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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of cryptococcal granulomatous arachnitis of the spinal cord was reported. A 12-year-old boy suffered from sudden occipitalgia and left hemiparesis. The symptoms disappeared spontaneously in about a half year. The next year, he consulted an orthopedist because of lumbago and gait disturbance. Myelography through the cisternal route showed complete block at the level of L1. Exploratory laminectomy of D12 and L1 revealed adhesive arachnitis. Symptoms were improved immediately after the operation. At the age of 15, he was admitted to our clinic, because of sudden onset of headache and vomiting. Computed tomography showed marked hydrocephalus. He recovered by ventriculoperitoneal shunt, and was discharged. The next year, sudden back pain occurred. Gait disturbance, sensory disturbance of the legs and trunks below the mamilla, and dysuria appeared gradually. He was readmitted and laminectomy of D2-4 was performed. The arachnoid membrane was white and 2 mm in thickness diffusely. Thickened arachnoid membrane was removed at the level of D2-4. Histological diagnosis was granulomatous arachnitis. Cryptococcus was seen in the removed tissue. Symptoms were improved after operation. One thousand milligrams of amphoterisin B was injected intermittently. He was discharged on food. Spinal symptoms in cryptococcosis are rare. Operative procedures were effective before the administration of amphoterisin B.
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PMID:[Cryptococcal granulomatous arachnitis of the spinal cord--a case report (author's transl)]. 49 61

Thirty-four patients with locally advanced bladder cancer have been treated with selective intra-arterial infusion of CDDP and/or ADM (IA therapy) prior to planned surgical resection. Follow-up ranged from 25 to 108 months (median 61). Initial tumor stage was cT2 in 10 patients, cT3 in 19 and cT4a in 5. Catheterization technique: gluteal muscles were dissected gently along the muscle fiber to expose the inferior gluteal artery with the patients in prone position, then the catheter was inserted. The tip was wedged in the internal iliac artery below the bifurcation of the superior gluteal artery. ADM 10-20 mg and/or CDDP 10-20 mg were infused once or twice a week. Total dose of ADM and CDDP were 40-580 and 60-240 mg. Thirteen patients received IA therapy + hyperthermia and 8 IA therapy + irradiation. Surgical resection included total cystectomy (22 patients), partial cystectomy (3 patients) and transurethral resection of the prostate (5 patients). Survival rate at 5 years is 57.9% (T2 = 90.0, T3 = 52.1, T4 = -). Eighteen patients are alive with no evidence of recurrences, and 11 patients were free of disease for more than 5 years. Side effects were bone marrow suppression (5 patients), vomiting (4), erosion of gluteal skin (7), and neurotoxicity, such as sensory disturbance in lower extremities or ischialgia (2); treatment was well tolerated in others. In conclusion, our results suggest that intra-arterial infusion of ADM and/or CDDP by insertion of catheter from inferior gluteal artery is safe with minimal systemic side effects, and prolongs survival for invasive bladder cancer.
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PMID:Intra-arterial chemotherapy for bladder cancer by insertion of catheter from inferior gluteal artery. 194 65

A case of 25-year-old woman with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) was reported. She had short stature, episodic vomiting with headache, several episodes with homonymous hemianopsia, progressive intellectual decline, generalized convulsion, muscular atrophy, sensory disturbance on the left side of the body, and primary amenorrhea. Lactate, pyruvate and the lactate to pyruvate ratio were elevated in the serum and cerebrospinal fluid. Muscle biopsy revealed ragged-red fibers. On electron microscopy there were subsarcolemmal aggregations of abnormal mitochondria with proliferation of crista and inclusions. Activities of the respiratory chain enzymes of the muscle mitochondria were normal. She showed a failure of GH response to arginine and levodopa and delayed response of serum GH to growth hormone releasing factor (GRF). She also showed decreased gonadotropin levels and delayed response of the hormone to LH-RH. In this case, a dysfunction of the hypothalamo-pituitary axis may be related to the short stature and primary amenorrhea. It is suggested that the hypothalamo-pituitary hypofunction may be one of the characteristic features in MELAS.
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PMID:[Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) associated with hypothalamo-pituitary hypofunction--a case report]. 206 Feb 43

A case of adult Moyamoya disease, with formation of a transcranial external carotid-internal carotid (EC-IC) anastomosis through burr holes which had been made previously. A 43-year-old male suffered sudden headache and vomiting. Neurological examination revealed mild consciousness disturbance and dysarthria. The computed tomography (CT) scans showed intraventricular hemorrhage, which was drained through burr holes bifrontally. The diagnosis of Moyamoya disease was subsequently made by cerebral angiography. A month later he was discharged with mild gait disturbance and mental retardation. Seven years later he suddenly complained of gait disturbance, dysarthria and sensory disturbance involving the right upper extremity. A CT scan revealed a small hemorrhage in the left putamen. Carotid angiograms disclosed transcranial EC-IC anastomosis through the burr holes which had been made previously. It is suggested that revascularization can be expected after opening burr holes and incising the dura matter for Moyamoya disease in adults as well as, possibly, in children.
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PMID:[Adult moyamoya disease with a transcranial internal carotid-external carotid (EC-IC) anastomosis through burr holes]. 237 49

