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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 69-year-old man suffered from dizziness and nausea after work, and was admitted to our hospital on the next day. On admission, he showed bilateral horizontal nystagmus and left hemiparesis. On the 3rd day he vomited frequently, and the dizziness became worse. Bilateral horizontal and upward gaze palsy and bilateral facial nerve palsy were observed. Brain MRI on the 5th day disclosed bilateral upper medial medullary infarction that extended to the pontomedullary junction. Cerebral angiography on the 13th day revealed occlusion of the right vertebral artery. This case did not show typical medial medullary syndrome. The mechanism was unknown, but similar cases were reported. Recently, many cases of medullary infarction are reported with the progress of MRI technology. It is suggested that the addition of the new concepts on the conventional syndromes of medullary infarction is necessary.
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PMID:[A case of bilateral infarction of medial pontomedullary junction]. 899 47

A patient with low-grade lymphoma presented 8 months after autologous marrow transplantation with dizziness, aphasia and hemiparesis. Magnetic resonance imaging (MRI) showed an abnormal T2 signal in the frontoparietal region unilaterally. Biopsy of the area demonstrated progressive multifocal leukoencephalopathy positive for JC virus and p53. Treatment with interleukin-2 at 0.5 MU/m2/day i.v. continuous infusion resulted in near complete resolution of symptoms and MRI abnormalities. The absolute number of CD3+CD4+ and CD3-CD56+ cells in the peripheral blood also increased, and the CD4/CD8 ratio normalized. She remains free of evidence of progressive multifocal leukoencephalopathy 1 year off therapy.
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PMID:Successful treatment of progressive multifocal leukoencephalopathy with low-dose interleukin-2. 942 79

From Jan. 1993 to Sept. 1995 23 patients suffering from brain metastases from renal cell carcinoma were treated with the Leksell Gamma Knife at the University of Vienna. At the time of diagnosis 13 patients had single and 10 patients presented with multiple metastatic lesions with a total of 44 metastases in MRI scans. Median tumour volume was 5500 cmm (range 100-24000 cmm). Predominant neurological symptoms and signs were different forms of hemiparesis, focal and generalized seizures, cognitive deficit, headache, dizziness, ataxia and CN XII paresis. Fourteen patients received Gamma Knife Radiosurgery (GKRS) with a median dose of 22 Gy (range 8-30 Gy) at the tumour margin. Nine patients underwent a combined treatment of a radiosurgical boost with a median dose of 18 Gy (range 10-22 Gy) at the tumour margin followed by Whole Brain Radiotherapy (total dose 30 Gy/2 weeks). In 20 patients tumour volume reduction up to 30% of the primary tumour volume was found after 4 weeks, evaluated on CT or MRI. A total remission was seen in 4 cases 3 months after GKRS. We achieved a local tumour control of 96%. Rapid neurological improvement after GKRS was seen in 17 patients. The median survival time was 11 months; the one-year actual survival in this unselected group was 48%. Five long term survivors were still alive, 18 patients had subsequently died, 15 of them of general tumour progression. GKRS induces a significant tumour remission accompanied by rapid neurological improvement and therefore provides the opportunity for extended high quality survival. Neither local tumour control was improved nor CNS relapse free survival was prolonged significantly by additional WBRT.
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PMID:Gamma-knife radiosurgery for brain metastases of renal cell carcinoma: results in 23 patients. 975 21

A primary lymphoma in the left temporal lobe of the brain in a 66-year old man is presented. The brain tumor was diagnosed on the basis of clinical symptoms (temporary dizziness, mixed aphasia and right hemiparesis) and repeated CT scanning of the brain. The patient with diagnosed malignant, non-operative brain tumor underwent a series of radiotherapy and steroidtherapy. The patient died twelve months after the first signs and symptoms had occurred. A general autopsy did not reveal any neoplasmatic changes. A macroscopic neuropathological examination showed large tumor's mass in the left temporal lobe which was not separated clearly from its surrounding. A microscopic examination included histopathological (HE, Kanzler-Arendt, Perdrau, PATH, PAS) and immunocytochemical techniques (GFAP, anti-galactocerebroside, LCA, CD45RO, OPD4, CD20). It was found that the examined brain tumor was B-cell malignant lymphoma with the presence of T-cells. Since no changes were revealed in internal organs, the tumor was diagnosed as a primary brain lymphoma.
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PMID:Primary malignant lymphoma of the brain. 981 26

Recent advances in neuroradiology have enabled us to approach cavernous angioma in the brain stem. A case of large cavernous angioma, which was located in the pontomedullary junction, was removed surgically. A 24-year-old female was admitted with occipitalgia, dizziness, nausea, gait disturbance. On neurologic examination, the patient had right hemiparesis, slight right facial palsy and paresthesia, right hemiparesthesia, dysphagia. T1 weighted Gd enhanced MRI revealed a mixed intensity lesion. These findings were thought to be consistent with a cavernous angioma. Follow up MRI findings demonstrated progressive increase in cavernous angioma. Vertebral angiograms showed a mass sign and a venous angioma in the midline of the pontomedullary junction. Therefore, the operation was performed in an attempt to remove the cavernous angioma through the midline of the fouth ventricle. The operation was performed under monitoring of electromyogram of facial muscle and external ocular muscle. The cavernous angioma was removed totally, and addition neurogical deficits were minimal.
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PMID:[Surgical removal of large cavernous angioma in the pontomedullary junction: a case report]. 1034 54

