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https://www.readbyqxmd.com/read/28919186/non-surgical-treatment-of-delayed-onset-brachial-plexopathy-due-to-hypertrophic-clavicular-callus-a-case-report
#1
REVIEW
Benjamin M Carpenter, David R Pettersson, Adam J Mirarchi, Drew Groshong, Hans L Carlson
Clavicular fractures are common injuries which are traditionally managed non-surgically without clinically significant sequelae. However, they may develop hypertrophic callus formation that compresses the brachial plexus. These cases may present months to years after initial injury with varying degrees of pain, paresthesia and weakness on the affected side, and are usually treated by surgical resection of the hypertrophic callus. We present a case of brachial plexopathy due to hypertrophic clavicular callus causing weakness and paresthesia...
September 12, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28913502/regional-anesthesia-for-a-total-knee-arthroplasty-on-an-adult-patient-with-spastic-diplegia-and-an-intrathecal-baclofen-pump
#2
Elird Bojaxhi, David R Salek, Courtney E Sherman, Roy A Greengrass
We describe the clinical presentation of a patient with spastic diplegia, and its unique perioperative challenges. Opioids and antispasmodic medications are the primary therapy for managing pain and spasticity in the perioperative setting. However, such combination results in several side-effects and their sedative properties are synergistic. A 64-year-old woman with a history of spastic diplegia and an intrathecal baclofen pump for the treatment of her lower extremity spasticity was scheduled for a third elective left knee arthroplasty...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28894809/tympanic-plexus-neurectomy-for-intractable-otalgia
#3
Daniel S Roberts, Alisa Yamasaki, Ahmad R Sedaghat, Daniel J Lee, Edward Reardon
OBJECTIVE: The goal of this study was to analyze whether tympanic plexus neurectomy is a successful surgical option in patients with intractable otalgia. STUDY DESIGN: A retrospective single institution study from the experience of two surgeons was conducted. METHODS: Records of adult patients with intractable unilateral otalgia of likely glossopharyngeal origin were reviewed, with institutional review board approval. Patients who responded to a tympanic plexus block were considered for tympanic neurectomy...
October 2016: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28868305/vertebroplasty-and-delayed-subdural-cauda-equina-hematoma-review-of-literature-and-case-report
#4
Maria Pia Tropeano, Biagia La Pira, Lorenzo Pescatori, Manolo Piccirilli
Vertebroplasy is considered an alternative and effective treatment of painful oncologic spine disease. Major complications are very rare, but with high morbidity and occur in less than 1% of patients who undergo vertebroplasty. Spinal subdural hematoma (SDH) is an extremely rare complication, usual developing within 12 h to 24 h after the procedure. We report the case of a tardive SDH in an oncologic patient who underwent VP for Myxoid Liposarcoma metastasis. Trying to explain the pathogenesis, we support the hypothesis that both venous congestion of the vertebral venous plexus of the vertebral body and venous congestion due to a traumatic injury can provoke SDH...
August 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28831503/-migration-of-an-axillary-plexus-catheter-fragment-a-severed-catheter-tip-unnoticed-on-removal-wandered-into-the-central-nervous-system
#5
REVIEW
Ludwig Brandt, Ulrike Artmeier-Brandt
MIGRATION OF AN AXILLARY PLEXUS CATHETER FRAGMENT INTO THE INTRACEREBRAL COMPARTMENT: During removal of an axillary plexus catheter used for pain therapy, the catheter was probably inadvertently and unnoticed severed together with the suture fixation. The error went unnoticed and an approximately 14 cm long catheter fragment remained in the patient. The patient complained of neck pain, nausea and vomiting 2.5 years later. A computed tomography scan of the cranium and neck region revealed a tubular foreign body with a diameter of ca...
August 22, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28806828/-prophylactic-plexus-catheter-treatment-in-operations-following-complex-regional-pain-syndrome-crps
#6
Florian Neubrech, Roderick Franciscus Pronk, Amir Khosrow Bigdeli, Christian Tapking, Ulrich Kneser, Leila Harhaus
Background This paper investigates and discusses the effect of perioperative plexus catheter treatment in former CRPS patients. Patients and Methods A retrospective matched-pair analysis was conducted on 10 CRPS patients with comparable injuries, who underwent surgery in the disease-free interval. In 10 cases, the procedure was performed with perioperative plexus catheter treatment (intervention group), whereas 10 patients did not receive perioperative plexus catheter treatment (control group). Results In the intervention group, after a follow-up time of 105 (20-184) days after the last surgical procedure, pain intensity on the visual analogue scale (VAS; 0 to 10) was 6...
August 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28795293/endoscopic-palliation-of-pancreatic-cancer
#7
REVIEW
Vishal B Gohil, Jason B Klapman
Pancreas cancer is a fourth-leading cause of cancer death in the USA and its incidence is rising as the population is aging. The majority of patients present at an advanced stage due to the silent nature of the disease and treatment have focused more on palliation than curative intent. Gastroenterologists have become integral in the multidisciplinary care of these patients with a focus on providing endoscopic palliation of pancreas cancer. The three most common areas that gastroenterologists palliate endoscopically are biliary obstruction, cancer-related pain, and gastric outlet obstruction...
August 9, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28791598/opioid-medications-in-the-management-of-chronic-abdominal-pain
#8
REVIEW
Dajie Wang
PURPOSE OF REVIEW: Chronic abdominal pain is a complex medical condition. The causes of chronic abdominal pain are extremely diverse ranging from chronic pancreatitis, Crohn's disease, to chronic pain with no clear etiology. Treatment of chronic abdominal pain remains a challenge in our clinical practice. While current interventions with celiac plexus blocks and pain medications provide some relief for these patients, but these treatments are typically less efficacious and limited by various adverse effects...
August 8, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28776638/a-novel-combination-of-peripheral-nerve-blocks-for-arthroscopic-shoulder-surgery
#9
D Musso, S Flohr-Madsen, K Meknas, T Wilsgaard, L M Ytrebø, Ø Klaastad
BACKGROUND: Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia...
October 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28761389/concurrent-imatinib-and-radiation-therapy-for-unresectable-and-symptomatic-desmoid-tumors
#10
Everett J Moding, Lynn Million, Raffi Avedian, Pejman Ghanouni, Christian Kunder, Kristen N Ganjoo
Desmoid tumors are locally aggressive fibroproliferative neoplasms that can lead to pain and dysfunction due to compression of nerves and surrounding structures. Desmoid tumors often progress through medical therapy, and there is frequently a delay of multiple months before radiation can provide symptomatic relief. To achieve more rapid symptomatic relief and tumor regression for unresectable desmoid tumors causing significant morbidity such as brachial plexus impingement with loss of extremity function, we have selectively utilized a combination of imatinib and radiation therapy...
2017: Sarcoma
https://www.readbyqxmd.com/read/28756361/a-case-of-single-incision-laparoscopic-total-colectomy-for-intestinal-neuronal-dysplasia-type-b
#11
Taro Masuda, Takashi Nonaka, Toshiyuki Adachi, Makoto Hisanaga, Shigeki Nagayoshi, Takayuki Tokunaga, Ken Taniguchi, Hirokazu Kurohama, Masahiro Ito, Hikaru Fujioka
INTRODUCTION: Intestinal neuronal dysplasia type B (IND-B) is an infrequent disease of the submucosal plexus of intestine manifesting chronic intestinal obstruction or severe chronic constipation. IND is rarely reported in adult patients. PRESENTATION OF A CASE: The present study reports on the case of a 36 year-old woman suffering from longstanding chronic constipation and who was diagnosed with severe constipation in more than 20 years. Although she began to take a large amount of stimulant laxatives, such as "senna" and "bisacodyl", constipation symptoms did not improve, she was admitted to our hospital...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28735950/associations-between-clinical-diagnostic-criteria-and-pretreatment-patient-reported-outcomes-measures-in-a-prospective-observational-cohort-of-patients-with-neurogenic-thoracic-outlet-syndrome
#12
Joshua Balderman, Katherine Holzem, