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1.
Int J Neurosci ; 129(3): 245-251, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30238820

RESUMEN

OBJECTIVE: Multiple sclerosis (MS) is a demyelinating autoimmune disease of the central nervous system. T2W-hyperintense demyelinating lesions are detected in cranial magnetic resonance imaging (MRI). Developmental venous anomalies (DVAs) have frequently been detected in enhanced cranial MRI images, and are generally accepted as normal variants of venous development. The aim of the present study was to investigate whether there was an association between demyelinating diseases and venous anomalies. METHODS: One hundred five patients who were diagnosed as having MS in accordance with the McDonald diagnostic criteria, and 105 patients who were diagnosed as having vascular headache who had no lesions similar to MS were included in the present retrospective study. RESULTS: DVAs were detected in 31 of the study group and in 14 patients in the control group. A statistically significant higher rate of DVAs and abnormal signal increase in the neighboring tissue was detected in the study group (p = 0.004) (p = 0.006). The DVA was superficially localized in the RRMS, It was deeply located in RIS. CONCLUSION: Recent studies have emphasized the association of the central vein and the lesion severity of MS with the detection of the central collecting vein in MS lesions. In our study, DVAs, which are generally regarded as innocent developmental anomalies, and neighboring signal increase were found significantly higher in the MS group compared with the control group. The role of DVAs in the etiology of demyelinating lesions must be clarified through comprehensive future studies that use more advanced techniques.


Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central/complicaciones , Malformaciones Vasculares del Sistema Nervioso Central/patología , Venas Cerebrales/anomalías , Esclerosis Múltiple/etiología , Cefalalgias Vasculares/etiología , Adolescente , Adulto , Anciano , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/diagnóstico por imagen , Estudios Retrospectivos , Cefalalgias Vasculares/diagnóstico por imagen , Adulto Joven
2.
Headache ; 57(5): 737-745, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28217873

RESUMEN

BACKGROUND: Arteriovenous malformations (AVMs) can underlie many diverse neurological signs and symptoms. Headaches are a common presentation that can have a significant impact on quality of life. OBJECTIVE: The authors investigated Gamma Knife® stereotactic radiosurgery (SRS) outcomes in patients with AVMs and associated headaches. METHODS: This retrospective study analyzed 102 patients with AVMs who underwent SRS between 1995 and 2013. The patient's headache symptoms led to their AVM diagnosis or developed post hemorrhage of their AVM. Information regarding headache characteristics was obtained from the patient's medical records and at follow-up using a scripted clinical interview. The median imaging follow-up was 61.7 months and clinical follow-up was 89.7 months. The median treatment volume at SRS was 4.1 cm3 and the median marginal dose was 20 Gy. RESULTS: The actuarial AVM obliteration rate was 60% at 5 years and 78% at 10 years. Patients reported that their overall headache severity decreased by -43.6% and their headache frequency was reduced by -53.4%. Headache reduction was reported in 49.1% of patients at 1 year and 69.5% at 5 years. The median time until improvement was 6.5 months. After SRS, headache medication usage decreased in 29% of patients. Permanent adverse radiation effects after SRS occurred in 3% of patients. Until obliteration was complete, the annual risk of a hemorrhage after SRS was 0.4% per year. CONCLUSION: Although recall bias related to a retrospective analysis can impact outcomes, headache symptoms associated with AVMs may potentially be decreased or eliminated in a subset of patients treated with Gamma Knife radiosurgery.


Asunto(s)
Fístula Arteriovenosa/terapia , Malformaciones Arteriovenosas Intracraneales/terapia , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Radiocirugia/métodos , Cefalalgias Vasculares/terapia , Adolescente , Adulto , Anciano , Fístula Arteriovenosa/complicaciones , Fístula Arteriovenosa/diagnóstico por imagen , Femenino , Humanos , Malformaciones Arteriovenosas Intracraneales/complicaciones , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiocirugia/efectos adversos , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/etiología , Adulto Joven
3.
Br Med Bull ; 65: 223-34, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12697628

RESUMEN

Most idiopathic headache syndromes are still recognized as vascular headaches although the clinical picture points towards a central triggering cause. The early functional imaging work using PET shed light on the genesis of some syndromes, implying that the observed activation in migraine (brainstem) and in cluster headache (hypothalamic grey) is involved in the pain process in a permissive or triggering manner rather than simply as a response to first division nociception per se. Using the advanced method of voxel-based morphometry (VBM), it has been suggested that there is a correlation between the brain area activated particularly in acute cluster headache, the posterior hypothalamic grey matter, and some change in grey matter in the same region. Moreover, also in a PET study in cluster headache and experimental headache, a vasodilation of major basal vessels has been observed which is non-specific to the cause and most likely the effect of a trigemino-parasympathetic reflex. Taken together, functional neuroimaging in headache patients has revolutionised this area of study and provided unique insights into some of the commonest maladies in man, suggesting that migraine and cluster headache are primarily driven from the brain.


