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https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#1
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186472/clinical-presentation-and-treatment-outcomes-of-spinal-epidural-arteriovenous-fistulas
#2
Deena M Nasr, Waleed Brinjikji, Michelle J Clarke, Giuseppe Lanzino
OBJECTIVE Spinal epidural arteriovenous fistulas (SEDAVFs) constitute a rare but treatable cause of vascular myelopathy and are a different subtype from the more common Type I spinal dural AVFs. The purpose of this study was to review a consecutive series of SEDAVFs from a single institution and report on the clinical presentations, functional status, and treatment outcomes. METHODS The authors identified all SEDAVFs treated at their institution from 2005 to 2015. SEDAVFs were defined as spinal AVFs in which the fistulous connection occurred in the epidural venous plexus...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28180101/evaluation-of-complications-after-surgical-treatment-of-thoracic-outlet-syndrome
#3
Mohammad Ali Hosseinian, Ali Gharibi Loron, Yalda Soleimanifard
BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. METHODS: In this study, 448 patients with symptoms of TOS were assessed...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28162730/-475-pulsed-radiofrequency-of-brachial-plexus-for-the-treatment-of-refractory-shoulder-pain
#4
A Dua, J Shepherd, S Bahadur, D Martin
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28159317/novel-treatment-protocol-for-ameliorating-refractory-chronic-pain-in-patients-with-autosomal-dominant-polycystic-kidney-disease
#5
Niek F Casteleijn, Maatje D A van Gastel, Peter J Blankestijn, Joost P H Drenth, Rosa L de Jager, Anna M Leliveld, Ruud Stellema, Andreas P Wolff, Gerbrand J Groen, Ron T Gansevoort
Autosomal dominant polycystic kidney disease (ADPKD) patients can suffer from chronic pain that can be refractory to conventional treatment, resulting in a wish for nephrectomy. This study aimed to evaluate the effect of a multidisciplinary treatment protocol with sequential nerve blocks on pain relief in ADPKD patients with refractory chronic pain. As a first step a diagnostic, temporary celiac plexus block with local anesthetics was performed. If substantial pain relief was obtained, the assumption was that pain was relayed via the celiac plexus and major splanchnic nerves...
January 31, 2017: Kidney International
https://www.readbyqxmd.com/read/28144616/steroid-induced-psychosis-after-eus-guided-celiac-plexus-blockade
#6
David C Olson, Jason J Lewis
A 46-year-old female with no previous personal or family psychiatric history underwent endoscopic ultrasound (EUS)-guided celiac plexus blockade (CPB) to treat pain related to cystic fibrosis transmembrane conductance regulator-associated chronic pancreatitis. She had excellent response to her first three CPBs using bupivacaine and triamcinolone. The patient's subsequent CPBs were complicated by symptoms of racing thoughts, delusional thinking, and insomnia. She was diagnosed with acute psychosis secondary to triamcinolone...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28138407/the-value-of-ultrasonography-in-the-diagnosis-of-varicocele
#7
REVIEW
Tomasz Lorenc, Leszek Krupniewski, Piotr Palczewski, Marek Gołębiowski
A varicocele is described as pathologically enlarged, tortuous veins of the pampiniform plexus, leading to an increased testicular temperature and adrenal metabolite reflux into the testes. Varicocele can impair spermatogenesis and is considered to be the most common cause of male infertility. Patients may palpate a thickening in the scrotum or complain of dull scrotal or inguinal pain, which increases when standing or during erection. In the case of a sudden onset of varicocele in elderly men, it is necessary to exclude renal tumor and extend diagnostic ultrasound with the assessment of the abdominal cavity...
December 2016: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28109859/microsurgical-anatomy-of-the-hypoglossal-and-c1-nerves-description-of-a-previously-undescribed-branch-to-the-atlanto-occipital-joint
#8
Joe Iwanaga, Christian Fisahn, Fernando Alonso, Daniel DiLorenzo, Peter Grunert, Matthew T Kline, Koichi Watanabe, Rod J Oskouian, Robert J Spinner, R Shane Tubbs
OBJECTIVE: Distal branches of the C1 nerve that travel with the hypoglossal nerve have been well investigated but relationships of C1 and the hypoglossal nerve near the skull base have not been described in detail. Therefore, the aim of this study was to investigate these small branches of the hypoglossal and first cervical nerves by anatomical dissection. METHODS: Twelve sides from six cadaveric specimens were used in this study. To elucidate the relationship among the hypoglossal, vagus, and first and cervical nerve, the mandible was removed and these nerves were dissected under the surgical microscope...
