1/6. giant cell arteritis with CD8 instead of CD4 T lymphocytes as the predominant infiltrating cells in a young woman.giant cell arteritis is rarely reported in people aged less than 50 years. We report a case of giant cell arteritis in a woman who developed symptoms of dizziness, headache, bilateral sensorineural hearing impairment, and had 1 episode of transient left hemiparesis before the age of 30. Carotid angiography showed multiple segmental narrowing in cranial vessels. Subsequently, at the age of 31, she had weight loss and developed a fever. Chest radiograph revealed mediastinal widening, and chest computed tomography revealed dilated pulmonary arteries and veins. coronary angiography and aortography showed irregular narrowing of the descending aorta and multiple stenosis, with aneurysmal dilatation involving the proximal and distal coronary, pulmonary and mesenteric arteries. Multinucleated giant cells and predominant CD8 T lymphocyte infiltration were noted in a left temporal artery biopsy specimen. The patient's age and the finding of dilated pulmonary veins and prominent CD8 T lymphocytes in the biopsy specimen suggest that this case was a distinct form of systemic giant cell arteritis.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/6. Delayed hearing loss after neurovascular decompression.We report two unusual cases of delayed hearing loss after neurovascular decompression of structures within the cerebellopontine angle. In the first case, the patient noted a unilateral hearing loss 3 weeks after undergoing vascular decompression of the trigeminal nerve for tic douloureux. This gradually improved over an 18-month period. In the second case, the patient awoke on the 4th day after vascular decompression of the facial nerve for hemifacial spasm with a bilateral hearing loss that has remained unchanged after the onset. These are examples of delayed acoustic dysfunction occurring with a shift in surgically freed vessels and may have been induced by newly directed neurovascular compression or distortion.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/6. Unilateral sudden hearing loss as a result of anomalous carotid anatomy.The term sudden hearing loss refers to hearing losses of sensorineural origin that evolve over a short period of time and are often of unknown origin. Common causes include damage to the cochleovestibular nerve by viral infection, autoimmune disease, vascular insult, and labyrinthine membrane rupture. A 70-year-old man had a history of recent diplopia, dysarthria, syncopal episodes, dysequilibrium, and the sudden onset of deafness in his right ear. Angiography demonstrated severe ulcerative stenosis of the right internal carotid origin and an anomalous vessel (probable remnant of hypoglossal artery) originating from the distal right internal carotid artery that perfused the entire distal vertebral and basilar artery circulation. Arch angiograms confirmed the absence of a proximal right vertebral artery and revealed a small left vertebral artery that ended in the cervical region without reaching the posterior fossa. Standard right carotid endarterectomy with patch angioplasty resolved all neurologic symptoms except for persistent unilateral deafness at 9 months' follow-up. Presumed embolization through this anomalous vessel to the internal auditory artery and subsequent cochlear and vestibular branches represents the first reported case of sudden hearing loss as a result of anterior circulatory ulcerative disease.- - - - - - - - - - ranking = 2keywords = vessel (Clic here for more details about this article) |
4/6. diagnosis and cure of venous hum tinnitus.Sounds arising from abnormalities of or abnormal communications between blood vessels in the neck or cranial cavity may result in objective tinnitus. It is audible to patient and examiner alike. Contrary to the usual subjective tinnitus of non-vascular origin, it is low pitched and pulsatile in character. That tinnitus which arises from and within the internal jugular vein is particularly important, as it may be loud enough to interfere with sleep, and result in some loss of hearing. diagnosis is important as it can be cured by simple ligation of the internal jugular vein. Such a case is reported.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/6. A cochlear vascular anomaly in a patient with hearing loss and tinnitus.An unusual blood vessel in the cochlea of a patient is reported. The blood vessel derives from the osseous lamina spiralis and crosses straight through the scala tympani toward the lateral wall of the perilymphatic duct. In its course a branch derives from this vessel toward the other spiral vessel. In the region of this abberrant vessel a complete hair-cell loss is present. A high tone perceptive loss with a relative dip and tinnitus was found in the same ear during life. The possible cause and effects of this abberrant vessel are discussed.- - - - - - - - - - ranking = 6keywords = vessel (Clic here for more details about this article) |
6/6. Internal auditory artery infarction: clinicopathologic correlation.OBJECTIVE: To study the pathophysiology of labyrinthine infarction. BACKGROUND: The syndrome of sudden onset vertigo or hearing loss is commonly attributed to inner ear vascular disease, yet histologic studies of isolated labyrinthine infarction in humans have been rare and have not included a complete examination of the vertebrobasilar vascular system. methods: Temporal bones, brainstem, cerebellum, and the supplying blood vessels were subjected to gross and microscopic postmortem examinations in a 92-year-old woman who had a sudden onset of vertigo and hearing loss in the right ear 7 years before death. RESULTS: There were prominent atherosclerotic changes at the vertebrobasilar junction, but the internal auditory artery and its branches were patent on both sides. Histologic studies showed degenerative changes in the cochlea and vestibular labyrinth on the right. The posterior canal ampulla and saccular macule were relatively preserved showing partial areas of intact sensory epithelium with underlying nerve fibers. The right vestibulocochlear nerve showed a fibrotic scar and multiple patchy areas of degeneration. These findings are most consistent with a transient period of reduced perfusion of the internal auditory artery. CONCLUSION: The partial sparing of the inferior vestibular labyrinth may indicate a decreased vulnerability to ischemia because of its better collateral blood supply.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |