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Bhavesh Trikamji, Mariam Thomas, Gasser Hathout, Shrikant Mishra
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is an autosomal dominant angiopathy caused by a mutation in the notch 3 gene on chromosome 19. Clinically, patients may be asymptomatic or can present with recurrent ischemic episodes and strokes leading to dementia, depression, pseudobulbar palsy, and hemi- or quadraplegia. Additional manifestations that have been described include migraine (mostly with aura), psychiatric disturbances, and epileptic seizures...
April 2016: Annals of Indian Academy of Neurology
Brian M Haus, Andrew R Hsu, Eugene S Yim, Jeffrey J Meter, Lawrence A Rinsky
BACKGROUND CONTEXT: No studies have discussed the long-term surgical management and outcomes of Charcot arthropathy of the spine. This case series presents nine patients treated over 30 years. The study hypothesis was that surgery would reduce instability, pain, recurrence, and the need for revision surgery in the long-term, given previous study findings of successful fusion of Charcot spine in the short-term. PURPOSE: To evaluate the long-term outcomes of surgery for Charcot spine...
June 2010: Spine Journal: Official Journal of the North American Spine Society
Gregory G Heuer, Douglas A Hardesty, Deb A Bhowmick, Robert Bailey, Suresh N Magge, Phillip B Storm
There are several treatment options for rigid fixation at C1-C2 including Brooks and Gallie type wired fusions and C1-2 transarticular screws. The use of a Goel-Harms type fusion, a construct with C1 lateral mass screws and C2 pedicle screws, has not been extensively described in pediatric patients. Here, we describe its relatively safe and effective use for treating pediatric patients by retrospective chart review of patients treated by the senior author for atlantoaxial instability with a Goel-Harms-type constructs during a 3-year period (2005-2007)...
June 2009: European Spine Journal
Caroline Schnakers, Steve Majerus, Serge Goldman, Melanie Boly, Philippe Van Eeckhout, Stephane Gay, Frederic Pellas, Valerie Bartsch, Philippe Peigneux, Gustave Moonen, Steven Laureys
OBJECTIVE: The lockedin syndrome (LIS) originates from a ventro-pontine lesion resulting in a complete quadraplegia and anarthria. Classically, communication remains possible by means of spared vertical eye movements and/or blinking. To allow assessing cognitive functions in LIS patients, we propose here a neuropsychological testing based on eye-coded communication. METHODS: Ten chronic LIS survivors were assessed 1 to 6 years after their brain insult. One patient was evaluated subacutely (at 2 months) and retested at 6 and 16 months...
March 2008: Journal of Neurology
Sameer J Patel, Richard C Huard, Christian Keller, Marc Foca
An adolescent with HIV/AIDS presented subacutely with progressive encephalopathy, spastic quadraplegia, and diarrhea. His brain biopsy was suggestive of central nervous system Whipple's disease, a disease rarely described in HIV patients. Due to overlapping, nonspecific symptoms associated with several opportunistic infections and to the difficulty in culturing the causative organism Tropheryma whipplei, Whipple's disease may be more common than previously suspected, and it is an important consideration in patients with AIDS...
March 2008: Journal of the International Association of Physicians in AIDS Care: JIAPAC
L F Ibrahim, M J Hennessy
Central Pontine Myelinolysis (CPM) is a clinical entity first described by Adams et all in 1958 in the context of malnourishment and alcoholism. Classically, this demyelinating disease arises from the rapid correction of hyponatraemia, resulting in profound neurological deficits such as spastic quadraplegia and pseudobulbar palsy. Diagnosis is usually made on the presence of a symmetrical, centralized and well-circumscribed lesion in the pens, seen on MRI. Extrapontine lesions have also been described, frequently affecting the midbrain, thalamus, cerebellum and rarely extends to the medulla...
February 2007: Irish Medical Journal
John R Bach
Patients with a variety of neuromuscular diseases including quadraplegia due to high spinal cord lesions can be managed with full-time noninvasive ventilation instead of intermittent positive pressure ventilation (IPPV) via a tracheostomy. This approach is not suitable for patients with severe bulbar involvement. To be successful with full-time noninvasive IPPV, the ventilator user must realize three goals. First, respiratory system compliance should be optimized and maintained by frequent full inflations delivered by stacking breaths from a volume-cycled ventilator or by insufflating air at adequate pressures using a mechanical insufflator-exsufflator...
June 2002: Seminars in Respiratory and Critical Care Medicine
D Graber, J C Hebert, M C Jaffar-Bandjee, J L Alessandri, J C Combes
BACKGROUND: Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and the Pacific islands. Adults develop transient meningitis with a benign course, whilst severe or fatal disease may occur in pediatric patients. CASE REPORTS: Three infant girls, aged 8 to 11 months, living on the island of Mayotte, developed fever, hypotonia, coma (2 cases), and, for one of them, seizures. Eosinophilia was detected in the peripheral blood and cerebrospinal fluid...
July 1999: Bulletin de la Société de Pathologie Exotique
J F Giguère, D St-Vil, A Turmel, M Di Lorenzo, C Pothel, S Manseau, C Mercier
Over 30 children who were improperly restrained or in rear facing safety seats have been reported killed in motor vehicle accidents (MVA) involving airbags. The authors report one minor and two major injuries in properly restrained children in the front passenger seat. In case 1, A 10-year-old seat-belted boy was involved in an MVA (40 km/h) with deployment of both airbags. Physical examination findings showed right hyphema with corneal abrasion, right cheek abrasion and minimal cervical tenderness. C-spine x-ray was normal...
