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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Interhemispheric subdural empyema complicating sinusitis was diagnosed in two children by CAT scan. One of them presented with intracranial hypertension and paresis of one foot (syndrome of the falx cerebri). Antibiotic treatment alone without surgery (in one case with brief initial steroid therapy) brought rapid and complete clinical and radiological cure. A nonsurgical approach can now be considered in certain cases of intracranial local suppurations, given the possibility of earlier and more precise initial diagnosis and follow-up with CAT scan.
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PMID:Nonsurgical treatment of interhemispheric subdural empyemas. 54 Dec 20

The author analysed from the standpoint of familial history of headaches 89 cases of headaches treated at a neurological outpatient clinic in a period of 3 years. In 14 cases migraine was diagnosed, in 31 cases vasomotor headaches, in 16 post-traumatic headaches, in 7 psychogenic headaches, in 5 cases sinusitis, in 4 intracranial hypertension, in 12 cases the aetiology was unclear. In cases of vasomotor headaches in 90% of cases strong headaches were present in close relatives of the patients while in other groups the familial factor was infrequent.
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PMID:[Role of familial factor in vasomotor headache in children]. 60 Mar 46

Headache is an alarm symptom, whether there is an organic disease (lesional headache) or a perturbation of one of the various functions of the head (functional headache). Lesional headaches follow a sinusitis or an arthrosis, or accompany a "temporal arteritis of Horton". Functional headaches include several varieties. 1. Trigemellar neuralgia. 2. Vascular algia originating from the basal arteries, the large cerebral venous sinuses or the branches of the external carotid. Among these are: a) headaches due to a dilatation of the internal wall, causing "Horton headache", migrain-like psychosomatic migraine and hormonal migraines (premenstrual, menstrual, menopausal or linked to the use of contraceptive pills); b) headaches caused by an angiospasm of the arteriole, which is the case in exposure to the cold, in traumatic headaches (malfunction of temporomandibular articulation, dry alveolitis), in psychosomatic angiospastic algias and in ethmoidal artery algias previously described by the author in 1949 (Godin's disease). 3. Headaches due to psychic hypertension. 4. Postconcussional psychogenic headaches. 5. Neurotic headaches. The author gives a detailed description of the subjective symptoms in each case, including localisation, form, intensity, duration course and associated phenomenons. This facilitates greatly the differential diagnosis and the choice of complementary examinations. Necessary biological investigations should be performed (e.g. hormonal balance). One should however avoid to increase the number of complementary examinations which would only delay treatment and would expose patients to somatisation. Furthermore, in each case drug treatment, periarterial infiltration technics of the temporal, internal frontal, facial, mastoid and occipital arteries are described. The necessity of questioning the patient at length and to listen to him to enable him to verbalise conscious conflicts is emphasized. A serious medicopsychological examination and a relaxation treatment to reduce anxiety and muscular tension are advised in some cases.
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PMID:[Headache]. 98 3

Headache is an alarm sympton, whether there is an organic disease (lesional headache) or a perturbation of one of the various functions of the head (functional headache). Lesional headaches follow a sinusitis or an arthrosis, or accompany a "temporal arteritis of Horton". Funstional headaches include several varieties. 1. Trigemellar neuralgia. 2.Vascular algi originating from the basal arteries, the large cerebral venous sinuses or the branches of the external carotid. Among these are: a) headaches due to a dilatation of the internal wall, causing "Horton headache", migraine-like psychosomatic migraine and hormonal migraines (premenstrual, menstrual, menopausal or linked to the use of contraceptive pills); b) headaches caused by an angiospasm of the arteriole, which is the case in exposure to the cold, in traumatic headaches (malfunction of temporomandibular articulation, dry alveolitis), in psychosomatic angiospastic algias and in ethmoidal artery algias preciously described by the author in 1949 (Godin's disease).3. Headaches due to psychic hypertension. 4. Postconcussional psychogenic headaches. 5. Neurotic headaches. The author gives a detailed description of the subjective symptoms in each case, including localisation, from, intensity, duration course and associated phenomenons. This facilitates greatly the differential diagnosis and the choice of complementary examinations. Necessary biological investigations should be performed (e.g. hormonal balance). One should however avoid to increase the number of complementary examination which would only delay treatement and would expose patients to somatisation. Furthermore, in each case drug treatment, periarterial infiltration technics of the temporal, internal frontal, facial, mastoid and occipital arteries are described. The necessity of questioning the patient at lenght and to listen to him to enable him to verbalise conscious conflicts is emphasized. A serious medicopsychlogical examination and a relaxation treatment to reduce anxiety and muscular tension are advised in some cases.
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PMID:[Headache]. 103 33

