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

Between 1990 and 1992 six cases of subdural empyema were surgically treated at the Neurosurgical Division of Emergency Department of Cardarelli Hospital in Naples. Three cases were associated with paranasal sinusitis and three cases with otitis media. Headache and fever were the presenting symptoms in all cases; in only two cases they were associated with seizures and altered mental status. CT scans showed convexity low density collections in five cases and multilocalized pus collection in one; concurrent paranasal or mastoid infections were visualized as well. The organisms responsible for the subdural empyema were Peptococcus in four cases, Streptococcus and anaerobius in the other two cases. In five cases surgical treatment consists in pus drainage by selective burr hole and placement of a subdural small silicon tube for local antibiotic therapy. In one case with a loculated diffuse empyema, craniotomy was performed in order to provide a better access to all the localizations. In all cases drainage of the wound and intravenous antibiotic therapy were used. Paranasal sinus drainage or mastoidectomy performed by the otolaryngologist when a localized collection of pus was present, grave a quicker regression of symptoms. A full recover of the original neurological status was achieved in all cases; a 20 months mean followup confirms the results.
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PMID:Surgical treatment of subdural empyema: a critical review. 891 61

Medieval headache treatment is largely unknown. Medieval incantations against headache enumerate bodily organs to be protected. One 8th-century Latin hymn from Lake Constance using this device is addressed to St. Aid "mechprech", who has been identified as Aed Mac Bricc, Bishop of Killare, 6th century. This Irish Saint inspired unusual legends by some rather unorthodox activities: He abducted a young girl as hostage while his inheritance was withheld, but at the same time was seen surrounded by angels. He prayed for a nun who was pregnant and made the pregnancy vanish by a miracle, and he replaced the severed heads of maids, men and horses, creating a new spring as a by-product of this operation. Already at his birth his head had hit a stone, leaving a hole in the stone which collected rainwater that cured all ailments. In our own time, such "bullaun stones" are still believed to cure headache in Ireland. According to the legends collected by Plummer and Colgan, St. Aed Mac Bricc was well known for his power to cure headaches. He relieved St. Brigid's headache when she was suffering many miles away, but his most impressive cure was in convincing a headache sufferer that the patient's headache could actually be transferred own head. The headache hymn or incantation is intended to repeat Aed's unique miracle.
Cephalalgia 1996 Dec
PMID:A sixth-century Irish headache cure and its use in a south German monastery. 898 Aug 54

The authors report a case of so-called "infected subdural hematoma" as a complication of chronic subdural hematoma. The patient was a 55-year-old man who had sustained a small laceration of the forehead in a traffic accident on March 29, 1995. No fractures were detected on skull roentgenograms, and general and neurological examinations failed to reveal any abnormal findings. In early August 1995, the patient began to experience headaches, and on August 5 he developed a fever of 38 degrees C. On August 8 he suffered a left motor seizure and was admitted to our hospital. Laboratory studies revealed a peripheral leukocyte count of 10,800/mm3 and a C-reactive protein level of 18.1 mg/dl. Computed tomography scans showed a thick right fronto-parietal subdural low density mass and a thin left frontal subdural low density mass. An emergency operation was performed via a single right fronto-parietal burr hole. A chronic subdural hematoma containing slightly yellowish, bloody, purulent fluid was found beneath an outer membrane. The hematoma was irrigated with physiological saline containing antibiotics, and a drain was inserted into the subdural space. A subdural membrane was also present on the left but it contained no pus. Aggressive antibiotic therapy was performed, and the patient was discharged without any neurological deficit. Histologically the membrane was determined to be the outer membrane of a typical chronic subdural hematoma. Enterococcus faecalis, which has rarely been reported to cause infection of the central nervous system, was detected in a bacterial culture of the pus. Systemic investigation showed no evidence of otorhinologic or other focal infection. The above clinical findings suggested that hematogenous seeding of a chronic subdural hematoma had occurred in this patient. Subdural empyema arising from hematogenous seeding to a pre-existing subdural hematoma by an infection is very rare, but this type of complication must be kept in mind not only in the elderly, infants, and compromised hosts, but in patients without complications as well.
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PMID:[A case of infected subdural hematoma complicating chronic subdural hematoma in a healthy adult man]. 902 8

Arteriovenous fistula of the scalp secondary to punch autograft technique is a relatively uncommon occurrence, similar to traumatic scalp arteriovenous fistulas from other causes. A pulsatile subcutaneous mass with an associated thrill or bruit and symptoms including pain or headache is a common presentation. Angiography is required for full diagnostic evaluation. Angioarchitecture may appear complex, even with a single-hole fistula. Super-selective angiography and embolization facilitate surgery and provide essential information regarding angioarchitecture. Complete excision of the lesion is curative. Identification and resection of the draining vein is mandatory to ensure a complete resection. The lesion may extend across traditional anatomic planes. Ligation of proximal feeding arteries is inadequate and potentially harmful. Histopathology of the traumatic arteriovenous fistula may appear similar to that of an arteriovenous malformation. Acquired arteriovenous fistulas and congenital arteriovenous malformations are markedly similar in their ultimate histopathology, angioarchitecture, angiographic appearance, hemodynamics, and treatment requirements. They should be considered to represent a spectrum of the same disease state rather than discrete entities.
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PMID:Arteriovenous fistula of the scalp secondary to punch autograft hair transplantation: angioarchitecture, histopathology, and endovascular and surgical therapy. 920 82

