General Neurology
Reflex syncope (neurally-mediated syncope)
May. 01, 2024
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Cochlear and vestibular endolymphatic hydrops with different degrees
High-resolution 3D-FLAIR images were obtained 6 hours after intravenous gadolinium injection. (a) Cochlear hydrops grade II: a 45-year-old man with right Meniere disease. Axial 3D-FLAIR image showed that the scala vestibuli was fully obliterated due to the dilated cochlear duct (arrow). (b) Vestibular hydrops grade II: a 49-year-old man with right Meniere disease. Axial 3D-FLAIR image showed a confluence of the saccule and utricle (long arrow) with continuous peripheral rim enhancement of the perilymphatic space (short arrows) Note: abnormal cochlear perilymphatic enhancement (arrowhead) was shown on the same side. (c) Vestibular hydrops grade III: a 48-year-old woman with right Meniere disease. Axial 3D-FLAIR image showed that the perilymphatic enhancement was no longer continuous. There was a full obliteration of the bony vestibule, and the perilymphatic enhancement was no longer visible (short arrow). (Source: Li J, Li L, Jin X, et al. MRI can help differentiate Ménière's disease from other menieriform diseases. Sci Rep 2023b;13[1]:21527. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)