1/5. Bilateral sensorineural deafness, partial agenesis of the corpus callosum, and arachnoid cysts in two sisters.We describe two sisters (ages 10 and 3 years, respectively) with a normal development and a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, arachnoid cyst, and hydrocephalus. Neither girl has distinctive physical anomalies. In the oldest girl, there was a hearing loss of 80 dB bilaterally, and the most severe loss on audiogram was seen at 2,000-4,000 Hz. In the youngest girl, there was a hearing loss of 100 dB bilaterally. Above 2,000 Hz no neural reactions were seen. Cerebral magnetic resonance imaging in one girl and computed tomography in the other showed a partial agenesis of the corpus callosum and a cyst in the pineal region, causing an aqueduct stenosis by compression and consequent hydrocephalus. The parents have normal hearing, and brain magnetic resonance imaging showed no abnormalities. They are nonconsanguineous but from the same small village. This is the first report of a combination of congenital sensorineural hearing loss, partial agenesis of the corpus callosum, and an arachnoid cyst. The pattern of inheritance is probably autosomal recessive.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. Two teenagers with syncope.We report the cases of 2 teenagers with syncope and headaches who were subsequently found, on head computed tomography examinations, to have central nervous system etiologies (arteriovenous malformation and arachnoid cyst) of their syncope. These cases highlight the importance of a focused history and physical examination when evaluating patients who present with syncope.- - - - - - - - - - ranking = 14.916277159647keywords = physical examination, physical (Clic here for more details about this article) |
3/5. cerebrospinal fluid rhinorrhea: an allergist's perspective.Perplexing cases of profuse rhinorrhea may be referred for allergy evaluation as reported in three patients ultimately found to have cerebrospinal fluid rhinorrhea. physicians should be alert to this possibility when confronted with patients needing towels to collect nasal discharge, or whose handkerchiefs are limp upon drying. Coughing and choking at night are common. patients should be asked to lie face down during the course of physical examination, as rate of flow often increases greatly in this position.- - - - - - - - - - ranking = 14.916277159647keywords = physical examination, physical (Clic here for more details about this article) |
4/5. Tethered thoracic cord resulting from spinal cord herniation.Tethered cord syndrome (TCS) usually involves tethering of the lower cord at the conus medullaris from dural abnormalities, but may occur after spinal cord herniation. A tethered thoracic spinal cord is rare. We present an unusual case of a 30-year-old woman with a history of myelopathy presumed to be secondary to T6 cord compression resulting from T6-T8 arachnoid cyst. She continued to deteriorate after partial excision of the cyst. Repeat magnetic resonance imaging suggested recurrence of the presumed arachnoid cyst with cord compression and showed tethering at T6-T8. Surgical exploration revealed myelocele with cord herniation through the anterior thoracic dura. Pathologic diagnosis showed neural tissue with gliosis. After physical therapy treatments, the patient had increased lower extremity strength, ambulated with a cane, and regained some bladder control. Progressive myelopathy may represent tethering of the cord resulting from cord herniation. Early recognition of TCS, even in patients with minimal neurologic deficits, could prevent progressive disability.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/5. Iatrogenic arachnoid cyst with distinct clinical picture as a result of bone defect in the floor of the middle cranial fossa: case report.OBJECTIVE AND IMPORTANCE: This kind of arachnoid cyst has not previously been described as a complication of a cranial base bone defect. Recognition of this rare complication may be delayed, because clinicians are unaware of its possibility. CLINICAL PRESENTATION: A 22-year-old man presented with severe headache and increasing difficulty in breathing and swallowing. A physical examination revealed a pulsatile mass in the oral cavity, arising from the parapharyngeal area. A cystic mass that protruded into the oral cavity, through a dural and bony defect in the left middle fossa, was detected on neuroimages. INTERVENTION: A left frontotemporal craniotomy was made, and the cyst was decompressed. Duraplasty was performed with lyophilized dura. The bone defect was managed with a calvarial free bone graft and a pedicled myofacial flap. Serial neuroimaging studies performed postoperatively showed that the cyst had decreased in size. CONCLUSION: This report describes an unusual complication of a cranial base bone defect. Although not all bone defects in the cranial base require reconstruction, management of the large bone defect, particularly in the middle fossa, should preferably be accomplished with the help of a bone graft to support the dural graft.- - - - - - - - - - ranking = 14.916277159647keywords = physical examination, physical (Clic here for more details about this article) |