosine.
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PMID:Cryptococcal meningitis: our experience in 24 black patients. 98 16

The authors report the case of an AIDS patient with rare neurologic manifestations: primary vasculitis of the central nervous system and VIII cranial nerve dysfunction. The authors make a review on the subject, and call special attention for the differential diagnosis. In fact, the patient, a 36 year old woman, with promiscuous life, presented with dizziness, gait ataxia, nausea, headache and hypoacusia. Seven days after the admission, she noted blurred vision in both eyes and soon she became blind. The physical examination showed bilateral optic neuritis and vestibulocochlear dysfunction, stiff neck and fever. No abnormalities were detected on CT scan. CSF showed 40 mononuclear cells/mm3, 79 mg/dl of proteins and normal glucose content. Microbiological research was negative. Serum anti-HIV test was positive. The hypothesis of primary CNS vasculitis was made, and pulse methylprednisolone therapy was introduced with good recovery of neurological syndrome except for persistent amaurosis.
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PMID:[Isolated vasculitis of the central nervous system and involvement of the 8th cranial nerve: rare manifestations of acquired immunodeficiency syndrome]. 130 67

A 59-year-old woman suffered from occipital headache and bilateral cranial nerve VII, VIII, IX, X, XI and right XII deficit after developing otitis media. Magnetic resonance imaging (MRI) showed a thickening of the dura mater which was enhanced by gadolinium-DTPA (Gd). Aspergillus flavus was identified from the culture of otorrhea. She was treated with miconazole, flucytosin and fluconazole, which resulted in an improvement of the clinical symptoms and a thinning of the Gd-enhanced lesions on MRI. This is the first case of hypertrophic cranial pachymeningitis caused by Asp. flavus infection.
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PMID:Hypertrophic cranial pachymeningitis due to Aspergillus flavus. 132 16

Researchers analyzed data on 47 black, pregnant women of more than 33 weeks gestation who had preeclampsia with diastolic blood pressure of at least 110 mm Hg and 1+ of proteinuria and were in the delivery department of King Edward VIII Hospital in Durban, South Africa to compare antihypertensive effects of dihydralazine infusion with that of epoprostenol sodium infusion. Overall, both treatments reduced the patient's systolic and diastolic blood pressures. No significant differences in the hypertensive effects existed between the 2 groups. Yet the reduction in blood pressures occurred much more quickly in the epoprostenol group than in the dihydralazine group (51.1 minutes vs. 86.8 minutes;p=.0072). Epoprostenol reduced high blood pressure in all 22 patients while dihydralazine did not adequately control blood pressure in 2 of 25 patients. Physicians had to perform a cesarean section in these 2 cases due to considerable deceleration of the fetal heart rate. They had to 1st administer the rapidly acting ganglion blocking agent, trimetaphan, before placing the women under general anesthesia. Their blood pressures returned to normal after delivery. Even though both groups experienced tachycardia after treatment, the pulse rate of dihydralazine patients was significantly higher than that of epoprostenol patients (102.68/minute vs. 88.36/minute; p=.0024). Only 2 women suffered from side effects. The epoprostenol patient experienced nausea and vomiting. The other patient received dihydralazine and experienced a severe headache. The researchers concluded that physicians should use epoprostenol in patients with severe hypertension and tachycardia and those who need acute control of severe hypertension on the operating table before endotracheal intubation (which tends to cause considerable increases in blood pressure) and administration of general anesthesia.
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PMID:A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy. 142 10

Thirty cases of congenital cholesteatomas of the cerebellopontine angle (CPA) treated over a period of 20 years are reviewed with regard to their clinical features, the pathophysiology of their symptoms, and their management. The predominant symptoms were related to cranial nerves VII and VIII and headaches. Signs and symptoms were divided into those caused by local involvement of the cholesteatoma, increased intracranial pressure, or both. Diagnostic procedures from invasive procedures such as ventriculography to more sophisticated noninvasive procedures including computed tomography and magnetic resonance imaging are discussed. The surgical management of 27 congenital cholesteatomas was accomplished via a posterior cranial fossa approach. Total excision of the cholesteatoma was the aim but was carried out in only five (18%) patients because of concern regarding the preservation of nearby neurovascular structures. Partial excision was possible in 22 (82%) patients. To minimize re-formation, the residual cholesteatoma was carefully cauterized with the aid of the operating microscope and bipolar diathermy without damaging surrounding neurovascular structures. Follow-up has ranged from 2 to 15 years, with four (13%) cases of re-formation.
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PMID:Congenital cholesteatomas of the cerebellopontine angle. 281 5

