keyword
https://read.qxmd.com/read/37910277/fully-endoscopic-microvascular-decompression-for-trigeminal-neuralgia-technical-note-and-early-outcomes
#21
JOURNAL ARTICLE
Hongpeng Guan, Shiting Li, Xuhui Wang
Microscopic microvascular decompression (MVD) has been considered a curative and reliable method for treating classical trigeminal neuralgia (TN) for decades. Endoscopy can provide bright illumination and a panoramic view, which enhances the visualization of the posterior fossa. In view of the above advantages of endoscopy, it gradually became an option for MVD for treating TN. This study was performed to evaluate the advantages of fully endoscopic MVD for treating TN and is presented with a description of our operative technique...
November 1, 2023: Neurosurgical Review
https://read.qxmd.com/read/37887849/concordant-grade-3-truncal-ataxia-and-ocular-laterodeviation-in-acute-medullary-stroke
#22
JOURNAL ARTICLE
Jorge C Kattah
Background: Severe truncal ataxia associated with an inability to sit up without assistance (STA grade 3) is frequent in patients with central acute vestibular syndrome (AVS) involving the brainstem or cerebellum. When these patients have nystagmus, central HINTS excludes peripheral lesions; however, additional localization and lateralization signs are helpful, not only to resolve the peripheral versus central vestibular lesion dilemma, but to zero in on a precise lesion localization/lateralization to the lateral medulla, the most common ischemic lesion localization associated with an initially false-negative stroke MRI...
October 18, 2023: Audiology Research
https://read.qxmd.com/read/37875319/developing-an-implementation-intervention-for-managing-acute-vertigo-in-the-emergency-department
#23
JOURNAL ARTICLE
David Herdman, Hena Ahmad, George Antoniades, Gokul Bailur, Arun Pajaniappane, Phil Moss
BACKGROUND: There are evidence-based bedside tests for diagnosing acute vertigo, but no evidence-based strategies to support clinicians in implementing them. The purpose of this study was to design an implementation strategy for treating acute vertigo by examining current facilitators and barriers to using these tests in the ED using the principles of implementation science. METHODS: A survey was developed using the Theoretical Domains Framework and Consolidated Framework for Implementation Research to examine barriers and facilitators for using HINTS+ (head impulse, nystagmus, test of skew, plus hearing) and Dix-Hallpike tests...
November 28, 2023: Emergency Medicine Journal: EMJ
https://read.qxmd.com/read/37872758/sudden-hearing-loss-and-vertigo-with-silent-pontine-infarction-a-case-report
#24
Jae Yeong Jeong, Hayoung Byun, Seung Hwan Lee, Jae Ho Chung
Most cases of sudden sensorineural hearing loss (SSNHL) occur without a specific identifiable cause, although vascular factors may serve as potential etiological contributors. Silent infarction refers to ischemic changes observed on imaging studies without accompanying clinical symptoms; however, this condition is clinically significant owing to the increased risk of future stroke. We report a case of left-sided SSNHL accompanied by dizziness in a 62-year-old male patient who was diagnosed with left pontine infarction without any other neurological symptoms...
October 2023: Journal of Audiology & Otology
https://read.qxmd.com/read/37839091/reverse-flow-thromboembolism-from-distal-subclavian-artery-aneurysm-due-to-arterial-thoracic-outlet-syndrome-and-posterior-circulation-stroke-role-of-dynamic-doppler-imaging
#25
JOURNAL ARTICLE
Adarsh Anil Kumar, Santhosh Kumar Kannath, Bejoy Thomas, Sylaja Pn, Shivanesan P, Manju Surendran
INTRODUCTION: Arterial thoracic outlet syndrome (aTOS) is the least common among the 3 subtypes of thoracic outlet syndrome and can be the cause of posterior circulation infarction due to thrombus from a secondary thrombosed subclavian-axillary artery aneurysm. CASE REPORT: Here, we report a case of a 51-year-old man who presented to our institute with sudden onset vertigo, dizziness, vomiting, gait imbalance, and visual field defects immediately after strenuous exercise...
