ABSTRACT
OBJECTIVE: To report a case of labyrinthine hemorrhage with a sudden sensorineural hearing loss and vertigo. This is a rare mechanism of inner ear damage, which may be considered in patients with anticoagulant therapy. MATERIAL AND METHODS: We report a case of sudden sensorineural hearing loss and vertigo in a 73-year-old male on anticoagulant therapy for arrhythmia. An audiovestibular and imaging work-up was performed. RESULTS: Audiometry showed a left profound hearing loss. Videonystagmography demonstrated a left labyrinthine deficit. Hemostasis assessment showed an INR at 7.5 MR imaging evidenced a high intralabyrinthine signal on T1-weighted images without gadolinium and on FLAIR T2-weighted images, suggesting labyrinthine hemorrhage. At clinical follow-up the vertigo regressed but the hearing function was not recovered. CONCLUSION: Labyrinthine hemorrhage should be evoked in the event of sudden sensorineural hearing loss in patients with anticoagulant therapy. MRI is a useful diagnostic tool in this case.
Subject(s)
Anticoagulants/adverse effects , Hemorrhage/chemically induced , Labyrinth Diseases/chemically induced , Aged , Ear, Inner/pathology , Hearing Loss, Sudden/etiology , Hemorrhage/diagnosis , Humans , Labyrinth Diseases/diagnosis , Magnetic Resonance Imaging , Male , Vertigo/etiologyABSTRACT
To develop blood pressure reference values for Maroccan children, a survey was carried out in 1987-88 in a group of 10,000 children 4 to 18 years of age. Study subjects were randomly selected among schoolchildren from the Great Casablanca Wilaya. There were 4,818 boys and 5,182 girls. To ensure optimal reliability of data, a precise, standardized methodology was used; blood pressure was measured in the supine position after at least five minutes rest, two cuffs of different sizes were available and selected according to age and body weight, and diastolic blood pressure was defined as Korotkow phase V. Distribution of blood pressure values was studied by age, sex and stature. Results were expressed as means +/- standard deviations and as percentiles. Blood pressure values were found to increase gradually with age, with sex-specific variations. Values were higher in post-pubertal girls. A linear positive correlation between arterial blood pressure and stature was found. This correlation was stronger than the blood pressure-age correlation. These data were compared with previous reports in the literature, although this analysis proved difficult because of variations in methods and results across studies.
Subject(s)
Blood Pressure , Adolescent , Age Factors , Blood Pressure Determination/methods , Body Weight , Child , Child, Preschool , Diastole , Female , Humans , Male , Morocco , Reference Values , SystoleABSTRACT
Numerous and various devices are being used in the treatment of congenital dislocation of the hip before the age of 1 year. We prefer the abduction pillow of Becker, owing to the simple design and use; there is also an economical factor: everybody can afford it. The abduction pillow can in no way be used for prevention. Only pathological hips with clinical signs confirmed by X-ray or sonography justify this treatment. Because of the good tolerance and efficacity of the pillow, it is the first choice treatment for unstable and luxated hips before the age of 4 months. If hips are not centered, other procedures should be used, in particular the Pavlik harness.
Subject(s)
Hip Dislocation, Congenital/therapy , Orthotic Devices , Hip Joint , Humans , Infant , Infant, Newborn , Joint Instability/therapyABSTRACT
Between 1976 and 1987, 85 cases of CDH occurring after walking age were followed in the department. Eighteen children aged 5 years or older were reviewed. In 11 children the dislocation was unilateral and in 7 bilateral; out of these 25 hips, 20 were high luxations and 5 occurred at a lower level. Two children, 6 and 13 years old, had a bilateral dislocation. Except for 2 children of 5 years of age who were treated conservatively, surgical treatment was indicated in the other 18 cases usually after tenotomy and derotation. In 13 hips, a surgical repositioning was performed, associated with femoral osteotomies, either shortening osteotomies (7) or derotation osteotomies (3). Pelvic osteotomies were indicated either immediately or later in 15 hips. A triple osteotomy was usually performed (11); a Salter (2) or a Chiari (2) has been rarely used. After a follow-up of 5 years, evaluation according to clinical and radiological criteria showed 14 good and 7 bad results. The latter 7 cases had either a dislocation or an eccentration. Reviewing these series, the authors describe the problems in the treatment of the dislocated hip in the older child: the indications, the therapeutic strategy for those dislocations and the decision for treatment of the bilateral high dislocation in the older child.
Subject(s)
Hip Dislocation, Congenital/surgery , Osteotomy/methods , Age Factors , Child , Female , Femur/surgery , Hip Dislocation, Congenital/diagnostic imaging , Humans , Male , Pelvic Bones/surgery , Radiography , Recurrence , Tendons/surgeryABSTRACT
Between 1976 and 1984, 100 children aged 13 months to 15 years were treated for tuberculosis of the spine. 29 patients seen at an early stage and presenting limited lesions healed completely with mild or moderate residual kyphosis after orthopaedic treatment associating antibiotherapy and strict immobilization in plaster shells. 71 patients having extensive vertebral destruction or after failure of the orthopaedic treatment underwent surgery for excision and anterior spine fusion. A supplementary posterior spine fusion was performed in 48 patients. This procedure, in conjunction with preoperative traction, obtained stabilization of the spine and healing of vertebral lesions in most cases with excellent correction of recent kyphosis. In view of these results, it seems possible to determine which treatment is best adapted according to: the extent, severity and level of the lesions, the degree and age of kyphosis, the existence or not of paraplegia. The possibility to reduce fixed severe kyphosis (6 cases) and the indication for a supplementary posterior fusion are evaluated.
Subject(s)
Kyphosis/therapy , Tuberculosis, Spinal/therapy , Adolescent , Antitubercular Agents/therapeutic use , Casts, Surgical , Child , Child, Preschool , Combined Modality Therapy , Female , Humans , Infant , Kyphosis/etiology , Male , Radiography , Spinal Fusion/methods , Traction , Tuberculosis, Spinal/complications , Tuberculosis, Spinal/diagnostic imagingABSTRACT
A series of 9 cases of atlanto-axial dislocation observed between 1976 and 1982 illustrates the wide range of etiologic factors as well as their possible implication. The findings were as follows: 3 congenital anomalies of the odontoid process, 2 luxations resulting from trauma, 1 spine infection, 2 Grisel syndromes, 1 psoriatic rheumatism. Among them 3 children had incomplete tetraplegia. Six patients were treated by posterior spine fusion either directly or after failure of conservative management. The authors emphasize the difficulty in relating the disorder to its real cause and discuss the various methods of treatment according to the etiology, whether reduction and stabilization are possible and according to the neural involvement and the date of onset of the disorders.
