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2.
BMJ Case Rep ; 17(2)2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38320821

RESUMO

We report the case of a middle-aged hypertensive woman presenting to the neurology department with short-lasting episodic headaches for 4 years. She was initially diagnosed and treated with cluster headaches for one year. Following this, she presented with right lower limb arterial claudication. Arterial Doppler of lower limbs showed thrombosis of the bilateral common femoral arteries. Further computed tomography (CT) angiogram of the lower limbs confirmed extensive arterial thrombosis in bilateral lower limbs. The CT angiogram incidentally detected a left adrenal lesion. She had elevated urinary vanillylmandelic Acid and 24-hour metanephrines suggesting the presence of a pheochromocytoma. She was initially medically managed and later underwent left open adrenalectomy. Histopathology examination of the sections proved pheochromocytoma. Postsurgery, the patient's symptoms improved remarkably. This case highlights the importance of diagnosing pheochromocytoma when you encounter a patient with refractory short-lasting headaches, hypertension and hypercoagulability.


Assuntos
Neoplasias das Glândulas Suprarrenais , Hipertensão , Feocromocitoma , Trombofilia , Trombose , Pessoa de Meia-Idade , Feminino , Humanos , Feocromocitoma/complicações , Feocromocitoma/diagnóstico , Feocromocitoma/cirurgia , Hipertensão/etiologia , Hipertensão/cirurgia , Neoplasias das Glândulas Suprarrenais/complicações , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/cirurgia , Adrenalectomia , Cefaleia/etiologia , Cefaleia/cirurgia , Trombofilia/complicações , Trombofilia/diagnóstico , Trombose/cirurgia
3.
Neurology ; 102(5): e209190, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38330283

RESUMO

A 54-year-old woman presented with headache and vasculopathy. She was treated for reversible cerebral vasoconstriction syndrome but continued to have clinicoradiographic decline with headache, seizures, systemic symptoms, and progression of vasculopathy on imaging. We present the diagnosis of a rare genetic disease with its various neurologic complications and systemic manifestations. Our case also illustrates the importance of differences in the metabolism of various antiseizure medications, recognition of which may avoid precipitating the disease.


Assuntos
Transtornos Cerebrovasculares , Vasoconstrição , Feminino , Humanos , Pessoa de Meia-Idade , Angiografia Cerebral , Cefaleia/etiologia , Raciocínio Clínico
4.
J Headache Pain ; 25(1): 18, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38331709

RESUMO

Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456-3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732-2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718-2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293-1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159-1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120-1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023-1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039-1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264-0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190-1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too.


Assuntos
Influenza Humana , Humanos , Feminino , Influenza Humana/complicações , Influenza Humana/epidemiologia , Cefaleia/epidemiologia , Cefaleia/etiologia , Prognóstico , Hospitalização , Absenteísmo
5.
BMC Endocr Disord ; 24(1): 20, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38326790

RESUMO

BACKGROUND: Lymphocytic hypophysitis is a rare autoimmune condition that usually presents during pregnancy and causes inflammation of the pituitary gland. Although the pathophysiology is not well understood, it often presents with headaches, visual disturbances, and symptoms of hypopituitarism. However, not all cases may present with hypopituitarism which can make this rare disease with an incidence of ~ 1 in 9 million much more difficult to diagnose. CASE PRESENTATION: We present a 35-year-old G4P4 woman with progressive vision loss and intermittent frontal headaches during her first trimester through 2 months postpartum. She presented with no symptoms of hypopituitarism and her hormone panel only showed elevated prolactin, possibly due to her breastfeeding. She was treated with a right pterional craniotomy with decompression of both optic nerves, partial resection of the suprasellar mass, and glucocorticoid therapy for headaches and visual disturbances. CONCLUSION: This case is notable for a presentation of lymphocytic hypophysitis without symptoms of hypopituitarism. This is important for outpatient providers to be aware of, especially those that care for pregnant patients so that unfavorable outcomes can be avoided.


