1
|
Africk BN, Heiferman DM, Wozniak AW, Behzadi F, Ballard MS, Chazaro JM, Zsigray BM, Shanker RM, Reynolds MR, Anderson DE, Serrone JC. Angioarchitectural features amongst patients with unruptured brain arteriovenous malformations presenting with headache: findings from a single center retrospective review of 76 patients. J Headache Pain 2021; 22:122. [PMID: 34627140 PMCID: PMC8501699 DOI: 10.1186/s10194-021-01331-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/21/2021] [Indexed: 12/30/2022] Open
Abstract
Background Brain arteriovenous malformations (AVMs) consist of abnormal connections between arteries and veins via an interposing nidus. While hemorrhage is the most common presentation, unruptured AVMs can present with headaches, seizures, neurological deficits, or be found incidentally. It remains unclear as to what AVM characteristics contribute to pain generation amongst unruptured AVM patients with headaches. Methods To assess this relationship, the current study evaluates angiographic and clinical features amongst patients with unruptured brain AVMs presenting with headache. Loyola University Medical Center medical records were queried for diagnostic codes corresponding to AVMs. In patients with unruptured AVMs, we analyzed the correlation between the presenting symptom of headache and various demographic and angiographic features. Results Of the 144 AVMs treated at our institution between 1980 and 2017, 76 were unruptured and had sufficient clinical data available. Twenty-three presented with headaches, while 53 patients had other presenting symptoms. Patients presenting with headache were less likely to have venous stenosis compared to those with a non-headache presentation (13 % vs. 36 %, p = 0.044). Conclusions Our study suggests that the absence of venous stenosis may contribute to headache symptomatology. This serves as a basis for further study of correlations between AVM angioarchitecture and symptomatology to direct headache management in AVM patients.
Collapse
Affiliation(s)
- Benjamin N Africk
- Department of Pediatric Neurology, Lucile Packard Children's Hospital at Stanford, 725 Welch Road, CA, 94304, Palo Alto, USA
| | | | - Amy W Wozniak
- Clinical Research Office, Stritch School of Medicine, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Faraz Behzadi
- Loyola Stritch School of Medicine, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Matthew S Ballard
- Loyola Stritch School of Medicine, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Joshua M Chazaro
- Loyola Stritch School of Medicine, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Brandon M Zsigray
- Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Rachyl M Shanker
- Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Matthew R Reynolds
- Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA
| | - Douglas E Anderson
- Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA.,Edward Hines Jr Veteran Administration Hospital, 5000 5th Avenue, IL, 60141, Hines, USA
| | - Joseph C Serrone
- Department of Neurological Surgery, Loyola University Medical Center, 2160 S. First Avenue, IL, 60153, Maywood, USA. .,Edward Hines Jr Veteran Administration Hospital, 5000 5th Avenue, IL, 60141, Hines, USA. .,Loyola University Medical Center, 2160 S 1st Avenue, IL, 60153, Maywood, USA.
| |
Collapse
|
2
|
Ray JD, Kener KB, Bitner BF, Wright BJ, Ballard MS, Barrett EJ, Hill JT, Moss LG, Tessem JS. Nkx6.1-mediated insulin secretion and β-cell proliferation is dependent on upregulation of c-Fos. FEBS Lett 2016; 590:1791-803. [PMID: 27164028 DOI: 10.1002/1873-3468.12208] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/02/2016] [Accepted: 05/05/2016] [Indexed: 01/01/2023]
Abstract
Understanding the molecular pathways that enhance β-cell proliferation, survival, and insulin secretion may be useful to improve treatments for diabetes. Nkx6.1 induces proliferation through the Nr4a nuclear receptors, and improves insulin secretion and survival through the peptide hormone VGF. Here we demonstrate that Nkx6.1-mediated upregulation of Nr4a1, Nr4a3, and VGF is dependent on c-Fos expression. c-Fos overexpression results in activation of Nkx6.1 responsive genes and increases β-cell proliferation, insulin secretion, and cellular survival. c-Fos knockdown impedes Nkx6.1-mediated β-cell proliferation and insulin secretion. These data demonstrate that c-Fos is critical for Nkx6.1-mediated expansion of functional β-cell mass.
Collapse
Affiliation(s)
- Jason D Ray
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Kyle B Kener
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Benjamin F Bitner
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Brent J Wright
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Matthew S Ballard
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Emily J Barrett
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Jonathon T Hill
- Physiology and Developmental Biology Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| | - Larry G Moss
- Sarah W. Stedman Nutrition and Metabolism Center and Duke Molecular Physiology Institute, Departments of Pharmacology and Cancer Biology and Medicine, Duke University, Durham, NC, USA
| | - Jeffery S Tessem
- Nutrition, Dietetics and Food Science Department, College of Life Sciences, Brigham Young University, Provo, UT, USA
| |
Collapse
|
3
|
Abstract
A case of contact dermatitis resulting from temporary tattooing with henna is described. The skin was stained using a dye described as 'black' henna. This is produced by the addition of paraphenylenediamine (PPD) to traditional henna dye in order to make temporary skin tattoos appear darker. Sensitisation to PPD may also cause sensitivity to printers' inks, clothing dyes, hair dyes, local anaesthetics, sulphonamides, and para-aminosalicylic acid. The case of contact dermatitis described responded to application of topical steroid with no sequelae; however patients may be left with hypo- or hyper-pigmentation of the skin or even permanent scarring.
Collapse
Affiliation(s)
- M S Ballard
- 23 Air Assault Medical Squadron, 16 Close Support Medical Regiment, Goojerat Barracks, Colchester, Essex.
| |
Collapse
|