We reported a 51-year-old male with ischemic disturbance of right inner ear resembling Meniere's disease. The patient had a sudden-onset episode of vertigo, right severe hearing disturbance, nausea, vomiting and gait disturbance. Two days after, he had hypersomnia, vertical gaze palsy, double vision, left Horner's sign, and sensory disturbance of pain and temperature of right half body involving face. Brain MRI disclosed high intensity area in T2-weighted image and proton density in bilateral paramedian thalamo-mesencephalic region and right cerebellum (area of the anterior inferior cerebellar artery). Cerebral angiography showed 90% or more stenosis of the right vertebral artery, 50% stenosis of the left vertebral artery before the posterior inferior cerebellar artery (PICA), and 60% stenosis of distal portion of the basilar artery. Furthermore, stem portion of the posterior cerebral artery, and the right anterior cerebellar artery and the left vertebral artery after the PICA were absent or occluded. Right deafness was evaluated to be Jerger type II, namely disturbance of inner ear. Caloric tests showed no response, and right auditory brainstem response showed no waves. Main cause of this vertigo and right deafness was considered to be disturbance of inner ear due to ischemia of right labyrinthine artery, though this patient was not a typical case of the anterior cerebellar artery syndrome. Ischemic disturbances of inner ear have been reported only in patients with the anterior cerebellar artery syndrome, therefore this patient who had only acute ischemic disturbance of inner ear and did not have disturbance of caudo-lateral portion of the pons was considered to be very rare.
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PMID:[A case of ischemic disturbance of inner ear]. 259 43

A 45-year-old Japanese man, who had had bilateral visual disturbance due to Vogt-Koyanagi-Harada (VKH) disease 17 years before entry, was admitted to this hospital because of headache, vertigo and vomiting. On examination at entry, no abnormalities except for poliosis, patches of vitiligo on his left shin, sunset glow fundus, and positional nystagmus with Frenzel glasses were found. Laboratory data other than leukocytosis and elevated level of gamma-GTP were normal and the results of brain CT scan were within normal limits. On the following day, diplopia was developed and the neurological symptoms including loss of bilateral visual acuity, Horner's syndrome on the right side, right facial palsy, bilateral sensorineural hearing disturbance, palsy of the soft palate on the right side with swallowing difficulty, and dissociated sensory disturbance on the right face and the upper and lower extremities on the left side appeared with a few days. He couldn't get up. The cerebrospinal fluid (CSF) was clear and had pleocytosis with normal sugar content. The protein, immunoglobulin G and myelin basic protein (MBP) were elevated but the tests for oligoclonal band and antiviral antibodies were negative. Brain CT scan showed low density areas in right cerebellar hemisphere and in left putamen without abnormality with contrast material and evoked potentials were normal. Prednisolone was prescribed and his symptoms were subsided but his gait remained ataxic. Magnetic resonance imaging (MRI) 4 months later showed an atrophy of the lower half of bilateral cerebellar hemisphere supplied by posterior inferior cerebellar artery, suggesting cerebellar infarction, and high intensity areas on T2 image in bilateral cerebral white matters, basal ganglia, and left cerebral peduncle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Wallenberg's syndrome in a case of Vogt-Koyanagi-Harada disease]. 261 5

The clinical manifestations and computed tomographic (CT) findings of small intracerebral haematomas (ICHs) were studied in 31 consecutive cases which comprised 6% of 520 cases of non-traumatic, non-neoplastic ICH confirmed by CT in a 3-year period. A small ICH was defined by CT as a sharply demarcated high density area with the maximum dimension not exceeding 20 mm and on no more than two contiguous 10-mm scan sections. The ages ranged from 50 to 85 years, being between 50 and 69 in about two thirds. Twenty-nine patients (93%) were hypertensive. The haematoma was in the capsulothalamus (9 cases), thalamus (6 cases), capsuloputamen (6 cases), subthalmus (2 cases), internal capsule (2 cases) pons (4 cases), midbrain (1 case), and cerebellum (1 case). Headache (4 cases) and vomiting (3 cases) were rare, whereas dizziness was rather frequent (16 cases). None had loss of consciousness. The essential clinical manifestations were sensorimotor deficits in 13 cases, pure motor hemiparesis in 6, pure sensory disturbance in 4, and involuntary movements in 2. Five patients with haemorrhage in the brain stem presented with various syndromes. None of the 31 cases had a fatal outcome directly due to the small haemorrhagic stroke. Two patients had recurrent stroke; a small, deep infarct in 1 and a large haemorrhage in the other. Full neurological and functional recovery was made in 17 cases (56.7%), recovery with mild sequelae in 7 (23.3%) and little recovery in 6. Poor recovery was related to the location (pons), the age (above 75 years), and the presence of involuntary movements. Some clinical features common to lacunar infarcts and small ICHs were discussed, and the possibility of a combination of these two conditions in a same hypertensive patient was raised. Small ICH as a type of benign, non-fatal stroke is not infrequent in communities where the incidence of hypertensive ICH is relatively high. CT scanning in the early stage of stroke even for patients with mild neurological symptoms may enhance the detection rate of such small ICHs.
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PMID:Small intracerebral haemorrhage: a study of clinical manifestations and CT findings on 31 cases. 400 23

The authors described a case of arteriovenous malformation (AVM) of the choroid plexus, and presented a review of literature. This 40-year-old male experienced a sudden onset of severe headache and vomiting on February 5th 1982. At the other hospital, CT scans revealed marked intraventricular hemorrhage, however his general condition was relatively good without a loss of consciousness, motor weakness and sensory disturbance. After about a month of conservative treatment, he was transferred to the Kochi Medical School Hospital. On admission, he had shown no neurological deficit except for slight occipital headache. Transfemoral cerebral angiography revealed an angioma of the choroid plexus, which was fed by the anterior and medial posterior choroidal arteries and drained into the internal cerebral vein. CT scans showed a small high density area due to the nidus of angioma at the interspace of bilateral frontal horns of the lateral ventricles. On March 25th 1982, using an anterior transcallosal approach, the angioma was totally removed. The histological diagnosis was AVM. The post-operative course was uneventful and the patient discharged without adding neurological deficit on April 12th 1982. Review of literature revealed 27 documented cases of angioma of the choroid plexus; 12 cases of AVM, 5 of cavernous angioma, 2 of telangiectasia, 1 of venous angioma and the other 7 of undefined description. Almost all cases were initiated with an episode of variable intracranial hemorrhage, particularly of intraventricular hemorrhage. Clinical course of them, however, were variable. On the contrast to male prevalence of AVM located in the other sites, the ratio of female to male was 2:1.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Arteriovenous malformations of the choroid plexus--a case report]. 663 12

Clinical features of cerebellar infarction in the territory of the superior cerebellar artery (SCA) were investigated in six male patients, ranging in age from 50 to 69 years. In all patients, there were MR images of infarction located in the area supplied by the SCA. The lesion was on the left-side in 2, right-side in 3 and bilateral (recurrent) in 1 patient. The onset of disease occurred with nausea, vomiting and floating sensation, with no overt brain stem signs other than symptoms of unilateral cerebellar ataxia and dysarthria. Five of the 6 patients had heart disease and cerebral angiography without definite evidence of SCA occlusion, strongly suggesting occlusion of the artery at its periphery due to cardiogenic embolism. A comparison of these 6 patients with those reported previously in Japan suggests that patients with SCA occlusion may be divided into two distinct subgroups: one manifesting diffuse brain stem signs in addition to cerebellar signs, and the other showing cerebellar signs as the only neurologic manifestation. In the former group, comprising the vast majority of patients, SCA occlusion occurred at the origin of the vessel due to a thrombus under a state of hypertension, diabetes mellitus or malignancy, producing signs of brain stem involvement, such as dissociating sensory disturbance and Horner's sign. While in the latter group, which included these 6 patients, paucity of brain stem signs, absence of definite cerebral angiographic evidence of SCA occlusion, and the presence of heart disease were distinguishing clinical features. Cardiogenic cerebral embolism was probably the underlying pathology in many of the cases and the functional prognosis was favorable.
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PMID:[Cerebellar infarction in the territory of the superior cerebellar artery, presenting a predominant cerebellar symptom--with special reference to its pathophysiology]. 761 47

A 50-year-old male developed gait disturbance and bilateral sensory disturbance in territories below Th 11 level in February, 1990. On February 26, 1990, an intradural tumor was partially removed at Th 11-12 levels, which was histologically diagnosed as glioblastoma multiforme; followed by post-operative radiotherapy (40Gy to the tumor area). CT scan of the brain was unremarkable and he was discharged home as ambulatory in July, 1990. Gait disturbance, occasional headache and vomiting developed in June, 1991. MRI revealed multiple spinal cord tumors at Th 11-12 and L 2-3 levels, as well as multiple intracranial tumors in the cerebellum, cingulate gyrus, and sylvian fissure, all of which were thought to be located in the cerebrospinal fluid (CSF) space. VP shunt was performed for hydrocephalus. MRI taken 2 months after operation demonstrated diffuse subarachnoid dissemination and new spinal cord tumors at C 3-4 and Th 3-10 levels. Although pathology of the intracranial tumors was not confirmed, dissemination from the spinal tumor was strongly suggested by the evidence including the long interval after the spinal cord operation, the location of the multiple tumors in the CSF space, and the simultaneous intraspinal dissemination. Only 31 cases with intracranial dissemination from malignant spinal astrocytoma or glioblastoma have been reported, and, of these, most were located around the brainstem, cerebellum, and other regions bordering the CSF space. In malignant spinal cord tumor, every effort should be made to prevent CSF dissemination at operation or to detect it as early as possible thereafter. MRI was found to be the most effective method for evaluating CSF dissemination.
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PMID:[A case of spinal glioblastoma with intracranial dissemination]. 825 21


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