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Query: UMLS:C0262471 (ENT)
5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lumbar puncture is the best way to prove bacterial meningitis. It should be performed without any delay if the diagnosis is suspected. Herniation is a rare complication of LP. CT is normal in most cases of purulent meningitis, including those complicated by a subsequent herniation; normal CT results does not mean that performing a LP is safe. Three main clinical features can help determine which patient is at risk of herniation and should have a CT before LP. This risk has to be determined rapidly in the emergency ward while assessing anamnestic data, localization signs or symptoms, and level of consciousness. Cranial imaging (mainly MRI) is useful in the course of bacterial meningitis. Patients who do not respond well to treatment or with atypical presentation, persistence of fever, or new neurological signs should undergo brain imaging; MRI and CT may identify subdural effusions, brain abscesses, empyemas, hydrocephaly, or brain parenchymal changes (cerebritis, infarction, hemorrhage). CT and MRI are useful to screen for an ENT cause of bacterial meningitis, and mandatory in case of pneumococcal meningitis. Numerous MRI sequences are useful to identify bacterial meningitis complications: SE T1 without and with gadolinium injection, SE T2, FLAIR, gradient-echo T2, diffusion weighted imaging, MR angiography.
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PMID:[Indication of neuro-imaging for the initial management and the follow-up of acute community-acquired bacterial meningitis]. 1939 88

Stridor in paediatric age group is not an uncommon presentation to the ENT emergency. The range of differential diagnosis is vast. The presentation may vary from noisy breathing to severe respiratory distress and apnea. Early and meticulous diagnosis is crucial for the management as the condition may be life threatening. We report a rare case series of 3 infants with Arnold Chiari Malformation who presented to the hospital with stridor and were diagnosed with bilateral vocal cord palsy. These 3 infants had similar underlying neurological condition with hydrocephalus and raised intracranial pressure. Chiari malformation is the one of the most common congenital central nervous system anomaly associated with bilateral vocal cord paralysis. However, the presentation is rare. This article, thus, emphasizes the significance of early diagnosis and immediate management of this condition.
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PMID:Bilateral Vocal Cord Palsy with Arnold Chiari Malformation: A Rare Case Series. 2779 Apr 80

We report a case of a 54-year old female patient, complaining for chronic dizziness, hearing loss, tension headaches without aura, postural instability and gait dysfunction. The patient referred having these symptoms from 1992, but the last few months she experienced a noticeable aggravation of the symptoms. A magnetic resonance imaging test revealed a triventricular hydrocephalus, not associated with signs of intracranial hypertension decompensation. The ENT-Audiology evaluation revealed a bilateral sensorineural hearing loss with a conductive component, video-nystagmography resulted in an areflexia of the right ear and a reduced vestibular activity for the left ear. Auditory brainstem response test was also carried out and showed pathologic findings for the latencies of the waves I-III, III-V and I-V bilaterally but more significant in the right ear. On January 2016 the patient had endoscopic third ventriculostomy. On the follow up the patient referred an important subjective improvement regarding instability and gait dysfunction. In this paper we study the correlation between hydrocephalus, hearing loss and vestibular dysfunction.
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PMID:Asymmetric hearing loss and chronic dizziness in a patient with idiopathic normal pressure hydrocephalus. 2999 94

Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%. The case report presents a patient with subdural empyema which resulted from sinusitis. The integral and first part of therapy was an urgent neurosurgical drainage of subdural empyema, followed by functional endoscopic sinus surgery performed by ENT surgeon. Conservative treatment consisted of systemic antibiotics and antiedematous therapy. Later the patient developed post-infectious hydrocephalus, which was solved by implantation of a ventriculo-peritoneal shunt. Consequently, cranioplasty was performed. Despite acute onset of the disease and severe neurologic deficit prior to the first neurosurgical intervention, the clinical condition of the patient is favorable after multiple surgeries. The patient is able to live independently without any significant limitations in everyday activities. The presenting symptoms of subdural empyema are reflective of increased intracranial pressure, meningeal irritation, and cerebritis. Radiographic imaging (contrast CT, DWI-MRI, contrast MRI) is an essential diagnostic tool. The integral part of therapy is a neurosurgical evacuation of subdural empyema combined with intravenous antibiotic therapy. Subdural empyema is a rare, rapidly progressing disease which is underestimated by the physicians in many cases. Diagnosis is often delayed and therefore, despite recent progress in treatment, the mortality rate remains high. Key words: empyema - subdural - sinusitis - diagnostic imaging - surgical method.
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PMID:Subdural empyema case report of a rare disease with a high mortality. 3044 8