At a time when the acquired immunodeficiency syndrome as well as hepatitis and other blood-borne diseases are a threat to patients with bleeding disorders who need treatment with blood products, it is rewarding to realize that a number of these patients can be safely and effectively treated with their own desmopressin-stimulated F.VIII:C and vWF. Desmopressin is clinically useful for treatment of patients with moderate and mild hemophilia. The limits of the clinical indications are established by the nature of the bleeding episode, the resting factor level, the level that must be achieved, and the length of time the level must be maintained to manage any given bleeding episode. In von Willebrand disease, desmopressin can be used more extensively to raise F.VIII:C levels than in classic hemophilia, because fewer of the patients have the severe form of the disease that is unresponsive to desmopressin. Increases in the level of F.VIII:C of about four times the resting value can be expected both in hemophilia and von Willebrand disease, but it must be borne in mind that the range of individual responses is large. Even though it is not easy to correct the prolonged bleeding time, particularly in patients with dysfunctional vWF, this drawback is of clinical relevance only in a minority of cases. A role for the use of desmopressin in acquired diseases of primary hemostasis has been proposed more recently, and experience is more limited than in congenital bleeding disorders. Uremia is probably the most firmly established indication because it has been shown that the bleeding time is often dramatically shortened by desmopressin, and hemorrhages can be stopped or prevented before surgical procedures. The indications for use of the compound in liver cirrhosis and congenital and acquired platelet dysfunctions are promising but much less established from a clinical standpoint. The bulk of available clinical experience is based on intravenous administration. Intranasal and subcutaneous administration have been successfully attempted and might be more convenient in selected circumstances, such as home treatment and the stimulation of blood donors to provide more abundant supplies of F.VIII:C and vWF. However, the responses after intranasal administration are less predictable and consistent than after intravenous administration. Desmopressin has few troublesome side-effects. Mild facial flushing, a small increase in heart rate, and, more rarely, mild headache can occur transiently during infusion. Signs of hyponatremia or cerebral edema are extremely rare, providing that excessive fluid intake is avoided.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Desmopressin (DDAVP) for treatment of disorders of hemostasis. 310 87

The involvement of the central nervous system in acute leukemia was studied in 15 adult patient. 60% of the patients were up to 35 years of age and 12 of them (80%) were with acute lymphoblastic leukemia. In 12 of the patients the nervous system was affected in the acute course of the disease, in one female patients--in the course of induction treatment and in the remaining patients--after the induction treatment. The manifestations of neuroleukemia are predominantly meningoradicular irritation with headache--in 86.7% of the patients, diplopia, papilledema, dysarthria and palpebral ptosis with affection of the cranial nerves (III, IV, V, VI, VII, VIII, IX, XII). In 12 patients (87.5%) blast cells were found in the cerebrospinal fluid in numbers ranging from 70 up to 36,000/mm3. In 26.7% of the patients other extramedullary localizations of leukemia were found parallelly (testes, thyroid gland hypopharynx, muscles). The application of methotrexate intrathecally and radiation therapy of the cranium led to a remission in 43% of the patients. Favourable results with considerably prolonged survival can be achieved also in patients with many recurrences of the disease. The need of neuroleukemia prophylaxis is proved (it is obligatory for the patients with acute lymphatic leukemia and with some forms of acute myeloblastic leukemia).
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PMID:[Extramedullary localization of acute leukemia. I. The involvement of the central nervous system]. 316 77

A case of ruptured cerebral aneurysm with hemophilia B is reported, and discussion is made concerning the management of mild type hemophilia in surgical operations. A 41-year-old male came to our hospital with complaints of severe headache, vomiting, and transient consciousness disturbance. His dentist said the patient had a mild bleeding tendency when he was 30 years old, however no postoperative hemorrhage was repeated in appendectomy in his childhood. He also had had no episodes of spontaneous bleeding. CT scan on admission showed subarachnoid hemorrhage, and angiography revealed a ruptured aneurysm at the trifurcation of the left middle cerebral artery. His coagulation screening tests (bleeding time, clotting time, prothrombin time, and activated partial thromboplastin time) were normal. An aneurysmal neck clipping was carried out, and operators did not detect any bleeding tendency during the surgery. CT scan on the next day showed no remarkable finding. On the third postoperative day, right hemiparesis occurred. Left putaminal hemorrhage took place. His coagulation tests and FDP were also normal. The hematoma was partially evacuated. After the second operation his condition was good, and rehabilitation program started. On the 15th hospital day his consciousness deteriorated suddenly, and CT scan showed a massive epidural hematoma on the left. His prothrombin time elongated mildly, but other tests were normal. Coagulation factors VIII and IX were examined and the factor IX was 22.5% of control. He was thought to be a patient with mild type hemophilia B. Despite a third operation for hematoma removal he died on the 20th hospital day. Mild type hemophilia B does not bleed spontaneously.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Unusual postoperative hemorrhage in a patient with ruptured aneurysm and hemophilia B]. 321 Dec 77

Aneurysm of the vertebrobasilar system is not a rare lesion but constituting 5-10% of all intracranial aneurysms. Aneurysm at the peripheral part of the anterior inferior cerebellar artery (AICA), however, is rare and only 20 cases have been reported previously. In this report, two cases of aneurysm arising at the junction between the AICA and internal auditory artery and extending into the internal auditory meatus are reported. The first patient was a 51-year-old male who was admitted because of sudden onset of dizziness, rt. tinnitus and deafness. Left vertebral angiograms demonstrated an AVM in the rt. cerebellar hemisphere and two aneurysms on the feeding arteries, one on the superior cerebellar artery and the other on the meatal loop of the rt. AICA. Removal of the AVM and neck clipping of the aneurysms, which were found unruptured, were performed through the rt. suboccipital approach. The second patient was a 42-year-old female who was admitted because of sudden onset of severe headache and vomiting followed by rt. tinnitus, deafness and double vision. CT scan showed subarachnoid clot mainly located in the rt. cerebellopontine angle. Repeated vertebral angiograms revealed an aneurysm at the meatal loop of the rt. AICA. Complete neck clipping was carried out. The clinical features of the aneurysms of this location can be divided into three subgroups according to the characters of onset: sudden onset with subarachnoid hemorrhage, insidious onset of the VII th, VIII th, nerve palsies by the mass effect of the aneurysm, intermittent episodes of the VIII th nerve disfunction due to the insufficiency of the internal auditory artery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Aneurysm of the anterior inferior cerebellar artery at the internal auditory meatus: report of two cases]. 378 69


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