Assuntos
Hipofisite Autoimune , Hipopituitarismo , Doenças da Hipófise , Neoplasias Hipofisárias , Humanos , Gravidez , Feminino , Adulto , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/diagnóstico , Neoplasias Hipofisárias/cirurgia , Hipofisite Autoimune/diagnóstico , Hipofisite Autoimune/complicações , Doenças da Hipófise/diagnóstico , Doenças da Hipófise/complicações , Hipopituitarismo/diagnóstico , Hipopituitarismo/etiologia , Hormônios Hipofisários , Cefaleia/etiologia , Cefaleia/complicações , Imageamento por Ressonância Magnética
6.
Rev Med Liege ; 79(2): 94-98, 2024 Feb.
Artigo em Francês | MEDLINE | ID: mdl-38356425

RESUMO

We aimed to determine whether sphenopalatine ganglion block (SPGB) had a place as a treatment for headache, as well as its place as an anterior component of scalp block for supratentorial intracranial surgery. Using the keywords «sphenopalatine ganglion¼, «sphenopalatine ganglion block¼, «pain¼, «surgery¼ and «craniotomy¼ in PubMed and Google Scholar, we identified 14 relevant articles. The methods used to perform the block and the treatment of control groups differed between studies. The main outcomes studied were reduction in pain scores and hemodynamic variations during supratentorial intracranial surgery. All articles concluded that SPGB was equal or superior compared with other procedures. Although there are still several points to be studied, considering the ease of application, the low number of complications and the results of the studies, the use of SPGB for the headache treatment and in neurosurgery as an anterior component of scalp block seems appropriate.


Cette revue de la littérature narrative vise à déterminer la place du bloc du ganglion sphénopalatin (BGSP) comme traitement des céphalées ainsi que sa place comme composante antérieure du bloc de scalp pour la chirurgie intracrânienne supratentorielle. Avec les mots-clés «ganglion sphénopalatin¼, «bloc du ganglion sphénopalatin¼, «douleur¼, «chirurgie¼ et «crâniotomie dans PubMed et Google Scholar, nous avons identifié 14 articles pertinents. Les méthodes de réalisation du bloc ainsi que les traitements des groupes témoins différaient selon les études. Les résultats principaux étudiés étaient la réduction des scores de douleur ainsi que les variations hémodynamiques au cours de la chirurgie intracrânienne supratentorielle. Tous les articles ont conclu à la non-infériorité ou la supériorité du BGSP en comparaison à d'autres procédures. Bien que plusieurs points restent à étudier, compte tenu de la facilité d'application, du peu de complications et des résultats, l'utilisation du BGSP pour le traitement des céphalées et en neurochirurgie comme composante antérieure du bloc de scalp semble appropriée.


Assuntos
Bloqueio do Gânglio Esfenopalatino , Humanos , Bloqueio do Gânglio Esfenopalatino/métodos , Cefaleia/etiologia , Cefaleia/terapia , Dor
7.
BMC Pediatr ; 24(1): 94, 2024 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-38308216

RESUMO

BACKGROUND: Headaches are the most common neurologic symptoms in the pediatric population. Most primary headache in children and adolescents focuses on associated factors, including noise. Auditory discomfort is related to recognizing the pain. We aimed to analyze the headache profile of pediatric populations and the connection between noise exposure and head pain in children and adolescents. METHODS: We reviewed retrospectively medical records of the pediatric population with headaches in Gyeongsang National University Changwon Hospital from January 2022 to April 2023. Personal headache profiling from self-questionnaires and environmental noise data from the National Noise Information System (NNIS) were used to analyze each variable, and chi-square tests and linear regression models by SAS were used to analyze the statistical correlation. RESULTS: Of the 224 participants, 125 were clinically diagnosed with headaches. Of the 104 pubertal subjects, 56.7% were diagnosed with headaches, compared to 60% in the prepubertal group. Both daytime and nighttime noise was significantly higher in the diagnosed headache group than in the non-diagnosed group. Headache duration increased by daytime and nighttime noise with statistical significance in age-adjusted models. CONCLUSION: We found that noise exposure is correlated to headaches in children and adolescents. Daytime and nighttime environmental noise exposure was significantly associated with the duration of headaches through our data. Therefore, we assume that noise exposure is vitally relevant to prolonged headaches in the pediatric population. Further research is needed to improve our data.


