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MRI showed a right CP angle mass 20x15-mm low signal on T1W and mildly hyperintense on T2W and flair images.
As is the case with most other intracranial pathology, MRI is the investigation of choice for the diagnosis and characterization of meningiomas.
Usually MRS does not play a significant role in diagnosis, but can help distinguish meningiomas from mimics. Universal Viewers Offer Freedom from Platform and Format Limitations Putting Clinical Insights within Reach; Is Your Image Viewer as Universal as You Think?
If a structure that is innervated by (or being monitored by) the sympathetic system becomes injured, then it is the job of the sympathetic system to react to that injury. Diagnosis can be difficult, especially if the treating physician is not familiar with the disorder.
Medications, physical therapy and sympathetic blocks (nerve blocks directed toward the sympathetic system) are all used to restore physiology to normal and relieve symptoms. Traditional and pioneering assessments using leading-edge technology help uncover diagnoses faster.
In 1997, the authors described a large family with classic Menière's syndrome and migraine inherited as an autosomal dominant trait.
In 1941 [1] and 1949 [2], Brown reported the familial incidence of Menière's syndrome.
From Dolowitz's work [6], we know that headache is very prevalent also in idiopathic (nonhereditary) Menière's syndrome.
We have submitted a special questionnaire, designed to describe the natural history of tinnitus and its relationship with the Menière's and migraine attacks, to all affected members of the family that we described in 1997.
A standard questionnaire focusing on the symptom of tinnitus was submitted to 31 members of the family whose pedigree is shown in Figure 1. Headache was the most frequent symptom found in this family, being present in 26 of 31 patients who answered the questionnaire and, in more than 80% of these patients, it could be characterized as true migraine. Tinnitus and vertiginous attacks were present in 19 of 31 patients who answered the questionnaire. Vertiginous attacks preceded tinnitus in 50% of the patients who had both symptoms, and tinnitus preceded the vertiginous crisis or came at the same time in 50% of the patients. When asked about tinnitus behavior over time, 74% of the tinnitus patients said that the symptom did not change, 21 % said that the symptom worsened over time, and only 5% said it disappeared altogether. In 76% of patients who have migraine, tinnitus, and vertiginous attacks, migraine starts before tinnitus and vertiginous crisis. Tinnitus and vertiginous attacks are present with the same frequency (19 of 31 patients interviewed) and appear after migraine.
In hereditary Menière's syndrome, tinnitus and vertiginous attacks seem to be caused by a permanent change in the inner ear. Of the tinnitus patients we interviewed, 79% described their symptom as something close to a white noise. This study was-presenred at Twenty-Fifth Ordinary Scientific Congress of the Neurootological and Equilibriometric Society, March 19-22, 1998, Bad Kissingen, Germany.
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Pheromones to attract women is what I'm talking about and you better believe they are real. The answer lies within the sympathetic nervous system (a portion of the autonomic nervous system) that monitors and regulates various activities that occur independently from the rest of the nervous system.
In the case of Barre-Leiou, the Posterior Cervical Sympathetic Chain forgets to stop monitoring the injury site; like a car engine that diesels, it forgets to shut down. People with persistent head and neck pain, such as after a motor vehicle accident, or with persistent migraine associated with blurred vision, numbness or tinnitus, should consider Barre-Lieou when looking for help. Using a special questionnaire applicable to all the affected members of this family, the majority of respondents convincingly demonstrated true migraine preceding or after the Menière's attacks. The mechanism of genetic transmission was autosomal dominant in all the families he described.
Here, we describe the findings gathered from the answers to this questionnaire, and we offer our interpretation of these results.
We excluded those members of this family who did not have any of the following symptoms: migraine headache, tinnitus, or vertiginous attacks.
Furthermore, migraine crisis appeared before vertiginous attacks and tinnitus in 76% of the patients who had all these symptoms.
Tinnitus was present for more than 5 years in 68% of the patients and, in 16%, it was 2-5 years old. Somewhat surprisingly, tinnitus did not change during the vertiginous attacks in 62% of patients, became more intense during the vertiginous episodes in 31 %, and had a variable behavior during the vertiginous attacks in 7%.
Hearing loss was present in 68% of the patients with tinni-tus, and 53% of them could not point out any stimulus that influenced their tinnitus behavior.
As migraine is a central symptom, this progression would suggest that the pathological process begins in the central nervous system. This finding suggests that both are peripheral symptoms and that the pathological process that started in the central nervous system reaches the inner ear later.
