ABSTRACT
Vertigo mimicking labyrinthine lesions may have resulted from ischemic insult to the inner ear or the vestibular nerve and nucleus in the AICA infarction syndrome. A 56-year-old female was admitted to the emergency room with vertigo and hearing loss in right ear. On neurological examination, she had left beating jerky torsional and horizontal nystagmus with falling and past pointing to right side. Brain magnetic resonance images showed high signal intensity in anterolateral portion of inferior pons on T2- weighted images. Severe right facial palsy of peripheral type developed 24 hours after admission. Audiometry and electronystagmography documented absent auditory and vestibular function on the affected side. We argue that vertigo of the acute infarction in AICA territory can be involved the eight and seventh nerve root entry zoon and mimic labyrinthine lesions
Subject(s)
Female , Humans , Middle Aged , Audiometry , Brain , Ear , Ear, Inner , Electronystagmography , Emergency Service, Hospital , Facial Nerve , Facial Paralysis , Hearing Loss , Infarction , Neurologic Examination , Nystagmus, Pathologic , Pons , Vertigo , Vestibular NerveABSTRACT
Background: Hematopyometra, an accumulation of bloody, purulent material in the ute-rine cavity, is a relatively uncommon event. The incidence is almost 0.01~0.5% in gynec-ologic patients. The most common cause of this condition is interference with the normal drainage of the uterus;endocervical obstruction by malignant disease. Other obstructive causes are the benign tumors in uterus, senile endocervicitis, long-term use of intrauterine device, cervical occlusion after surgery or radiation, intrauterinel infection, and congenital cervical anomaly. Methods: This report was performed to evaluate the hematopyometra patients, who were diagnosed and treated at Catholic University Medical College Hospitals from 1991 to 1995. Forty cases of hematopyometra were retrospectively reviewed by charts, radiologic and pathologic findings concerning with the clinical features. Results: 1) The most frequent age of hematopyometra patients was 50 to 59 years(45 %) and mean age was 63 years old. 2) Four patients(10 %) were at premenopausal period, and remaining 36 patients(90 %) were at the period of menopause(p<0.01). 3) The clinical manifestations of the patients were variable;profuse vaginal discharge(75 %), vaginal ble- eding or spotting(40 %), and lower abdominal pain(30 %). 4) The associating medical cond- itions or possible risk factors of hematopyometra are senile atrophic change(52.5 %), IUD inserted condition(25 %), genital malignant diseases(17.5 %), and uterine myoma(5 %). 5) The bacterial infection are frequently associated with hematopyometra and the causative ag ents are streptococci(50 %), E. coli(42 %), and mixed type(17 %). 6) Eight cases of them showed generalized peritonitis in the preoperative clinical course and three patients had been serious condition by septicemia. 7) The genital malignant diseases are associated with he- matopyomerta in 7 cases(17.5 %) of them(cervical cancer;4 cases, endometrial cancer;2 cases, and ovarian cancer;1 case). 8) All the cancer patients could be followed-up at le-ast for 2 years. Two patients, who were diagnosed for cervical cancer in the stage IIb and III, died of the persistent or recurrent disease in the period of following-up after the pri-mary treatment.