Experience in the management of 100 cases of acromegaly is described. Three quarters of these had been referred directly to the endocrine clinic at the Middlesex Hospital. The remainder were referred from the Royal Post-graduate Hospital because they were thought unsuitable for yttrium implantation. The patients were studied by clinical assessment of severity, by measurement of basal growth hormone levels on three separate mornings, and by a review of possible complications. Particular attention was paid to diabetes, hypertension, cardiomegaly, respiratory, vascular and skeletal changes as well as visual field defect. Aggressive treatment was recommended in 77 patients. It was not recommended in the remainder on account of age, intercurrent illness or the apparent mildness of the condition. Fifty-nine patients were treated by trans-sphenoidal hypophysectomy. In 46 of the 59 patients the mean basal growth hormone level has been reduced to 5 ng/ml or less. In 39 this followed operation, in five operation and subsequent X-ray therapy and in two operation and the continuing effect of previously implanted yttrium. Of these 46 patients in whom the growth hormone level has been reduced to normal, 26 do not show any deficiency of anterior pituitary trophic hormones, 13 have gonadotrophin defect (in eight of these it was present before the operation) and seven require full replacement therapy. One patient died at home six weeks after the operation from a pulmonary embolus. There was one case of CSF rhinorrhoea which stopped spontaneously and three of acute frontal sinusitis. Trans-sphenoidal hypophysectomy is shown to be an effective means of treating acromegaly. If the basal level of growth hormone is not reduced to normal by six weeks after operation, it is recommended that a course of X-ray therapy should be given. This does not apply if irradiation has been used before operation.
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PMID:The treatment of acromegaly with special reference to trans-sphenoidal hypophysectomy. 115 91

Some specific features of the course of rhinosinogenic brain abscesses (RBA) in adults and children were distinguished on the basis of analysis of the clinical data in 49 patients. RBA is encountered more frequently among adults and rarely among children, especially those of young age. In adults RBA are mostly consequent upon chronic frontitis or polysinusitis, while in children they occur after maxillary sinusitis, and in young children also after acute purulent processes in the nasal cavity. The contact route of infection of the cranial cavity and solitary abscesses are usually encountered in adults, and the hematogenous-metastatic route in children with the formation of solitary RBA and, in many cases, of multiple and multichamber abscesses. In children the abscesses grow to a large size. The hypertension syndrome is clearly defined in adults, while the hydrocephalus-hypertension syndrome comes to the forefront in children. The infectious-toxic symptoms are more marked in children. Focal neurologic symptomatology is manifested more markedly in adults and is less marked and labile in children.
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PMID:[The clinical picture and differential diagnosis of rhinosinogenic brain abscesses]. 133 11

Of 3632 consecutive admissions to the Wilmer Ophthalmological Institute between July 1, 1987 and June 30, 1989, 27 patients required transfer to a medical or surgical service (0.74%). The major reasons for transfer included acute or decompensated cardiac disease (26%), poorly controlled diabetes mellitus (19%), acute renal failure (11%), coagulopathy, stroke, and hypertension (7% each). Only one transfer was a direct result of an anesthesia complication. The highest rates of transfers were associated with orbital (4.3%), enucleation/evisceration (3.1%), and glaucoma (2.3%) surgeries, while vitreoretinal surgery had the lowest rate of transfer (0.3%). Most of the transfers of patients with orbital disease were for management of related problems such as sinusitis or increased intracranial pressure.
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PMID:Transfer from ophthalmology to another service is a marker of high risk medical events. 190 39

To contribute more comprehensive information about the characteristics of asthma, this article analyzed patients served by the University of Alabama at Birmingham Comprehensive Asthma Program. Their physicians rated one fifth of these patients as having "severe" asthma with the remainder about equally divided between "moderate" and "mild". One in two first received a diagnosis of asthma ten or more years previously. Common comorbidities were hypertension, obesity, rhinitis, bronchitis, sinusitis, and arthritis. One half had visited an emergency room or been hospitalized for asthma in the past year. Inhaled bronchodilators and continuous theophylline were the most commonly prescribed medications. Side effects, especially tachycardia and insomnia, were common and almost exclusively associated with theophylline or corticosteroid therapy. Spirometric assessment showed chronic airflow obstruction in those with more severe asthma. Prevalence of respiratory symptoms, intensity of medication regimen, incidence of side effects, and health care utilization increased as asthma severity increased.
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PMID:Characteristics and correlates of asthma in a university clinic population. 220 37

Epistaxis is a common emergency usually caused by local trauma to the nasal mucosa. Occasionally, it may result from systemic diseases such as atherosclerosis, hypertension, or coagulopathy. Anterior nosebleed often can be controlled with topical vasoconstriction and cautery. Intranasal packing may be necessary to tamponade bleeding vessels. Occlusion of the sinus ostia by anterior nasal packing may necessitate prophylactic use of antibiotics to prevent sinusitis. Posterior nosebleed requires nasopharyngeal packing. Patients must be closely monitored and given supplemental high-humidity oxygen. Persistent or recurrent nosebleed or failure of posterior nasopharyngeal packing to control bleeding indicates the need for otolaryngologic consultation and perhaps surgical intervention.
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PMID:How to stop a nosebleed. 233 22

With reference to three cases the main features of subdural empyema are recalled. These collected suppurations are often secondary to frontal or maxillary sinusitis due to a streptococcus. Clinical features are those of meningo-encephalitis but signs of cortical damage are more prevalent. Many cases of subdural empyema which would have been unrecognized by conventional procedures are now diagnosed by CT scan. CT scan has also improved monitoring; thus, two of the three patients could be given medical treatment alone. The authors believe that non-surgical treatment would ensure recovery in many cases of subdural empyema. Surgery should be restricted to patients with severe intracranial hypertension or persistence of a large mass after several weeks of antibiotic treatment. Non-surgical treatment may improve prognosis.
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PMID:[Intracranial subdural empyema. 3 cases]. 614 Jul 59


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