1/33. Rotational vertebral artery occlusion syndrome with vertigo due to "labyrinthine excitation".Leftward head rotations in a patient with a rotational vertebral artery occlusion syndrome elicited recurrent uniform attacks of severe rotatory vertigo and tinnitus in the right ear. These attacks were accompanied by a mixed clockwise torsional downbeat nystagmus with a horizontal component toward the right. A transient ischemia of the right labyrinth probably induced the attacks and led to a combined transient excitation of the right anterior and horizontal semicircular canals as well as the cochlea.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
2/33. Proper management of the rotational vertebral artery occlusion secondary to spondylosis.A 66-year-old man with cervical spondylosis noticed severe vertigo when turning his head to the right. He underwent subclavian arteriography elsewhere, which showed a block of the contrast medium in the right vertebral artery (VA) at the C5/6 level when the patient turned his head to the right. After referral to our institute, however, postcontrast CT scan revealed an attenuated shadow of the venous plexus around the right VA at the C3/4 level. Repeated selective angiography with rotation of the head after visualization of the entire VA verified the level of obstruction to be at C3/4. Resection of the C4 transverse process through an anterior approach with drilling of the C3/4 spondylotic spur of the uncinate processi completely resolved the arterial impingement and the symptom. When evaluating rotational VA occlusion, dynamic angiography with selective catheterization is essential in determining which level is affected. The postcontrast CT scan is also useful because it suggests the level even without head rotation.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
3/33. Familial multiple trichoepithelioma associated with subclavian-pulmonary collateral vessels and cerebral aneurysm--case report.A 63-year-old woman presented with cerebellar infarction caused by occlusion of the right posterior inferior cerebellar artery. She had papules on her face that were identified histologically as multiple trichoepithelioma. Angiography revealed right subclavian-pulmonary collateral vessels and a cerebral aneurysm arising from the bifurcation of the right middle cerebral artery. Her grandmother, mother, and uncle had had similar papules, and the deaths of her mother and uncle were due to subarachnoid hemorrhage.- - - - - - - - - - ranking = 0.2keywords = occlusion (Clic here for more details about this article) |
4/33. Treatment of anterior benign paroxysmal positional vertigo by canal plugging: a case report.A 75-year-old man with incapacitating anterior canal benign paroxysmal positional vertigo (BPPV) was relieved of symptoms following anterior semicircular canal occlusion using a transmastoid approach. The preoperative symptoms were similar to those of posterior canal BPPV. The preoperative findings on Dix-Hallpike's maneuver were a paroxysmal torsional nystagmus with a down-beating component that increased when the patient's gaze was directed towards the affected ear. The most provoking head movement for the vertigo/nystagmus was Dix-Hallpike's maneuver with the affected ear lowermost.- - - - - - - - - - ranking = 0.2keywords = occlusion (Clic here for more details about this article) |
5/33. Unexpected complication of posterior canal occlusion surgery for benign paroxysmal positional vertigo.OBJECTIVE: The purpose of this report was to illustrate how an unusual complication of posterior canal occlusion surgery for benign paroxysmal positional vertigo (BPPV) may be recognized and prevented. recurrence of BPPV after occlusion surgery of the posterior semicircular canal has not previously been reported in the literature, to the authors' knowledge. Failure of occlusion not only permits the continued symptoms of BPPV but also burdens the patient with the additional morbidity of a fistula of the PSCC. The authors describe the successful treatment of a patient with recurrent and incapacitating BPPV after the failure of occlusion surgery of the posterior semicircular canal, when the patient was simultaneously crippled by the distressing morbidity of an iatrogenic fistula. DESIGN: Case report. SETTING: Tertiary care referral center. INTERVENTION: Surgical excision of the fistulous segment of the membranous posterior semicircular canal. OUTCOME MEASURES: The BPPV was resolved. The distressing symptom of a fistula was eliminated. Hearing was preserved. CONCLUSION: Failure to completely occlude the posterior semicircular canal during posterior canal occlusion surgery results in recurrence of BPPV and an iatrogenic fistula, both of which are preventable. The occurrence of such an event is described, its management is outlined, and some thoughts are offered about its prevention.- - - - - - - - - - ranking = 1.8keywords = occlusion (Clic here for more details about this article) |
