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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The medical records of 109 patients who presented to the emergency department during a five-year period with proven nontraumatic, spontaneous subarachnoid hemorrhage (SAH) were retrospectively reviewed. The clinical presentation, diagnostic modalities used, and accuracy of diagnosis by emergency physicians were analyzed. The most common historical features were headache (81 patients, or 74%), nausea or vomiting (85 patients, or 77%), and loss of consciousness (58 patients, or 53%). Nonexertional activities preceding SAH were more frequent than exertional events (57% vs 21%). Neurologic findings were present in 70 patients (64%) and consisted primarily of altered levels of consciousness. Thirty-eight patients (35%) had nuchal rigidity. Ninety-six emergency cranial computed tomography scans were performed, of which 91 were diagnostic for SAH (sensitivity, 95%). Lumbar puncture was performed on two patients with normal computed tomography scans and revealed bloody spinal fluid. The overall diagnostic accuracy by emergency physicians was 85%. The correct diagnosis was delayed in 16 patients (15%), the majority of whom had headaches and normal neurologic examinations. Atypical symptoms, the warning leak syndrome, and the need for prompt diagnosis and therapy are reviewed.
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PMID:Recognition of subarachnoid hemorrhage. 238 75

A case of the anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms was reported. A 20-year-old female suffered from sudden onset of dysphagia and throat pain. Three days later, she was admitted to our hospital, suffering from sudden onset of headache, nausea, vomiting and consciousness disturbance. On admission, consciousness disturbance, bilateral abducent nerve palsy, and left caudal cranial nerve palsy was observed. CT scan revealed a subarachnoid hemorrhage in the basal cisterns with the densest area in the left ambient cistern. Left vertebral angiogram revealed an aneurysm at the left anterior inferior cerebellar artery (AICA). On the third day after admission, operation was performed. The aneurysm was found near the jugular foramen, surrounded by thick clots. The dome was attached to the caudal cranial nerves, and the neck was located at the bending portion of AICA without branches. Neck ligation and clipping was performed. On the fortieth day after the operation, the patient was discharged from our hospital without neurological deficits. To our knowledge, aneurysm at the AICA is rare and only 33 cases have been reported. However, a case with a sudden onset of caudal cranial nerve symptoms, before evident symptoms due to subarachnoid hemorrhage, has never been reported previously.
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PMID:[Anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms]. 277 Sep 75

Increasing recognition of the importance of calcium in the pathogenesis of cardiovascular disease has stimulated research into the use of calcium channel blocking agents for treatment of a variety of cardiovascular diseases. The favorable efficacy and tolerability profiles of these agents make them attractive therapeutic modalities. Clinical applications of calcium channel blockers parallel their tissue selectivity. In contrast to verapamil and diltiazem, which are roughly equipotent in their actions on the heart and vascular smooth muscle, the dihydropyridine calcium channel blockers are a group of potent peripheral vasodilator agents that exert minimal electrophysiologic effects on cardiac nodal or conduction tissue. As the first dihydropyridine available for use in the United States, nifedipine controls angina and hypertension with minimal depression of cardiac function. Additional members of this group of calcium channel blockers have been studied for a variety of indications for which they may offer advantages over current therapy. Once or twice daily dosage possible with nitrendipine and nisoldipine offers a convenient administration schedule, which encourages patient compliance in long-term therapy of hypertension. The coronary vasodilating properties of nisoldipine have led to the investigation of this agent for use in angina. Selectivity for the cerebrovascular bed makes nimodipine potentially useful in the treatment of subarachnoid hemorrhage, migraine headache, dementia, and stroke. In general, the dihydropyridine calcium channel blockers are usually well tolerated, with headache, facial flushing, palpitations, edema, nausea, anorexia, and dizziness being the more common adverse effects.
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PMID:Differential effects of 1,4-dihydropyridine calcium channel blockers: therapeutic implications. 332 59

