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unpredictable effects but relieve the pain in some cases Unilateral occipital headache is often misinterpreted as occipital neuralgia (see further on) The headache of meningeal irritation (infection or hemorrhage) is acute in onset, usually severe, generalized, deep-seated, constant, and associated with stiffness of the neck, particularly on forward bending It has been ascribed to increased intracranial pressure; indeed, the withdrawal of CSF may afford some relief However, dilatation and in ammation of meningeal vessels and the chemical irritation of pain receptors in the large vessels and meninges by chemical agents, particularly serotonin and plasma kinins, are probably more important factors in the production of pain and spasm of the neck extensors In the chemically induced meningitis from rupture of an epidermoid cyst, for example, the spinal uid pressure is usually normal but the headache is severe A singular headache is produced by subarachnoid hemorrhage; it is very intense and paroxysmal in onset, as already mentioned, and is associated with vomiting and neck stiffness, the latter being a re ection of meningeal irritation There may be transient loss of consciousness The ocular examination assumes importance in that there may be subhyaloid hemorrhages It is not uncommon for the rupture of an aneurysm that gives rise to subarachnoid hemorrhage to be precipitated by exertion, even of minor degree Very few other headache syndromes simulate this disease (see page 716) Lumbar puncture (LP) headache, as elaborated in Chap 2, is characterized by a steady occipitonuchal and frontal pain coming on within a few minutes after arising from a recumbent position and is relieved within a minute or two by lying down Its cause is a persistent leakage of CSF into the lumbar tissues through the needle track The CSF pressure is low (often zero in the lateral decubitus position), and the injection of sterile isotonic saline solution intrathecally or the placing of an epidural blood patch relieves the headache Usually this type of headache is increased by compression of the jugular veins but is unaffected by digital obliteration of one carotid artery It seems probable that, in the upright position, a low intraspinal and negative intracranial pressure permits caudal displacement of the brain, with traction on dural attachments and dural sinuses Pannullo and colleagues, with magnetic resonance imaging, have demonstrated this downward displacement of the cranial contents Headache following cisternal puncture is less frequent As soon as the leakage of CSF stops and CSF pressure is restored (usually within hours or a few days), the headache disappears Spontaneous low-pressure headache may follow a sneeze, strain, or athletic injury, sometimes as a result of rupture of the arachnoid sleeve along a nerve root (page 542) Less frequently, lumbar puncture is complicated by severe stiffness of the neck and pain over the back of the neck and occiput (page 541); a second spinal tap in some instances discloses slight pleocytosis but no decrease in glucose a sterile or chemical meningitis This benign reaction must be distinguished from the rare occurrence of bacterial meningitis due to introduction of bacteria by the LP needle Headaches that are aggravated by lying down or lying on one side occur with acute and chronic subdural hematoma and some brain tumors, particularly those in the posterior fossa The headache of subdural hematoma, when it occurs, is dull and unilateral, perceived over most of the affected side of the head The headaches of pseudotumor cerebri are also generally worse in the supine position (Chap 31) In all these states of raised intracranial pressure, headaches are typically worse in the early morning hours after a long period of recumbency.

As of Oracle Database 11g Release 1, you are not required to individually set each of the three parameters discussed earlier You can set one single parameter, DB_ULTRA_SAFE, and that takes care of implementing the appropriate level of protection by setting DB_BLOCK_CHECKING, DB_ BLOCK_CHECKSUM, and DB_LOST_WRITE_PROTECT The DB_ULTRA_ SAFE can have the following values:

Exertional headaches are usually benign but are sometimes related to pheochromocytoma, arteriovenous malformation, or other intracranial lesions The same applies to headaches induced by stooping (see further on)

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Cable modems use the same cable that cable televisions use Because television cables can transmit digital signals, cable modems are not really modems at all; that is, they do not modulate or demodulate signals They act more as a router Unlike analog modems, cable modems do not need to perform a dial-up or handshake To understand this concept, compare your phone to your television When you phone a friend, you can t simply pick up the phone and speak to him; you must first dial his number and wait for him to answer The same is true for analog modems Television channels, however, are always there You don t need to dial up the cable company through your television to request a channel; all you need to do is switch to that channel, which was there all along This is the case with cable modems As long as there is a physical connection between cable modems, they can communicate

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