January 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28059708/impact-of-mr-neurography-in-patients-with-chronic-cauda-equina-syndrome-presenting-as-chronic-pelvic-pain-and-dysfunction
#9
J R Petrasic, A Chhabra, K M Scott
BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome...
November 10, 2016: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28054138/-ultrasound-guided-interventions-on-the-peripheral-nervous-system
#10
A Loizides, L Gruber, S Peer, M Plaikner, H Gruber
CLINICAL/METHODICAL ISSUE: Up to the advent of high-resolution ultrasound, interventions on the peripheral nervous system, including local anesthesia and pain treatment were performed without visual guidance, which in some cases led to treatment failure or local tissue and nerve damage. METHODICAL INNOVATIONS: Progress in the field of ultrasound has enabled the functional visualization, anesthesia and anti-inflammatory or neurolytic treatment of many peripheral nerves, such as the brachial plexus, nerves of the upper and lower extremities and various nerves of the trunk...
January 4, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#11
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/27984834/-ophthalmological-monitoring-of-diabetic-neuropathy-in-a-mouse-model
#12
S Baltrusch
Patients with diabetes mellitus suffer from late damage, including microvascular and macrovascular complications and diabetic polyneuropathy, even though blood glucose is well controlled and the HbA1c value normalised. Peripheral nerves are affected, and when these are damaged, this can result in disturbed sensation and pain. Such nerves are mainly Aδ und C fibres, which are present in the skin, but also in the subbasal nerve plexus of the cornea. Imaging of the subbasal nerve plexus using microscopic techniques allows a very early and objective view of neuropathy, which is only possible invasively by skin biopsy...
December 2016: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/27977849/conservative-interventions-for-treating-middle-third-clavicle-fractures-in-adolescents-and-adults
#13
REVIEW
Mário Lenza, Flávio Faloppa
BACKGROUND: Clavicle (collarbone) fractures account for around 4% of all fractures. Most (76%) clavicle fractures involve the middle-third section of the clavicle. Treatment of these fractures is usually non-surgical (conservative). Commonly used treatments are arm slings, strapping and figure-of-eight bandages.This is an update of a Cochrane review first published in 2009 and updated in 2014. OBJECTIVES: To evaluate the effects (benefits and harms) of different methods for conservative (non-operative) treatment for acute (treated soon after injury) middle third clavicle fractures in adolescents and adults...
15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27930554/pulsed-radiofrequency-treatment-of-the-superior-hypogastric-plexus-in-an-interstitial-cystitis-patient-with-chronic-pain-and-symptoms-refractory-to-oral-and-intravesical-medications-and-bladder-hydrodistension-a-case-report
#14
Jong Hae Kim, Eugene Kim, Bong Il Kim
RATIONALE: A variety of therapeutic modalities are available for the treatment of interstitial cystitis. However, among them, the less invasive therapies are usually ineffective, whereas the invasive ones carry potential risks of serious side effects and complications. Pulsed radiofrequency (PRF) treatment of the superior hypogastric plexus may be an alternative to conventional treatments, as it provides nondestructive neuromodulation to the superior hypogastric plexus, which transmits the majority of pain signals from the pelvic viscera...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27913002/clinical-evaluation-and-management-of-radiation-fibrosis-syndrome
#15
REVIEW
Michael D Stubblefield
Radiation fibrosis syndrome describes the multiple neuromuscular, musculoskeletal, visceral, and other late effects that result from radiation-induced fibrosis. Radiation can damage the spinal cord, nerve roots, plexus, local peripheral nerves, and muscles within the radiation field. This constellation is known as a "myelo-radiculo-plexo-neuro-myopathy" and can result in pain, sensory loss, weakness, and other signs and symptoms. Although there is no curative treatment for radiation damage, supportive management of symptoms can be helpful in restoring and maintaining function and quality of life...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27904860/interventional-therapy-for-pancreatic-cancer
#16
REVIEW
Jianwei Zhu, Zhendong Jin
BACKGROUND: Palliative therapy and primarily chemoradiotherapy are the mainstream treatments in patients with locally advanced or metastatic pancreatic cancer (PC). Conventional endoscopy and endoscopic ultrasound (EUS)-guided interventional therapy has emerged as an important procedure for PC management. In this review, the progress in conventional endoscopy and EUS for PC management is discussed. SUMMARY: For local palliative therapy against PC, EUS-guided fine needle injection (FNI) could deliver different kinds of agents, such as radioactive seeds and fiducials...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27895411/reoperation-in-an-adult-female-with-right-sided-hirschsprung-s-disease-complicated-by-refractory-hypertension-and-cough
#17
Zhi-Jian Wei, Lei Huang, A-Man Xu
Hirschsprung's disease (HD) is an intestinal malformation caused by the innate absence of ganglion cells in the neural plexus of the colorectal wall, and is most common in male infants. It is rare in adult, and is usually left-sided. Herein we reported based on the CARE guidelines a case of a 47-year-old adult female suffering from "right-sided" HD complicated by refractory hypertension and cough. The patient with a history of cesarean section and with digestive unfitness (abdominal pain, distention, and constipation) only since 20 years old had recurrence of HD after initial surgery due to the incomplete removal of the HD-affected bowel based on a diagnosis of "chronic ileus", leading to the relapse of the digestive symptoms and the emergence of some intractable circulatory and respiratory complications which could be hardly controlled by conservative treatment...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27879550/successful-treatment-of-brachial-plexopathy-due-to-herpes-zoster-infection-with-intravenous-immunoglobulin
#18
Michel Sáenz-Farret, Valeria Sandoval-Rodríguez, Claudia Esther Paz-Navarro, Carlos Zúñiga-Ramírez
OBJECTIVE: The aim of this study was to report the case of a male patient with Parkinson disease who developed brachial plexopathy (BP) due to varicella-zoster virus, which was successfully treated with human immunoglobulin. METHOD: We report the case of a 75-year-old male subject with a diagnosis of Parkinson disease who came to our hospital complaining of pain, skin lesions, and strength loss in his right arm during the past 2 months. Physical examination revealed vesicular rash compatible with varicella-zoster virus lesions...
January 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/27871553/fascia-iliaca-block-associated-only-with-deep-sedation-in-high-risk-patients-taking-p2y12-receptor-inhibitors-for-intramedullary-femoral-fixation-in-intertrochanteric-hip-fracture-a-series-of-3-cases
#19
Carlos Rodrigues Almeida, Emília Milheiro Francisco, Vítor Pinho-Oliveira, José Pedro Assunção
OBJECTIVE: We present a series of 3 cases in which the impact in outcome was, first of all, related to the capacity to offer early and safer treatment to some hip fracture high-risk patients using a fascia iliaca block (FIB; ropivacaine 0,5% 20 cc and mepivacaine 1,3% 15 cc, given 30 minutes before incision) associated only with deep sedation, contributing to better practice and outcome. CASE REPORTS: All elderly patients were American Society of Anesthesiologists IV patients, under P2Y12 receptor inhibitors, suffering from an intertrochanteric fracture, and purposed for intramedullary femoral fixation (IMF)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27819420/effect-of-co-morbid-conditions-on-persistent-neuropathic-pain-after-brachial-plexus-injury-in-adult-patients
#20
Asish Subedi, Pongparadee Chaudakshetrin, Haruthai Chotisukarat, Sahatsa Mandee
BACKGROUND AND PURPOSE: Neuropathic pain (NeuP) associated with traumatic brachial plexus injury (BPI) can be severe, persistent, and resistant to treatment. Moreover, comorbidity associated with NeuP may worsen the pain and quality of life. This study compared persistent NeuP after BPI between patients with and without co-morbid conditions (psychiatric dysfunction and other painful conditions) and tramadol usage as a second-line agent in combination with an antiepileptic and/or antidepressant during a 2-year follow-up...
October 2016: Journal of Clinical Neurology
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