1/4. Acute posterior multifocal placoid pigment epitheliopathy associated with a systemic necrotizing vasculitis.PURPOSE: The authors present a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) associated with a systemic necrotizing vasculitis with mixed features of wegener granulomatosis and polyarteritis nodosa (PAN). methods: Case report. RESULTS: A 29-year-old woman developed a severe nosebleed, followed by a low-grade fever, night sweats, and a productive cough. One month later, she began experiencing high fevers, headache, myalgia, neck stiffness, and abdominal pain as well as bilateral blurred vision from APMPPE. Systemic evaluation revealed nasal ulcerations, bilateral pleural effusions, and a bilateral maxillary and ethmoid sinusitis, consistent with wegener granulomatosis. However, ANCA testing was negative, and a renal and mesenteric angiogram showed aneurysmal dilatations suggestive of PAN. Her ocular and systemic symptoms markedly improved with systemic corticosteroids. CONCLUSIONS: The cause of APMPPE is unknown. This case of APMPPE associated with systemic necrotizing vasculitis provides support for the choroid as being primarily involved by a diffuse vasculitic process that interrupts choroidal perfusion and causes the characteristic fundus findings in APMPPE.- - - - - - - - - - ranking = 1keywords = headache (Clic here for more details about this article) |
2/4. Sinusitis and headache.Nasal endoscopic examination and CT views of the sinuses were obtained in patients with symptoms of headache and sinusitis who had failed to respond to conservative medical therapy. Endoscopic sinus surgery has challenged traditional concepts of sinus disease management. The site of obstruction rather than the extent of the disease is the major concern. Removal of pressure points with reestablishment of a competent airway, and revision of sinus passageways to facilitate mucociliary drainage and ventilation of the obstructed cavity can benefit patients with chronic headaches.- - - - - - - - - - ranking = 6keywords = headache (Clic here for more details about this article) |
3/4. A new approach to sinus relief.You suffer from "sinus". Medical treatment isn't getting you better, and now you need surgery. It is better that you be treated surgically today rather than as in the past. Five years ago, surgery meant an incision through the eyebrow, with probable numbing of the forehead, in order to relieve the pain of acute frontal sinusitis; or a long eyebrow incision, or shaving the front part of the scalp and pulling down the forehead skin from the skull was the procedure of choice for chronic disease in these sinuses. If the cheek sinuses were chronically diseased, an incision was made through the gums above the upper teeth, often resulting in numbing of the teeth and marked swelling of the cheek.- - - - - - - - - - ranking = 0.014129273491517keywords = upper (Clic here for more details about this article) |
4/4. role of Haller's cell in headache and sinus disease: a case report.Although anatomic variations in the development of the nose and paranasal sinuses such as the Haller's cell do not themselves represent a disease state, in many cases they are responsible for the patient's symptoms. Particularly in the absence of extensive associated mucosal changes, these conditions may be easily overlooked unless specifically sought. Haller's cells may cause recurrent or chronic sinusitis and persistent sinugenic headache, without significant findings on physical examination including nasal endoscopy. The presence of Haller's cells on coronal CT in a patient with corresponding symptoms deserves consideration as the potential cause of the symptoms. When medical therapy is ineffective, such cases respond well to surgical therapy through the functional endoscopic approach.- - - - - - - - - - ranking = 5keywords = headache (Clic here for more details about this article) |