Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Surgical treatment of brainstem lesions has been encouraged after the development of magnetic resonance imaging. However, direct approaches to intra-axial lesions in the brainstem still carry a high risk of morbidity because the neuronal structures can be injured along the entry routes. We present two patients whose pontine cavernous angiomas were removed via incision of the lateral aspect of the pons with presigmoid approach. The first case, a 41-year-old woman, presented with paresis of the cranial nerves VI, VII, and VIII, and left hemiparesis progressing over 2 weeks caused by a cavernous angioma ventrally located in the lower pons. The second case, a 50-year-old woman, developed dizziness over 2 months due to a large cavernous angioma in the center of the pons. These lesions were totally removed through the presigmoid approach and no additional neurological deficits were observed. An image-guided navigation system was used for the craniotomy and removal of the lesion in the second patient. The presigmoid approach provides a safe route to intra-axial lesions in the pons. A technique for presigmoid craniotomy with one-piece bone flap under the image-guided navigation is also described.
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PMID:Presigmoid approach for cavernous angioma in the pons--technical note. 1194 97

Haemophilus aphrophilus infection is rare, and the organism is infrequently implicated in serious infection. We report a case of a 61-year-old patient who experienced left hemiparesis with dizziness. Computed tomography of the brain demonstrated a lesion with ring enhancement in the right frontotemporal region. Craniotomy was performed, abscess was drained, and H. aphrophilus was isolated. Following the surgical procedure and further antibiotic treatment, the patient recovered completely.
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PMID:Haemophilus aphrophilus brain abscess: a case report. 1238 Jul 92

We describe a 25-year-old woman that presented with frequent rotational dizziness, visual loss of the right eye one month later, and unilateral deafness one year after. After 2 years, she presented with a right hemiparesis and deafness greater for low frequency tones. Magnetic resonance imaging with angiography of the brain showed constriction in the first segment of the cerebral anterior artery diagnosed as Susac's syndrome.
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PMID:Susacs syndrome. 1496 24

Giant cell arteritis is rarely reported in people aged less than 50 years. We report a case of giant cell arteritis in a woman who developed symptoms of dizziness, headache, bilateral sensorineural hearing impairment, and had 1 episode of transient left hemiparesis before the age of 30. Carotid angiography showed multiple segmental narrowing in cranial vessels. Subsequently, at the age of 31, she had weight loss and developed a fever. Chest radiograph revealed mediastinal widening, and chest computed tomography revealed dilated pulmonary arteries and veins. Coronary angiography and aortography showed irregular narrowing of the descending aorta and multiple stenosis, with aneurysmal dilatation involving the proximal and distal coronary, pulmonary and mesenteric arteries. Multinucleated giant cells and predominant CD8+ T lymphocyte infiltration were noted in a left temporal artery biopsy specimen. The patient's age and the finding of dilated pulmonary veins and prominent CD8+ T lymphocytes in the biopsy specimen suggest that this case was a distinct form of systemic giant cell arteritis.
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PMID:Giant cell arteritis with CD8+ instead of CD4+ T lymphocytes as the predominant infiltrating cells in a young woman. 1534 Jun 54

We describe the first case of Weber's Syndrome to present as a manifestation of decompression illness in a recreational scuba diver. Weber's Syndrome is characterized by the presence of an oculomotor nerve palsy and contralateral hemiparesis. The patient was a 55 year-old male with a past medical history of a pulmonary cyst, in whom symptoms developed after a multilevel drift dive to a depth of 89 feet for 53 minutes, exceeding no-decompression limits. Symptom onset was within 30 minutes of surfacing and included the Weber's Syndrome, a sixth nerve palsy, dizziness, nausea, sensory loss, and ataxia. The patient received four U.S. Navy Treatment Tables with complete resolution of all neurological signs and symptoms. The mechanism of injury remains unclear, but may involve aspects of both air gas embolism and decompression sickness. Individuals with pre-existing pulmonary cysts may be at increased risk for dive-related complications.
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PMID:Weber's syndrome and sixth nerve palsy secondary to decompression illness: a case report. 1592 1

Medial medullary infarct (MMI) is a rare type of brain stem infarction. Its clinical picture was characterized by contralateral hemiparesis, deep sensory disturbance, and ipsilateral hypoglossal paresis, but conjugate deviation or nystagmus is uncommon as initial symptom. Case 1: A 73-year-old man developed vomiting and vertigo. Examination revealed right conjugate deviation and horizontal nystagmus beating toward the left side, and numbness on his right upper limb,but no hypoglossal nerve palsy. Cranial MRI demonstrated an infarction in the left paramedian region of the upper medulla and thrombus of the left vertebral artery. Case 2: A 74-year-old man suffered from dizziness and nausea. He showed left conjugate deviation and right-beating horizontal nystagmus without Horner syndrome or hypoglossal nerve palsy. MRI disclosed an infarction in the right upper medial medulla. MRA revealed the right dissecting vertebral artery. Case 3: A 71-year-old man developed vertigo when watching at TV. He showed transient left conjugate deviation and transient motor paresis on the left upper limb. MRI showed the thickened wall of the right vertebral artery but no abnormal ischemic lesion. Digital subtraction angiograms revealed the dissecting right vertebral artery. All ischemic events limited to the upper third of the medulla were caused by the vertebral artery lesions, and prognosis was good. The unilateral MMI lesion in the nucleus prepositus hypoglossi and/or the medullary reticular formation caused contralesional shift of the eyes and ipsilesional nystagmus. The upper MMI will be characterized by a triad of contralateral hemiparesis, deep sensory disturbance and abnormal ocular motor findings.
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PMID:[Conjugate deviation in ischemia of medial medullary oblongata--report of three cases]. 1737 Jun 54

