1/5. Hyperactive rhizopathy of the vagus nerve and microvascular decompression. Case report.A 37-year-old woman underwent microvascular decompression of the superior vestibular nerve for disabling positional vertigo. Immediately following the operation, she noted severe and spontaneous gagging and dysphagia. Multiple magnetic resonance images were obtained but failed to demonstrate a brainstem lesion and attempts at medical management failed. Two years later she underwent exploration of the posterior fossa. At the second operation, the vertebral artery as well as the posterior inferior cerebellar artery were noted to be compressing the vagus nerve. The vessels were mobilized and held away from the nerve with Teflon felt. The patient's symptoms resolved immediately after the second operation and she has remained symptom free. The authors hypothesize that at least one artery was shifted at the time of her first operation, or immediately thereafter, which resulted in vascular compression of the vagus nerve. To the authors' knowledge, this is the first reported case of a hyperactive gagging response treated with microvascular decompression. The case also illustrates the occurrence of a possibly iatrogenic neurovascular compression syndrome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. Spinal angiolipoma: case report and review of literature.Spinal extradural angiolipomas are distinct, benign, and rare lesions composed of mature lipocytes admixed with abnormal blood vessels. They account for 0.14% of all spinal axis tumors. The case described here was a 72-year-old patient presenting with a history of paraparesis, hypoesthesia under the T2 level, hyperreflexia, and urinary overflow incontinence that appeared within 7 days after the administration of a coronary vasodilator drug regimen. The spinal magnetic resonance scan showed a lipomatous mass with signal void lesions, suggesting a vascular component of the tumor. The patient improved rapidly after surgical resection of the epidural tumor and decompression of the cord. According to the present literature, the duration of neurological symptoms ranges from 1 to 180 months (mean 28 months). But this patient's neurological deterioration took place 4 days before hospitalization. We believe that this can be explained by the increased tumor blood volume caused by vasodilator drugs, which in turn exerted a pulsatile compressive effect on the cord.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. anterior spinal artery syndrome in a 16-year-old male.spinal cord infarction is a relatively uncommon condition in young children and adolescents, however, it should be included in the differential diagnosis of acute cord compression. Depending on the vessel involved, the clinical presentation may differ. The degree of recovery in spinal cord infarcts varies from one individual to another. Recovery of motor function is progressive in most of the patients, with the deficit being maximal at the onset. For successful outcome, it is imperative that these patients get access to approriate rehabilitation very early in the course of the disease. Prevention and early treatment of specific complications, especially chronic pain, is of vital importance in young patients. This article describes our experiences diagnosing and treating a 16-year-old boy with anterior spinal artery syndrome.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Familial foveal retinoschisis associated with a rod-cone dystrophy.A brother and sister born of a consanguinous marriage had bilateral foveal retinoschisis and a generalized rod-cone dysfunction. This was associated with nyctalopia, hyperopia, minimal vitreous opacities in the sister, a paramacular tapetal sheen reflex, normal retinal vessels, an abnormal electroretinogram, and a normal electro-oculogram in the less affected brother. Foveal retinoschisis is not pathognomonic for x-chromosome-linked juvenile retinoschisis. It may be seen as a manifestation of a macular dystrophy or associated with a generalized tapetoretinal dystrophy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/5. Coronary reperfusion and Bezold-Jarisch reflex (bradycardia and hypotension).This study reports the occurrence of bradycardia and hypotension (Bezold-Jarisch reflex) induced by myocardial reperfusion. Among 92 patients undergoing interventional catheterization for intracoronary thrombolysis in an early phase of acute myocardial infarction, left anterior descending, right coronary, and left circumflex (LC) arteries were identified as the "infarct vessel" in 44, 41, and 7 cases, respectively. The Bezold-Jarisch reflex occurred in 15 of 23 patients (65%) after right coronary recanalization and in 1 of 34 patients after left anterior descending recanalization. The reflex also was observed in 4 (22%) of 18 patients with nonoccluded or nonrecanalized right coronary arteries. The average time from onset of symptoms to right recanalization was significantly shorter (p less than 0.01) among patients in whom the reflex did not develop. atropine, postural changes, or temporary pacing, or all 3, were generally sufficient to control symptoms. The findings of this study are substantially parallel to those reported by others and confirm that reperfusion of the inferoposterior myocardium is capable of stimulating a cardioinhibitory reflex. Follow-up data available in 15 patients with occluded and recanalized right coronary arteries indicate that the occurrence of the Bezold-Jarisch reflex after reperfusion is not a reliable predictor of myocardial salvage.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |