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Applications of the marchbanks transcranial-cerebral sonography technique in neurootology: preliminary report.
[hydrocephalus with stenosis of the aqueduct of sylvius]
Transcranial-
cerebral
sonography
(
TCCS
)
is
a
noninvasive
technique
that
allows
clinicians
to
detect
nanoliter
(
billionths
of
a
liter
)
displacements
of
the
tympanic
membrane
.
This
technique
was
developed
to
assess
cerebrospinal
fluid
(
CSF
)
pressure
in
cases
of
shunted
hydrocephalus
;
it
takes
advantage
of
the
CSF
connection
to
the
inner
ear
through
the
cochlear
aqueduct
.
The
movements
of
the
tympanic
membrane
that
are
observed
in
TCCS
are
those
evoked
by
the
acoustic
stapedius
reflex
and
those
spontaneous
movements
generated
by
intracranial
arterial
,
venous
,
and
respiratory
pulses
transmitted
through
the
inner
ear
to
the
stapes
and
thence
to
the
tympanic
membrane
.
Analysis
of
the
amplitude
and
direction
of
these
displacements
has
enabled
neurosurgeons
and
neurologists
to
estimate
CSF
pressures
accurately
in
patients
evaluated
by
TCCS
.
TCCS
allows
for
applications
in
neurootology
,
particularly
in
those
patients
who
present
with
symptoms
of
pulsating
tinnitus
,
dizziness
and
imbalance
,
or
hearing
loss
.
This
preliminary
report
describes
the
test
and
its
application
in
a
series
of
patients
whose
diagnoses
included
pulsating
tinnitus
,
idiopathic
intracranial
hypertension
,
Ménière
's
disease
,
perilymphatic
fistula
,
perilymphatic
hypertension
,
arterial
stenosis
,
and
Arnold
-
Chiari
syndrome
.
We
conclude
that
TCCS
is
a
valuable
addition
to
the
armamentarium
of
neurootologists
.
Diseases
Validation
Diseases presenting
"intracranial arterial"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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