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

Permanent or transient reduction of the blood flow to the brain is often responsible for dizziness and occasionally sensorineural hearing loss. So far the diagnosis of this condition has been made by angiography, either carotid or vertebral arteriography, but there is a justified reluctance of subjecting unselected patients to this invasive procedure. It is the purpose of this paper to present a new approach to the diagnosis of cerebral vascular insufficiency based on a three-step protocol. The two initial steps are formed by noninvasive techniques and may be used for the selection of those cases requiring additional diagnostic procedures. 1) Cerebral hemodynamic evaluation provides a physiologic assessment of the direct carotid and indirect carotid and vertebral blood flow. It includes ocular plethysmography and ophthalmodynamometry obtained with the patient supine and erect, without and during carotid compression. 2) Computerized tomography allows an evaluation of the brain substance and of the changes produced by vascular insufficiency such as brain atrophy, infarcts and encephalomalacia. A new form of radiographic assessment based on a dynamic evaluation of regional blood flow will be introduced in this paper. 3) Carotid and vertebral arteriograms are performed only on these cases demonstrating a significant cerebral vascular insufficiency by the previous tests and in cases where corrective surgery is contemplated.
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PMID:Vertebrobasilar insufficiency. 49 1

The clinical features in 268 patients with diffuse cerebral atrophy of initially unknown origin have been analysed. Pneumoencephalography showed supratentorial ventricular atrophy in 87 per cent (cortical in 71 per cent), and brain stem and/or cerebellar atrophy in 17 per cent of the patients. Epileptic seizures, dizziness and clumsiness were the most frequent initial symptoms. Vibration in work, psychic impairment, gait difficulties, co-ordinative dysfunction, excessive use of alcohol, and arterial hypertension dominated the clinical picture. Serum cholesterol and triglycerides, and beta-globulins in the cerebrospinal fluid protein electrophoresis were normal. Diffuse cerebral atrophy without defined cause appears to affect all parts of the brain, with particular predilection for the frontotemporal area and the left side, and to have diffuse and unspecific clinical characteristics.
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PMID:Pneumoencephalographic and clinical characteristics of diffuse cerebral atrophy. 121 60

Thirty-eight workers from a factory producing nickel-cadmium and other types of batteries came to us for medical evaluation. They included 21 women and 17 men (seniority 2-20 years, age range 31-63 years), and represented a self-selected subset of 700-900 ever-employed and 200+ recently or currently employed workers in the factory. Thirty-four worked on the nickel-cadmium assembly line. Symptoms and signs included: headache in 34; weakness, fatigue and lassitude in 26; dizziness in 16; pruritus and skin eruptions in 37; gingivitis, teeth loss and caries in 34; nasal congestion, nosebleeds and anosmia in 30; cough, phlegm production, wheezing and shortness of breath in 26; "asthma" in 14; bone pain in 18; urinary frequency, beta 2 microglobulinuria and kidney stones in 17; and sterility or multiple abortions (33) in 8 of 21 women. One additional patient had died from an "amyotrophic lateral sclerosis-like syndrome", while CT scans in six workers revealed brain atrophy. One other worker had leukemia, and two had died from cancer (lung and pancreas). Those who had worked for more than 10 years had more symptoms and signs than shorter-term employees, especially neurological illness, bone pain and urinary tract problems, including beta 2 microglobulinuria. Past blood and urinary cadmium levels were in the range of 1.6-8.7 micrograms/dl and 8-306 micrograms/l, respectively. Our findings indicated that: a) health risks for workers were not confined to the nickel-cadmium assembly line or to older workers, b) hazardous exposures still existed and illness appeared in new workers after a clean-up and intervention program, and c) exposures involved increased risks for renal disease and cancers. Finally, there is a need to control exposures and determine health risks in the full cohort of those ever employed, in the workers' children, and in the surrounding environment (air, ground, water) due to the dumping of waste from the plant.
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PMID:Medical findings in nickel-cadmium battery workers. 142 13

Head injuries have been shown to account for between 4 and 22% of soccer injuries. Clinical and neuropsychological investigations of patients with minor head trauma have revealed organic brain damage. 69 active football (soccer) players and 37 former players of the Norwegian national team were included in a neurological and electroencephalographic (EEG) study to investigate the incidence of head injuries mainly caused by heading the ball. 3% of the active and 30% of the former players complained of permanent problems such as headache, dizziness, irritability, impaired memory and neck pain. 35% of the active and 32% of former players had from slightly abnormal to abnormal EEG compared with 13 and 11% of matched controls, respectively. There were fewer definitely abnormal EEG changes among typical 'headers' (10%) than among 'nonheaders' (27%). The former players were also subjected to cerebral computed tomography (CT), a neuropsychological examination and a radiological examination of the cervical spine. One-third of the players were found to have central cerebral atrophy and 81% to have from mild to severe (mostly mild to moderate) neuropsychological impairment. The radiological examination of the cervical spine revealed a significantly higher incidence and degree of degenerative changes than in a matched control group.
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PMID:Head and neck injuries in soccer. Impact of minor trauma. 143 95

