Ayhan Bölük

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.