We describe a patient with established systemic lupus erythematosus (SLE) in whom an intracerebral hemorrhage developed secondary to a ruptured aneurysm of the lenticulostriate artery (LSA). A 24-year-old woman with a four-year history of SLE was admitted to the department of internal medicine of Iwate Medical University for the treatment of lupus nephritis in 1985. She suddenly complained of severe headache and nausea, and soon lost consciousness. The computed tomographic scan revealed intracerebral hemorrhage in the left front-temporal region and subarachnoid hemorrhage. Left common carotid angiography demonstrated a 3 X 3 mm aneurysm of the LSA and displacement of other LSAs and anterior cerebral artery. The incidence of intracerebral hemorrhage in SLE was about ten percent in the reported central nervous system SLE, and it seemed that the prognosis of SLE with intracerebral hemorrhage was poor. The mechanisms of the intracerebral hemorrhage and the aneurysmal formation in SLE seemed to be due to lupus angiitis, but without clinical, radiologic and pathologic correlation. In operation, a ruptured aneurysm without neck was found in LSA and extirpated. In the pathological study, there was transmural angiitis, which fibrinoid necrosis, elastic tissue disruption and infiltration of inflammatory cells were found. Inflammatory cells were chiefly lymphohistiocytic with some polymorphonuclear leukocytes. It seemed that pathologic studies confirmed transmural angiitis with secondary aneurysm formation.
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PMID:[A case of systemic lupus erythematosus associated with an aneurysm of the lenticulostriate artery]. 332 45

We report the findings in a patient in whom torsade de pointes atypical ventricular tachycardia occurred as a complication of subarachnoid hemorrhage. The patient was a 54-year-old female and she was admitted to our hospital to treat gastric ulcer on October 8, 1985. The electrocardiogram on admission showed mild left ventricular hypertrophy. She complained of severe headache and nausea in hospital on November 10 and she was transferred to our department. Her consciousness was clear. Computed tomography revealed a subarachnoid hemorrhage and left carotid angiogram showed a left middle cerebral artery aneurysm. Laboratory findings of blood and a chest roentgenogram were normal, but the electrocardiogram revealed a prominent prolongation of the QT interval and generalized giant negative T waves. The aneurysm was clipped on November 11, but a torsade de pointes atypical ventricular tachycardia occurred after clipping of the aneurysm during the surgery. Several anti-arrhythmic agents were not effective but phenytoin suppressed the arrhythmia. Postoperative course was almost uneventful. Since she had mild right hemiparesis, she continued the rehabilitation in our department. Five months later her electrocardiographic findings became normal. Prolongation of the QT interval and the giant negative T wave are typical electrocardiographic abnormalities in patients of subarachnoid hemorrhage, causing a predisposition to torsade de pointes ventricular tachycardia. The arrhythmia should be kept in mind as a complication in a viewpoint of the management of subarachnoid hemorrhage in the acute stage.
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PMID:[An electrocardiographic abnormality called torsade de pointes in a patient of subarachnoid hemorrhage]. 339 96

Fenestration of basilar artery is an uncommon vascular anomaly that is usually an incidental product on autopsy or angiography. None of the cases in the literature had clinical symptoms associated with this anomaly except for subarachnoid hemorrhage when accompanied with saccular aneurysm. We report a rare case of the basilar artery fenestration associated with clinical symptoms without any aneurysm. A 71-years-old male, who had been treated for labile hypertension and had had recurrent attacks of vertigo, nausea, sometimes diplopia or unsteady gait, for 5 years, was referred to our hospital on Sept. 13, 1985. One day prior to admission, he suddenly felt diplopia and vertigo and unsteady gait. His family noticed he was dysarthric. On admission, he was alert and normotensive. He complained of dysesthesia on the right half of the perioral region and his right fingers. A neurological examination showed a mild weakness and hyperactive deep tendon reflexes on his right leg. His motor coordination was almost normal, but he was unsteady when he stood on one foot with his eyes closed. Laboratory examinations were normal except for an elevated serum uric acid level. A chest x-ray film showed a sclerotic change of aorta and mild cardiomegaly. Left ventricular hypertrophy was observed on his ECG. His CT scans showed multiple lacunae and mild brain atrophy. On cerebral angiography, his basilar artery (BA) had a fenestration almost in its total length that divided the BA, like a duplication, into two components with a smaller diameter than normal.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of basilar artery fenestration with recurrent attacks of vertebrobasilar insufficiency]. 344 54