June 1998: Journal of Pediatric Surgery
D Graber, M C Jaffar-Bandjee, T Attali, J Poisson, M Renouil, J L Alessandri, J C Combes
BACKGROUND: Eosinophilic meningitis caused by Angiostrongylus cantonensis is widespread in Southeast Asia and Pacific islands. Adults develop a transient meningitis with a benign course but severe or fatal disease may occur in pediatric patients. CASE REPORT: Case 1. A 11-month-old boy living in Mayotte island was hospitalized a few days with fever and skin rash following by seizure, coma, flaccid quadraplegia, absence of deep tendon reflexes, urinary retention and anal incontinence...
May 1997: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
R M Powell, K J Heath
A 59 year old man was found collapsed and unconscious, tracheal intubation was performed without immobilisation of the cervical spine. Examination revealed signs of spinal cord transection with quadraplegia and a lateral cervical spine radiograph showed a displaced fracture of the odontoid peg. This case reinforces the importance of appropriate cervical spine management in all victims of trauma especially those with head injuries and is particularly relevant to the military situation.
June 1996: Journal of the Royal Army Medical Corps
B L Priestley, J Lorber
Of 10 children with macrocephaly in association with achondroplasia only two children had progressive hydrocephalus. They were treated with a shunt procedure. One of these is intellectually and neurologically normal, and one is wheelchair bound and mentally retarded, with a spastic quadraplegia. Three children showed mild dilatation of the ventricles and one of these died from severe constriction at the foramen magnum. The other two are neurologically normal; one is intellectually normal but below average (WISC 88) and the other is slow normal at 18 months of age...
December 1981: Surgery in Infancy and Childhood
R M Jameson
When paraplegia occurs as a result of malignant disease, it generally means that the patient's survival is limited to a few months. The exceptions to this rule include patients with paraplegia or quadraplegia as a result of metastases from carcinoma of the prostate. This study concerns 24 men with paraplegia, 20 of whom lived for over 5 years following the onset of paralysis, 18 being rehabilitated. The prostatic cause of paralysis may not be obvious at the first, and conventional X-rays of the spine may be negative...
1983: European Urology
D Carroll
No abstract text is available yet for this article.
September 1967: Maryland State Medical Journal
R B Stewart, M Forgnone, F E May, J Forbes, L E Cluff
Of 415 adult patients treated for acute drug intoxications in a university hospital emergency room, 64 (15.4%) required admission to the medical service for intensive care. A significantly larger proportion of patients over 40 years of age required hospitalization. Forty-eight of the episodes requiring hospitalization were identified as intentional drug intoxication. Women were admitted in 41 (64.0%) instances while men were admitted on 23 (36.0%) occasions. Non-barbiturate depressants, barbiturates, tranquilizers, and antidepressants were the drug classes most commonly incriminated...
1974: Clinical Toxicology
S A Slagel, J J Skiendzielewski, F G McMurry
Pyogenic osteomyelitis of the vertebrae accounts for 4% of all osteomyelitis, and is believed to be increasing in incidence. Pyogenic osteomyelitis of the cervical spine is even more uncommon, accounting for 10% of all spinal pyogenic osteomyelitis. Presented is a case of pyogenic osteomyelitis of the cervical spine in which appropriate methods of immobilization of the cervical spine resulted in a surgically reversible acute deterioration of the patient's neurologic status. While immobilization of the cervical spine remains the initial treatment of choice in most patients with suspected disease of the cervical spine, it is not without potential complications...
September 1985: Annals of Emergency Medicine
E B Winslow, M Lesch, J V Talano, P R Meyer
Twenty-two of 83 consecutive patients with traumatic quadraplegia admitted to a regional spinal injury center had significant bradycardia. These bradycardic patients accounted for 66% of the cervical spinal cord injured patients' mortality. In general, bradycardia in patients with cervical spinal cord injuries appears to be due to unopposed vagal tone. This bradycardia is self-limited within 3-5 weeks after the onset of paraplegia and does not require permanent pacemaker therapy.
October 1986: Spine
E R Wald, I Bergman, H G Taylor, D Chiponis, C Porter, K Kubek
Group B Streptococcus is a common cause of neonatal sepsis and meningitis. The purpose of this study was to evaluate the neurologic, psychologic, and academic status of children who had group B streptococcal meningitis and to compare these children with their siblings. Seventy-four children who acquired group B streptococcal meningitis between one day and 6 months of life formed the study population. Survivors were 3 to 18 years old at the time of their follow-up evaluations. Twenty children (27%) died, two were institutionalized, one severely affected child died at age 2 years, 15 were assessed by phone interview, and two were lost to follow-up...
February 1986: Pediatrics
D F Edwards, T G Nyland, J P Weigel
The clinical, laboratory, radiographic, and histologic features and the response to therapy in three dogs with actinomycosis are reported. One dog (dog 1) had a 12-cm nonresectable mass extending from the ventrolateral chest wall into the left ventricular myocardium. Another dog (dog 2) had a diffuse peritonitis with "sulfur granules" and two large masses. One of these masses was nonresectable involving adjacent abdominal structures. A third dog (dog 3) had a subvertebral mass at T1-3 producing quadraplegia...
October 1988: Journal of Veterinary Internal Medicine
W R Beach, W B Strecker, J Coe, P R Manske, P L Schoenecker, L Dailey
We retrospectively reviewed Green procedures and transfer of the flexor carpi ulnaris (FCU) in treatment of spastic forearm pronation, wrist volarflexion, and ulnar deviation deformities. Patient's ages ranged from 3 years 5 months to 16 years 5 months. Surgically, a single volar incision was made and the extensor carpi radialis brevis and/or longus (ECRB, ECRL) were used for insertion. The FCU was tensioned at neutral against gravity and immobilized in 5 degrees of dorsiflexion and 45 degrees of supination...
November 1991: Journal of Pediatric Orthopedics
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