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1.
U. Meyding-Lamadé K. Rieke D. Krieger W. Hacke Michael Forsting Klaus Sartor Christian Sommer 《Journal of neurology》1995,242(5):335-343
Acute ischaemia of the vertebrobasilar circulation leads to a variety of clinical manifestation and is mostly due to cardiogenic or artery-to-artery embolism. We describe four neurological emergency situations involving vertebrobasilar artery aclusion of other origins: basilar migraine, extrinsic compression by rheumatoid inflammatory tissue, generalized vasculitis in subacute rheumatic fever and basilar artery dissection. The differential diagnosis of acute vertebrobasilar artery occlusion may have an important impact on patient management. 相似文献
2.
We present a patient with vertebrobasilar insufficiency, with vertigo and horizontal nystagmus, induced by turning the head to the right. Angiography demonstrated transient occlusion of the left vertebral artery at the atlantoaxial joint during rotation of the head. The pathogenesis and angiographic findings are discussed. 相似文献
3.
对60例临床诊断为椎—基底动脉供血不足的老年人进行脑干听觉诱发电位(BAEP)检查,51例异常者(异常率为85%)均在发作期检查,9例颈性眩晕病人于缓解期检查(BAEP)正常。BAEP异常提示老年人可能由于长期椎—基底动脉供血不足造成脑干内有影响听觉通路的微小梗塞灶。证明BAEP检查叫老年性椎—基底动脉供血不足的诊断很有价值。 相似文献
4.
Mariko Hosono H. Kobayashi Ryota Fujimoto Kazushige Tsutsui Yoshihiko Kotoura Tadao Tsuboyama Hikaru Hayashi Takashi Nakamura Junji Konishi 《Skeletal radiology》1997,26(9):525-528
Objective. To clarify the MRI features of parasymphyseal insufficiency fractures of the os pubis. Design and patients. MRI was performed in four postmenopausal women with parasymphyseal insufficiency fractures. The diagnosis was confirmed with
plain films in every patient. T1-weighted and T2-weighted images were obtained in four patients using a 1.5-T unit. Postcontrast
T1-weighted imaging was also done in three patients. Results and conclusions. MRI of pubic parasymphyseal insufficiency fracture characteristically demonstrates a hyperintense mass lesion with a hypointense
rim on T2-weighted imaging, showing peripheral and septal enhancement after contrast administration. It is important to have
this entity in mind in patients with osteoporosis, especially in patients with a history of pelvic irradiation for malignant
disease, so as not to misinterpret it as a chondroid tumor or bone metastasis. 相似文献
5.
The primary objective of revascularization procedures in the posterior circulation is the prevention of vertebrobasilar ischemic stroke. Specific anatomical and neurophysiologic characteristics such as posterior communicating artery size affect the susceptibility to ischemia. Current indications for revascularization include symptomatic vertebrobasilar ischemia refractory to medical therapy and ischemia caused by parent vessel occlusion as treatment for complex aneurysms. Treatment options include endovascular angioplasty and stenting, surgical endarterectomy, arterial reimplantation, extracranial-to-intracranial anastomosis, and indirect bypasses. Pretreatment studies including cerebral blood flow measurements with assessment of hemodynamic reserve can affect treatment decisions. Careful blood pressure regulation, neurophysiologic monitoring, and neuroprotective measures such as mild brain hypothermia can help minimize the risks of intervention. Microscope, microinstruments and intraoperative Doppler are routinely used. The superficial temporal artery, occipital artery, and external carotid artery can be used to augment blood flow to the superior cerebellar artery, posterior cerebral artery, posterior inferior cerebellar artery, or anterior inferior cerebellar artery. Interposition venous or arterial grafts can be used to increase length. Several published series report improvement or relief of symptoms in 60 to 100% of patients with a reduction of risk of future stroke and low complication rates. 相似文献
6.
Mano J. Thubrikar Michel R. Labrosse Kenton J. Zehr Francis Robicsek Geoffrey G. Gong Brett L. Fowler 《European journal of cardio-thoracic surgery》2005,28(6):850-855
Objective: Valve-sparing surgery can be used in patients with dilated aortic roots and aortic insufficiency (AI) but has not become a common practice, in part because the spared valve may be incompetent. Our goal was to study how the dimensions of the aortic root and leaflets have changed in such patients. Methods: Fourteen patients with dilated aortic root and AI were examined by transesophageal echocardiography. The annulus diameter, sinotubular junction (STJ) diameter, sinus height, leaflet free-edge length, and leaflet height were measured. Correlations among these dimensions and with the AI grades were explored. Measurements were also made in 19 normal human aortic valves from silicone molds. Results: There was no evident change in the average diameter of the annulus between the normal valves and those in the dilated aortic roots. The STJ diameter was obviously increased in the dilated aortic roots; the aortic sinuses also appeared to be taller and the leaflets larger than normal. The leaflet free-edge length, the leaflet height, and the sinus height were found to increase with the dilated STJ diameter. The degree of AI was not found to correlate well with any of the dimensions measured. Conclusions: The dimensions of the leaflets may change parallel to aortic root dilatation with AI. Therefore, during valve sparing, it may be necessary to correct both the dilatation of the root and the leaflet free-edge length to achieve a competent valve. 相似文献
7.