Asunto(s)
Encéfalo/fisiopatología , Trastornos de Cefalalgia/fisiopatología , Tomografía Computarizada de Emisión , Animales , Encéfalo/diagnóstico por imagen , Cefalalgia Histamínica/diagnóstico por imagen , Cefalalgia Histamínica/fisiopatología , Trastornos de Cefalalgia/diagnóstico por imagen , Humanos , Trastornos Migrañosos/diagnóstico por imagen , Trastornos Migrañosos/fisiopatología , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/fisiopatología
4.
Lik Sprava ; (7-8): 62-4, 1999.
Artículo en Ruso | MEDLINE | ID: mdl-10672692

RESUMEN

Overall twenty-four children aged 10 to 15 years suffering from headache were examined. Doppler sonography technique employed in the study of vessels of the brain and spine reveals a high level of anomalous vessels of the brain and spine in the absence of manifest hemodynamic disturbances in the arterial bed of the vertebral artery and in apparent changes in the venous system. Those patients with headache having been exposed to thiotriasoline treatment demonstrated a positive dynamics of indices for the venous circulation as evidenced by dopplerography.


Asunto(s)
Antioxidantes/uso terapéutico , Triazoles/uso terapéutico , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/tratamiento farmacológico , Adolescente , Arteria Basilar/diagnóstico por imagen , Arteria Basilar/efectos de los fármacos , Arteria Basilar/fisiopatología , Niño , Enfermedad Crónica , Hemodinámica/efectos de los fármacos , Humanos , Ultrasonografía Doppler en Color , Cefalalgias Vasculares/fisiopatología , Arteria Vertebral/anomalías , Arteria Vertebral/diagnóstico por imagen , Arteria Vertebral/efectos de los fármacos , Arteria Vertebral/fisiopatología
5.
Pediatrics ; 96(3 Pt 1): 413-6, 1995 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-7651770

RESUMEN

OBJECTIVE: To determine the value of performing computed tomography (CT) on magnetic resonance imaging (MRI) studies in children with chronic headaches. BACKGROUND: Headache is a common complaint in children. With the proliferation of brain imaging centers and the increasing patient demand for CT or MRI studies, brain imaging has become widely used to evaluate headaches. METHODS: A retrospective chart review was conducted of all children referred to the pediatric neurology clinic for evaluation of headaches over a 2-year period. Charts were reviewed for headache characteristics, clinical indications for performing CT and MRI studies, and imaging results. Particular attention was paid to evidence of brain tumors, vascular anomalies, or hydrocephalus. RESULTS: A total of 133 records were studied. Subjects ranged in age from 3 to 18 years. Most patients were diagnosed as having either vascular migrainous headaches (52%) or chronic tension headaches (21%). Other headache diagnoses were mixed tension-migraine, psychogenic, and post-traumatic. Headaches were unclassified in 25 patients (19%). Seventy-eight patients (59%) had brain imaging: 45 had MRI, 27 had CT, and 6 patients had both. In most cases, brain imaging studies were performed in patients with atypical headache pattern, presence of neurologic abnormalities during the headache, general symptoms (ie, weight loss or fatigue), or because of parents' or doctors' concerns about brain tumors. Cerebral abnormalities were found on brain imaging in four patients, but none indicated the presence of a treatable disease and all were deemed unrelated to the presenting complaint. Our findings of no relevant abnormalities in a series of 78 brain imaging studies indicate that the maximal rate at which such abnormalities might appear in this population is 3.8%. CONCLUSIONS: These results indicate that brain imaging studies have very limited value in evaluating headaches in pediatric patients without clinical evidence of an underlying structural lesion.


Asunto(s)
Encéfalo/patología , Cefalea/diagnóstico por imagen , Cefalea/diagnóstico , Adolescente , Encéfalo/diagnóstico por imagen , Niño , Preescolar , Enfermedad Crónica , Femenino , Cefalea/etiología , Humanos , Imagen por Resonancia Magnética , Masculino , Estudios Retrospectivos , Cefalea de Tipo Tensional/diagnóstico , Cefalea de Tipo Tensional/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Cefalalgias Vasculares/diagnóstico , Cefalalgias Vasculares/diagnóstico por imagen
6.
J Emerg Med ; 12(6): 849-51, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-7884207

RESUMEN

We report the case of an 18-year-old male with a vascular-type headache occurring 3 days after a minor closed-head injury. The headache resolved completely, without recurrence, with a single dose of intravenous chlorpromazine. This case and the few others reported in the literature illustrate that the response of a headache to antimigraine therapy cannot be relied upon to diagnose or confirm a diagnosis of migraine headache, or to rule out other intracranial pathology.


Asunto(s)
Clorpromazina/uso terapéutico , Traumatismos Cerrados de la Cabeza/complicaciones , Cefalalgias Vasculares/tratamiento farmacológico , Adolescente , Clorpromazina/administración & dosificación , Humanos , Inyecciones Intravenosas , Masculino , Tomografía Computarizada por Rayos X , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/etiología
7.
Angiology ; 45(1): 1-6, 1994 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-8285379

RESUMEN

Eighteen consecutive patients with severe headache syndromes underwent noninvasive interrogation to explore the intracranial vascular involvement in their headaches. The authors used a colorflow duplex scanner with a 2.25 MHz, tightly curved, phased-array transducer to insonate and visualize the terminal segments of the vertebral arteries; the anterior, middle, and posterior cerebral circulations; and the basilar artery. Blood flow velocities and vessel caliber were obtained during a headache-free period and during a grade 8-10 headache in all patients. Comparisons of these data indicated that 14 of the 18 patients had demonstrable arterial changes associated with their headaches. Of these 14, 4 patients were found to have marked vasospasm of at least two of the arteries in the Circle of Willis and/or the vertebrobasilar system. The remaining 10 patients had headaches associated with intracerebral vasodilation. The authors conclude that color flow duplex ultrasonography of the intracerebral arteries is capable of determining the presence and mode of vascular headache development.


Asunto(s)
Cefalalgias Vasculares/diagnóstico por imagen , Adolescente , Adulto , Arterias Cerebrales/diagnóstico por imagen , Femenino , Humanos , Ataque Isquémico Transitorio/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Ultrasonografía
8.
J Neurosurg Sci ; 37(4): 251-5, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-7931651

RESUMEN

A case is reported of persistent primitive trigeminal artery associated with recurrent facial pain and noncomitant strabismus by partial ipsilateral oculomotor palsy. Transcranial Doppler disclosed indirectly persistent carotid-basilar anastomosis. CT and angiography allowed complete diagnosis excluding a posterior communicating artery aneurysm, a Tolosa-Hunt syndrome and an ophthalmoplegic migraine. Steroid therapy is recommended treatment. Surgery should be considered when symptoms are intractable to medical therapy.


Asunto(s)
Arterias Cerebrales/anomalías , Dolor Facial/etiología , Enfermedades del Nervio Oculomotor/etiología , Cefalalgias Vasculares/etiología , Adulto , Fístula Arterio-Arterial/diagnóstico por imagen , Arteria Basilar/anomalías , Arteria Carótida Interna/anomalías , Diagnóstico Diferencial , Dolor Facial/diagnóstico por imagen , Femenino , Humanos , Enfermedades del Nervio Oculomotor/diagnóstico por imagen , Radiografía , Cefalalgias Vasculares/diagnóstico por imagen
9.
Wiad Lek ; 45(7-8): 281-3, 1992 Apr.
Artículo en Polaco | MEDLINE | ID: mdl-1462589

RESUMEN

Sudden violent headache occurring for the first time in life suggests subarachnoid haemorrhage and requires diagnostic management. In 20 cases the authors failed to find blood in cerebrospinal fluid, but in 8 cases the protein level was raised. The patients were examined again after 2-10 years, and had control neurological examination and CT of the brain. In half the cases similar headaches returned after various time periods, and haemorrhage was again ruled out. In all patient chronic headaches of lower intensity developed. Control CT examination showed in 7 cases scars or atrophy of brain tissue. It is difficult to qualify such headaches as migraine and other known types of headache. Recently in the literature a new name has been coined for them--thunderclap headaches, and some authors regard them as a sign of minor intracranial haemorrhage. CT changes, raised protein level in cerebrospinal fluid, and the type of pain may suggest haemorrhage. The usefulness of cerebral arteriography in such patients should be considered. We propose the name of stoke headache for suggesting the cause and special management.


