Arquivos de neuro-psiquiatria
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Review Case Reports
[Cerebral aneurysm and arachnoid cyst: about a case with intracystic hemorrhage].
We report a case of a carotid artery bifurcation aneurysm which ruptured into a silvian fissure arachnoid cyst. In the review of the literature, only three cases were before reported. We discuss about uncommon clinical findings, the surgical aspects and the associations among the lesions.
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Headache is a common symptom in the population, with a life prevalence around 90%. It results in an important impact in the life quality of sufferers. The aim of this study is to evaluate the prevalence of migraine among employees of an university hospital (HC), as well as to measure the headache intensity, interference and impact in the daily activities. ⋯ It can be concluded that migraine represents a public health problem among the HC employees. Because migraine brings about an important impact in the life quality of those workers, it is possible that a reduction of working capacity with considerable economic burden exists. This problem deserves, thus, special attention, through a better diagnostic and treatment.
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Multicenter Study
[Clinical evaluation of the efficacy of the paracetamol and caffeine combination in the treatment of tension headache].
Tension type headache in both its forms, episodic and chronic, is the most common type of headache experienced by the population. The headache attack or the prevention of new crises may be treated with pharmacological as well as non-pharmacological measures. This study included 5,490 patients from out-patient clinics and medical offices covering various regions of Brazil. ⋯ Good/excellent efficacy ratings were achieved in 61.93%/37.80% of the cases according to the physician's assessment and in 48.51%/40.29% according to the patients' assessment. Adverse events, commonly gastrointestinal manifestations, were reported by 5.57% of the patients. This is a Brazilian study of the efficacy and safety of the combined use of acetaminophen-caffeine for the treatment of tension type headache.
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Case Reports
Saphenous vein graft bypass in the treatment of giant cavernous sinus aneurysms: report of two cases.
Two cases of giant intracavernous aneurysms treated by high flow bypass with saphenous vein graft between the external carotid artery (ECA) and branches of the middle cerebral artery (MCA) are presented. Very often these aneurysms are unclippable because they are fusiform or have a large neck. Occlusion of the internal carotid artery (ICA) is the treatment of choice in many cases. ⋯ Immediate high flow revascularization of MCA branches was achieved and the patients showed no ischemic events. Follow-up of 8 and 14 months after operation shows patency of the venous graft and no neurological deficits. Angiographic control examination showed complete aneurysm occlusion in both cases.
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Most daily headache patients seen in specialized clinics present a past history of migraine. Some authors refer to it as transformed migraine and emphasize its milder intensity and clinical characteristics different from migraine. The aim of this study was to evaluate the clinical presentation of the daily headache in patients with prior history of migraine. ⋯ We observed that a significant percentage of the patients presenting the so-called transformed migraine, reported frontal and/or temporal bilateral pain and had pressure or tightening pain, which is a characteristic of chronic tension-type headache. It emphasizes the loss or changing of the standard migraine features. The pulsatile pain quality remained as an important feature, specially for those with intermittent typical migraine attacks.