RESUMO
BACKGROUND: Dizziness is a common presenting complaint among patients in Malaysia. It is a vague term which could be associated with vertigo, imbalance, ataxia or syncope. In order to deal with this overwhelming complaint, a detailed history-taking is essential in confirming aetiology of disease and this should be followed by a meticulous clinical examination. The purpose of the video manuscript it to provide a step-by-step approach to a dizzy and swaying patient, specially catered for Malaysian medical students and trainees. METHODS: A series of videos were shot, which involved the eye, ear, vestibular system, cerebellar, proprioceptive sense and gait examination. These videos, conducted in Universiti Sains Malaysia (USM) School of Medical Sciences, will be first in Malaysia and will highlight the proper technique and rapport with patients and essential points of each examination. There will be summary at the end of each examination on how to report findings which is a common weakness among students. CONCLUSION: We hope that students and junior doctors could be apply these methods in their daily assessment of dizzy patients and ultimately, reach an accurate diagnosis.
RESUMO
Primary osteosarcomas involving the base of the skull in middle-aged patients are rare. We describe the case of a 59-year-old Asian woman presenting with lethargy, epistaxis, left maxillary and mandibular pain, and headache. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large left greater sphenoid wing tumour with extensive local infiltration and intracranial extension. The tumour was diagnosed as osteosarcoma based on histological examination. In this report, we discuss the clinical presentations, radiological features, and imaging differential diagnoses of this case.