Duplicate origin of left vertebral artery with thrombosis at the origin: color Doppler sonography and CT angiography findings.

We describe a rare case of vertebral artery duplication in a patient with vertigo, weakness, and nausea. A color Doppler examination revealed a duplicate origin of the left vertebral artery and a hyperechoic thrombus at the origin of 1 of the duplicated arteries. CT angiography of the lower neck area demonstrated duplicated vertebral arteries on the left side. MR angiography of the vertebrobasilar system did not show duplication, indicating that the duplicated vertebral arteries fused at a level higher than C2.

Sympathetic skin response in patients with chronic renal failure.

Sympathetic skin response (SSR) was measured in 20 normal healthy subjects and in 22 patients with chronic renal failure on regular hemodialysis, and its correlation with abnormalities of sensorimotor nerve conduction study and clinical autonomic symptoms was investigated. Nerve conduction studies (NCS) were abnormal in 17 of 22 patients (77.3%), and SSR was absent in 14 of 22 patients (63.6%). Patients were divided into three groups based on their SSR response: patients with normal SSR (n: 8, 36.4%), patients with absent SSR in the foot only (n: 9, 40.9%), and patients with absent SSR in both hand and foot (n: 5, 22.7%). Good correlation between abnormalities of NCS and absent SSR was observed. No correlation was noted between patient age, sex, duration of hemodialysis, duration of renal failure history, and absent SSR. However, statistically significant correlation was found between mean amplitude of the foot SSRs and sensorimotor nerve conduction velocities, and weekly frequency of hemodialysis.

Autonomic nervous system involvement in Behçet's disease: a pupillometric study.

The aim of this study was to elucidate whether autonomic nervous system dysfunction exists in patients with Behçet's disease by pupillometric tests. Thirty-one patients with Behçet's disease with a mean age of 41.3 years (range 21-64) and 41 control subjects with a mean age of 39.5 years (range 18-66) were selected for the study. To test the autonomic nervous system, four pupillometric techniques were used: pupil cycle time (PCT), dark-adapted pupil size (DAPS), 0.05% pilocarpine drop test, and 1% phenylephrine drop test. In all four tests, there were significant differences between the patients and controls. Mean PCTs were 1,156 ms (range 856-1,560 ms) and 919 ms (range 650-1,261 ms) in the patients and controls, respectively (p < 0.0001). The mean DAPS was 0.45 (range 0.31-0.66) in the patients, whereas it was 0.56 (range 0.42-0.67) in controls (p < 0.001). Iris sensitivity to both 0.05% pilocarpine and 1% phenylephrine showed significant differences between patients and controls, respectively (p < 0.05, p < 0.05). Among all four tests, only 0.05% pilocarpine sensitivity was correlated with the duration of Behçet's disease (p < 0.05). The results suggest that the autonomic nervous system innervating the iris is affected in Behçet's disease. This involvement may be due to the vasculitic nature of Behçet's disease.