Assuntos
Cefaleia , Dor , Adolescente , Humanos , Criança , Estudos Retrospectivos , Cefaleia/etiologia , Inquéritos e Questionários
8.
Medicine (Baltimore) ; 103(2): e36972, 2024 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-38215096

RESUMO

RATIONALE: Central nervous system involvement is a rare manifestation of active-phaselocalized Granulomatosis with polyangiitis (GPA). In hypertrophic dura meningitis, GPA with headache is typical. In this case, cerebral magnetic resonance (MR) enhancement revealed no meningeal thickening, to our knowledge, this manifestation had not been found previously. PATIENT CONCERNS: The patient presented to the Rheumatology and Immunology Clinic with severe headache and hearing loss, and central nervous system granulomatosis with polyangiitis was confirmed after a series of examinations. The patient had no significant effect after treatment with cyclophosphamide (CTX), but after the use of rituximab, the headache and hearing loss were significantly improved, and laboratory indicators returned to normal levels. DIAGNOSIS: We comprehensively screened for craniocerebral infection and malignant tumors, diagnosed central nervous system granulomatosis with polyangiitis. INTERVENTIONS: We gave sequential treatment of rituximab. OUTCOMES: All indicators are mostly back to normal when the patient was monitored at the outpatient clinic. LESSONS: GPA and severe headache are more prevalent in hypertrophic dura meningitis, but the patient early headache could not be explained by hypertrophic dura meningitis or localized granulomatous lesions that invaded the central nervous system. Patients with severe headaches likely have vascular inflammation and local bone destruction at the base of the skull.


Assuntos
Granulomatose com Poliangiite , Perda Auditiva , Meningite , Humanos , Rituximab/uso terapêutico , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/tratamento farmacológico , Cefaleia/etiologia , Meningite/etiologia , Perda Auditiva/complicações
9.
Lupus ; 33(3): 293-297, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38285490

RESUMO

OBJECTIVE: The aim is to investigate the clinical characteristics of systemic lupus erythematosus with intracranial hypertension. METHODS: The clinical characteristics of one case of systemic lupus erythematosus with chronic persistent intracranial hypertension were analyzed, and related literature was reviewed by searching Medline and Wanfang databases. RESULTS: Intracranial hypertension in SLE patients may occur at the onset or during the course of the disease. Our patient was diagnosed with IH 3 years after the onset of SLE. Headache and papilledema were the most common symptoms of intracranial hypertension, followed by nausea or vomiting, vision changes, and cerebral palsy. Our patient had a headache and cranial hypertension that lasted for years, but no papilledema was found. Corticosteroid is currently the mainstay of the treatment of IIH in patients with SLE, and immunosuppressive agents, acetazolamide, intravenous mannitol and furosemide are also used. However, our patient did not respond to these treatments and presents the characteristics of chronic persistent intracranial hypertension. CONCLUSION: Systemic lupus erythematosus with intracranial hypertension is a rare manifestation of SLE, which is not completely parallel to SLE activity. Headache and papilledema were the most common presenting symptoms. Different from previous reported cases, our patient had poor response to treatments, showing chronic and persistent characteristics.


Assuntos
Hipertensão Intracraniana , Lúpus Eritematoso Sistêmico , Papiledema , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Papiledema/complicações , Papiledema/tratamento farmacológico , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/tratamento farmacológico , Acetazolamida/uso terapêutico , Cefaleia/etiologia
10.
BMC Neurol ; 24(1): 21, 2024 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-38184518

RESUMO

BACKGROUND: Patients with severe thalassemia may experience adverse effects from transfusion such as fever, rash, and iron overload after long-term transfusion therapy. Severe headaches as a side effect of blood transfusion in patients with thalassemia are not commonly observed, especially when combined with superficial siderosis of the central nervous system, which is easily misdiagnosed and requires excessive examination and treatment. CASE PRESENTATION: A 31-year-old woman was admitted with severe headache and vomiting over 3 days following blood transfusion. She was diagnosed with intermediate α-thalassemia at 2 years of age and had a history of irregular blood transfusions. Physical examination revealed horizontal nystagmus with no other abnormal neurological signs. Magnetic resonance (MR) imaging, MR venography, MR arteriography, and cerebrospinal fluid analysis were normal. However, susceptibility-weighted imaging showed abnormal signals in the bilateral and fourth ventricles. Initial antibiotics, antivirals, decompression of intracranial pressure, iron chelation, and symptomatic treatments were administered; subsequently, small intermittent blood transfusions were cautiously administered for severe anemia. The patient's headache was gradually relieved, and she was discharged on day 9. At the 5-month follow-up, the patient's headache recurred following another transfusion. CONCLUSIONS: Severe post-transfusion headache in patients with thalassemia has not been fully recognized and is easily misdiagnosed, leading to excessive examination and treatment. Understanding the clinical features of transfusion-related headaches can help identify this complication, but the exact pathophysiological mechanism requires further research.


