Bir Olgu Eşliğinde Kusma Semptomu ve Birinci Basamaktaki Önemi

Nausea and vomiting are protective mechanisms developed as a result of various chemical, physical and humoral effects or diseases and may be preliminary symptoms of several dis¬eases. These symptoms can occur in diseases of cerebral, vestibular and gastrointestinal origin. Nausea and vomiting is under the control of two functionally different centres. These are the vomiting centre and the chemoreceptor trigger zone (CTZ). In the way to clarify the etiologic factor producing nausea and vomiting, history, physical examination and diagnostic tests are important auxiliaries. Therapy is planned accord¬ing to the etiologic disease causing nausea and vomiting. Case report: A forty year-old male patient presented to our out-patient clinic with symptoms of mild nausea, vomiting and dizziness appearing periodically since 2 months. The Patient could walk with help and had difficulty in standing upright. His right pupil was 1 mm more dilated than the left one. In his fundus examination minimal papillary stasis existed. Rotating nistagmus was present while gazing in upper right direction. Deep tendon reflexes were hypoactive in the upper extremi¬ties; there were ataxia on the right upper and lower extremi¬ties and dismetria on the right side. Tumor in the posterior fossa was the preliminary diagnosis. In the magnetic reso¬nance images of the brain, a the tumoral mass was detected in the right pontocerebellar corner. In the digital subtraction angiography, the tumor was found to be consistent with hae-mangioblastoma. The tumor was totally excised.