Three children with intracerebral abscesses were treated endoscopically. Two of the treated abscesses were located in the left temporal lobe and one in the right parietal lobe. The presenting symptoms included headaches, seizures, hemiparesis and signs of infection. Burr hole craniotomy, insertion of a peelaway sheath, obtaining of a specimen, introduction of endoscope, and complete irrigation under view was performed. After this a draining catheter was positioned in the abscess. All three abscesses grew multiple organisms. The patients received longstanding intravenous treatment with antibiotics. The follow-up period in this group ranges between 5 and 32 months. The initial neurological deficits were relieved in all three patients. The follow-up MRI studies revealed minor residual changes without evidence of significant sequelae. Neuroendoscopic treatment of brain abscesses has additional advantages compared to stereotactic aspiration or more complete drainage and lavage.
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PMID:Endoscopic treatment of brain abscess in children. 935 89

Recently, endoscopic procedures have been recommended as the first surgical option for cerebral arachnoid cyst (AC). The author reports seven ACs treated endoscopically and discuss the role of endoscopic fenestration. The age of the patients ranged from two to 62 years. Three ACs were located in the posterior cranial fossa, two in the suprasellar area, one in the middle cranial fossa, and one in the convexity. All cases were examined by cine magnetic resonance (MR) flow study. The patient's symptoms included headache, vomiting, dizziness, problems in balance, visual disturbance, and seizure. The author performed a cysto-cisternostomy or cysto-ventriculostomy via a single burr hole. The follow-up periods ranged from six to 18 months. There was no mortality or morbidity except one case of intracisternal bleeding during endoscopic procedure. Symptoms were relieved in all seven patients. Follow-up imaging studies revealed a decrease in the size or disappearance of the cysts. The results support that the minimal fenestration procedure as possibly as preserving the internal environment is valuable for the management of ACs.
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PMID:The role of endoscopic fenestration procedures for cerebral arachnoid cysts. 1048 26

Dura-arachnoid puncture for spinal anesthesia is associated with several complications. Postdural puncture headache (PDPH) and needle bending are significant among these. The incidence of PDPH has been reduced significantly with the advent of pencil-point needles. However, these needles also have their limitations, such as obstruction of the delivery port by tissues affecting both cerebrospinal fluid flash back and drug delivery. Increasing the size of the lateral hole has led to mechanical complications, such as tip bending. A new spreading beveled spinal needle tip has been designed to overcome the disadvantages of all the currently used spinal needles. To assess the feasibility, a 26-gauge Quincke spinal needle (B. Braun, Melsungen, Germany) has been modified manually. The new tip-holed design seems to be sound both from theoretical and practical point of view. Searching Medline Plus through their Internet Web site (www.nlm.nih.com) did not reveal the existence of any such spinal needle.
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PMID:Tip-holed spinal needle: a new design concept. 1117 22

We reported a fourteen years old male with subdural empyema followed by consecutive magnetic resonance imaging (MRI) examination. He was admitted to our hospital, complaining incomplete paresis of the left upper extremities, headache and high fever. The first MRI T2-weighted image at admission revealed an abnormal high intensity in the right frontal subdural space, indicating an abscess. Antibiotics therapy and a burr hole operation were effective and he made a remarkable recovery. One month later, the third MRI T2-weighted image showed an abnormal high intensity in the deep white matter of the right frontal lobe, which had not been detected in the subsequent MRI after the operation. On the other hand, the meningeal enhancement on the second Gd-DTPA enhanced MRI was more thickened than the previous meningeal enhancement. This abnormal high intensity on MRI had disappeared two month later, when the meningeal enhancement had grown thin. These data suggested the meningeal enhancement was relative to the transient high intensity which was considered to represent brain edema. We concluded that careful observation and serial MRI examination might be necessary in patient with subdural empyema even after disappearance of all symptoms.
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PMID:[A case of subdural empyema with transient cerebral white matter lesions]. 1114 73

The mechanism of the disappearance of arachnoid cysts is not fully understood. We report a case of arachnoid cyst which disappeared after head injury. A 28-year-old male was found to have an arachnoid cyst in the left middle fossa following head injury. We followed him up, because he had no symptoms. Two weeks later, he suffered from severe headache. CT image showed a dilatation of the subdural space, and his symptom deteriorated. We performed subdural-perifocal shunt, but one month after, he developed a subdural hematoma. The subdural hematoma was irrigated through a burr hole. His symptom disappeared post operatively. Two months later, CT image showed the disappearance of subdural hematoma and the arachnoid cyst. This case suggested one of the mechanisms involved in the disappearance of arachnoid cyst after head injury.
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PMID:[Middle fossa arachnoid cyst presenting an interesting clinical course: a case report]. 1132 95

A 20-year-old male presented fever, nausea and headache 1 week after eating uncooked liver. On admission, it was revealed he had suffered a closed head injury 3 months before without unconsciousness. On admission, computed tomography scan showed a left chronic subdural hematoma. Gd-DTPA magnetic resonance images revealed unusual enhancement of the capsule and linear enhancement of the subarachnoid space. The patient underwent burr hole irrigation and drainage. The culture of the hematoma content showed Campylobacter fetus. Therefore, the diagnose was infected subdural hematoma. A drainage operation and administration of antibiotics were effective. Our case suggests that enhanced magnetic resonance images are useful for diagnosis and follow-up of infected subdural hematoma.
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PMID:[A case of infected subdural hematoma due to Campyrobacter fetus]. 1132 97


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