Spontaneous Low Cerebrospinal Fluid Pressure Headache Initially Misdiagnosed as a Tension-type Headache / General Medicine

We report the case of a 34-year-old man who was initially diagnosed with a tension-type headache after complaining of a headache and nausea. His headache worsened in severity and it was exacerbated on standing in the upright position. The patient was admitted to the hospital on suspicion of spontaneous low cerebrospinal fluid (CSF) pressure headache. Gadolinium-enhanced brain magnetic resonance imaging (MRI) revealed diffuse pachymeningeal enhancement, brain sagging, cerebellar tonsillar herniation, brainstem descent and a subdural hematoma. Successful emergency surgery was undertaken.<br>Spontaneous low CSF pressure headache syndrome is characterized by orthostatic headache, and if such a headache worsens, clinicians should consider a subdural hematoma, a life-threatening complication of this unusual disorder.

General Remarks : Effective Strategies for Preventing and Controlling SARS Infection / 日本農村医学会雑誌

For severe acute respiratory syndrome (SARS), methodologies are yet to be established for prompt diagnostic testing, treatment and prevention by means of vaccination. Such being the situation, it is necessary to implement stringent measures in preventing the transmission of this infectious disease based on a correct understanding of its epidemiological characteristics. The pathways of transmission are by droplet and by contact. Risk factors include social contacts with SARS cases within a radius of 2 meters or household contacts, badly ventilated rooms, touching contaminated objects and surfaces, exposure to body fluids. The major clinical symptoms of the acute respiratory disease include, like influenza, fever, chill, tiredness (malaise), muscle aches, trepidation, nausea and headache. Compared with patients who contract influenza, SARS patients often had dyspnea and diarrhea, but rarely complain of pharyngalgia and pituita. A close correlation has been noted between the stage of SARS and its infectivity, capability. During the incubation period, which lasts 2 to 10 days, the disease is asymptomatic and reportedly almost no infectious. But there is general agreement among experts that SARS becomes highly infectious when it enters the lower airway infection period and begins to produce such symptoms as fever and dry cough, dyspnea.As the main points of the measures to prevent SARS from spreading, we would like to refer to triage and prevention of cross infection. A triage system should be adopted as the need arises. Under the system, patients suspected to have SARS are separated from other patients and given priority in medical treatment. Standard precautions should not be forgotten. The use of alcohol-based hand rubs and the wearig of surgical masks are effective means to cut off the route of infection. These efforts would make it possible to effectively prevent the infectious diseases like SARS from being spread form person to person and thus protect the public from the pandemic.

General Remarks: Effective Strategies for Preventing and Controlling SARS Infection-Prevention from the Point of View of Epidemiology- / 日本農村医学会雑誌

For severe acute respiratory syndrome (SARS), methodologies are yet to be established for prompt diagnostic testing, treatment and prevention by means of vaccination. Such being the situation, it is necessary to implement stringent measures in preventing the transmission of this infectious disease based on a correct understanding of its epidemiological characteristics. The pathways of transmission are by droplet and by contact. Risk factors include social contacts with SARS cases within a radius of 2 meters or household contacts, badly ventilated rooms, touching contaminated objects and surfaces, exposure to body fluids. The major clinical symptoms of the acute respiratory disease include, like influenza, fever, chill, tiredness (malaise), muscle aches, trepidation, nausea and headache. Compared with patients who contract influenza, SARS patients often had dyspnea and diarrhea, but rarely complain of pharyngalgia and pituita. A close correlation has been noted between the stage of SARS and its infectivity, capability. During the incubation period, which lasts 2 to 10 days, the disease is asymptomatic and reportedly almost no infectious. But there is general agreement among experts that SARS becomes highly infectious when it enters the lower airway infection period and begins to produce such symptoms as fever and dry cough, dyspnea.<BR>As the main points of the measures to prevent SARS from spreading, we would like to refer to triage and prevention of cross infection. A triage system should be adopted as the need arises. Under the system, patients suspected to have SARS are separated from other patients and given priority in medical treatment. Standard precautions should not be forgotten. The use of alcohol-based hand rubs and the wearig of surgical masks are effective means to cut off the route of infection. These efforts would make it possible to effectively prevent the infectious diseases like SARS from being spread form person to person and thus protect the public from the pandemic.