MRI and neurophysiology in vestibular paroxysmia: contradiction and correlation

Background Vestibular paroxysmia (VP) is defined as neurovascular compression (NVC) syndrome of the eighth cranial nerve (N.VIII). The aim was to assess the sensitivity and specificity of MRI and the significance of audiovestibular testing in the diagnosis of VP. Methods 20 VP patients and, for control, 20 subjects with trigeminal neuralgia (TN) were included and underwent MRI (constructive interference in steady-state, time-of-flight MR angiography) for detection of a NVC between N.VIII and vessels. All VP patients received detailed audiovestibular testing. Results A NVC of N. VIII could be detected in all VP patients rendering a sensitivity of 100% and a specificity of 65% for the diagnosis of VP by MRI. Distance between brain stem and compressing vessels varied between 0.0 and 10.2 mm. In 15 cases, the compressing vessel was the anterior inferior cerebellar artery (75%, AICA), the posterior inferior cerebellar artery in one (5%, posterior inferior cerebellar artery (PICA)), a vein in two (10%) and the vertebral artery (10%, VA) in another two cases. Audiovestibular testing revealed normal results in five patients (25%), a clear unilateral loss of audiovestibular function in nine patients (45%) and audiovestibular results with coinstantaneous signs of reduced and increased function within the same nerve in six patients (30%). From the 20 TN patients 7, (35%) showed a NVC of the N. VIII (5 AICA, 1 PICA, 1 vein). Conclusions Only the combination of clinical examination, neurophysiological and imaging techniques is capable of (1) defining the affected side of a NVC and to (2) differentiate between a deficit syndrome and increased excitability in VP

Pseudo-shock waves and their interactions in high-speed intakes

In an air-breathing engine the flow deceleration from supersonic to subsonic conditions takes places inside the isolator through a gradual compression consisting of a series of shock waves. The wave system, referred to as a pseudo-shock wave or shock train, establishes the combustion chamber entrance conditions, and therefore influences the performance of the entire propulsion system. The characteristics of the pseudo-shock depend on a number of variables which make this flow phenomenon particularly challenging to be analysed. Difficulties in experimentally obtaining accurate flow quantities at high speeds and discrepancies of numerical approaches with measured data have been readily reported. Understanding the flow physics in the presence of the interaction of numerous shock waves with the boundary layer in internal flows is essential to developing methods and control strategies. To counteract the negative effects of shock wave/boundary layer interactions, which are responsible for the engine unstart process, multiple flow control methodologies have been proposed. Improved analytical models, advanced experimental methodologies and numerical simulations have allowed a more in-depth analysis of the flow physics. The present paper aims to bring together the main results, on the shock train structure and its associated phenomena inside isolators, studied using the aforementioned tools. Several promising flow control techniques that have more recently been applied to manipulate the shock wave/boundary layer interaction are also examined in this review

MRI and neurophysiology in vestibular paroxysmia: contradiction and correlation

Background Vestibular paroxysmia (VP) is defined as neurovascular compression (NVC) syndrome of the eighth cranial nerve (N.VIII). The aim was to assess the sensitivity and specificity of MRI and the significance of audiovestibular testing in the diagnosis of VP. Methods 20 VP patients and, for control, 20 subjects with trigeminal neuralgia (TN) were included and underwent MRI (constructive interference in steady-state, time-of-flight MR angiography) for detection of a NVC between N.VIII and vessels. All VP patients received detailed audiovestibular testing. Results A NVC of N. VIII could be detected in all VP patients rendering a sensitivity of 100% and a specificity of 65% for the diagnosis of VP by MRI. Distance between brain stem and compressing vessels varied between 0.0 and 10.2 mm. In 15 cases, the compressing vessel was the anterior inferior cerebellar artery (75%, AICA), the posterior inferior cerebellar artery in one (5%, posterior inferior cerebellar artery (PICA)), a vein in two (10%) and the vertebral artery (10%, VA) in another two cases. Audiovestibular testing revealed normal results in five patients (25%), a clear unilateral loss of audiovestibular function in nine patients (45%) and audiovestibular results with coinstantaneous signs of reduced and increased function within the same nerve in six patients (30%). From the 20 TN patients 7, (35%) showed a NVC of the N. VIII (5 AICA, 1 PICA, 1 vein). Conclusions Only the combination of clinical examination, neurophysiological and imaging techniques is capable of (1) defining the affected side of a NVC and to (2) differentiate between a deficit syndrome and increased excitability in VP

Experimental and numerical analysis of the structure of pseudo-shock systems in laval nozzles with parallel side walls

Detailed numerical and experimental investigations of pseudo-shock systems in a Laval nozzle with parallel side walls are carried out. The location of the pseudo-shock system is defined in this system of two choked Laval nozzles by the ratio of the critical cross sections A2*/A1*, the stagnation pressure loss across the shock system and viscous losses. The wall pressure distributions and high-speed schlieren videos recorded in the experiments are compared to the results of a steady and an unsteady numerical simulation. For the steady case, good agreement is found between the calculated and measured shock structure and pressure distribution along the primary nozzle wall, except for a remaining slight deviation in the shock position. For the unsteady case, in which asymmetric shock configurations are observed, deviations of the results with respect to the stochastic wall attachment of the shock system are given which indicate the necessity of further investigations on that topic

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