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headache diagnosis review

Jingyi Liu, David L Penn, Ethan Katznelson, Mina G Safain, Ian F Dunn, Edward R Laws
BACKGROUND: Sellar infections represent less than 1% of all sellar lesions and can be life-threatening. These infections occur de novo in up to 70% of patients, or can less commonly develop after surgical treatment of another primary lesion, such as a pituitary adenoma. CASE DESCRIPTION: We report a unique case of a 27 year-old woman with a recurrent pituitary adenoma treated with two prior transsphenoidal resections. She ultimately presented with hypopituitarism, followed by headaches, malaise, chills, and visual field and acuity deficits nine years after her second transsphenoidal resection...
August 13, 2018: World Neurosurgery
Bryan Lutman, Jamie Bloom, Brandon Nussenblatt, Victor Romo
PURPOSE OF REVIEW: This article discusses the etiology and management of post-craniotomy headache and pain. A review of available as well as investigatory treatment modalities is offered, followed by suggestions for optimal management of post-craniotomy headache. RECENT FINDINGS: There is a dearth of evidence-based practice regarding the differential diagnosis, natural history, and management of post-craniotomy headache. The etiology of post-craniotomy headache is typically multifactorial, with patients' medical history, type of craniotomy, and perioperative management all playing a role...
August 14, 2018: Current Pain and Headache Reports
Ana C Bradi, Lucian Sitwell, Clare Liddy, Amir Afkham, Erin Keely
Background: Access to neurology consultation is limited by high demand and urgency of the presentation. Champlain BASETM (Building Access to Specialists through eConsultation) (eConsult service) aims to increase access through direct communication between primary care providers (PCPs) and specialists. Rapid responses to PCP questions can guide management and sometimes relieve the need for a formal consultation. We reviewed which topics were frequently addressed, the types of questions asked, and the effect on primary care for the patient...
June 2018: Neurology. Clinical Practice
Jeffrey R Boris, Thomas Bernadzikowski
BACKGROUND: Postural orthostatic tachycardia syndrome encompasses multiple disabling symptoms that interfere with daily activities. Non-pharmacologic approaches can be insufficient and can require adjunctive medications to manage symptoms. Minimal data exist in the literature on medication outcomes in these patients. We reviewed our database for medication management outcomes.Materials and MethodsPatients aged 18 years and younger at initial diagnosis met the inclusion criteria. All prescribed patient medications were extracted from the electronic health record, excluding medications for unrelated symptoms or comorbid diseases...
August 6, 2018: Cardiology in the Young
Amaal Jilani Starling
PURPOSE OF REVIEW: Unusual headache disorders are less commonly discussed and may be misdiagnosed. These headache disorders frequently have a benign natural history; however, without reassurance, therapeutic education, and treatment, they can negatively affect the health and function of patients. RECENT FINDINGS: This article reviews the clinical features, diagnosis, workup, and proposed treatments for several unusual headache disorders including primary cough headache, primary headache associated with sexual activity, primary exercise headache, cold-stimulus headache, primary stabbing headache, nummular headache, hypnic headache, and headache attributed to travel in space...
August 2018: Continuum: Lifelong Learning in Neurology
Mark Burish
PURPOSE OF REVIEW: This article covers the clinical features, differential diagnosis, and management of the trigeminal autonomic cephalalgias (TACs). The TACs are composed of five diseases: cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA), and hemicrania continua. RECENT FINDINGS: New classifications for the TACs have two important updates; chronic cluster headache is now defined as remission periods lasting less than 3 months (formerly less than 1 month), and hemicrania continua is now classified as a TAC (formerly classified as other primary headache)...
August 2018: Continuum: Lifelong Learning in Neurology
Matthew S Robbins
PURPOSE OF REVIEW: Headache disorders are extraordinarily common and disproportionately impact women of childbearing age. This article reviews the importance of proper diagnosis, natural history, and management of headache disorders in pregnant and postpartum women. RECENT FINDINGS: Red flags for secondary headache specifically among pregnant women include elevated blood pressure and lack of a previous headache history, as well as a prolonged duration of the headache attack in those with a prior history of migraine...
