Research Article
Asymmetries of Transverse Sinuses in Patients with Menière Disease and Non-Migrainous Headache
Giampiero Neri*
,
Letizia Neri,
Giovanni Sanese,
Klajdi Xhepa,
Andrea Mazzatenta,
Anna Rita Fetoni,
Giuseppe Chiarella
Issue:
Volume 13, Issue 3, June 2025
Pages:
32-42
Received:
17 May 2025
Accepted:
13 June 2025
Published:
26 June 2025
Abstract: Menière's disease (MD) is a chronic inner ear disorder characterised by vertigo, fluctuating hearing loss, and fullness, frequently associated with migraine. The aetiology of MD is multifactorial but unclear. Endolymphatic hydrops (EH) is the histopathological marker. The correlation between venous disorders and MD is described in the literature. Our study aims to evaluate the incidence of Transverse Sinus Asymmetries (TSA) in patients with Menière Disease (MD) and non-migrainous headaches to test a physiopathological hypothesis. Materials and Methods: We conducted a retrospective study of 32 patients with symptoms of MD and non-migrainous headaches who presented to TSA on Magnetic Resonance Imaging (MR). Each patient underwent clinical evaluation, Audiometry, impedanceometry, VHIT, VEMPS, RM Angiography (RMA), transcranial colour doppler ultrasound (TCD) to study the intracranial venous system and vascular flow. Results: All patients were diagnosed as probable in 41% and certain in 59%. On RMA results, 91% showed TSA. We propose four TSA stages. RMA showed 83% left TS hypoplasia and 17% right TS hypoplasia. All patients with TSA showed MD. Patients with left TSA showed right MD; patients with right TSA showed left or bilateral MD. We used TCD in 15 patients: 10 patients showed alteration or flow reversal. In 5 subjects was not possible due to mastoid ossification. Conclusions: Ultimately, a clear association exists between TS absence or hypoplasia in many Menière’s patients with non-migrainous headaches. Moreover, there is a correspondence between the side of MD and TSA, which is contralateral. Our study suggests to follow-up patients with TSA to prevent the onset of EH.
Abstract: Menière's disease (MD) is a chronic inner ear disorder characterised by vertigo, fluctuating hearing loss, and fullness, frequently associated with migraine. The aetiology of MD is multifactorial but unclear. Endolymphatic hydrops (EH) is the histopathological marker. The correlation between venous disorders and MD is described in the literature. O...
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Case Report
Pasteurella Multocida Pneumonia in an Immunocompetent Female: A Case Report
Ermiyas Berehanu Hayle*
Issue:
Volume 13, Issue 3, June 2025
Pages:
43-47
Received:
19 June 2025
Accepted:
5 July 2025
Published:
24 July 2025
Abstract: Pasteurella multocida, a zoonotic gram-negative coccobacillus commonly found in the oral flora of domestic animals like cats and dogs, is a rare cause of pneumonia, particularly in immunocompetent individuals. This case report describes a 55-year-old immunocompetent woman who presented with a two-month history of worsening shortness of breath, fatigue, low-grade fever, night sweats, loss of appetite, and weight loss, alongside a six-year history of intermittent respiratory symptoms. She reported prolonged close contact with her pet dog and cat and a 20-year history of indoor biomass fuel exposure. Physical examination revealed diminished breath sounds in the right middle lung field and oxygen saturation of 90% on room air. Chest CT showed right middle lobar bronchus stenosis, segmental atelectasis, bilateral bronchial wall thickening, ground-glass opacities, and mild centrilobular emphysema. Bronchoalveolar lavage culture confirmed Pasteurella multocida, sensitive to Amoxicillin-Clavulanate, leading to a diagnosis of P. multocida pneumonia. Treatment with a 10-day course of oral Amoxicillin-Clavulanate resulted in significant clinical improvement, with resolution of respiratory and systemic symptoms and a 2 kg weight gain by day 15. This case underscores the importance of considering zoonotic pathogens in the differential diagnosis of community-acquired pneumonia in patients with animal exposure, even without typical risk factors like immunosuppression or chronic lung disease. It highlights the role of environmental factors, such as biomass fuel exposure, in predisposing to pulmonary infections and the value of early bronchoscopy for definitive diagnosis. Patient education on pet hygiene and avoidance of respiratory irritants is crucial for prevention, emphasizing the need for a thorough exposure history to manage rare zoonotic infections effectively.
Abstract: Pasteurella multocida, a zoonotic gram-negative coccobacillus commonly found in the oral flora of domestic animals like cats and dogs, is a rare cause of pneumonia, particularly in immunocompetent individuals. This case report describes a 55-year-old immunocompetent woman who presented with a two-month history of worsening shortness of breath, fati...
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