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

This case series aims to highlight that although extremely rare, osteoma can arise from the middle turbinate. We discuss the condition and treatment options. We describe 2 cases of osteomas arising from the middle turbinate. One occurring in a 29-year-old gentleman who presented to the ENT clinic with left nasal obstruction, and the other in a 65-year-old lady admitted to hospital with headaches and hypotension. Both cases were further investigated with CT scan. Both patients were treated with endoscopic fusion navigation assisted excision. Due to the large size of the mass, the gentleman required the mass to be delivered after it was drilled through and requiring septal deflection and vomerine spur reduction. As for the lady, the mass also required drilling and a posterior septotomy to facilitate dissection and removal of the tumour. Both patients made good recoveries with resolution of symptoms. Although extremely rare, osteomas can arise from the middle turbinate causing symptoms such as headache, facial pain, nasal obstruction and visual problems. As they are slow growing, they can be of large size at presentation. Treatment usually involves surgical excision. Endoscopic excision is usually adequate and safe.
AME Case Rep 2019
PMID:Osteoma arising from the middle turbinate-a case series. 3123 18

We present a case of C1/C2 osteomyelitis secondary to malignant otitis externa complicated by atlantoaxial subluxation. This case is unique because surgical fixation of the spine was delayed, and despite clearance of the infection with antibiotics, the patient developed cervical myelopathy and required instrumented spinal fusion surgery. He presented with 1 month of fever, headache and worsening neck stiffness. An MRI of his cervical spine showed C1/C2 osteomyelitis with atlantoaxial subluxation. He was initially treated non-operatively with prolonged intravenous antibiotics and external immobilisation of his cervical spine. However, the first course of antibiotics failed, and he represented with a progression of his infection to the contralateral ear. He declined surgical intervention and completed a second course of antibiotics. Unfortunately, he eventually progressed to cervical myelopathy and subsequently underwent posterior C1 decompression with occipital to C4 instrumentation. There was no biochemical or bacterial culture evidence of infection at the time of the surgery. This case highlights the potential challenges in the management of cervical osteomyelitis-optimal duration of antibiotics is not supported by strong evidence and the clinician will therefore have to decide each treatment in the context of the patient. Spinal instability may still remain an issue after adequate treatment of the infection.
AME Case Rep 2020
PMID:C1/C2 osteomyelitis secondary to malignant otitis externa complicated by atlantoaxial subluxation-a case report and review of the literature. 3279 61

Atypical headaches are uncommon and require special consideration by a primary care physician. We report the case of a 37-year-old male, who presented to the family medicine practice with persistent headaches which subsided postprandial and was later hospitalized for stroke-like symptoms. The lumbar puncture (LP) suggested viral etiology; however, cerebrospinal fluid (CSF) yielded no evidence of a specific virus. The patient computed tomography (CT) was non-diagnostic and magnetic resonance imaging (MRI) confirmed no acute intracranial abnormalities. Electroencephalogram (EEG) showed no definite epileptiform discharges, electrographic seizures, or evidence of non-convulsive status epilepticus. He was started empirically on intravenous (IV) acyclovir 800 mg Q6 for 10 days, followed by another 10 days of oral valacyclovir 500 mg twice a day (BID) antivirals leading to a complete resolution of his symptoms and confirming the diagnosis as viral encephalitis. This case is unique in its presentation due to the postprandial resolution of the patient's headache with no evidence of a specific virus in the CSF. In primary care setting, headaches are often referred routinely to neurologist for further management. However, more insidious causes for a headache, such as viral infections, should not be ruled out; and if the symptoms are acute and severe, an immediate inpatient work-up with empiric treatment for the most probable etiology may be warranted, despite unequivocal exam and laboratory findings.
AME Case Rep 2020
PMID:The curious case of an atypical headache, a case report and review of literature. 3317