August 2018: Continuum: Lifelong Learning in Neurology
Maria J Duarte, Elliott D Kozin, Miriam B Barshak, Katherine Reinshagen, Renata M Knoll, Kalil G Abdullah, D Bradley Welling, David H Jung
Objective: Otogenic brain abscesses are one of the most significant life-threatening complications of otologic infections. Given their low prevalence, otogenic brain abscesses require a high index of suspicion for diagnosis. In this systematic review, we aim to provide an analysis of otogenic brain abscesses and describe common clinical signs and symptoms, bacteriology, location, treatment options, morbidity, and mortality. Data Sources: PubMed, Cochrane CENTRAL database, Google Scholar, and Scopus...
June 2018: Laryngoscope Investigative Otolaryngology
Marcy Yonker
INTRODUCTION: Headaches are a common occurrence in childhood and adolescence. Most children presenting with a chief complaint of headache have a self-limited infectious disorder or primary headache syndrome that should not require extensive workup. PURPOSE OF REVIEW: Differentiating these conditions from other more serious causes of headache in children can sometimes be difficult. This article aims to provide information regarding "red flags" that should indicate a need for concern for disorders that require more urgent evaluation...
July 30, 2018: Current Neurology and Neuroscience Reports
Linxin Zhu, Bing Liu, Jingxiang Zhong
BACKGROUND: To report a case of a carotid-cavernous fistula (CCF) that occurred after a motor vehicle accident and review the uniqueness of this case and the main confusing points for the diagnosis of such cases. CASE PRESENTATION: A 22-year-old man complained of left eyelid swelling, eye redness, visual decrease and occasional headache after motor vehicle accident 4 months prior during which he experienced a head injury. He was initially thought to have glaucoma, but he was finally diagnosed with a right CCF based on magnetic resonance imaging (MRI) and digital subtraction angiography (DSA)...
July 25, 2018: BMC Ophthalmology
Yuan Hong, Yuanjian Fang, Qun Wu, Jianmin Zhang, Yongjie Wang
INTRODUCTION: Ganglioglioma is a generally benign tumor, mostly occurring in patients <30 years old. Temporal lobe is most frequently involved. Up to now, only 3 cases were reported of ganglioglioma in the pituitary gland, all being confined to the neurohypophysis. Here, we are the first to report an adenohypophysis ganglioglioma. CASE PRESENTATION: A 43-year-old woman presented with chronic headache was referred to our hospital. Magnetic resonance imaging (MRI) indicated pituitary adenoma...
July 2018: Medicine (Baltimore)
Dev Mehta, Megan C Leary, Hussam A Yacoub, Mohammed El-Hunjul, Hope Kincaid, Vitaliy Koss, Katrina Wachter, Don Malizia, Barry Glassman, John E Castaldo
BACKGROUND: Status migrainosus (SM) is defined as a debilitating migraine attack lasting more than 72 hours in patients previously known to suffer from migraine headache. Typically, these attacks fail to respond to over the counter and abortive medications. The sphenopalatine ganglion (SPG) plays a critical role in propagating both pain and the autonomic symptoms commonly associated with migraines. SPG block via transnasal lidocaine is moderately effective in reducing migraine symptoms, but this approach is often poorly tolerated and the results are inconsistent...
July 25, 2018: Headache
Dilek Cebeci, Ebru Arhan, Ercan Demir, Murat Uçar, Habibe Koç Uçar, Ayşe Serdaroğlu, Zeynep Öztürk
INTRODUCTION: Carotid artery dissections may occur in severe trauma such as motor vehicle accidents or may also develop due to minor trauma. We aimed to present a case with internal carotid artery dissection that referred to the pediatric neurology department due to speech impairment after minor shoulder trauma. CASE: A previously healthy 10-year-old male patient was admitted to the pediatric emergency clinic due to headache, vomiting and speech impairment. In his story, we learned that he had bumped shoulder to shoulder with his friend about 6 h ago...
July 21, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Carolin Beuker, Antje Schmidt, Daniel Strunk, Peter B Sporns, Heinz Wiendl, Sven G Meuth, Jens Minnerup
Primary angiitis of the central nervous system (PACNS) represents a rare inflammatory disease affecting the brain and spinal cord. Stroke, encephalopathy, headache and seizures are major clinical manifestations. The diagnosis of PACNS is based on the combination of clinical presentation, imaging findings (magnetic resonance imaging and angiography), brain biopsy, and laboratory and cerebral spinal fluid (CSF) values. PACNS can either be confirmed by magnetic resonance angiography (MRA)/conventional angiography or tissue biopsy showing the presence of typical histopathological patterns...
2018: Therapeutic Advances in Neurological Disorders
Masaki Nakamura, Satoshi Katagiri, Takaaki Hayashi, Mayumi Yoshioka, Tadashi Nakano
PURPOSE: To describe two cases of paracentral acute middle maculopathy (PAMM) that occurred unilaterally after endovascular coil embolization. METHODS: Medical records including ophthalmic examinations of two PAMM cases were retrospectively reviewed. RESULTS: The first case was a 64-year-old woman with hyperlipidemia and chronic sinusitis. The second case was a 49-year-old man with hypertension, hyperlipidemia, tension headache, and vertigo...
July 13, 2018: Retinal Cases & Brief Reports
Bill Zhou, Catherine Yim, Soni Chawla
Background . Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is a diagnosis of exclusion in the clinical scenario of increased intracranial pressure without an identifiable cause. This case report provides a brief review of current literature on IIH, important differential considerations to rule out prior to diagnosis, and relevant imaging findings of IIH. Case Presentation . An 18-year-old male presenting with headache and blurry vision was found to have signs of increased intracranial pressure on imaging without other abnormalities to explain the cause, suggesting IIH as a diagnosis...
2018: Global Pediatric Health
Jia Xu, Fu-Qing Zhang, Jian Pei, Jun Ji
BACKGROUND: Migraine without aura (MWoA), the most common type of migraine, has great impacts on quality of life for migraineurs. Acupuncture is used in the treatment and prevention of migraine for its analgesic effects. OBJECTIVE: The aim of this systematic review and meta-analysis is to systematically assess the therapeutic and preventive effect of acupuncture treatment and its safety for MWoA. SEARCH STRATEGY: Nine electronic databases (PubMed, MEDLINE, Cochrane Library, Lilacs, Embase, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data and Chinese Clinical Trial Registry (ChiCTR)) were systematically searched from their beginning through June 2017 using MeSH terms such as "acupuncture, acupuncture therapy, electro-acupuncture, ear acupuncture, acupuncture points, acupuncture analgesia," and "migraine disorders, cluster headache...
June 28, 2018: Journal of Integrative Medicine
Wenting Jia, Ryuta Saito, Masayuki Kanamori, Naoya Iwabuchi, Masaki Iwasaki, Teiji Tominaga
This report presents a case of stroke-like migraine attacks after radiation therapy (SMART) syndrome in a 31-year-old man in whom symptoms and radiological findings resolved with steroid pulsed therapy and reviews the literatures with special emphasis on the use of steroids against SMART syndrome. The patient had a past history of left temporal anaplastic astrocytoma and was treated with surgery followed by local 72 Gy radiation therapy and chemotherapy using Nimustine Hydrochloride. Four years after the surgery, he was suffering from subacute progressing symptoms of headache, right hemianopia, right hemiparesis and aphasia from 2 to 4 days before admission to our hospital...
September 2018: ENeurologicalSci
Mohammad-Amin Khajezadeh, Gholamreza Zamani, Bobak Moazzami, Zahra Nagahi, Mahdie Mousavi-Torshizi, Vahid Ziaee
Objective: Systemic lupus erythematosus (SLE) is a complex autoimmune disorder characterized by multisystem involvement, including the nervous system. In the present study, we aimed to assess neuropsychiatric manifestations in juvenile-onset systemic lupus erythematosus (JSLE) in Iran. Methods: One hundred and forty-six pediatric onset patients with SLE who had registered in our pediatric rheumatology database were evaluated prospectively and cross sectionally within 2013-2015...
2018: Neurology Research International
Randy S D'Amico, George Zanazzi, Peter Wu, Peter Canoll, Jeffrey N Bruce
INTRODUCTION: Pineal region glioblastomas (GBM) are very rare, with approximately 46 cases described in the literature. The epidemiology, pathogenesis, and treatment of these lesions are poorly characterized. METHODS: We identified all cases of pineal region GBM treated surgically at our institution between 1990 and 2017. Demographic and clinical follow-up data were extracted from the medical records for all cases. Pathology was reviewed and classified according to 2016 World Health Organization (WHO) criteria...
July 10, 2018: Journal of Neuro-oncology
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