A certain family with a history of familial hypercholesterolemia (FH) in which several members suffered cerebral infarction (CI) for 3 successive generations is reported. The first case is a 54-year-old female who suffered from medial longitudinal fasciculus syndrome caused by a lesion on the pons. The second case is the son of the first case and is a 28-year-old male who suffered from left hemiparesis by a lesion on the corona radiata. The third case is the mother of the first case and is a 77-year-old female who suffered from dizziness as a result of cerebellar lacunae. All 3 patients showed a marked elevation of their serum cholesterol level without any apparent history of coronary heart disease (CHD). Our cases are peculiar and unique because the patients are of 3 successive generations who suffer from CI without any apparent history of CHD. Moreover, the latter generations are having CI at younger ages. The mechanism of CI was thought to be the occlusion of the arteriole by the increased viscosity associated with other risk factors rather than the apparent arteriosclerosis in our cases. Although FH is often associated with a high incidence of CHD, the information about the occurrence of CI has not always been available. The patients may suffer from CI more frequently than was previously thought. We hope to point out the need for such FH patients to be carefully monitored and to be treated as a high-risk group for CI as well as CHD.
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PMID:Familial hypercholesterolemia: a family who suffered cerebral infarction over three successive generations. 1790 64

Intracranial dural arteriovenous fistulas (AVFs) are potentially at risk for hemorrhage, and their symptoms and prognosis are highly variable. We present 7 surgical cases with the initial symptoms of venous ischemia by dural AVF. The series comprises 3 male and 4 female, ranging in age from 37 to 76 years (mean age, 61.1 years). Initial symptoms were dizziness in 3 cases, headache in 2 cases, unconsciousness in 1 case, and hemiparesis in 1 case. The locations included the superior sagittal sinus in 3 cases and the transverse-sigmoid sinus in 4 cases. Computed tomography with contrast media and magnetic resonance imaging revealed abnormal vessels. In all cases, retrograde feeding into the cortical veins was observed. On angiography, multiple retrograde venous drainage into the cortical veins were observed in all cases. Single photon emission computed tomography (SPECT) demonstrated apparent hypoperfusion in all 7 cases and further decrease by diamox challenging test in 4 cases. The dural AVFs were removed, and the symptoms disappeared in all cases, although transient aphasia was observed in a single case postoperatively. Postoperative SPECT showed improvement of cerebral blood flow in 4 and no change in 2 of 6 follow-up cases. Cerebral ischemia was induced by venous hypertension, and the hypoperfused brain improved immediately after the operation. Cerebral venous ischemia is a reversible condition that can be improved by appropriate early-stage treatment.
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PMID:Cerebral venous ischemia by dural arteriovenous fistulas. 1790 17

Sildenafil citrate (Viagra) is one of the frequently prescribed drugs for men with erectile dysfunction. We describe a 52-year-old man with bilateral middle cerebral artery (MCA) territory infarction after sildenafil use. He ingested 100 mg of sildenafil and about 1 h later, he complained of chest discomfort, palpitation and dizziness followed by mental obtundation, global aphasia and left hemiparesis. Brain magnetic resonance imaging documented acute bilateral hemispheric infarction, and cerebral angiography showed occluded bilateral MCA. Despite significant bilateral MCA stenosis and cerebral infarction, systemic hypotension persisted for a day. We presume that cerebral infarction was caused by cardioembolism with sildenafil use.
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PMID:Bilateral cerebral hemispheric infarction associated with sildenafil citrate (Viagra) use. 1829 Aug 52

Primary central nervous system (CNS) marginal zone B-cell lymphoma (MZBL) is very rare and shows an indolent disease course with potential of being cured. It seems to originate from meningothelial cells, and the most common site of occurrence is the dura of the cerebral convexity. Primary CNS MZBL is often misdiagnosed as meningioma because of its similar tumor locations and appearances on magnetic resonance imaging (MRI). Surgery, radiation therapy, chemotherapy, and combinations of these are considered treatment modalities depending on the case. Herein, we describe an 18-year-old man who presented with acute onset of right-sided central facial nerve palsy, right-sided hemiparesis with motor power grade 4+, dizziness, and dysarthria. After an MRI scan of the brain, wherein he was first diagnosed with high-grade glioma, a biopsy sample showed that he had primary CNS MZBL arising in the left basal ganglia. He was treated with radiation therapy, which resulted in complete remission for 1 year and 10 months up to the date of this case report. It is important to diagnose primary CNS MZBL correctly because it is curable without unnecessary invasive treatment in cases of localized disease.
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PMID:Primary central nervous system marginal zone B-cell lymphoma of the Basal Ganglia mimicking low-grade glioma: a case report and review of the literature. 1885 86


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