RESUMO
The position of the jugular bulb is extremely variable. A high jugular fossa with a diverticulum of the jugular bulb can alter the inner ear function with sensorineural hearing loss, vertigo and tinnitus. Nine cases of jugular bulb diverticulum with vertigo mimicking Menière's disease were operated on and followed up from 3 months to 4 years. Eight patients were treated surgically. The jugular bulb was approached through a mastoïdectomy and the diverticulum was compressed downwards using bone wax. The vertigo disappeared after surgery in all cases. These observations suggest that an abnormally of the jugular bulb should be considered as a possible symptom of Ménière's disease and that vertigo can be cured by downward compression of the diverticulum.
Assuntos
Divertículo/complicações , Veias Jugulares , Doença de Meniere/cirurgia , Idoso , Divertículo/fisiopatologia , Divertículo/cirurgia , Feminino , Humanos , Masculino , Doença de Meniere/etiologia , Doença de Meniere/fisiopatologia , Pessoa de Meia-Idade , Fatores de TempoRESUMO
The position of the jugular bulb is extremely variable. A high jugular fossa with a diverticulum of the jugular bulb can alter the inner ear function with neurosensory hearing loss, vertigo and tinnitus. Six cases of jugular bulb diverticulum with vertigo mimicking Meniere's disease were operated on and followed up from 6 months to 4 years. The jugular bulb was approached through a mastoidectomy and the diverticulum was decompressed downward using bone wax. The vertigo disappeared after surgery in all the cases. These observations suggest that an abnormality of the jugular bulb should be considered as a possible origin of Meniere's disease and that vertigo can be cured by downward decompression of the diverticulum.
Assuntos
Transtornos da Audição/etiologia , Veias Jugulares/anormalidades , Doença de Meniere/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Veias Jugulares/diagnóstico por imagem , Veias Jugulares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Doença de Meniere/etiologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We report three cases of small cerebellar infarcts mimicking labyrinthine dysfunction. A sudden rotatory vertigo might be the only presenting symptom of a cerebellar infarct. In these cases, the clinical features may closely mimick an acute peripheral labyrinthine disorder. However, the absence of nystagmus or a direction changing nystagmus with different eye position and the normality of caloric responses may be suggestive of a cerebellar infarct. This syndrome may be explained by the involvement of the nodulus, part of the flocculo-nodular complex, that has primary vestibular connections. Cerebellar infarcts mimicking labyrinthine dysfunctions involved usually the cerebellar territory of the posterior inferior cerebellar artery (PICA). Infarcts may be limited to the territory of the medial branch of the PICA which supplies the nodulus.
Assuntos
Cerebelo/irrigação sanguínea , Infarto Cerebral/complicações , Vertigem/etiologia , Artérias , Audiometria , Infarto Cerebral/diagnóstico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
The purposes of this study were to test the pharmacokinetics and renal and otologic tolerances of a once-daily regimen of netilmicin and teicoplanin administered intramuscularly, alone or in combination (4.5 and 6 mg/kg, respectively), for 7 days in 30 healthy male volunteers. Teicoplanin induced only a mild increase in enzymuria. Nephrotoxicity was moderate and reversible with netilmicin; there was increased enzymuria and alteration in diluting ability, without significant changes in urinary beta 2-microglobulin levels, concentrating ability, and glomerular filtration rate. Ototoxicity was not detected in any of the subjects. Our results suggest that (1) teicoplanin and netilmicin given once daily induced only slight, reversible tubular damage, without any sign of ototoxicity; (2) their combination was not more toxic; and (3) clinical studies can be envisaged to evaluate the efficacy and tolerance of once-daily regimens in long-term treatment.
Assuntos
Quimioterapia Combinada/efeitos adversos , Netilmicina/efeitos adversos , Acetilglucosaminidase/urina , Adulto , Esquema de Medicação , Quimioterapia Combinada/administração & dosagem , Quimioterapia Combinada/farmacocinética , Orelha/efeitos dos fármacos , Glicopeptídeos/administração & dosagem , Glicopeptídeos/efeitos adversos , Glicopeptídeos/farmacocinética , Humanos , Rim/efeitos dos fármacos , Netilmicina/administração & dosagem , Netilmicina/farmacocinética , TeicoplaninaRESUMO
The authors report two cases of regression of lung metastases from renal cell cancer with cytological and histological proof. They present a complete review of the literature and analyse the theories proposed to explain this phenomenon.