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headache pearls

Mesha Martinez, Paola Pergami, Jonathan Murnick, Monica S Pearl
Traumatic arteriovenous fistulas (AVFs) involving the middle meningeal artery (MMA) are uncommon lesions and rare in the pediatric population. An adolescent with headaches developed a bruit and a rhythmic "swooshing" noise in the left ear 9 weeks after a traumatic brain injury involving a left temporal bone fracture. An MRA of the brain demonstrated an enlarged left MMA and arterialized flow in the left middle meningeal vein (MMV), suggestive of an AVF. Cerebral angiography confirmed and characterized the left MMA-MMV fistula, which drained into the pterygoid plexus...
March 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Tomoya Shibahara, Masahiro Yasaka, Yoshiyuki Wakugawa, Koichiro Maeda, Takeshi Uwatoko, Takahiro Kuwashiro, Gregory Y H Lip, Yasushi Okada
BACKGROUND: Intracranial vertebral artery dissection (VAD) is a well-recognized cause of stroke in young and middle-aged individuals, especially in Asian populations. However, a long-term natural course remains unclear. We investigated the long-term time course of VAD using imaging findings to examine the rate and predisposing factors for improvement. METHODS: We registered 56 consecutive patients (40 males; mean age, 51.8 ± 10.7 years) with acute spontaneous VAD and retrospectively investigated neuroimaging and clinical course within 1 month and at 3 months ± 2 weeks, 6 months ± 2 weeks, and 12 months ± 2 weeks after onset to ascertain predisposing factors and time course for improvement...
2017: Cerebrovascular Diseases Extra
Michael J Ellis, Dean Cordingley, Richard Girardin, Lesley Ritchie, Janine Johnston
The evaluation and management of athletes presenting with clinical features of migraine headache with aura in the setting of sports-related head trauma is challenging. We present a case report of a 15-yr-old boy with a history of migraine with visual aura that developed acute visual disturbance and headache after a head injury during an ice hockey game. The patient underwent comprehensive assessment at a multidisciplinary concussion program, including neuro-ophthalmological examination, neurocognitive testing, and graded aerobic treadmill testing...
January 2017: Current Sports Medicine Reports
Keisuke Kadooka, Michihiro Tanaka, Kenji Shimada, Hiromu Hadeishi
A 36-year-old woman on chronic hemodialysis presented with sudden onset of headache and deterioration of consciousness. She was sent to our hospital on day 1, with subarachnoid hemorrhage. Cerebral angiography showed pearl and string sign on the left posterior communicating artery, which was consistent with a diagnosis of hemorrhage from a dissecting aneurysm of the left posterior communicating artery. She underwent parent artery occlusion via endovascular treatment on day 2. Although cone beam computed tomography before embolization showed a perforator from the lesion, there were no ischemic lesions on diffusion-weighted imaging after the procedure...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Fary Khan, Bhasker Amatya, Rodney Judson, Pearl Chung, Melinda Truesdale, Alaeldin Elmalik, Mary P Galea
OBJECTIVE: To examine factors impacting long-term functional and psychological outcomes in persons with moderate-severe traumatic brain injury. METHODS: A prospective cross-sectional study (n = 103) assessed the long-term (up to 5 years) impact of traumatic brain injury on participants' current activity and restriction in participation using validated questionnaires. RESULTS: Participants' median age was 49.5 years (interquartile range (IQR) 20...
April 28, 2016: Journal of Rehabilitation Medicine
Anna Pinto, Mustafa Sahin, Phillip L Pearl
Epilepsy is a major morbidity in Sturge Weber syndrome, a segmental vascular neurocutaneous disorder classically associated with facial angiomas, glaucoma, and leptomeningeal capillary-venous type vascular malformations. The extent of the latter correlates with neurological outcome. Post-zygotic mosaicism for the activating mutation p.R183Q of the GNAQ gene has been identified as the major cause.  GNAQ encodes for an alpha subunit of a heterotrimeric G protein critical to blood vessel development. The earlier the timing of the mutation in development, the more severe the involvement, e...
2016: F1000Research
Anil Nanda, Subhas Konar, Piyush Kalakoti, Tanmoy Maiti
Owing to a deep-seated location and intricate venous anatomy, pathologies of the posterior third ventricular region pose formidable challenges to the operating neurosurgeon. In this video, we present a case of an elderly Caucasian female with a rare histological variant of a pineal parenchymal mass who presented with gait disturbances and worsening retro-orbital headache. Radiological and clinco-histopathological correlates of this rare tumor pathology having intermediate differentiation are highlighted. Briefly outlined are surgical pearls and strategies to minimize complications, as the tumor is approached through the posterior interhemispheric corridor, to achieve a gross-total decompression...
January 2016: Neurosurgical Focus
Sherilee L Harper, Victoria L Edge, James Ford, M Kate Thomas, David Pearl, Jamal Shirley, Scott A McEwen
BACKGROUND: The incidence of self-reported acute gastrointestinal illness (AGI) in Rigolet, Nunatsiavut, and Iqaluit, Nunavut, is higher than reported elsewhere in Canada; as such, understanding AGI-related healthcare use is important for healthcare provision, public health practice and surveillance of AGI. OBJECTIVES: This study described symptoms, severity and duration of self-reported AGI in the general population and examined the incidence and factors associated with healthcare utilization for AGI in these 2 Inuit communities...
2015: International Journal of Circumpolar Health
Christophe Hézode, Tarik Asselah, K Rajender Reddy, Tarek Hassanein, Marina Berenguer, Katarzyna Fleischer-Stepniewska, Patrick Marcellin, Coleen Hall, Gretja Schnell, Tami Pilot-Matias, Niloufar Mobashery, Rebecca Redman, Regis A Vilchez, Stanislas Pol
BACKGROUND: Hepatitis C virus (HCV) genotype 4 accounts for about 13% of global HCV infections. Because interferon-containing treatments for genotype 4 infection have low efficacy and poor tolerability, an unmet need exists for effective all-oral regimens. We examined the efficacy and safety of an all-oral interferon-free regimen of ombitasvir, an NS5A inhibitor, and paritaprevir (ABT-450), an NS3/4A protease inhibitor dosed with ritonavir (ombitasvir plus paritaprevir plus ritonavir), given with or without ribavirin...
June 20, 2015: Lancet
James E Bates, Erika F Augustine
No abstract text is available yet for this article.
October 14, 2014: Neurology
Haneen Sadick, Michael Huber, Stephen W Perkins, Heather H Waters, Grant S Hamilton, Ashley G O'Reilly, Holger G Gassner
IMPORTANCE: Direct transcutaneous resection has been a widely accepted standard for the removal of benign forehead lesions. In recent years, the endoscopic approach has become more prevalent because of its noninvasiveness. To date, only a few studies with limited case numbers have reported on this technique. We report our findings from one of the largest cohorts of patients undergoing tumor resection of the forehead via the endoscopic approach. OBJECTIVES: To evaluate results of the endoscopic forehead approach for benign tumor excisions, to give a more nuanced insight into this procedure, and to discuss technical pearls and potential pitfalls from our experience...
September 2014: JAMA Facial Plastic Surgery
Yung-Chu Hsu, Sheng-Feng Sung
PURPOSE: Vertebral artery dissection (VAD) is an important and under-recognized etiology of stroke in young patients. No clinical symptoms or signs appear to be specific for VAD. This report describes a representative patient and reviews the headache pattern and imaging findings commonly noted in VAD to help with the early diagnosis of VAD. CASE REPORT: A 44-year-old female presented with severe right posterior neck pain and vertigo followed closely by thunderclap headache that was confirmed as right VAD (V4 segment) with delayed right dorsal medullary infarction two days later...
March 2014: Acta Neurologica Taiwanica
Peter Ferenci, David Bernstein, Jacob Lalezari, Daniel Cohen, Yan Luo, Curtis Cooper, Edward Tam, Rui T Marinho, Naoky Tsai, Anders Nyberg, Terry D Box, Ziad Younes, Pedram Enayati, Sinikka Green, Yaacov Baruch, Bal Raj Bhandari, Florin Alexandru Caruntu, Thomas Sepe, Vladimir Chulanov, Ewa Janczewska, Giuliano Rizzardini, Judit Gervain, Ramon Planas, Christophe Moreno, Tarek Hassanein, Wangang Xie, Martin King, Thomas Podsadecki, K Rajender Reddy
BACKGROUND: The interferon-free regimen of ABT-450 with ritonavir (ABT-450/r), ombitasvir, and dasabuvir with or without ribavirin has shown efficacy in inducing a sustained virologic response in a phase 2 study involving patients with hepatitis C virus (HCV) genotype 1 infection. We conducted two phase 3 trials to examine the efficacy and safety of this regimen in previously untreated patients with HCV genotype 1 infection and no cirrhosis. METHODS: We randomly assigned 419 patients with HCV genotype 1b infection (PEARL-III study) and 305 patients with genotype 1a infection (PEARL-IV study) to 12 weeks of ABT-450/r-ombitasvir (at a once-daily dose of 150 mg of ABT-450, 100 mg of ritonavir, and 25 mg of ombitasvir), dasabuvir (250 mg twice daily), and ribavirin administered according to body weight or to matching placebo for ribavirin...