69 active football (soccer) players and 37 former members of the Norwegian national team were included in a neurological and electroencephalographic (EEG) study to investigate the incidence of head injuries, mainly caused by heading the ball. 3% of the active players and 30% of the former players complained of permanent problems such as headache, dizziness, irritability, impaired memory and pain in the neck. 35% of the active players and 32% of former players had from slightly abnormal to abnormal EEG, as against 13 and 11% of respective matched controls. There were fewer definitely abnormal EEG changes among typical headers (10%) than among "non-headers" (27%). The former players were also subjected to cerebral computed tomography (CT), a neuropsychological examination and a radiological examination of the cervical spine. One third of the players were found to have central cerebral atrophy and 81% to have from mild to severe (mostly mild to moderate) neuropsychological impairment. The radiological examination of the cervical spine revealed a significantly higher incidence and degree of degenerative changes than in a matched control group.
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PMID:[Head and neck injuries among Norwegian soccer players. A neurological, electroencephalographic, radiologic and neuropsychological evaluation]. 157 6

A 56-year-old woman initially noticed dizziness in October, 1988, and later dementia and gait disturbance developed, associated with myoclonus and periodic synchronous discharge in the electroencephalogram. On the basis of these clinical findings we made a diagnosis of Creutzfeldt-Jakob disease (CJD). Using RIA for ubiquitin (signal peptide of the ATP dependent proteolytic system), we measured the cerebrospinal fluid (CSF) ubiquitin levels. The CSF level of ubiquitin was markedly elevated in this case five months after the initial symptoms (230.0 ng/ml) compared with normal values (14.3 +/- 1.1 ng/ml) and values in patients with senile dementia of Alzheimer type (21.3 +/- 6.1 ng/ml) and vascular dementia (16.6 +/- 6.4 ng/ml). With progression of brain atrophy in this case, CSF levels of ubiquitin rapidly decreased to near the normal values. These findings suggest that CSF ubiquitin concentration reflects the activity of the disease process in CJD, and it may be useful in the diagnosis of CJD.
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PMID:[A case of Creutzfeldt-Jakob disease with markedly elevated ubiquitin concentration in the cerebrospinal fluid]. 165 80

Computerized tomography of the head was done in 5021 patients aged 21 to 81 years from various neurological, neurosurgical and neurotraumatological indications. Brain atrophy as an only finding (primary) was noted in 11.5%- and in 5.4% of cases it was associated with other changes. The neurological-radiological correlations were established in 200 cases of primary strophy. History data included: headaches in 54.5%, dizziness in 15.0%, epilepsy in 24.5%. Objective examination showed: slight hemiparesis in 37.5%, spastic-atactic gait disturbances in 31.5%, isolated damage to the corticospinal tracts with signs limited to one side of the body was more frequent in cortical atrophy, and these signs associated with ataxia were more frequent in subcortional atrophy. The authors explain this as a loss of cortical cells or damage to the paraventricularly coursing nerve fibres. A probable aetiology of "primary" atrophy was established in 405% of cases (hypertension, atherosclerosis, minor craniocerebral trauma). No signs or neurological syndromes were observed which could be regarded as more or less characteristic of brain atrophy.
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PMID:[Brain atrophy: radiological-neurological correlations]. 213 53

Neurotoxic volatile organic solvents used by house and car painters may lead to professional toxic encephalopathy after several years of exposure. The symptoms are memory impairment, fatigue, personality changes, headache and dizziness. Vestibular dysfunction was found in 55% of 113 painters examined, mainly in the form of reduced caloric vestibular reactions. No correlation between vestibular dysfunction and the duration of exposure, cerebral atrophy or intellectual impairment could be demonstrated. Vestibular examination may be helpful in detecting early changes in exposed persons and in determining more accurate safety limits for harmful chemicals.
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PMID:Vestibular dysfunction in occupational chronic solvent intoxication. 697 23

The prognosis of chronic toxic encephalopathy in former house painters was examined in a prospective study with a two-year observation period. Twenty-six patients, who at the initial examination had cerebral atrophy and/or intellectual impairment, were selected for the follow-up study. No competitive etiological factors (including alcohol) to the encephalopathy were suspected. During the two-year follow-up interval these patients were not professionally exposed to organic solvents. At the follow-up examination neurological, biochemical, neuropsychological, and neuroradiological parameters were reassessed and compared to the original findings. Generally the condition was unchanged. Slight improvements with regard to headache and dizziness were reported by some. However, the neurological status, the neuropsychological impairment, and the cerebral atrophy, did not change significantly. In three patients further deterioration was observed. It is argued that our patients suffered from a brain disorder different from presenile dementia of the Pick-Alzheimer type. Other alternative etiological entities were also excluded. Our findings indicate that long-term exposure to organic solvents may lead to a chronic brain syndrome. Once intellectual impairment and/or cerebral atrophy had developed, reversibility is not observed. Nor is further progression to be expected if exposure is stopped. Occupational exposure to organic solvents should be maximally restricted as it represents a risk of inducing invalidating brain syndromes.
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PMID:Prognosis in chronic toxic encephalopathy. A two-year follow-up study in 26 house painters with occupational encephalopathy. 731 95

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


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