Assuntos
Nistagmo Patológico , Siderose , Talassemia , Feminino , Humanos , Adulto , Siderose/complicações , Siderose/diagnóstico por imagem , Sistema Nervoso Central , Talassemia/complicações , Talassemia/terapia , Cefaleia/etiologia , Cefaleia/terapia
11.
Headache ; 64(2): 131-140, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38284213

RESUMO

BACKGROUND: Daith piercing is a special ear-piercing method that punctures the crus of the helix. The penetrated site at the ear's innermost point is assumed to stimulate a pressure point associated with the vagus nerve. It has been reported that the pierced spot relieves migraine and tension-type headaches by activating vagal afferents, leading to the inhibition of neurons in the caudal trigeminal nucleus via the nucleus tractus solitarii. OBJECTIVE: The objective of this narrative literature review is to summarize the current state of knowledge concerning daith piercing for the treatment of migraine and tension-type headaches from the perspectives of the Chinese and Western auricular systems. METHODS: PubMed and China National Knowledge Infrastructure databases were searched using the keywords "daith piercing," "auricular points," "headache," and "acupuncture" from database inception to September 1, 2023. Only studies on humans were eligible; otherwise, no further restrictions were applied to the study designs, type of headache, or patient population of the identified articles. Bibliographies of all eligible studies were screened for further eligible studies. The main outcome of interest was a quantitative measure of pain relief by daith piercing. Secondary outcomes were relapse time of headache and further outcomes related to daith piercing, if available. RESULTS: From a total of 186 identified articles, one retrospective study and three case reports fulfilled the inclusion criteria. No clinical trial was identified. The obtained studies describe patients experiencing chronic headaches undergoing daith piercing without changing or reducing their usual medication. In all case studies and the retrospective study, patients reported substantial reductions in pain immediately after daith piercing; however, headache symptoms recurred several weeks to months thereafter. From the perspective of the Chinese and Western auricular systems, no sufficient explanation for the described treatment effect of daith piercing was found. CONCLUSION: The available literature, combined with the reported recurrence of pain as well as the associated side effects of daith piercing, indicate that current evidence does not support daith piercing for the treatment of migraine, tension-type headaches, or other headache disorders. PLAIN LANGUAGE SUMMARY: This paper summarizes what we know about Daith piercing (DP) for chronic migraine and tension-type headache and discusses how DP might work. Current evidence does not support DP as an effective treatment of chronic migraine and tension-type headache. These findings might assist clinicians in discussing this subject with patients as well as guide future research.


Assuntos
Terapia por Acupuntura , Acupuntura Auricular , Transtornos de Enxaqueca , Cefaleia do Tipo Tensional , Humanos , Estudos Retrospectivos , Cefaleia/etiologia , Cefaleia/terapia , Transtornos de Enxaqueca/terapia , Terapia por Acupuntura/métodos , Dor
12.
Semin Neurol ; 44(1): 74-89, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38183973

RESUMO

Headache occurs commonly in individuals diagnosed with cerebral neoplasm. Though the features of a brain tumor-associated headache may vary, a progressive nature of headache and a change in headache phenotype from a prior primary headache disorder often are identified. Pathophysiologic mechanisms proposed for headache associated with brain tumor include headache related to traction on pain-sensitive structures, activation of central and peripheral pain processes, and complications from surgical, chemotherapeutic and/or radiotherapy treatment(s). Optimization of headache management is important for an individual's quality of life. Treatments are based upon patient-specific goals of care and may include tumor-targeted medical and surgical interventions, as well as a multimodal headache treatment approach incorporating acute and preventive medications, nutraceuticals, neuromodulation devices, behavioral interventions, anesthetic nerve blocks, and lifestyles changes.


Assuntos
Neoplasias Encefálicas , Qualidade de Vida , Humanos , Cefaleia/diagnóstico , Cefaleia/etiologia , Cefaleia/terapia , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/terapia
14.
Headache ; 64(1): 48-54, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38238973