May 22, 2014: New England Journal of Medicine
Inka Wiegratz, Susana Bassol, Edith Weisberg, Uwe Mellinger, Martin Merz
This Phase III, uncontrolled, open-label, multicenter study was conducted to investigate the contraceptive efficacy, bleeding pattern, and cycle control of a novel once-a-week contraceptive patch, delivering low-dose ethinyl estradiol (EE) and gestodene (GSD) at the same systemic exposure seen after oral administration of a combined oral contraceptive containing 0.02 mg EE/0.06 mg GSD. Participants were women aged 18 to 35 years, all of whom received the EE/GSD patch for 13 cycles each of 21 treatment days (one patch per week for 3 weeks) followed by a 7-day, patch-free interval...
December 2014: Reproductive Sciences
Venugopalan Y Vishnu, Gayathri Petluri, Vivek Gupta, Vivek Lal, Dheeraj Khurana, Manoj Kumar Goyal
BACKGROUND: Unilateral isolated abducens palsy can occur due to any lesion from pons to orbit. The precise localization is made through the associated neurological signs. Parkinson syndrome is a symptom complex of unilateral abducens palsy with ipsilateral postganglionic Horner syndrome localizing the lesion to posterior cavernous sinus. RESULTS: We describe here a 55 year old lady who presented with headache and diplopia for 3 months. On examination she had right lateral rectus palsy and postganglionic Horner syndrome...
January 15, 2014: Journal of the Neurological Sciences
Seong Son, Sang-Gu Lee, Cheol-Wan Park
Spinal subarachnoid hemorrhage (SAH) due to solitary spinal aneurysm is extremely rare. A 45-year-old female patient visited the emergency department with severe headache and back pain. Imaging studies showed cerebral SAH in parietal lobe and spinal SAH in thoracolumbar level. Spinal angiography revealed a small pearl and string-like aneurysm of the Adamkiewicz artery at the T12 level. One month after onset, her back pain aggravated, and follow-up imaging study showed arachnoiditis. Two months after onset, her symptoms improved, and follow-up imaging study showed resolution of SAH...
July 2013: Journal of Korean Neurosurgical Society
Jorge Arturo Santos-Franco, Cristóbal Vallejo-Moncada, Griselda Collado-Arce, Edgar Villalpando-Navarrete, M Sandoval-Balanzario
BACKGROUND: epidermoid neoplasm (EN) accounts for 1 % of whole intracranial neoplasms. Usually, it is found at the cerebello-pontine angle and the location in the fourth ventricle (FV) is rare. The aim was to report two cases of EN of the FV. CLINICAL CASES: case 1: a female 22 year old presented with an intense headache with a history of 3 months. At the hospital entry, symptoms and signs of high intracranial pressure were found. Tomography images showed hydrocephalus with high pressure in the FV...
July 2013: Revista Médica del Instituto Mexicano del Seguro Social
Phillip L Pearl, Robert McCarter, Colleen L McGavin, Yuezhou Yu, Fabian Sandoval, Stacey Trzcinski, Shireen M Atabaki, Tammy Tsuchida, John van den Anker, Jianping He, Pavel Klein
Posttraumatic seizures develop in up to 20% of children following severe traumatic brain injury (TBI). Children ages 6-17 years with one or more risk factors for the development of posttraumatic epilepsy, including presence of intracranial hemorrhage, depressed skull fracture, penetrating injury, or occurrence of posttraumatic seizure were recruited into this phase II study. Treatment subjects received levetiracetam 55 mg/kg/day, b.i.d., for 30 days, starting within 8 h postinjury. The recruitment goal was 20 treated patients...
September 2013: Epilepsia
Forhad Hossain Chowdhury, Mohammod Raziul Haque, Mainul Haque Sarker
OBJECTIVES: An intracranial epidermoid tumor is relatively a rare tumor, accounting for approximately 0.1% of all intracranial space occupying lesions. These are also known as pearly tumor due to their pearl like appearance. In this series, the localization of the tumor, presenting age and symptoms, imaging criteria for diagnosis, surgical management strategy with completeness of excision and overall outcome were studied prospectively. Here, we report our short experience of intracranial epidermoid as a whole...
January 2013: Asian Journal of Neurosurgery
Cenk Ayata
BACKGROUND: Spreading depression (SD) is the electrophysiological substrate of migraine aura and a potential trigger for headache. Since its discovery by Leão in 1944, SD has transformed from being viewed as an epiphenomenon into a therapeutic target relevant in the pathophysiology of migraine and brain injury. AIM: Despite decades of research, the underpinnings of SD are still poorly understood, hampering our efforts to selectively block its initiation and spread...
June 2013: Cephalalgia: An International Journal of Headache
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