Better Health Through Research image
 Better Health Through Research image
      

Search Center...



SEARCH PARAMETERS
Search:
Journal: Author:
Years: through Show:  Display: 
 

  Page 1 of 100  
Imaging of : Cephalgia
Merck Online Lab
Diagnosis Therapy Rehabilitation < Imaging > Clinical Laboratory
Primary angioleiomyoma in the sellar region: a case report and literature review.
Author(s): Xu, Y; Jing, Y; Ma, S; Ma, F; Wang, Y; Ma, W; Li, Q
Journal: Clin Neuropathol 2010 Mar 20; Vol. 29, Issue 1; Page(s) 21-5
[Medline ID - 20040329]

OBJECTIVE: Angioleiomyoma (vascular leiomyomas, angiomyoma) is a rare, benign soft tissue tumor which consists of a mixture of well-differentiated smooth muscle cells and thick-walled vessels. Here we report a case of angioleiomyoma in the sellar region, which is the first case report of angioleiomyoma at this anatomical location. CLINICAL PRESENTATION: A 53-year-old man was admitted with a medical history of three months episodic headache and one month visual deterioration, both of which progressed gradually. The neurological examination showed nothing remarkable except a slightly decreased adrenocorticotrophic hormone (ACTH) level. Preoperative magnetic resonance imaging revealed a pituitary apoplexy. Gross total resection of the tumor was then performed. PATHOLOGICAL FINDINGS: Histological and immunohistochemical studies showed a typical microscopic appearance of an angioleiomyoma present in a rather uncommon place. The pertinent literature regarding the features of this tumor was reviewed and discussed. CONCLUSIONS: Intracranial angioleiomyoma is a benign soft tissue tumor with excellent prognosis. Early diagnosis of this tumor is difficult.

The primary headaches as a reflection of genetic darwinian adaptive behavioral responses.
Author(s): Montagna, P; Pierangeli, G; Cortelli, P
Journal: Headache 2010 Aug 19; Vol. 50, Issue 2; Page(s) 273-89
[Medline ID - 20039962]

OBJECTIVE: The objective of this study is to present a view of the primary headaches as genetically determined behavioral responses consistent with sickness behavior and defense reaction, respectively. BACKGROUND AND DESIGN: A review of the literature bearing on the behavioral, humoral, and functional imaging aspects of the primary headaches shows that migraine and cluster headache (CH) are pain conditions characterized by different behaviors during the attacks. Here it is postulated that the behavioral responses to migraine and CH are evolutionary conserved reactions consistent with sickness behavior and defense reaction. RESULTS: The sickness behavior observed during migraine attacks is a pan-mammalian adaptive response to internal and external stressors, characterized by withdrawal and motor quiescence, sympatho-inhibition and lethargy, in which visceral pain signals a homeostatic imbalance of the body and/or brain. In contrast, the defense reaction in CH consists of a fight-or-flight reaction, with motor restlessness and agitation, in which pain is exteroceptive in kind. CONCLUSION: These different behavioral responses are thus specific to different kinds of pain, distinguished by the behavioral significance of the pain (visceral pain in migraine vs exteroceptive pain in CH), and imply brain matrices involving different networks in the brainstem, hypothalamus, and forebrain regions that engender evolutionarily conserved adaptive genetic responses. Cytokines play an important role in their development. Predictions and limitations of the hypothesis are discussed together with implications for genetic studies on headaches.

