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

The purpose of this article is to review the endoscopic management of cerebrospinal fluid (CSF) leaks and encephaloceles, with particular emphasis on safety and efficacy, by retrospective assessment utilizing the results of a mailed questionnaire. Surveys were mailed to members of the American Rhinologic Society with practices in both academic centers and/or private settings. Survey results were then assessed and tabulated. There were 635 mailings, with 197 responses (31%). Seventy-two (36% of respondents) indicated that they performed endoscopic management of CSF leaks and encephaloceles, while 125 (64% of respondents) did not. Respondents reported approximately 522 cases of CSF leaks and approximately 128 cases of encephaloceles managed by endoscopy. Success rates after a single procedure were estimated at 90% for CSF leaks and 93% for encephaloceles. Success rates after a secondary procedure were estimated at 86% and 97%, respectively; 29% of respondents have, at some point, made a referral to neurosurgery. A total of 13 complications related to endoscopic repairs were reported (2.5%). For CSF leak repair, complications included seizures, 0.2%; meningitis, 1.1%; and one reported case each of cavernous sinus thrombosis, temporary visual problems, sinusitis, and intracranial hypertension/bleed. There was only one reported death in the approximately 522 cases. Eleven complications following encephalocele repairs (8.5%) included seizures, 3.1%; meningitis, 2.3%; and one reported case each of brain abscess, sinusitis, false aneurysm of middle cerebral artery, and mild dizziness. No deaths following encephalocele repair were reported. The endoscopic management of CSF leaks and encephaloceles has become increasingly popular and has proven to have low morbidity and mortality with high success. Overall, our results confirm that in the hands of the skilled endoscopist, endoscopic management of CSF leaks and encephaloceles is highly efficacious and has a very low incidence of significant complication.
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PMID:Safety and efficacy of endoscopic repair of CSF leaks and encephaloceles: a survey of the members of the American Rhinologic Society. 1125 50

The purpose of this report is to describe our experience of infected false aneurysm treatment following internal carotid artery (ICA) reconstruction. Five and 6 years before admission, bilateral reconstruction was done because of ICA kinking at a local health center. The patient was symptomless for 5 years but later became partially symptomatic (dizziness, vertigo, and visibly bilateral neck pulsatile masses). On routinely performed ultrasonography and multislice scanner examinations, the bilateral ICA pseudoaneurysms were revealed. The final treatment was surgery and aneurysmal sac resection followed by end-to-end arterial reconstruction. A right-sided wound swab was positive; Staphylococcus aureus was cultured. Antibiotics were administered: teicoplanin (Targocid) 800 mg as an initial dose followed by 400 mg maintenance doses over the following 4 days. After 1 month, left ICA reconstruction was done and a wound swab showed staphylococcal infection as well. At the 12-month follow-up, the patient was doing well; cerebral vascularization was well preserved. Infected false aneurysms are rare complications following carotid artery reconstruction. Aneurysmal sac resection and arterial reconstruction with end-to-end anastomosis or autologous saphenous vein are recommended. A wound swab is mandatory.
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PMID:Extracranial internal carotid artery pseudoaneurysms after kinking reconstruction. 2097 24