Sacral insufficiency fractures develop over a period of time and show time-dependent changes. We report on 15 CT examinations of 5 patients with early-stage insufficiency fractures of the sacrum. In 4 patients only irregular sclerosis without distinct fracture lines was present in 7 of 8 fractures. Of these 4 patients; 3 exhibited intraosseous gas inclusions in a ventral part of a lateral mass; 5 of 8 fractures disclosed a ventral cortical break. When distinct fracture lines had developed in 1 patient, intraosseous vacuum phenomenon had disappeared. Fracture lines evolve over weeks to months and show central bone absorption. The fractures can heal as demonstrated in 4 of 6 fractures in 3 patients, can persist over 1 year without significant changes or can progress to pseudoarthrosis with bone destruction similar to neuropathic joint disease. Intraosseous vacuum phenomena can persist to this stage. Intraosseous vacuum phenomenon is recognized as a potential finding in the early stage of sacral insufficiency fracture, which also is true for irregular sclerosis and ventral cortical disruption.
Correspondence to: A. Stäbler 相似文献
8.
瞬目反射、脑干听觉诱发电位、经颅多普勒超声对椎基底动脉供血不足的诊断价值 总被引:2,自引:0,他引:2
目的:观察瞬目反射(BR)、脑干听觉诱发电位(BAEP)、经颅多普勒超声(TCD)对椎基底动脉供血不足(VBI)的诊断意义。方法:对41例已经临床确诊的VBI病人在间歇期进行BR、BAEP及TCD检查。结果:TCD、BR、BAEP异常率分别为83%、80%、68%。BR提示脑桥损害1例、延髓损害15例、广泛性脑干损害17例;BAEP发现内耳听力减退20例、脑干病变13例;TCD发现多血管流速异常14例、一支流速改变16例,有或伴有血管张力异常13例。结论:由于BR、BAEP反射路径不同,检测结果不尽一致。联合检查有助于对病损部位进行定位。TCD则有助于定性诊断 相似文献
9.
Introduction and importanceTrigeminal neuralgia (TN) secondary to vertebrobasilar dolichoectasia (VBD) was a rare condition. This paper reported a successful endoscopic-assisted microvascular decompression (MVD) for TN secondary to VBD.Case presentationA 53-year-old male with a history of myocardial infarction and heart failure complained of left refractory facial pain three years prior to admission. His pain was intermittent, electrical-like, severe, sharp, and radiated along the maxillary and mandibular branches. He used carbamazepine 600 mg daily. Brain magnetic resonance imaging revealed a neurovascular conflict between VBD and the left trigeminal nerve. The endoscopic-assisted MVD was indicated. The shredded neurosurgical sponges were interposed between VBD and trigeminal nerve. The 0° and 30° rigid rod-lens endoscope was used to explore and confirm the complete decompression. Postoperatively, TN was disappeared entirely. At a three-month postoperative, no facial pain and paraesthesia were found. The patient discontinued carbamazepine permanently.Clinical discussionMVD was still the most effective treatment. An inspection of root entry zone (REZ) and complete MVD with a solely operating microscope were challenging due to the massive diameter of VBD and multiple offending arteries behind the VBD. However, the wide viewing field and high-quality resolution of endoscopes allowed better visualization of REZ and neurovascular conflicts behind neural structures and least cerebellar retraction. This is essential in case of less potential space created by VBD.ConclusionEndoscope-assisted MVD allowed better visualization of REZ and neurovascular conflicts behind neural structures and least cerebellar retraction in management of trigeminal neuralgia secondary to VBD. 相似文献
10.
不同灸治时程对阳虚小鼠免疫功能影响的比较 总被引:4,自引:2,他引:4
本采用不同灸治时程(5分钟,15分钟,25分钟)治疗阳虚小鼠模型,结果显示:不同灸治时程对阳虚小鼠模型的T淋巴细胞酯酶阳性率,白细胞介素Ⅱ的影响存在的差异,灸15分钟可显提高阳虚小鼠T淋巴细胞酯酶阳性率(P〈0.01),灸5分钟,25分钟则无显作用,灸15分钟和25分钟均可显提高阳虚小鼠白细胞介素Ⅱ的活性,二之间无显性差异,灸5分钟无此显作用,提示在改善阳虚小鼠免疫功能有作用上,以灸 相似文献