How reliably can autoimmune hypophysitis be diagnosed without pituitary biopsy.
Author(s): Howlett, TA; Levy, MJ; Robertson, IJ
Journal: Clin Endocrinol (Oxf) 2009 Dec 31; Vol. 73, Issue 1; Page(s) 18-21
[Medline ID - 20039888]

Autoimmune hypophysitis is a rare chronic inflammatory condition of the pituitary gland which typically presents with hypopituitarism and a pituitary mass. Cases involving anterior pituitary alone (65%) are six times more common in women, typically presenting during pregnancy or postpartum (57%). Anterior and posterior pituitary involvement (25%) are twice as common in women, and neurohypophysis alone (10%) occurs equally in both sexes. It has a prevalence of around 5 per million, an annual incidence of 1 in 7 to 9 million and in our experience represents the known or suspected cause of 0.5% of cases of hypopituitarism, < 1% of pituitary masses and 2% of nonfunctioning macro lesions presenting to an endocrine clinic. However, 'missed' cases of autoimmune hypophysitis may be the aetiology of some other unexplained cases of hypopituitarism. Clinically, headache and visual disturbance are common. Anterior hypopituitarism shows a characteristic but atypical pattern of deficiency of ACTH followed by TSH, gonadotrophins and prolactin deficiency or hyperprolactinaemia. Eighteen percent of cases have evidence of another autoimmune condition. On magnetic resonance imaging (MRI), autoimmune hypophysitis is typically symmetrical and homogeneous with thickened but undisplaced stalk in contrast to typical findings with pituitary tumours. Ultimately, the histological diagnosis of autoimmune hypophysitis can only be confirmed by surgery but a presumptive diagnosis can often be made on the basis of a combination of context and clinical features, and pituitary biopsy is not always clinically necessary for effective clinical management of the patient.

[Clinical features of 337 patients with recurrent nasopharyngeal carcinoma]
Author(s): Li, JX; Lu, TX; Huang, Y; Han, F; Chen, CY; Xiao, WW
Journal: Ai Zheng 2009 Dec 30; Vol. 29, Issue 1; Page(s) 82-6
[Medline ID - 20038316]

BACKGROUND AND OBJECTIVE: At present, although appropriate radiotherapy and combined treatments are widely used for the patients with primary nasopharyngeal carcinoma (NPC), local or regional recurrence rates are still high. According to clinical performance, pathology, and diagnostic imaging of the patients with the first recurrence of NPC, this study analyzed the clinical features of recurrent NPC to provide a reference for tracking the rules of recurrence after the treatment of patients with NPC. METHODS: Clinical data of 337 patients diagnosed with recurrent NPC for the first time were collected. The diagnoses were based on pathology and/or imaging and the patients were treated at the Sun Yat-sen University Cancer Center between January 1999 and December 2004. Data used for statistical analysis included clinical performance during the patient visit, the extension of the invasion as shown on imaging, pathologic features, Epstein-Barr virus (EBV) serology, restaging, etc. RESULTS: Patients were staged according to the system developed by the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC) in 2002. Patients with diseases at stages I/II accounted for 25.2%, while those with stage III/IV accounted for 74.8%. The median interval of relapse was 25 months. Patients had local recurrence (69.4%), regional recurrence (4.5%), or both (26.1%). Epistaxis and headache were the most common symptoms. Abduct dysfunction and facial numbness induced by cranial nerve damage were the most common signs. The probability of invasion of structures adjacent to the nasopharynx, such as the oropharynx, the prestyloid space, and the carotid sheath area, was low in patients with recurrent NPC. By contrast, the probability of invasion of structures far from the nasopharynx, such as the base of the skull, the paranasal sinuses, cranial nerves, the cavernous sinus, the brain, the pterygopalatine fossa, the infratemporal fossa, the orbital apex, and the soft palate, was higher in recurrent NPC. CONCLUSIONS: The most common interval of relapse is about 2 years. The relapsed disease is usually more widespread and located deeper. Most recurrent NPC is advanced disease.

Postural tremor as a manifestation of spontaneous intracranial hypotension.
Author(s): Turgut, N; Unl; ü, E; Hamamcio; ğlu, MK; G; üldiken, B; Albayram, S
Journal: J Clin Neurosci 2010 Jun 9; Vol. 17, Issue 2; Page(s) 255-7
[Medline ID - 20036551]

Spontaneous intracranial hypotension (SIH) is a syndrome caused by low cerebrospinal fluid (CSF) pressure due to leakage of CSF. Clinically, orthostatic headache, neck pain, nausea, emesis, interscapular pain, diplopia, dizziness, changes in hearing, visual blurring and radicular upper extremity symptoms are most frequently observed. We describe a 57-year-old man with SIH who presented with postural tremor. CSF leakage was revealed by cranial MRI. Lumbar puncture identified low CSF pressure and intrathecal gadolinium enhanced MR cisternography showed diffuse CSF leakage in the thoracolumbar region. The patient underwent epidural blood patching, which resulted in complete resolution of postural tremor within 2 months.

Seeding metastases of a benign intraventricular meningioma along the surgical track.
Author(s): Mahore, A; Chagla, A; Goel, A
Journal: J Clin Neurosci 2010 Jun 9; Vol. 17, Issue 2; Page(s) 253-5
[Medline ID - 20036547]

Seeding metastases of a benign intraventricular meningioma along the surgical track is rare. We report a patient with a benign fibroblastic intraventricular meningioma that had spread along the path of previous surgery; the recurrences as well as the primary tumor were benign.

Cerebral venous sinus thrombosis in the emergency department: retrospective analysis of 17 cases and review of the literature.
Author(s): Fischer, C; Goldstein, J; Edlow, J
Journal: J Emerg Med 2010 May 21; Vol. 38, Issue 2; Page(s) 140-7
[Medline ID - 20031365]

BACKGROUND: Cerebral venous sinus thrombosis (CVST) is a rare but serious cause of neurologic impairment. Due to its relative rarity, there is limited research that describes the incidence and clinical features of CVST in the emergency department (ED). Objectives: To describe the demographic, clinical, and historical characteristics of patients with CVST who were initially seen in the ED. METHODS: This is a retrospective analysis of all patients presenting to three urban, tertiary care hospitals between January 2001 and December 2005 who were diagnosed with CVST. Patients were exclud ed if they were transferred from other hospitals, or admitted directly to the hospital without evaluation in the ED. We use one representative case to describe the presentation, evaluation, and treatment of CVST. RESULTS: Seventeen patients met the inclusion criteria. Patients had a mean age of 42 years. Presenting complaints included headache (70%), focal neurologic complaints (numbness, weakness, aphasia) (29%), seizure (24%), and head injury (12%). Ninety-four percent of patients had a focal neurologic finding in the ED. A likely contributing cause of thrombosis was identified in all but one patient. More than half of the patients had been evaluated in the ED in the previous 60 days. Two patients died, both as a result of their thrombosis and resulting cerebral infarctions and edema. Of the patients who survived, 80% had a good functional outcome. CONCLUSIONS: CVST is rare, but it can have significant associated morbidity and mortality. Whereas the clinical outcome and functional outcomes of treated patients can vary, prompt recognition of the disease is important.

Intracranial plasmacytoma with apoplectic presentation and spontaneous intracerebral hemorrhage: Case report and review of the literature.
Author(s): Crowley, RW; Sansur, CA; Sheehan, JP; Mandell, JW; Kassell, NF; Dumont, AS
Journal: Clin Neurol Neurosurg 2010 Apr 24; Vol. 112, Issue 2; Page(s) 172-5
[Medline ID - 20031303]

Involvement of the nervous system is not uncommon in patients with multiple myeloma, with polyneuropathy and myelopathy predominating. Intracranial involvement producing neurological symptoms, however, is distinctly uncommon. Massive intraparenchymal hemorrhage from a previously unrecognized intracranial plasmacytoma is exceedingly rare. The authors report the case of a 57-year-old male who presented with sudden onset of severe headache, rapid onset of right-sided weakness and deterioration in level of consciousness while at work. Two years earlier the patient had completed treatment for multiple myeloma and was considered to be in remission, with a recent bone marrow biopsy that was negative, and complete normalization of serum protein electrophoresis. Imaging studies revealed a massive intracerebral hemorrhage with the possibility of an underlying lesion, and the patient was taken for emergent hematoma evacuation and tumor resection. The patient made an excellent recovery and was treated with intracranial radiation. Even in patients with multiple myeloma without evidence of systemic disease following successful treatment, the possibility of unrecognized lesions lingers. The onset of new symptoms referable to potential intracranial pathology in this setting should prompt consideration of intracranial plasmacytoma in the differential diagnosis.

Delayed presentation following accidental inhalation of a pushpin.
Author(s): Bell, PR; Curran, P
Journal: Emerg Med J 2009 Dec 24; Vol. 27, Issue 1; Page(s) 72-3
[Medline ID - 20029018]

A previously fit and well 18-year-old woman presented to the accident and emergency department following referral by her general practitioner with a provisional diagnosis of appendicitis. The history obtained from the patient revealed the presence of a bitemporal headache with associated neck stiffness, photophobia and vomiting for approximately 1.5 weeks. The patient complained of abdominal pain localised to her right iliac fossa and anorexia for approximately 1 week. She also noted the presence of a cough productive of green sputum for 3 weeks. A chest radiograph was obtained which showed a large area of consolidation in the right lower lobe consistent with infection and a linear density in keeping with a metallic foreign body. Following review of the chest radiograph, the patient was interviewed further and recalled having inhaled a pushpin approximately 1 year before her presentation. Aspiration of foreign bodies is relatively common in children and is often associated with delayed diagnosis and high morbidity. To prevent delayed diagnosis, characteristic symptoms and clinical and radiological signs of foreign body aspiration should be checked in all suspected cases and a low index of suspicion for ordering additional imaging or using bronchoscopy for diagnostic purposes should be employed.

Phase II study of oral fingolimod (FTY720) in multiple sclerosis: 3-year results.
Author(s): Comi, G; O'Connor, P; Montalban, X; Antel, J; Radue, EW; Karlsson, G; Pohlmann, H; Aradhye, S; Kappos, L; Easton, JD; Kesselring, J; Weinshenker, BG; Laupacis, A; Zarbin, M; Calandra, T; Temkin, N; DiMarco, J; Hudson, LD; Kappos, L; Antel, J; Comi, G; Montalban, X; O'Connor, P; Radue, EW; Antel, J; Durcan, L; Bar Or, A; Duquette, P; Bernier, G; Freedman, M; MacLean, H; Costello, F; O'Connor, P; Gray, TA; Hohol, M; Devonshire, V; Oger, J; Hashimoto, S; S; ørensen, PS; Datta, P; Faber-Rod, JC; Frederiksen, J; Knudsen, S; Petrenaite, V; F; ärkkila, M; Harno, H; Halavaara, J; Elovaara, I; Kuusisto, H; Palmio, J; Airas, L; Kaasinen, V; Laaksonen, M; Vermersch, P; Pelletier, J; Feuillet, L; Suchet, L; Mauch, E; Gunser, C; Oberbeck, K; Rieckmann, P; Buttmann, M; Klein, M; Ghezzi, A; Zaffaroni, M; Baldini, S; Mancardi, G; Cioli, F; Capello, E; Comi, G; Rodegher, M; Radaelli, M; Pozzilli, C; Onesti, E; Romano, S; Czlonkowska, A; Litwin, T; Darda-Ledzion, L; Kwiecinski, H; Golebiowski, M; Podlecka, A; Cunha, L; Sousa, L; Matias, F; Pedrosa, R; Almeida, M; Pena, JE; de S; á, J; Ferreira, J; Rosa, M; Arbizu, T; Carmona, O; Casado, V; Montalban, X; Tintore, M; Pelayo, R; Arroyo, R; Bartolome, M; De las Heras, V; Casanova, B; Bosca, I; Fernandez, O; Leon, A; Romero, F; Izquierdo, G; Gamero, M; Garcia, JM; Kappos, L; Kuhle, J; Mehling, M; Achtnichts, L; Goebels, N; Skulina, C; Waskoenig, J; Bates, D; Nichols, P; Radue, EW; Bendfeldt, K; Karlsson, G; de Vera, A; Gruenbauer, W
Journal: Mult Scler 2010 Apr 23; Vol. 16, Issue 2; Page(s) 197-207
[Medline ID - 20028707]

In a 6-month, placebo-controlled trial, oral fingolimod (FTY720) 1.25 or 5.0 mg, once daily, significantly reduced MRI inflammatory activity and annualized relapse rate compared with placebo in patients with relapsing multiple sclerosis (MS). The objectives were to monitor the 36-month, interim efficacy and safety results of the ongoing extension of this study. In the extension (months 7-36), placebo-treated patients were re-randomized to either dose of fingolimod; fingolimod-treated patients continued at the same dose. During months 15-24, all patients receiving fingolimod 5.0 mg switched to 1.25 mg. Of the 250 patients who entered the extension study, 173 (69%) continued to month 36. Most patients were free from gadolinium-enhanced lesions (88-89%) or new T2 lesions (70-78%) at month 36. Patients receiving continuous fingolimod treatment had sustained low annualized relapse rates of 0.20-0.21, and 68-73% remained relapse-free at month 36. Over 36 months, nasopharyngitis (34%), headache (30%), fatigue (19%) and influenza (18%) were the most commonly reported adverse events. Pulmonary function remained stable and blood pres sure was stable after an initial increase (3-5 mmHg) during the first 6 months of fingolimod treatment; serious adverse events included infections and skin cancer. The low MRI and clinical disease activity at 6 months were maintained at 36 months with fingolimod, which was generally well tolerated by most patients. The efficacy and safety of oral fingolimod are being further evaluated in a large phase III MS study programme.
  Page 1 of 100  




 



Resource Center

 - Merck Manual

 - Lab Test On-Line

 - MeSH Search



Clinical Conditions

 - A/C Degeneration

 - Adolescent Low Back

 - Ankle Sprain

 - Ankylosing Spondylitis

 - Arthritides

 - Brachial Plexus Neuritis

 - Carpal Tunnel Syndrome

 - Headache/Cephalgia

 - Cervical Disc Degen

 - Cervical Sprain

 - Cervical Strain

 - Cervical Osteoarthritis

 - Cervical Radiculopathy

 - Cervical Spine Instability

 - Cervical Spondylosis

 - Cervical Torticollis

 - Chronic Low Back Pain

 - Chronic Pain

 - Disc Displacement

 - Facet Arthropathy

 - Facet Capsulitis

 - Failed Back

 - Fibromyalgia

 - Frozen Shoulder

 - Knee Sprain

 - Lateral Epicondylitis

 - Low Back Pain

 - Lumbar Disc Degen

 - Lumbar Stenosis

 - Metatarsalgia

 - Psoriatic Arthritis

 - Reactive Arthritis

 - Rheumatoid Arthritis

 - Rotator Cuff Syndrome

 - SI Dysfunction

 - Sciatica

 - Scoliosis

 - Shoulder Bursitis

 - Spondylolisthesis

 - Stroke

 - Tarsal Tunnel Syndrome

 - TMD

 - Tendinopathy

 - Thoracic Outlet Syn

 - Ulnar Nerve Entrapment

 - Whiplash Injuries

 - Wrist Sprain



Resources

 - Chiropractic Organizations

 - State Associations

 - Schools & Institutions

 - NIH Grants Feed

 - HRSA Grants Feed

 - Evidence-Based Resource

 - Journal Links


Bookmark and Share

|  Home  |


 Copyright © 2007 - | DCConsult.com | All Rights Reserved.


the primary url for this site ( "DCConsult" ) is http://DCConsult.com




Category : Topics




Support for DCConsult provided by :