In fact, there have been many people who have wondered what pheromones are, and a lot of research has been done on the topic. Most of the signals women send is through body language - which means you are not going to find out if she's interested from words alone. The concept of a human pheromone, or sexual scent of attraction, has been debated and researched for years. Some of the many behaviors affected by animal pheromones include, attracting or finding a mate, reproduction cycles, marking territory, warning of danger, and showing the way to food. Think about this for a minute and then ask yourself why you are naturally drawn to people who exude confidence.
Examples include pupil accommodation to light, equilibrium within the inner ear, and respiration. Treatment should be directed toward restoring normal sympathetic nerve function, enhancing blood flow, and reducing total load (the total number of things that do not allow the system to heal). Now we have used another questionnaire designed to describe the natural history of tinnitus and have posed the questions therein to all members of this sibship affected by migraine, Menière's syndrome, or both.
One family, however, included three affected siblings whose parents were first-degree cousins.
In his statistical analysis of the symptoms, he found tinnitus to be a relatively independent symptom and to have a positive association with headache when positional vertigo was present. All family members who had any of the foregoing symptoms and were available answered the questionnaire. Some patients who had only tinnitus or headache appear in the figure only as open circles and squares but did answer the questionnaire. Of the tinnitus patients, 68% rated the intensity of the symptom as greater than 4 on a scale of 1-10.
Regarding the migraine crisis, tinnitus did not change during the crisis in 77% of the patients who had both symptoms, and it worsened in 22%. Finally, 79% of the tinnitus patients described the symptom as a white noise (radio static, waterfall, whistle; see Table 1). However, migraine crisis often precedes vertiginous attacks, and this finding suggests a central trigger for both. This process probably involves the homeostasis of the inner ear fluids and causes both Menière's syndrome and endolymphatic hydrops.

The factor of heredity in labyrinthine deafness and paroxysmal vertigo (Menière's syndrome). These are usually used to attract a mate, but pheromones have also been found to have an effect in social and business circles. It's only been in the last few decades that we have begun to understand the presence of pheromones and their impact on our interaction with each other. To grasp the eternal truths displayed so beautifully in these old texts, you need only to see it is not a story.
More traditional studies include MRI (to rule out structural problems in the head and neck) and electrodiagnostic studies (to check for nerve damage).
This finding raised the possibility of an autosomal recessive mode of genetic transmission. This time, however, they submitted a special questionnaire to all affected members of this family so as to answer the question: Is the headache true migraine? He speculated that tinnitus and headache could be central symptoms in Menière's disease. Wellknown and generally accepted is that emotional crisis can provoke both migraine and Menière's attacks.
The relations oftinnitus with the other Menière's symptoms and with the migraine also were explored.
In 1965, Bernstein [3] reported several families with Menière's syndrome transmitted in an autosomal dominant mode.
Tinnitus was present for more than 5 years in 13 patients, for 2-5 years in 3, for 1 year in 2, and for less than 1 year in 1. Fluctuant hearing loss is the cochlear counterpart of the vestibular crisis and is absent in 22% of the tinnitus patients in our family. A pheromone is a substance that is secreted by the body primarily for the purpose of mating. Only headache appears more often than tinnitus in these patients, and the latter is the only symptom constantly present, with little variation during migraine and Menière's attacks. In 1992, Oliveira and Braga [4] reported one family having Menière's syndrome also transmitted in an autosomal dominant mode. On a scale of 1-10, tinnitus intensity was 4 or more in 13 patients and was less than 4 in 6 cases.
The female attracts the male of the same species by putting out just the right pheromones to bring him to her. It would have been too confusing and way too funny had this been not the case. This is nature's way of making sure that the right kind of animal mates with another of its own species and that the line of that animal can continue to reproduce. Vertiginous episodes preceded the appearance of tinnitus in eight patients, and tinnitus came first in four. It also is a way of making sure that nothing has to force certain animals to breed; they simply will when the time is right. Tinnitus and vertiginous attacks started together in two patients, and two patients could not remember the order of appearance. This can happen in any kind of living creature -- people, animals and insects -- because all living things need a mate in order to reproduce.
Tinnitus intensity did not change during acute episodes of vertigo in 10 patients, increased during the crisis in 5, and had a variable behavior during the vertiginous attack in 1. During the migraine crisis, tinnitus was unchanged in 10 patients and worsened in 3 patients.
Tinnitus worsened with alcohol intake in four cases, with stress in three, with noise in one, and with exercise in one.
A total of 10 patients did not identify any intercurrent events that would worsen tinnitus.
Finally, 15 patients described their tinnitus as a noise close to white (radio static, waterfall, whistle; Table 1).

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