6/33. Acute vertigo following cervical manipulation.OBJECTIVE/HYPOTHESIS: Either licensed American chiropractors or traditional Chinese herbalists may produce vertiginous attack in a patient after cervical manipulation. The purpose of the study was to present our experience in treating these patients to determine the risk of this procedure. STUDY DESIGN: A retrospective study from May 1999 to April 2002. methods: Nine patients (one man and eight women) with acute vertigo after cervical manipulation were admitted and underwent a battery of audiometric and vestibular tests, accompanied by magnetic resonance imaging and magnetic resonance angiography examination. RESULTS: The mean interval for the onset of acute vertigo after cervical manipulation was within 1 day (17 h). electronystagmography revealed multiple central signs. magnetic resonance angiography scan also disclosed abnormality in the vertebral artery such as occlusion, stenosis, or slow blood flow in three patients. After treatment with dextran, relief of vertigo without neurological deficits was experienced in all nine patients. CONCLUSIONS: When there are multiple central signs in electronystagmography results or slow blood flow of the vertebral artery is displayed in neck on Doppler sonography or magnetic resonance angiography scan, the therapeutic benefits of cervical manipulation cannot be expected to outweigh its potential risk for the morbidity of cervical vessels.- - - - - - - - - - ranking = 0.2keywords = occlusion (Clic here for more details about this article) |
7/33. Bilateral benign paroxysmal positional vertigo following a tooth implantation.Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo and may occur following recent head trauma. Bilateral involvement in BPPV is considered rare and has received little attention in the medical literature. We describe an unusual case of bilateral BPPV in a middle-aged woman that presented during a dental implantation, performed with the use of osteotomes. We discuss the diagnostic and therapeutic challenge of this entity.- - - - - - - - - - ranking = 0.0022674077569151keywords = dental (Clic here for more details about this article) |
8/33. Superior semicircular canal dehiscence syndrome. Case report.The authors present the case of a man who had superior semicircular canal dehiscence syndrome in addition to chronic otitis media. This case is atypical because the patient coincidentally had middle ear and mastoid disease, which previously had been treated surgically. The prior ear surgery delayed the diagnosis of superior semicircular canal dehiscence syndrome and increased the complexity of the repair of the superior semicircular canal dehiscence. Superior semicircular canal dehiscence syndrome is a recently recognized syndrome resulting in acute or chronic vestibular symptoms. The diagnosis is made using history, vestibular examination, and computerized tomography studies. Neurosurgeons should be aware that patients with superior semicircular canal dehiscence syndrome who experience disabling chronic or acute vestibular symptoms can be treated using a joint neurosurgical-otological procedure through the middle cranial fossa.- - - - - - - - - - ranking = 0.0022674077569151keywords = dental (Clic here for more details about this article) |
9/33. Far advanced otosclerosis and intractable benign paroxysmal positional vertigo treated with combined cochlear implantation and posterior semicircular canal occlusion.This paper presents a combined procedure for the management of intractable benign paroxysmal positional vertigo (BPPV) and profound hearing loss in a patient with far advanced otosclerosis. The procedure comprised of a posterior semicircular canal occlusion and cochlear implantation as one combined procedure in the same ear. The combined approach added little to the operative morbidity and proved effective in this patient's management. A search of the literature reveals this to be a unique case.- - - - - - - - - - ranking = 1keywords = occlusion (Clic here for more details about this article) |
10/33. Labyrinthine concussion and positional vertigo after osteotome site preparation.An incident of positional vertigo associated with osteotome technique for installation of multiple maxillary dental implants is reported. The symptoms resolved after 2 weeks with restricted physical activity and prohibition of lifting. There is a discussion of labyrinthine concussion and treatments. Suggestions for prevention are to use small sizes of osteotomes first and then progress to larger sizes and to avoid neck extension head position during osteotome use.- - - - - - - - - - ranking = 0.0022674077569151keywords = dental (Clic here for more details about this article) |
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