A 68-year-old male suffered from severe occipitalgia, nausea, and vomiting was admitted to our hospital. On admission, he complained only of headache and displayed no evidence of disturbed consciousness or neurological deficits. A computed tomographic (CT) scan revealed a subarachnoid hemorrhage in the basal subarachnoid cisterns, with the thickest, densest area in the bilateral ambient cisterns. Four-vessel angiograms disclosed no pathological findings. The patient was treated with bed rest and his blood pressure was maintained below 120 mmHg. Fortunately, no untoward events occurred during the period of bed rest, and a second vertebral angiogram was obtained 4 weeks after admission. At that time a vertebral artery aneurysm was discovered. At surgery a 3 X 3 X 3 mm aneurysm was found at the junction of the vertebral artery and a branch of the spinal artery. Small clots surrounding the aneurysm were removed. The aneurysm itself was easily clipped without destruction of the caudal cranial nerves and the patient recovered fully. The incidence of vertebral artery aneurysms is very small--about 5%. Moreover, to our knowledge an aneurysm on the proximal portion of the intracranial vertebral artery at the junction of the posterior-inferior cerebellar artery has never before been reported. On the other hand, our case might have been included among cases of subarachnoid hemorrhage of unknown etiology. The first cerebral angiogram revealed no aneurysm; it was found on the second set of angiograms. This case illustrates the importance of repeat angiography when the CT scan clearly shows a subarachnoid hemorrhage.
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PMID:[A case of aneurysm at the junction of the vertebral artery and a spinal arterial branch]. 374 95

A 53-year-old woman suffered from sudden onset of severe headache on February 28 in 1982. She was admitted to our hospital soon after onset. On admission, she had a severe headache and nausea, and her consciousness was drowsy. CT scan showed a marked subarachnoid hemorrhage with intracerebral and intraventricular hematoma, a separation of the lateral ventricles with enlargement of posterior horns, and deformity of anterior horn. By these findings, the patient was diagnosed as an agenesis of the corpus callosum with subarachnoid hemorrhage. Left carotid arteriogram revealed an azygos anterior cerebral artery and an aneurysm at the terminal portion of this artery. Surgery was performed on the 24 th day after subarachnoid hemorrhage. Operative finding revealed a little finger's head-sized tumor was situated over the right frontobasal artery. An azygos anterior cerebral artery aneurysm was clipped and tumor was removed. Pathological diagnosis of the tumor was a lipoma. Namely, she had an agenesis of the corpus callosum, an azygos anterior cerebral artery, an aneurysm and a lipoma. There are some reports in which an agenesis of the corpus callosum is accompanied with a lipoma and an azygos anterior cerebral artery is accompanied with an aneurysm. But a case of agenesis of the corpus callosum with an azygos anterior cerebral artery was rarely reported. So this rare case with these anomalies was reported and pathogenesis about the development of 4 anomalies was also discussed.
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PMID:[A case of agenesis of the corpus callosum accompanied by a ruptured azygos anterior cerebral artery aneurysm and lipoma--a case report]. 375 36

A case of intracranial traumatic aneurysms occurring after surgical treatment of a large cerebral aneurysm is reported. A 56-year-old man was admitted to our department with complaints of headache, nuchal pain and nausea. Left carotid angiography (Lt-CAG) revealed a large aneurysm, measuring 20 mm in maximum diameter, of the azygos anterior cerebral artery. Successful clipping operation was performed on day 17 of subarachnoid hemorrhage. Unfortunately, small cortical branches were pulled out during the procedure from the right pericallosal artery. The postoperative Lt-CAG showed formation of two other aneurysms. Second operation was done on day 28 after the first operation. These aneurysms were located at the previously injured sites on the right pericallosal artery. From the history sited above, we diagnosed them as traumatic aneurysms. The second operation resulted in successful obliteration of these two traumatic aneurysms. Literature review yielded 25 similar cases, and the authors discuss the etiologic factors of the traumatic aneurysm due to surgical procedure.
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PMID:[Traumatic aneurysm occurring after surgical procedure of large cerebral aneurysm]. 376 56

The author reports a case of systemic lupus erythematosus (SLE) with multiple intracranial aneurysms and subarachnoid hemorrhage. A 31-year-old woman was admitted to the department of internal medicine of Shizuoka General Hospital for the treatment of nephrotic syndrome due to systemic lupus erythematosus on 1984. She spend an uneventful life until April, 1985 when she suddenly complained of severe headache and nausea. The computed tomographic scan revealed subarachnoid hemorrhage and the cerebral angiography showed multiple intracranial aneurysms and stenotic lesion. A review of the literature was made to clarify the incidence, the pathological change, and the prognosis of systemic lupus erythematosus with subarachnoid hemorrhage. The incidence of subarachnoid hemorrhage in SLE was about two percent in the reported clinical cases. The mechanisms of the subarachnoid hemorrhage and the aneurysmal formation in SLE seemed to be due to angitic changes, which involved the vessels of the whole body systematically. The exact prognosis of SLE with subarachnoid hemorrhage is difficult to say, but it seems to be unfortunately poor due to multiplicity of the lesion and the difficulty of its treatment.
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PMID:[A case of systemic lupus erythematosus associated with multiple intracranial aneurysms]. 378 67


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