RESUMO

OBJECTIVE: To assess the incidence, characteristics, and risk factors for developing persistent headache attributed to past ischemic stroke. BACKGROUND: Although the most recent International Classification of Headache Disorders has recognized the existence of persistent headache attributed to past ischemic stroke, there has been limited research in this area. METHODS: This was a prospective cohort study. We initially assessed patients hospitalized with ischemic stroke admitted within 72 h of symptom onset. All patients underwent diffusion-weighted magnetic resonance imaging. These patients were re-interviewed by telephone 1 year after the stroke. Semi-structured questionnaires, the National Institutes of Health Stroke Scale (NIHSS), and six-item Headache Impact Test were used. RESULTS: A total of 119 participants answered the interview conducted 1 year after the stroke. The mean (standard deviation) age was 64 (13.1) years, 82/119 (68.9%) were female, and the median (interquartile range) NIHSS score was 2 (1.0-4.0). The incidence rate of persistent headache attributed to past ischemic stroke was 12/119 (10.1%; 95% confidence interval [CI] 5.3-17.0%). The most frequent pattern presented was a migraine-like pattern in seven of the 12 (58.3%) patients, which had a substantial/severe impact on five of the 12 (41.7%). For most patients this headache continued, although it began to improve. Previous migraine (odds ratio 7.1, 95% CI 1.06-50.0; p = 0.043) and headache intensity in the acute phase of stroke (odds ratio 1.75, 95% CI 1.13-2.7; p = 0.012) were associated with the occurrence of persistent headache attributed to past ischemic stroke. CONCLUSION: Persistent headache attributed to past ischemic stroke is a frequent complication after stroke. It often has a significant impact on patients' lives and presents a migraine-like pattern as its most frequent phenotype.


Assuntos
AVC Isquêmico , Transtornos de Enxaqueca , Acidente Vascular Cerebral , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , AVC Isquêmico/complicações , Estudos Prospectivos , Cefaleia/etiologia , Cefaleia/complicações , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/epidemiologia , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/epidemiologia
15.
Agri ; 36(1): 68-70, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38239117

RESUMO

Rarely, endolymphatic hydrops may occur after spinal anesthesia due to the perforation of the dural membrane and a decrease in cerebrospinal fluid pressure. Consequently, auditory complications such as tinnitus and hearing loss may arise. Tinnitus can be accompanied by headache and hearing loss. In this case report, isolated bilateral tinnitus, which occurred in the early intraoperative period and spontaneously regressed in a patient who underwent bilateral tubal ligation under spinal anesthesia, is presented.


Assuntos
Raquianestesia , Perda Auditiva , Zumbido , Humanos , Zumbido/etiologia , Zumbido/complicações , Raquianestesia/efeitos adversos , Cefaleia/etiologia
16.
BMC Pediatr ; 24(1): 79, 2024 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-38267910

RESUMO

BACKGROUND: Massive neurocysticercosis is a rare form of neurocysticercosis, and can lead to serious conditions and even death. CASE PRESENTATION: Here we present a case of ten-year-old Tibetan girl who developed headache and vomiting. Her brain magnetic resonance imaging (MRI) illustrated lots of intracranial cystic lesions, and no obvious extracranial lesions were found. Serum immunoglobulin G antibodies against cysticerci were positive by the use of an enzyme-linked immunosorbent assay (ELISA). These results in combination with her medical history were in line with massive neurocysticercosis. The patients recovered well after supportive management and antiparasitic treatment. CONCLUSIONS: This case provides insights on the diagnosis and treatment of massive neurocysticercosis. The treatment of patients with massive neurocysticercosis should be in an individualized fashion, and the use of antiparasitic drugs in these patients must be decided after carefully weighing the risks and benefits.


Assuntos
Neurocisticercose , Feminino , Humanos , Criança , Neurocisticercose/diagnóstico , Neurocisticercose/diagnóstico por imagem , Encéfalo , Ensaio de Imunoadsorção Enzimática , Cefaleia/etiologia , Vômito/etiologia
18.
Medicina (Kaunas) ; 60(1)2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38256389

