Think Like a Doctor: Think Like a Doctor: The Painter ’ s Headaches Solved!

Readers solve the case of a painter with terrible headaches.
Source: NYT Health - Category: Consumer Health News Authors: Tags: Headaches Brain Art Fistulas Ears and Hearing Magnetic Resonance Imagers Tinnitus Doctors Source Type: news

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CONCLUSION: There is low-quality evidence for a positive effect of conservative temporomandibular disorders treatment on tinnitus complaints. The combination of splint therapy and exercise treatment is currently the best investigated treatment approach, showing a decrease in tinnitus severity and intensity. Despite the low level of evidence and the methodologic issues in the included studies, it is noteworthy that all included studies show positive treatment effects. PMID: 30978269 [PubMed - as supplied by publisher]
Source: Journal of Orofacial Pain - Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research
Abstract Venous interruption through surgical clip ligation is the gold standard treatment for ethmoidal dural arteriovenous fistula (e-dAVF). Their malignant natural history is attributable to the higher predilection for retrograde cortical venous drainage. This video illustrates an e-dAVF in a 70-year-old man with progressive tinnitus and headache. Angiogram revealed bilateral e-dAVFs (Borden III-Cognard III) with one fistula draining into cavernous sinus and another to the sagittal sinus. A bifrontal craniotomy was utilized for venous interruption of both e-dAVFs. Postoperative angiography confirmed curative ob...
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
Abstract Dural arteriovenous fistulae (dAVFs) are vascular anomalies formed by abnormal connections between branches of dural arteries and dural veins or dural venous sinus(es). These pathologic shunts constitute 10%-15% of all intracranial arteriovenous malformations. The hallmark of malignant dAVFs is the presence of cortical venous drainage, a finding that increases the likelihood of nonhemorrhagic neurologic deficit, intracranial hemorrhage, and mortality if left unaddressed. Endovascular approaches have become the primary modality for the treatment of dAVFs. The authors present a case of staged endovascular t...
Source: Neurosurgical Focus - Category: Neurosurgery Authors: Tags: Neurosurg Focus Source Type: research
This article shows that CT is the imperative for the diagnosis of pneumocephalus and to detect the underlying cause. When there is doubt about the fistula location, MR-cisternography with gadolinium can be a valuable tool to detect or confirm the fistulous site.
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
A 34-year-old woman presented with a 3-month history of right-sided headaches associated with photophobia and pulsatile tinnitus. Investigations including lumbar puncture revealed elevated opening CSF pressure, increased protein, and presence of monocytosis consistent with an inflammatory/infective process. Brain MRI showed an area of thickened enhancing dura around the venous sinus posteriorly. 67Ga scintigraphy demonstrated focal intracranial uptake in the posterior occipital region, and biopsy confirmed a chronic inflammatory infiltrate with no granulomas.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Interesting Images Source Type: research
Conclusions Our data suggest that stenting may be a promising therapeutic option for IIH with cerebral venous sinus stenosis of non thrombotic, non external compression . The majority of patients may get longer-term positive outcomes with stenting. PMID: 30727893 [PubMed - as supplied by publisher]
Source: Current Neurovascular Research - Category: Neurology Authors: Tags: Curr Neurovasc Res Source Type: research
Fibromuscular dysplasia is a noninflammatory, nonatherosclerotic disease that results in fibrous tissue buildup of the medium-sized arteries. Areas of stenosis and dilation in the arteries can result in dissection or aneurysm. The stenotic areas of the vessel alternating with dilation result in what is often described as a “string of beads” appearance on imaging. Symptoms depend on location and severity of the disease. Common symptoms include migraine-type headache, flank pain, and pulsatile tinnitus.
Source: The Journal for Nurse Practitioners - Category: Nursing Authors: Tags: Feature Article Source Type: research
This study aimed to analyze the similarities and differences between IJV stenosis and CVS stenosis. Patients with either IJV stenosis or CVS stenosis confirmed by contrast-enhanced magnetic resonance venography between October 2017 and July 2018 were enrolled in this retrospective study. The similarities and differences between IJV stenosis and CVS stenosis on the aspects of clinical and imaging features were compared. A total of 82 eligible patients entered into the final analysis. The similarities of the two subsets of cerebral venous outflow insufficiency mainly included headache, head noises or tinnitus, visual disorde...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
ConclusionPLPH is a frequent complication of LP performed on daily-basis admission in MS work-up. The maximum onset is within the first 48  h. Age and gender seem the only predictors for the appearance and persistence of PLPH.
Source: Neurological Sciences - Category: Neurology Source Type: research
Objective: Characterize the morbidity associated with vestibular schwannoma (VS) as documented by treating providers. Study Design: Retrospective analysis of the MarketScan database. Setting: MarketScan database. Subjects and Methods: A study of morbidity in VS patients who underwent treatment between 2002 and 2012 was conducted. A detailed account of morbidity at multiple time points before and after treatment was described. Results: Of 3,355 patients treated for VS, 2,029 (60.5%) underwent surgery and 1,326 (39.5%) radiation. The average (SD) age of diagnosis was 52.5 (12.1) years. Patients were followed fo...
Source: Otology and Neurotology - Category: ENT & OMF Tags: VESTIBULAR DISORDERS Source Type: research
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