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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although cerebral angiography should be approached with caution in the diagnosis of inflammatory cerebro-vascular disease there are some characteristic angiographic findings which may be helpful for classification and differential diagnosis. The proximal cerebral arteries are favourably affected by basal meningitis and thrombangiitis obliterans with resulting stenoses and occlusions. Whereas those inflammations originating from neighbouring skull structures mostly involve the intracavernous parts of the carotid artery, the tuberculous and mycotic arteritis prefer the supraclinoid carotid siphon. Peripheral vascular changes are found in luetic endangiitis, necrotizing and toxic angiitis and in collagenoses. Simultaneous involvement of the temporal arteries is of great diagnostic importance demonstrating the systemic character of the inflammatory process; in Horton's arteritis it can be a pathognomonic finding. Infectious endocarditis, some mycoses and malaria may lead to embolic occlusion of cerebral vessels. Mycotic aneurysms mostly have a broad base or a fusiform shape and do not prefer the localizations of congenital aneurysms. Angiographically, abscesses, tuberculomas and viral encephalitis may result in circumscribed hypervascularized areas. The characteristic angiographic findings are exemplified and discussed on the basis of 8 cases of inflammatory cerebro-vascular disease (tuberculosis, pneumococcal and unspecific bacterial meningitis, syphilis, mycosis, Takayasu-syndrome, panarteritis nodosa, temporal arteritis).
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PMID:[Inflammatory cerebro-vascular disease: angiographic findings and distribution patterns (author's transl)]. 0 27

All patients who present with severe headaches merit careful medical and neurologic evaluation, and many require neuroimaging studies or lumbar puncture. To avoid missing the occasional seriously ill patient among the large number of patients with relatively benign headaches, physicians must maintain a high index of suspicion and a familiarity with the differential diagnosis. Patients with severe acute headaches must be evaluated for subarachnoid hemorrhage and bacterial meningitis. Temporal arteritis must be excluded in all older patients with recurrent headaches of recent onset. Trigeminal neuralgia and cluster headache usually do not signify serious underlying disease, but the severity of the pain mandates rapid diagnosis and institution of therapy. Migraines are extremely common and often mislabeled as tension or sinus headaches. All primary care physicians should be able to recognize the many faces of migraine and be familiar with symptomatic and prophylactic therapy. Difficult cases should be referred to a neurologist for ongoing care.
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PMID:Severe headaches. When to worry, what to do. 231 44

Uncommon headache syndromes can be classified into two broad categories: (1) urgent conditions, including subarachnoid hemorrhage, giant cell arteritis and bacterial meningitis, and (2) special syndromes, such as cluster headache, migraine with aura and headache caused by benign intracranial hypertension. In this article, uncommon headaches are differentiated from the common migraine and the tension headache, which fall into a third category. If a neurologic abnormality is detected during the physical examination, aggressive medical diagnostic intervention is required. Because of its cost, neuroimaging should be reserved for specific situations that herald life-threatening or acutely reversible conditions; it should not be used in the work-up of nonspecific headache. The diagnosis of common headaches can be simplified by considering tension and common migraine syndromes to exist at different points on a headache spectrum.
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PMID:Recognizing uncommon headache syndromes. 894 Sep 58