RESUMO
Facial palsy can be defined as a decrease in function of the facial nerve, the primary motor nerve of the facial muscles. When the facial palsy is peripheral, it affects both the superior and inferior areas of the face as opposed to central palsies, which affect only the inferior portion. The main cause of peripheral facial palsies is Bell's palsy, which remains a diagnosis of exclusion. The prognosis is good in most cases. In cases with significant cosmetic sequelae, a variety of surgical procedures are available (such as hypoglossal-facial anastomosis, temporalis myoplasty and Tenzel external canthopexy) to rehabilitate facial aesthetics and function.
Assuntos
Doenças do Nervo Facial , Paralisia Facial , Diagnóstico Diferencial , Progressão da Doença , Serviços Médicos de Emergência/métodos , Doenças do Nervo Facial/complicações , Doenças do Nervo Facial/diagnóstico , Doenças do Nervo Facial/etiologia , Doenças do Nervo Facial/terapia , Paralisia Facial/complicações , Paralisia Facial/diagnóstico , Paralisia Facial/etiologia , Paralisia Facial/terapia , Humanos , Modelos Biológicos , PrognósticoAssuntos
Aneurisma Infectado/diagnóstico , Aneurisma da Aorta Abdominal/microbiologia , Febre/etiologia , Infecções por Salmonella/diagnóstico , Idoso de 80 Anos ou mais , Aneurisma Infectado/tratamento farmacológico , Antibacterianos/uso terapêutico , Aneurisma da Aorta Abdominal/patologia , Humanos , Masculino , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Infecções por Salmonella/tratamento farmacológico , Salmonella enteritidis , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND AND PURPOSE: Stapes surgery for otosclerosis can be challenging when the oval window niche is narrow. We analyzed the reliability of CT to evaluate the height of the OWN and propose a quantitative criterion to distinguish normal and narrow OWNs. MATERIALS AND METHODS: Fifty-six patients were scheduled for primary stapes surgery and, with available preoperative CT scans, were prospectively enrolled in the study at a tertiary care hospital. OWN height was measured on coronal CT and qualitatively evaluated during surgery. CT findings and surgical observations were matched to determine the preoperative imaging criterion of a narrow OWN. RESULTS: OWN was found to be narrow during surgery in 8 of 56 patients (14%). On CT, mean OWN height measurement was 1.1 mm for the narrow group and 1.8 mm for the normal OWN surgical cases. The cutoff between normal and narrow OWN was computed at 1.3 mm by using discriminant analysis and at 1.4 mm with boxplot analysis. These CT cutoff values allowed a correct classification of "normal" and "narrow" OWN, compared with visual evaluation during surgery. CONCLUSIONS: Measurements of the OWN height provide an accurate and relevant evaluation of this region before otosclerosis surgery. A width below 1.4 mm should be considered at risk for technical difficulties during the stapes footplate approach.
Assuntos
Otosclerose/diagnóstico por imagem , Otosclerose/cirurgia , Janela do Vestíbulo/diagnóstico por imagem , Janela do Vestíbulo/cirurgia , Cirurgia do Estribo/métodos , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Janela do Vestíbulo/anormalidades , Cuidados Pré-Operatórios/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto JovemRESUMO
Floating carotid thrombi are a rare cause of stroke mostly associated with atheromatous plaques, cardiogenic emboli, arterial dissections and systemic diseases related to coagulopathic states or iron deficiency anaemia. We report the cases of two patients with stroke and carotid megabulb or suspended bulb associated with floating thrombus. These findings are rarely described probably related to a form of arterial dysplasia and seem to be responsible of local haemodynamic modifications.
Assuntos
Trombose das Artérias Carótidas/patologia , Acidente Vascular Cerebral/patologia , Trombose/patologia , Adulto , Anticoagulantes/uso terapêutico , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/patologia , Trombose das Artérias Carótidas/diagnóstico por imagem , Angiografia Cerebral , Circulação Cerebrovascular/fisiologia , Feminino , Heparina/uso terapêutico , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Parestesia/etiologia , Acidente Vascular Cerebral/diagnóstico por imagem , Trombose/diagnóstico por imagem , Trombose/etiologia , Tomografia Computadorizada por Raios X , Ultrassonografia DopplerRESUMO
BACKGROUND: Pulsatile tinnitus can be caused by fatal vascular disease. The authors reported a very rare case of pulsatile tinnitus that revealed a sigmoid sinus thrombosis. CASE REPORT: A 43-years-old man was referred to our department for a left pulsatile tinnitus that had lasted for 2 years. The CT angiography and the MRI retrieved a sigmoid sinus thrombosis that was responsible for emissary vein ectasis. The biological check up was normal. The tinnitus disappeared after two months of anticoagulation. CONCLUSIONS: Ten cases of pulsatile tinnitus associated with cerebral venous thrombosis have been published in the literature. In most of cases, pulsatile tinnitus was the only symptom. Few cases of headache, hearing loss and vertigo were described in association with the tinnitus. In 5 cases a cause was retrieved (hemostasis troubles, head injury and dural arteriovenous fistulas). Full recovery can be obtained for nearly all cases as a result of anticoagulation.
Assuntos
Trombose dos Seios Intracranianos/diagnóstico , Zumbido/etiologia , Adulto , Anticoagulantes/uso terapêutico , Humanos , Angiografia por Ressonância Magnética , Masculino , Trombose dos Seios Intracranianos/tratamento farmacológico , Tomografia Computadorizada por Raios XRESUMO
Sudden onset hearing loss is idiopathic. It occurs in less than 24 h and spontaneously resolves within 15 days in two thirds of cases. Imaging is performed to exclude other causes of sudden onset hearing loss (vestibular schwannoma, vertebral artery dissection, stroke) and evaluate the inner ear structures. A few anatomical anomalies have been associated with an increased risk of hearing loss. Morphological anomalies involved the following structures in decreasing order of frequency: lateral semicircular canal (hypoplasia and dilatation), superior semicircular canal, posterior semicircular canal, vestibule and cochlea. Enlargement of the vestibular aqueduct also is frequently observed.
Assuntos
Perda Auditiva Súbita/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
Invasive rhinosinusitis, occurring almost exclusively in immunosuppressed patients, is defined by the presence of local inflammation with vascular and osseous necrosis with extensive soft tissue extension. Imaging and bacteriological and even histological (mycelial filaments) criteria have been established. Because it can evolve to death in patients with hematological disorders, accurate diagnosis is important but difficult to achieve due to the non-specific nature of signs and symptoms. Imaging plays an important role with CT of the paranasal sinuses and MR imaging of the brain for early diagnosis and treatment in order to improve prognosis. We will present the imaging features of three cases of rhinocerebral infections, with two cases of fungal infection and one case of invasive bacterial sinus infection.
Assuntos
Aspergilose/complicações , Encefalopatias/complicações , Encefalopatias/microbiologia , Hospedeiro Imunocomprometido , Leucemia/complicações , Mucormicose/complicações , Sinusite/complicações , Sinusite/microbiologia , Adulto , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Carotid cavernous fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. The authors reported the clinical presentation and therapeutic procedure of two cases. The physician has to be aware of this diagnosis when a patient is referred for a posttraumatic exophthalmia. The medical behaviour is multidisciplinary (ENT, ophthalmologist, radiologist and neurosurgeon). The imaging of choice is the angiography but angio-MRI and angio-CT can help to confirm the diagnosis. The endovascular embolization is the treatment of choice. It presents an acceptable risk of complication and a low risk of failure. In this paper the authors report 2 posttraumatic CCF cases treated with success by endovascular embolization.