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

A case of hypertrophic cranial pachymeningitis was reported. A 58-year-old female presented the symptoms of headache and vomiting. At the age of 27, she had suffered from tuberculosis. Neurological examination on admission revealed bilateral papilledema, bilateral hearing disturbance, right hypoglossal nerve palsy, ataxic gait, and bilateral intentional tremor. CT scan showed dilatation of the lateral and third ventricles, and compression of the fourth ventricle with marked enhancement of cerebellar tentorium. A ventriculoperitoneal shunt was installed bringing about improvement in bilateral papilledema, ataxic gait, and bilateral intentional tremor. One month later, ataxic gait and bilateral intentional tremor recurred, and monoparesis of the left upper extremity developed. MRI demonstrated hypertrophic dura mater in the posterior fossa and compressed cervical spinal cord. Decompressive surgery was performed bringing about remarkable clinical improvement. The pathological specimen showed thickening of the dura mater with concentric layers of dense fibrous tissue infiltrated with plasma cells. A diagnosis of hypertrophic cranial pachymeningitis was established. Three years later, the clinical features were found unchanged, but contrast enhancement of cerebellar tentorium had progressed markedly. Hypertrophic pachymeningitis is a uncommon disease. But it should be noted that intracranial involvement is very rare. The etiology, symptomatology, neuroradiology, and treatment are discussed and the literature is reviewed.
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PMID:[A case of hypertrophic cranial pachymeningitis]. 203 16

The authors report a case of a patient with a pituitary tumor, in which pituitary apoplexy occurred only in the suprasellar part of the tumor. A 26-year-old woman suffered from abrupt worsening of vision and headache. A CT scan showed a dumb-bell-shaped tumor extending to the suprasellar region, in which an irregularly shaped low density area suggesting a liquidized hematoma was seen. The rapid worsening of her symptoms was highly indicative of pituitary apoplexy. The first operation was performed through the transsphenoidal route. There was no evidence of intratumoral hematoma in the intrasellar tumor, which could be removed successfully. However, the suprasellar mass could not be reached because of the hardness of the diaphragma sellae and the presence of a normal pituitary gland. MRI and CT cisternography after this first operation showed a narrow opening of the diaphragma sellae. The second operation using right frontotemporal craniotomy disclosed a suprasellar mass, which consisted of an old hematoma and a necrotic tumor. The tumor was sub-totally removed. The patient's visual acuity improved after the second operation. Although transsphenoidal surgery is the treatment of choice in patients with pituitary apoplexy, the selection of the surgical route should be made only after careful neuroradiological evaluation with regard to the extrasellar extension of the tumor.
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PMID:[Pituitary apoplexy with localized hematoma in the suprasellar region]. 203 17

Two rare cases of entirely suprasellar Rathke's cleft cyst were reported. Case 1. A 62-year-old man was admitted to our hospital on the 14th of January, 1988, complaining of headache and diplopia. A plain skull x-ray showed the sella turcica was normal. CT scan and MRI demonstrated a lesion mass located entirely in the suprasellar cistern. Right frontotemporal craniotomy was performed, and the cyst wall was resected subtotally. Microscopic sections of cyst wall showed ciliated single layer with focal stratified epithelium. Case 2. A 51-year-old man was hospitalized complaining of visual impairment in the left eye. Endocrinological examination showed no abnormalities. CT and MRI demonstrated a lesion mass located entirely in the suprasellar region. Right frontotemporal craniotomy was performed. The mass was opened and a large amount of yellowish fluid was released. Histologically, the specimens were simple ciliated cuboidal epithelium. Postoperative courses of these patients were uneventful. The findings on CT and MRI of the cases located entirely in the suprasellar region were varied. The histopathogenesis and embryological pathogenesis of Rathke's cleft cyst in the literature, particularly the entirely suprasellar type, were discussed.
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PMID:[Entirely suprasellar symptomatic Rathke's cleft cyst]. 203 19

A 55-year-old woman developed the sudden onset of headache and diplopia. The neurological findings showed the left 3rd and 4th cranial nerve palsies, loss of pain and temperature sensation in the region innervated by the ophthalmic nerve, and bruit on the left orbit. The mixed type of dural arteriovenous malformation (AVM) in the region of the cavernous sinus was diagnosed by MRI and cerebral angiography. The Matas procedure in which the patient was guided to compress the cervical carotid artery herself for 10 minutes three times a day was performed. Neurological signs and symptoms disappeared completely 3 months after starting the Matas procedure, and MRI revealed the regression of AVM. These results suggest that Matas procedure may promote its spontaneous regression of dural AVM occurred in the region of the cavernous sinus.
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PMID:[A case of dural arteriovenous malformation in the region of the cavernous sinus improved by Matas procedure]. 204 6

Hematomas of the basal ganglia in head injury have long been recognized by pathologists with an interest in head injury but their mechanism has not been revealed clearly. We report two cases of bilateral traumatic hemorrhage in the basal ganglia. Case #1, a 17-year-old male was admitted to our hospital immediately after a traffic accident. Neurological examination revealed that the patient was comatose and had right hemiparesis. CT scan showed bilateral hemorrhage of the basal ganglia and subarachnoid hemorrhage in the perimesencephalic cistern. MRI showed high signal intensity areas in the bilateral basal ganglia, perimesencephalic cistern, cerebral white matter and corpus callosum. The patient was diagnosed as having diffuse axonal injury coinciding with bilateral hemorrhage of the basal ganglia. Stereotactic aspiration for the hematoma of the left basal ganglia was carried out. Case #2, a 75-year-old male was admitted immediately after falling from the roof of his house. Neurological examination revealed no neurological deficit except for headache and nausea. CT scan on the day of injury revealed no abnormality. But CT scan 12 hours following the injury showed bilateral hemorrhage of the basal ganglia. Blood pressure of the patient was within normal range and he was diagnosed as having traumatic bilateral intracerebral hematoma. Conservative treatment was carried out and the patient was discharged 7 days after injury with no neurological deficit. The mechanism of traumatic hemorrhage of the basal ganglia has not been clear. In case #1, diffuse axonal injury (DAI) may have played an important role in the bilateral hemorrhage. But in case #2, non-DAI factor such as vasoparalysis syndrome may have existed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Bilateral traumatic hemorrhage in the basal ganglia: report of two cases]. 204 52

Two cases of headache during pregnancy were associated with MRI findings suggestive of venous sinus thrombosis. The findings, however, were atypical, and of uncertain clinical significance. Venous sinus thrombosis typically does not occur during the first and second trimesters (less than 10 percent of reported cases). Thus, these two cases are doubly unusual. The correct significance of these equivocal MRI findings of possible venous sinus thrombosis must be understood so that unnecessary and potentially harmful therapies are not employed, and so that appropriate management of what may otherwise be a typical vascular headache syndrome may be undertaken.
Headache 1991 Apr
PMID:Atypical MRI findings of venous sinus thrombosis in pregnancy: clinical significance relating to episodic vascular headache. 205 May 19

A rare case of the dural AVM mainly around the left petrosal sinus was reported. A 64 years old man was admitted just after the sudden onset of severe headache and nausea. The CT scan revealed subarachnoid hemorrhage in the left ambient cisterns. A small hematoma was also found in the left cerebellar peduncle. External carotid angiogram showed a dural AVM which nidus was located adjacent to the left superior petrosal sinus. Its feeding arteries were as follows; the middle meningeal artery, the artery of foramen rotundum, the accessory meningeal artery, the dural branch of occipital artery and the ascending pharyngeal artery. The voluminous petrosal vein and the dilated cortical veins were identified as drainers and, the portion of the latter appeared as "varix" embedded in the pons, which was clearly delineated by MRI. In the venous phase, stenotic straight sinus and residual Falcine sinus were illustrated. Superselective embolization of the feeding arteries was employed followed by the direct clippings of draining vein. Postoperative course was uneventful. The present case should be classified into the tentorial dural AVM. Only 26 cases of this rarely encountered entity was reported in the literature. Based on both the present and the previously reported cases, the clinical features, treatment and pathogenesis of this disease were briefly discussed.
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PMID:[Superior petrosal sinus dural arteriovenous malformation with varix indenting brain stem--report of a case and review of the literature]. 205 25

A case of cystic intracranial metastatic amelanotic melanoma is presented. As far as we know, cyst formation in intracranial melanoma is rare, and only 15 cases of intracranial amelanotic melanoma have been reported until now. A 63-year-old man was admitted with headache and progressive visual disturbance. CT scan revealed a large low-density mass with ring-like enhancement in the left frontal lobe. Both T 1-and T 2-weighted MRI images revealed hyperintensity. A left frontotemporal craniotomy was performed. A yellowish mass was observed in the frontal lobe. The content of the cyst consisted of old hematoma, xanthochromic fluid and necrotic tissue, was evacuated and the cyst wall was totally resected. No abnormal pigmentation was noted in the cyst wall and surrounding brain tissue. The histological examination revealed amelanotic melanoma. Primary lesion was found on the left thigh later and resected. The patient died of further intracranial metastasis with repeated hemorrhage 5 months after the admission. Both CT and MRI findings of our case is atypical as an intracranial malignant melanoma. However, these are compatible with those of intracerebral hemorrhage in subacute stage. It is suggested that melanoma may make the diagnosis difficult when tumor hemorrhage modifies the images of CT or MRI.
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PMID:[A case of cystic metastatic intracranial amelanotic melanoma--analysis of findings in CT and MRI]. 207 46

Reported is the case of a patient who underwent surgical resection of a brain metastasis from a hepatocellular carcinoma. The 62-year-old male was admitted to hospital because of headaches and a left hemiparesis. Six years earlier he had undergone transcatheter arterial embolization for a hepatocellular carcinoma. Further, one year ago the lower lobe of his right lung had been resected because of a pulmonary metastasis from the same tumor. A neurological examination on admission revealed disorientation, dressing apraxia, and a left hemiparesis. A CT scan revealed two highly dense masses with peripheral low dense areas in the right temporoparietal region, which were heterogenously enhanced with a contrast medium. Right carotid angiogram showed tumor stains in the same region. Also, a magnetic resonance T1 weighted image showed highly intense masses, and a T2 weighted image showed low intensity masses with prominent brain edema. Thus, a right fronto-temporo-parietal craniotomy was performed, and the two masses were removed. Histological examination revealed hepatocellular carcinoma. The postoperative course was uneventful, and the left hemiparesis improved gradually, enabling the patient to walk without assistance. A brain metastasis from a hepatocellular carcinoma has been rarely reported in the literature since the survival period is very short due to rapid disease progression at the primary site, so that most reports have been based on postmortem examination. The MRI, CT, and the angiographic findings are included in this report.
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PMID:[A case of brain metastasis from hepatocellular carcinoma]. 217 72

A 12-year-old boy had a long history of headache since the age of 4 years. Numbness and weakness of the upper extremities and chest tightness, especially in the morning, were noted since 2 years ago. The headache became more severe and frequent and attacked even in sleep since one year ago. Arnold-Chiari type 1 malformation, cervical syringomyelia and mild hydrocephalus were demonstrated by MRI scan of the central nervous system. Headache and other symptoms disappeared immediately after surgical intervention. The formation of syringomyelia may be multifactorial, but Arnold-Chiari type 1 malformation and uneventful birth history play an important role in the underlying cause of this case. We presented this youngest case who had Arnold-Chiari type 1 malformation and onset of headache from the age of 4 years, discussed the pathogenesis of syringomyelia and reviewed the literature.
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PMID:Arnold-Chiari type 1 malformation and syringomyelia. 217 27


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