Asunto(s)
Encéfalo/irrigación sanguínea , Hemorragia Subaracnoidea/diagnóstico , Cefalalgias Vasculares/diagnóstico , Angiografía Cerebral , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Terminología como Asunto , Factores de Tiempo , Tomografía Computarizada por Rayos X , Cefalalgias Vasculares/clasificación , Cefalalgias Vasculares/diagnóstico por imagen
10.
Cephalalgia ; 9(4): 265-9, 1989 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-2611884

RESUMEN

A medical history of a 46-year-old male is reported. At 23 years of age, he started having diffuse pain in the left side of his head for up to 30 min once or twice a month. At 28, the pain changed into left-sided cluster headache-like attacks with 2-3 h duration and with ipsilateral conjunctival injection, lacrimation, and rhinnorhea, but with short-lasting free intervals of about two to three weeks. At 36, the pattern of the attacks corresponded to chronic migrainous neuralgia. At 40, the symptoms changed to painful ophthalmoplegia-picture. A left-sided parasellar meningioma was then diagnosed. Removal of the tumor caused complete amelioration. The case history is suggested to support the hypothesis that the cavernous sinus region is involved in cluster headache.


Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Seno Cavernoso/diagnóstico por imagen , Cefalalgia Histamínica/diagnóstico por imagen , Meningioma/diagnóstico por imagen , Cefalalgias Vasculares/diagnóstico por imagen , Adulto , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Oftalmoplejía/diagnóstico por imagen , Tomografía Computarizada por Rayos X
12.
Cephalalgia ; 7(3): 207-11, 1987 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-3652205

RESUMEN

Thirteen patients with cluster headache in an active stage were investigated with orbital phlebography. About 60% of the patients showed pathologic changes on the phlebograms, such as changes in the appearance of the superior ophthalmic vein. Five patients had pathologic changes on both sides and three patients on one side only. All patients with unilateral pathologic findings on orbital phlebography had the attacks on the same side. The phlebographic findings in these patients with cluster headache were very similar to those of patients with the Tolosa-Hunt syndrome. There is also some similarity in the symptoms in the two disorders. It has previously been suggested that the Tolosa-Hunt syndrome is caused by venous vasculitis, and the present findings to some extent support the idea that cluster headache may have the same etiology.


Asunto(s)
Cefalalgia Histamínica/diagnóstico por imagen , Ojo/diagnóstico por imagen , Cefalalgias Vasculares/diagnóstico por imagen , Adulto , Cefalalgia Histamínica/etiología , Ojo/irrigación sanguínea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Flebografía , Vasculitis/complicaciones
14.
Digitale Bilddiagn ; 6(1): 35-9, 1986 Mar.
Artículo en Alemán | MEDLINE | ID: mdl-3516526

RESUMEN

The transarterial digital subtraction angiography (DSA) examination of 4 patients studied for cerebral sinus venous thrombosis of the intracranial venous structures was reviewed to determine the reliability and adequacy of visualization of the venous drainage of the brain. In addition, 4 patients were specifically evaluated with DSA for venous sinus thrombosis of the intracranial veins and sinuses. Conditions studies included: Compression, or occlusion of the venous structures. Transarterial DSA is usually sufficient to replace conventional angiography in the evaluation of the cerebral sinus venous thrombosis (SVT).


Asunto(s)
Angiografía Cerebral/métodos , Trombosis de los Senos Intracraneales/diagnóstico por imagen , Técnica de Sustracción , Enfermedad Aguda , Adolescente , Adulto , Arterias Carótidas/diagnóstico por imagen , Femenino , Humanos , Masculino , Trombosis de los Senos Intracraneales/complicaciones , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/etiología
17.
Am Fam Physician ; 11(5): 105-11, 1975 May.
Artículo en Inglés | MEDLINE | ID: mdl-236645

RESUMEN

"Common" nonspecific headaches are the most frequent headaches in childhood and do not require a visit to the physician. Migraine is the most common of the headache syndromes with characteristic profiles, followed by the muscle contraction (tension), inflammatory and psychogenic types. Less frequent are mass or brain tumor headaches, malformation and hypertensive headaches. Migraine goes unrecognized more than the other common syndromes. Minor tranquilization may stop the pattern. The most important aspect of treatment for muscle contraction headache is recognition.


Asunto(s)
Cefalea , Ansiolíticos/uso terapéutico , Absceso Encefálico/complicaciones , Neoplasias Encefálicas/complicaciones , Hemorragia Cerebral/complicaciones , Niño , Femenino , Cefalea/clasificación , Cefalea/diagnóstico , Humanos , Hipertensión/complicaciones , Inflamación/complicaciones , Masculino , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/tratamiento farmacológico , Contracción Muscular , Neuralgia/etiología , Trastornos Psicofisiológicos/complicaciones , Radiografía , Enfermedades Vasculares/complicaciones , Cefalalgias Vasculares/diagnóstico por imagen , Cefalalgias Vasculares/cirugía
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