RESUMO

Background and Objectives: Isolated sphenoid rhinosinusitis may have devastating consequences such as orbital complications due to its anatomical contiguity with vital structures. This study aimed to identify patients with isolated sphenoid inflammatory diseases at high risk for developing orbital complications and requiring aggressive management through investigation of the clinical and computed tomography (CT) characteristics of patients with isolated sphenoid rhinosinusitis. Materials and Methods: The medical records of patients who underwent endoscopic sinus surgery between 2005 and 2022 were retrospectively reviewed. Patients with isolated sphenoid rhinosinusitis were identified based on a manual review of the clinical and histopathological findings. Participants' clinical and CT features were reviewed. Results: Among the 118 patients with isolated sphenoid rhinosinusitis, 15 (12.7%) developed orbital complications, including diplopia, extraocular motility limitation, ptosis, and visual impairment. Headaches and facial pain occurred significantly more frequently in patients with orbital complications than in those without orbital complications (p < 0.001). Patients with diabetes mellitus or malignant neoplasms were more likely to develop orbital complications than those without these comorbidities (p < 0.05). Bony dehiscence on CT images was significantly more common in patients with orbital complications than in those without. In the regression analysis, diabetes mellitus (OR, 4.62), malignant neoplasm (OR, 4.32), and bony dehiscence (OR, 4.87) were significant predictors of orbital complications (p < 0.05). Conclusions: Headaches and facial pain are the most common symptoms of isolated sphenoid rhinosinusitis. Orbital complications of isolated sphenoid rhinosinusitis are more common in patients with comorbidities such as diabetes mellitus or malignancy or in those with bony dehiscence on CT images.


Assuntos
Diabetes Mellitus , Humanos , Estudos Retrospectivos , Fatores de Risco , Cefaleia/etiologia , Dor Facial
19.
Agri ; 36(1): 71-74, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38239118

RESUMO

Cluster headache is a rare, severe headache associated with hypothalamic dysfunction or sleep cycles. It is classified in the primary headache group in The International Classification of Headache Disorders-3-2018 (ICHD-3-2018). In this case report, we present a 62-year-old male patient whose cluster headache showed a five times longer remission interval after dental implant treatment and ceased for more than two years following cardiac stent therapy.


Assuntos
Cefaleia Histamínica , Transtornos da Cefaleia , Masculino , Humanos , Pessoa de Meia-Idade , Cefaleia Histamínica/diagnóstico , Cefaleia/etiologia , Inquéritos e Questionários
20.
J Clin Neurosci ; 119: 205-211, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38141436

RESUMO

INTRODUCTION: Headache after cerebral venous thrombosis (post-CVT headache [PCH]) is a common complaint during follow-up. Risk factors and their pathophysiology are not well known. We studied PCH prevalence in CVT patients, its pathophysiology, and possible risk factors. MATERIALS AND METHODS: We performed a retrospective observational study of patients admitted to a tertiary hospital between 2006 and 2019 with CVT and at least one follow-up appointment. We diagnosed PCH when patients reported headaches during the follow-up visit. Recanalization was retrospectively assessed by two neuroradiologists using the first available follow-up MRI/ MRV, and the PRIORITy-CVT study classification. RESULTS: Of 131 patients, sixty (60/131, 45.8 %) reported PCH at the 3-month follow-up. Of these PCH, 9 had previous migraine (9/60, 5.0 %) and 13 previous tension-type headaches (13/60, 21.6 %), before CVT. Forty-four (44/60, 73.3 %) PCH patients had de novo headache: 21 (21/60, 35.0 %) de novo tension-type headaches; 6 (6/60, 10.0 %) de novo migraine; 6 [(6/60, 10.0 %) secondary headache disorders: 3 due to dural arteriovenous fistula, 2 due to intracranial hypertension, and 1 recurrent CVT], and 11 other headache types. Most patients had at least partial recanalization, with no difference in PCH frequency amongst recanalization subgroups (p = 0.598). Premorbid depression (p = 0.009, OR 7.9, 95 % CI 1.6-31.4) increased the odds ratio of PCH, while superior sagittal sinus thrombosis (p = 0.005, OR 0.15, 95 % CI 0.03-0.56) decreased it. DISCUSSION: Our study shows that PCH is a common finding after CVT and elucidates potential risk factors. PCH is common in patients with previous or de novo primary headache. In PCH patients without previous headache, secondary causes of headache, namely related to CVT complications, should be excluded. PCH is also increased in patients with premorbid depression. There was no statistically significant difference in PCH amongst the PRIORITy-CVT recanalization subgroups, but most patients had at least partial recanalization.


Assuntos
Trombose Intracraniana , Transtornos de Enxaqueca , Trombose dos Seios Intracranianos , Cefaleia do Tipo Tensional , Trombose Venosa , Humanos , Estudos Retrospectivos , Prevalência , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologia , Fatores de Risco , Cefaleia/epidemiologia , Cefaleia/etiologia , Cefaleia/diagnóstico , Trombose Intracraniana/complicações , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/epidemiologia , Trombose dos Seios Intracranianos/complicações , Trombose dos Seios Intracranianos/epidemiologia
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