Cases reported "Dizziness"

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1/3. meningeal carcinomatosis manifested as bilateral progressive sensorineural hearing loss.

    OBJECTIVE: meningeal carcinomatosis is defined as the diffuse infiltration of the leptomeninges and subarachnoid space by malignant cells metastasizing from systemic cancer. The authors describe a rare case of meningeal carcinomatosis initially appearing as bilateral progressive sensorineural hearing loss. PATIENT: A 57-year-old man with lung cancer was referred to the authors' clinic because of progressive hearing loss, tinnitus, dizziness, and blurred vision for 1 month. RESULTS: magnetic resonance imaging revealed abnormal leptomeningeal enhancement. meningeal carcinomatosis was diagnosed by the detection of malignant cells in the cerebrospinal fluid after lumbar puncture. The patient died 1 year after diagnosis. CONCLUSIONS: meningeal carcinomatosis must be considered in the differential diagnosis in cancer patients with bilateral progressive sensorineural hearing loss. gadolinium-enhanced magnetic resonance imaging is a useful complementary diagnostic tool before lumbar puncture.
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ranking = 1
keywords = puncture
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2/3. Post-dural puncture thoracic pain without headache: relief with epidural blood patch.

    We report two unusual cases of postural, post-dural puncture upper thoracic interscapular backache, without headache, that were relieved by epidural blood patching. There is controversy concerning the aetiology of headache associated with the post-dural puncture syndrome. Mechanisms previously proposed have included traction on pain-sensitive intracranial structures such as the dura or blood vessels, or a vascular mechanism which may be adenosine-receptor mediated. These two cases suggest that traction on cervical or upper thoracic nerve roots should be considered as a possible mechanism of pain in the post-dural puncture syndrome.
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ranking = 3.5
keywords = puncture
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3/3. Postdural puncture symptoms in a child.

    An 11-year-old boy suffered an inadvertent dural puncture during placement of an epidural catheter for postoperative analgesia. He developed symptoms of mild headache only, but severe and protracted orthostatic nausea and dizziness, which eventually resolved completely following epidural blood patch. His symptoms were atypical and could have been misinterpreted in the context of dural puncture for diagnosis, or for administration of intrathecal chemotherapy. The reported incidence of headache following dural puncture in children is low. It may be that the manifestations are different from those of adults and that the true incidence of symptoms related to leakage of cerebrospinal fluid is higher in children than currently recognised.
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ranking = 3.5
keywords = puncture
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