Humans ; Post-Traumatic Headache/etiology* ; Risk Factors ; Cervical Vertebrae/surgery*

In this study, two school-aged children had an acute onset in spring and had the manifestations of fever, headache, vomiting, disturbance of consciousness, purpura and ecchymosis, and positive meningeal irritation sign. There were increases in peripheral white blood cells and neutrophils, but reductions in the hemoglobin level and platelet count in the two children. They had a significant increase in C-reactive protein. There were hundreds or thousands of white blood cells in the cerebrospinal fluid, mainly neutrophils. Increased protein contents but normal levels of glucose and chloride in the cerebrospinal fluid were found. Head CT scan showed multiple hematomas in the right cerebellum and both hemispheres in one child. Bone marrow cytology indicated infection in the bone marrow, and both blood culture and bone marrow culture showed methicillin-resistant Staphylococcus aureus (MRSA). Both patients had cardiac murmurs and progressive reductions in the hemoglobin level and platelet count during treatment, and echocardiography showed the formation of vegetation in the aortic valve. Therefore, the patients were diagnosed with infectious endocarditis (IE). Vancomycin was used as the anti-infective therapy based on the results of drug sensitivity test. One child was cured after 6 weeks, and the other child was withdrawn from the treatment and then died. Dynamic monitoring of cardiac murmurs should be performed for children with unexplained fever, and echocardiography should be performed in time to exclude IE. IE should also be considered for children with purulent meningitis and skin and mucosal bleeding which cannot be explained by the reduction in platelet count.
Adolescent ; Child, Preschool ; Endocarditis, Bacterial ; diagnosis ; drug therapy ; etiology ; Female ; Fever ; etiology ; Headache ; etiology ; Humans ; Male ; Purpura ; etiology

OBJECTIVETo investigate the clinical neurological manifestations of Takayasu arteritis (TA).

METHODSA retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010. All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology. Among the 63 TA patients, 27 with neurological manifestations were included in the present study. All the patients were evaluated using standardized neurological examination, sonography, computed tomography (CT) angiography, and cerebral CT or magnetic resonance imaging.

RESULTSDizziness and visual disturbance were the most common symptoms, which occurred in 20 (74.1%) and 16 (59.3%) patients respectively. Another common symptom was headache, observed in 15 (55.6%) patients. Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures. Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations.

CONCLUSIONSNeurological manifestations are common symptoms in TA patients in the chronic phase, including dizziness, visual disturbance, headache, ischemic stroke, seizures, and some unusual ones such as RPES. We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.

Adolescent ; Adult ; Child ; Dizziness ; etiology ; Female ; Headache ; etiology ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; Retrospective Studies ; Seizures ; etiology ; Stroke ; etiology ; Takayasu Arteritis ; complications

Lambl's excrescences are filiform structures attached to the edges of cardiac valves and have been associated with stroke. Here we report two patients with Lambl's excrescences who developed migraine-like headaches followed by cerebral infarction. Their Lambl's excrescences were first identified by transesophageal echocardiography. One patient was given aspirin and another had surgery for debridement of excrescences. Their outcomes were good. The migraine-like headache might be the first symptom of cerebral ischemia and might be triggered by micro-emboli originated from Lambl's excrescences. Patients with Lambl's excrescences should be closely monitored and surgery should be considered in recurrent stroke cases.
Adult ; Headache ; diagnosis ; etiology ; Heart Valve Diseases ; complications ; diagnosis ; pathology ; Humans ; Male ; Middle Aged ; Stroke ; diagnosis ; etiology

The clinical manifestation of acute invasive fungal sinusitis was associated with facial pain,altered sense of smell, blindness and headache. Physical examinations show that dark brown nasal secretions with bone resorption in paranasal sinus. Radiographi parameters showed uneven density in paranasal sinus and intraorbital extension. Fungus smears and pathological examination can make a definitive diagnosis.
Acute Disease ; Facial Pain ; etiology ; Fungi ; isolation & purification ; Headache ; etiology ; Humans ; Mycoses ; complications ; pathology ; Paranasal Sinuses ; Sinusitis ; complications ; microbiology ; pathology

Seven patients who developed a similar headache syndrome are described. They first developed severe, exploding headaches while swimming, and subsequently experienced less severe headaches during physical exertion. They also developed headaches during sexual activity, which were similar to the previous headaches brought on by swimming. Majority of them were women in their thirties or forties. These symptoms were gradually subsided with or without medication after several weeks or months. The possible pathogenesis of this headache syndrome is discussed.
Adult ; *Coitus ; Female ; Headache/*etiology ; Humans ; Male ; Middle Aged ; *Physical Exertion ; *Swimming

OBJECTIVES: This descriptive study was conducted to examine the degree of stress, coping styles, communication with the mother and depression between headache-suffering children and headache-free children and to explore predicted factors for headache occurrence in children. METHOD: The subjects of this study consisted of 196 headache-free children and 107 headache-suffering children. They were 4th-6th graders of an elementary school in T city. The instruments in this study were David's stressor of children, Lazarus & Folkman's Stress Coping Style, PACI (Parent-Adolescent Communication Inventory) by Barnes & Olsen and Kovac's CDI (Children's depression inventory). Data were collected from May 2 to July 16, 2004. RESULTS: Total stress(t=-3.76, p=.035), school stress(t=-3.02, p=.001), mass media stress(t=-1.39, p=.029) and depression(t=7.62, p=.001) in headache-suffering children were significantly higher than those of headache-free children. Problem-oriented coping skills (t=1.23, p=.023), and the score of communication with the mother (t=2.32, p=.012) in headache-suffering children were lower than those of headache-free children. Logistic regression analysis (stepwise) showed that the most powerful predictor was stressors in school, followed by depression, stressors in mass media and communication with the mother. CONCLUSIONS: This study revealed that important factors such as the degree of school stress, depression, the degree of mass media stress, communication with the mother and problem-oriented coping skills should be controlled for reducing of headaches in children.
Stress, Psychological/complications ; Mother-Child Relations ; Male ; Humans ; Headache/etiology/*psychology ; Female ; Child ; Adaptation, Psychological

Headaches are common in children. Common primary headaches can also be experienced by children. The most common causes of innocent headaches among children are tiredness, shortsightedness, viral fever, sinusitis and psychosocial stressors. Consultation tasks include an attempt to diagnose the headache, the exclusion of sinister causes, and an effort to address any underlying concerns that the child and his/her family members may have. At a busy primary care consultation, the use of a headache symptom diary may provide important information for the evaluation of children presenting with chronic headaches.
Child ; Female ; Headache ; diagnosis ; etiology ; therapy ; Humans ; Male ; Pediatrics ; methods ; Primary Health Care ; methods ; Symptom Assessment

Adult ; Arachnoid Cysts ; complications ; diagnosis ; diagnostic imaging ; Headache ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography

Adult ; Female ; Headache ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Paraspinal Muscles ; injuries