Cases reported "Headache"

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1/65. Compression of the visual pathway by anterior cerebral artery aneurysm.

    Visual failure is an uncommon presenting symptom of an intracranial aneurysm. It is even more uncommon in aneurysms arising from the anterior cerebral artery (ACA). We presented 2 patients with an aneurysm of the A1 segment of the anterior cerebral artery causing visual field defects. One patient presented with a complete homonymous hemianopia due to compression of the optic tract by a giant aneurysm of the proximal left A1 segment. The second patient had an almost complete unilateral anopia caused by compression of the optic nerve and chiasm by an aneurysm of the distal part of the A1 segment with a small chiasmatic hemorrhage and ventricular rupture.
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ranking = 1
keywords = aneurysm
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2/65. Nonaneurysmal thunderclap headache with diffuse, multifocal, segmental, and reversible vasospasm.

    OBJECTIVE: To highlight the clinical profiles and angiographic findings of two patients with recurrent thunderclap headache (TCH) without subarachnoid hemorrhage (SAH) and to present modified diagnostic criteria for this unusual syndrome. BACKGROUND: TCH may be a benign recurrent headache disorder or it may represent a serious underlying process such as SAH or venous sinus thrombosis. The pathophysiology of this disorder in the absence of underlying pathology is not well understood and its potential angiographic features are not well appreciated. methods: Two case descriptions with illustrative angiography. RESULTS: Both cases demonstrated the potential for reversible intracranial vasospasm without intracranial aneurysm or SAH and a benign clinical outcome. CONCLUSIONS: Primary TCH has a distinctive clinical and angiographic profile and must be distinguished from central nervous system vasculitis and SAH.
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ranking = 0.55555555555556
keywords = aneurysm
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3/65. Resolution of third nerve paresis after endovascular management of aneurysms of the posterior communicating artery.

    The effect of endovascular treatment on the recovery of neural function in patients with third nerve palsy caused by an aneurysm of the posterior communicating artery is poorly documented. We report three cases in which third nerve paresis resolved completely within 2 to 3 weeks of endovascular occlusion of a posterior communicating artery aneurysm.
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ranking = 0.66666666666667
keywords = aneurysm
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4/65. Endosaccular aneurysm occlusion with Guglielmi detachable coils for obstructive hydrocephalus caused by a large basilar tip aneurysm. Case report.

    The authors present the case of a 60-year-old man with obstructive hydrocephalus caused by a large basilar artery tip aneurysm, in whom direct surgical clipping of the aneurysm neck was considered hazardous. After endosaccular aneurysm occlusion, his symptoms (headache, intellectual impairment, and gait disturbance) and ventricular dilation immediately improved without placement of a ventricular shunt. To the authors' knowledge, this is the first case of its kind treated solely endovascularly.
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ranking = 1.2222222222222
keywords = aneurysm
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5/65. Guglielmi detachable coil treatment of a partially thrombosed giant basilar artery aneurysm in a child.

    We report a partially thrombosed giant of the aneurysm basilar artery with prominent mass effect, diagnosed in an 11 year-old child who presented with neurological deficits due to brain stem compression. After the patent portion of the aneurysm was embolised with Guglielmi detachable coils, remarkable clinical improvement occurred. Angiography demonstrated complete occlusion of the aneurysm and MRI revealed dramatic shrinkage of the aneurysm at 6-month and 1-year follow-up.
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ranking = 0.88888888888889
keywords = aneurysm
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6/65. Unruptured cerebral aneurysm producing a thunderclap headache.

    A sudden and severe headache is the most common presentation of an acutely ruptured cerebral aneurysm. A similar headache in the absence of subarachnoid blood has rarely been ascribed to an unruptured cerebral aneurysm, but may result from acute aneurysm expansion and indicate a high risk of future rupture. We present a patient who developed a sudden, severe, "thunderclap" headache, with no associated neurological deficit. Computed tomogram and lumbar cerebral spinal fluid obtained 5.5 hours after headache onset were negative for subarachnoid hemorrhage. The patient underwent cerebral angiography which revealed a posterior communicating artery aneurysm with an associated daughter aneurysm. craniotomy and clip obliteration of the aneurysm were performed. The aneurysm dome was very thin and there was no evidence of recent or old hemorrhage. A "thunderclap" headache without subarachnoid hemorrhage may be an important harbinger of a cerebral aneurysm with the potential for future rupture. Early recognition and neurovascular imaging of aneurysms presenting in this rare fashion are warranted.
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ranking = 1.4444444444444
keywords = aneurysm
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7/65. Spinal dural arteriovenous fistula with perimesencephalic subarachnoid haemorrhage.

    A case is reported of a 66 year old woman presenting with perimesencephalic subarachnoid haemorrhage (SAH) which was caused by a spinal dural arteriovenous fistula at the C1 level. The fistula drained into the venous system of the posterior cranial fossa through a perimedullary vein. The bleeding was thought to result from venous hypertension induced by the fistula. This case may support the hypothesis that perimesencephalic non-aneurysmal SAH can be ascribed to venous bleeding and that venous hypertension is the key to its pathology.
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ranking = 0.11111111111111
keywords = aneurysm
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8/65. hypertensive encephalopathy presenting with thunderclap headache.

    A 68-year-old woman presented with thunderclap headache, which led to a search for subarachnoid hemorrhage. Both computerized tomography of the head and cerebrospinal fluid examination were normal. magnetic resonance imaging revealed abnormalities in the white matter in the parieto-occipital regions. There was no aneurysm on magnetic resonance angiography. Treatment of hypertension led to resolution of the posterior leukoencephalopathy. hypertensive encephalopathy with reversible posterior leukoencephalopathy can present as a thunderclap headache.
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ranking = 0.11111111111111
keywords = aneurysm
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9/65. Aneurysmal bone cyst of the sphenoid sinus.

    Aneurysmal bone cysts of the sphenoid sinus are very rare, with only six cases described in the literature. We present a case of an aneurysmal bone cyst of the sphenoid sinus with associated fibrous dysplasia in which the radiological findings had some features of a mucocoele. We discuss the differences in pathogenesis, clinical presentation and radiological appearances between these two lesions, and propose a simple drainage procedure as an effective modality of treatment.
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ranking = 0.11111111111111
keywords = aneurysm
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10/65. Spontaneous retroclival hematoma presenting as a thunderclap headache. Case report.

    An excruciating headache of instantaneous onset, or thunderclap headache, may be caused by a variety of serious disorders, including aneurysmal subarachnoid hemorrhage, cerebral venous sinus thrombosis, pituitary apoplexy, and carotid artery or vertebral artery dissection. The authors describe a patient with this type of headache who was found to have a spontaneous retroclival hematoma. A 49-year-old woman experienced an instantaneous excruciating headache. Results of computerized tomography (CT) scans of the head were normal, but on examination of the cerebrospinal fluid xanthochromia was found. Magnetic resonance (MR) imaging of the cervical spine revealed a retroclival hematoma. Three cerebral angiographic studies did not reveal the source of the hemorrhage and a repeated MR image demonstrated resolution of the hematoma. The patient made an uneventful recovery. Spontaneous retroclival hematoma is an exceedingly rare type of intracranial hemorrhage and may be associated with normal findings on CT scans. Spontaneous retroclival hematoma should be included in the differential diagnosis of thunderclap headache.
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ranking = 0.11111111111111
keywords = aneurysm
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