Stereotactic radiosurgery (SR) is being used with increasing frequency in the treatment of brain metastases. This study provides data from a clinical experience with radiosurgery in the treatment of cases with multiple metastases and identifies parameters that may be useful in the proper selection and therapy of these patients. From January 1993 to April 1997, 97 patients (43 women and 54 men; median age 58 years) suffering from multiple brain metastases (median 3; range 2-4) in MRI scans, received SR with the Gamma Knife. The median dose at the tumor margin was 20 Gy (range 17-30 Gy). Median tumor volume was 3900 cmm (range 100-10,000). Different forms of hemiparesis, focal and generalized seizures, cognitive deficit, headache, dizziness and ataxia had been the predominant neurological symptoms. Major histologies included lung carcinoma (44%), breast cancer (21%), renal cell carcinoma (10%), colorectal cancer (8%), and melanoma (7%). The median survival time was 6 months after SR. The actual one-year survival rate was 26%. In univariate and multivariate analysis, a higher Karnofsky performance rating and absence of extracranial metastases had a significantly positive effect on survival. Local tumor control was achieved in 94% of the patients. Complications included the onset of peritumoral edema (n = 5) and necrosis (n = 1). SR induces a significant tumor remission accompanied by neurological improvement and, therefore, provides the opportunity for prolonged high quality survival. We conclude that radiosurgical treatment of multiple brain metastases leads to an equivalent rate of survival when compared to the historic experience of patients treated with whole brain radiotherapy. Patients presenting initially with a higher Karnofsky performance rating and without extracranial metastases had a median survival time of nine months. Each such case should therefore be evaluated based on these factors to determine an optimal treatment regimen.
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PMID:Prognostic factor analysis for multiple brain metastases after gamma knife radiosurgery: results in 97 patients. 1042 Oct 75

A group of 185 patients with brain atrophy found in CT is presented. The purpose of the study was to call attention to the the significance, frequency and clinical signs of brain atrophy. All patients were divided into two groups: 78 cases with secondary brain atrophy associated with other diseases of central nervous system and 107 cases of "primary" brain atrophy. The last one was an only finding without any other pathological lesions in the brain. Depending on the localisation, three groups of brain atrophy were isolated: generalized, subcortical and cortical. The clinical picture was analysed in the group of "primary" brain atrophy. In the studied group the most frequent cause of hospitalisation were epileptic seizures, the next one: headache, one-side hemiparesis or hemihypaesthesia, dizziness and incoordination. Neurological examination showed that one-side signs were observed very often in generalized brain atrophy. In the group of patients with cortical brain atrophy most patients were without any neurological signs. The analysis of the relationship between the clinical examination and "primary" brain atrophy found in CT, showed lack of characteristic, typical signs, which could be connected with brain atrophy. The problem of difficulty in the diagnosis of brain atrophy is stressed aesthesia. The definition and the significance of brain atrophy should be verified in diagnosis and the conclusions after finding brain atrophy have to be very careful.
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PMID:[Clinical symptomatology of primary brain atrophy]. 1046 19

Cerebral arteriovenous malformations (AVMs) are considered to be congenital disorders. However, their familial occurrence has so far been described in only 19 families in the literature. The authors report on two cases in one family and review the literature. A 45-year-old female subject with sudden onset of headache and vomiting due to a subarachnoid haemorrhage from a small AVM in the posterior part of the corpus callosum near the midline on the left side was studied. Irradiation of the AVM using Leksell's gamma knife led to its complete obliteration. Her older sister presented with temporal seizures at the age of 49 and later also with left hemiparesis, left hemihypaesthesia and dizziness - caused by a large AVM in the right temporal lobe. This AVM was treated by a combination of embolization and irradiation by the Leksell's gamma knife.
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PMID:Familial occurrence of cerebral arteriovenous malformation in sisters: case report and review of the literature. 1080 22

Inflammatory demyelinating diseases are a common cause of neurologic disability in young adults, and usually the cause is unknown. We describe a case of acute disseminated encephalomyelitis (ADEM) associated with Chlamydia pneumoniae infection. An 18-year-old previously healthy women, with a one-week history of coryzal illness, was admitted because of progressive headache, dizziness, and a left-sided hemiparesis. MR imaging of the brain and brainstem showed typical signs of ADEM. The diagnosis was established by PCR Chlamydia pneumoniae DNA positivity in a tracheal swab and by increasing titres of Chlamydia IgM antibody. The patient was treated with doxycycline and steroids and recovered completely. Apart from therapeutic implications, this case may contribute to our understanding of demyelinating diseases of the central nervous system.
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PMID:Chlamydia pneumoniae-associated ADEM. 1097 4

We report a 73-year-old woman with intravascular malignant lymphomatosis (IML) who showed generalized telangiectasia as well as various neurological symptoms. In July 1998, she developed fever, dizziness, and confusion followed by left hemiparesis, and was admitted to our hospital on August 11, 1998. Laboratory tests indicated a normochromic normocytic anemia, thrombocytopenia, elevated serum lactic dehydrogenase (LDH), C-reactive protein (CRP), and cerebrospinal fluid protein. Magnetic resonance imaging (MRI) of the brain revealed an infarct-like lesion in the left frontal lobe and multiple white matter lesions. After admission, her neurological status deteriorated and lapsed into coma and quadriplegia. At the end of September 1998, generalized telangiectasia appeared, and she was diagnosed as IML on skin biopsy. Although combination chemotherapy failed to improve her neurological symptoms, telangiectasia disappeared in a few days, and the infarct-like lesion on MRI decreased in size. Serum LDH, CRP, and thrombocyte counts were normalized. Autopsy findings revealed perivascular clustering of B cell type lymphoma cells in the left frontal lobe where abnormal signal intensity was found on MRI, as well as the spleen and the bone marrow. This case emphasizes the importance of early diagnosis and treatment in IML.
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PMID:[Intravascular malignant lymphomatosis: an autopsy case with generalized telangiectasia and various neurological manifestations]. 1148 51


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