September 22, 2023: Neurologist
https://read.qxmd.com/read/37827819/the-patient-with-acute-vertigo-the-role-of-clinical-examination-and-imaging
#26
JOURNAL ARTICLE
Lukáš Martinkovič
Vertigo/dizziness or balance disorders are among the most common patients complaints in emergency clinics. Up to 25% of them are potentially life-threatening, especially cardiovascular or cerebrovascular events. The combination of a careful history taking (triggers, duration of difficulties, associated symptoms) and the performance of a basic vestibular examination (nystagmus, oculomotor, head impulse test, positional maneuvers, standing and walking examination) leads to a reliable differentiation of central and peripheral vestibular etiology...
2023: Vnitr̆ní Lékar̆ství
https://read.qxmd.com/read/37811010/characteristics-and-factors-associated-with-hypertensive-crisis-a-cross-sectional-study-in-patients-with-hypertension-receiving-care-in-a-tertiary-hospital
#27
JOURNAL ARTICLE
Rattanaporn Chootong, Wasuntaraporn Pethyabarn, Supinya Sono, Thitiworn Choosong, Kittisakdi Choomalee, Maimoonah Ayae, Punnisa Wisan, Phappim Kantalak
BACKGROUND: The hypertensive crisis is characterized by poorly controlled hypertension, which can lead to unfavorable outcomes and high utilization. The purpose of this study was to examine the prevalence, clinical characteristics, and factors associated with hypertensive emergency. MATERIAL AND METHODS: This cross-sectional study collected data from the hospital information system that included patients greater than or equal to 18 years who were diagnosed with hypertensive crisis (blood pressure ≥180 and/or 120 mmHg) and receiving care from the primary care unit and emergency department from 2020 to 2022...
October 2023: Annals of Medicine and Surgery
https://read.qxmd.com/read/37806810/pearls-for-the-emergency-clinician-posterior-circulation-stroke
#28
REVIEW
Jessica Pelletier, Alex Koyfman, Brit Long
BACKGROUND: Posterior circulation (PC) stroke in adults is a rare, frequently misdiagnosed, serious condition that carries a high rate of morbidity. OBJECTIVE OF THE REVIEW: This review evaluates the presentation, diagnosis, and management of PC stroke in the emergency department (ED) based on current evidence. DISCUSSION: PC stroke presents most commonly with dizziness or vertigo and must be distinguished from more benign diagnoses. Emergency clinicians should consider this condition in patients with dizziness, even in younger patients and those who do not have traditional stroke risk factors...
November 2023: Journal of Emergency Medicine
https://read.qxmd.com/read/37795069/neurological-manifestation-in-hospitalized-patients-with-acute-sars-cov-2-infection
#29
JOURNAL ARTICLE
Natasa Pejanovic-Skobic, Kristina Galic, Ilijana Kapcevic, Svjetlana Grgic, Marina Vasilj, Sandra Lakicevic, Marija Bender, Tanja Zovko
OBJECTIVE: The main objective of this research is to determine the prevalence and characteristics of neurological manifestations in hospitalized patients with SARS-CoV-2 infection. METHODS: A cross-sectional study was conducted. 572 hospitalized patients at the COVID Department of Pulmonology of the Mostar University Clinical Hospital in the six-month period from October 31, 2020, to April 30, 2021, were included. We analyzed the incidence of neurological manifestations and the influence of comorbidities and metabolic syndrome on stroke incidence in COVID-19 patients...
September 2023: Curēus
https://read.qxmd.com/read/37738525/do-monosymptomatic-stroke-patients-with-dizziness-present-a-vestibular-syndrome-without-nystagmus-an-underestimated-entity
#30
JOURNAL ARTICLE
Florence Nikles, Hassen Kerkeni, Ewa Zamaro, Athanasia Korda, Franca Wagner, Thomas C Sauter, Roger Kalla, Miranda Morrison, Georgios Mantokoudis
BACKGROUND AND PURPOSE: Vestibular symptoms are common in emergency department (ED) patients and have various causes, including stroke. Accurate identification of stroke in patients with vestibular symptoms is crucial for timely management. We conducted a prospective cross-sectional study from 2015 to 2019 to determine stroke prevalence and associated symptoms in ED patients with vestibular symptoms, aiming to improve diagnosis and outcomes. METHODS: As part of the DETECT project, we screened 1647 ED patients with acute vestibular symptoms...
January 2024: European Journal of Neurology
https://read.qxmd.com/read/37736940/bedside-testing-in-acute-vestibular-syndrome-evaluating-hints-plus-and-beyond-a-critical-review
#31
REVIEW
Alexander A Tarnutzer, Jonathan A Edlow
Acute vertigo and dizziness are frequent presenting symptoms in patients in the emergency department. These symptoms, which can be subtle and transient, present diagnostic challenges because they can be caused by a broad range of conditions that cut across many specialties and organ systems. Previous work has emphasized the value of combining structured history taking and a targeted examination focusing on subtle oculomotor signs. In this review, we discuss various diagnostic bedside algorithms proposed for the acutely dizzy patient...
September 1, 2023: Audiology Research
https://read.qxmd.com/read/37728847/clinical-and-laboratory-findings-and-etiologies-of-genetic-homocystinemia-a-single-center-experience
#32
JOURNAL ARTICLE
Seyda Besen, Yasemin Ozkale, Serdar Ceylaner, Aytul Noyan, Ilknur Erol
BACKGROUND: Homocysteine (Hcy) is an endogenous nonprotein sulfur-containing amino acid biosynthesized from methionine by the removal of its terminal methyl group. Hyperhomocysteinemia (HHcy) has been linked to many systemic disorders, including stroke, proteinuria, epilepsy, psychosis, diabetes, lung disease, and liver disease. The clinical effects of high serum Hcy level, also known as hyperhomocysteinemia, have been explained by different mechanisms. However, little has been reported on the clinical and laboratory findings and etiologies of genetic HHcy in children...
September 20, 2023: Acta Neurologica Belgica
https://read.qxmd.com/read/37692677/from-dizziness-and-hearing-loss-to-coma-a-case-of-basilar-artery-occlusion
#33
Tiago Valente, Valter Duarte, Laura Baptista, Joana Melo, Gorete Jesus
Basilar artery (BA) occlusion is a rare and devastating cause of ischemic stroke. Presenting symptoms are frequently non-specific and include dizziness, vertigo, nausea, vomiting, headache, and, rarely, hypoacusis. Clinical history and appropriate neurological evaluation are essential for diagnosis. We present the case of a 65-year-old female with dizziness, vomiting, dysarthria, and hearing loss, progressing to right-side hemiparesis and decreased level of consciousness culminating in a coma in just a few hours...
August 2023: Curēus
https://read.qxmd.com/read/37622626/ponticulus-posticus-an-important-diagnostic-finding-often-missed-in-lateral-cephalograms
#34
JOURNAL ARTICLE
Nivedita Sahoo, Rudraraju Amrutha, George Sam, Linta Thomas, Mithun K Naik, Shabeel Ahamad, Nimish H Oberoi
AIM: The purpose of the current study was to investigate the presence of the ponticulus posticus (PP) frequently encountered in lateral cephalograms. MATERIALS AND METHODS: About 500 patients of age 12-40 years were selected whose digital lateral cephalogram was recorded and traced to confirm the presence of the PP and categorize as: (A) Absent, as evidenced by lateral cephalograms. (B) Complete PP evidenced by the presence of circumferential bone bridge that connected the upper articular process to the atlas's posterior arch...
July 1, 2023: Journal of Contemporary Dental Practice
https://read.qxmd.com/read/37592138/neurological-update-neuro-otology-2023
#35
JOURNAL ARTICLE
Gábor M Halmágyi, Gülden Akdal, Miriam S Welgampola, Chao Wang
Much has changed since our last review of recent advances in neuro-otology 7 years ago. Unfortunately there are still not many practising neuro-otologists, so that most patients with vestibular problems need, in the first instance, to be evaluated and treated by neurologists whose special expertise is not neuro-otology. The areas we consider here are mostly those that almost any neurologist should be able to start managing: acute spontaneous vertigo in the Emergency Room-is it vestibular neuritis or posterior circulation stroke; recurrent spontaneous vertigo in the office-is it vestibular migraine or Meniere's disease and the most common vestibular problem of all-benign positional vertigo...
December 2023: Journal of Neurology
https://read.qxmd.com/read/37584090/neurological-phenotype-of-ada2-deficient-patients-a-cohort-study
#36
JOURNAL ARTICLE
Merelijne A Verschoof, Laura C C van Meenen, M Valérie E Andriessen, Daniëlle M C Brinkman, Sylvia Kamphuis, Taco W Kuijpers, Helen L Leavis, G Elizabeth Legger, Catharina M Mulders-Manders, Anne P J de Pagter, Abraham Rutgers, Gijs T J van Well, Jonathan M Coutinho, A Elisabeth Hak, Joris M van Montfrans, Femke C C Klouwer
BACKGROUND: Patients with adenosine deaminase 2 (ADA2) deficiency can present with various neurological manifestations due to vasculopathies and autoinflammation. These include ischemic and hemorrhagic stroke, but less clearly defined neurological symptoms have also been reported. METHODS: In this cohort study, we included patients with confirmed ADA2 deficiency from seven university hospitals in the Netherlands. We analyzed the frequency and recurrence rates of neurological manifestations before and after initiation of TNF-α inhibiting therapy...
August 16, 2023: European Journal of Neurology
https://read.qxmd.com/read/37537083/vertigo-and-dizziness-in-children-when-to-consider-a-neurological-cause
#37
REVIEW
Thibault Beretti, Béatrice Desnous
Vertigo is common in childhood and adolescence. Although children and adults share common causes of vertigo, epidemiology changes with aging. For instance, ischemic stroke is less frequent in childhood, whereas audiovestibular disorders, such as vestibular neuritis and the migraine equivalent, are the leading causes of vertigo. However, even if severe causes of vertigo are rare, clinicians must not miss them. In this review, we discuss the neurological causes of central vertigo in children. The diagnostic approaches reviewed here are focused on the search for signs of severity, such as an abrupt onset, infectious context, or intracranial hypertension, which may subsequently require brain imaging...
October 2023: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://read.qxmd.com/read/37534665/-posterior-inferior-cerebellar-artery-infarction-with-episodic-postural-diplopia-as-the-initial-symptom-a-case-report
#38
JOURNAL ARTICLE
C F Fan, Y P Huang, X Li, Y Chen, Z Li, S D Qiao
Accurate and timely diagnosis of posterior circulation ischemic stroke is a challenge for emergency neurology clinicians, even MRI scan which is believed to be sensitive to acute ischemic lesions may be negative. It is particularly important to obtain the typical or characteristic symptoms and signs of the patients through comprehensive physical examination. We report a case of posterior inferior cerebellar artery (PICA) territory infarction with "episodic postural diplopia" as the initial symptom, hoping that clinicians notice the vertical diplopia caused by the disfunction of otolith gravity conduction pathway, which is characterized by the degree of diplopia being affected by postural changes...
August 18, 2023: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://read.qxmd.com/read/37532455/dental-procedure-induced-cerebellar-haemorrhage-with-visual-tilt-and-unsuspected-cadasil
#39
JOURNAL ARTICLE
Siavash Mortazavi, Ravi Ambati, Ferry Dharsono, David Prentice
A man in his late 60s had vertigo and vision tilt following a dental procedure. A cerebellar haemorrhage and cerebral microbleeds (CMBs) were diagnosed on imaging. Subsequent testing revealed CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy). The role of the dental procedure as a trigger for intracerebral haemorrhage (ICH) is discussed. The incidence of CMBs and ICH in CADASIL is discussed. A summary of the causes and pathology associated with visual tilt is documented...
August 2, 2023: BMJ Case Reports
https://read.qxmd.com/read/37519542/neuroanatomical-localization-of-the-vestibular-cortex-a-case-report
#40
Sana Gulraiz, Muhammad Fawad Ishfaq, Taha F Rasul, Adnan Qureshi
Vertigo, a symptom of illusory movement, is caused by asymmetry of the vestibular system. The vestibular system consists of the vestibular labyrinth, cranial nerve VIII, brainstem vestibular nuclei, cerebellum, ocular motor nuclei, spinal cord, and less well-defined cerebral projections. In this day and age of artificial intelligence, machine learning, advanced imaging, and cutting-edge research in the field of neurology, the exact cortical control of vestibular function is still uncharted. A 45-year-old woman with a past medical history of labyrinthitis about 4...
June 2023: Curēus
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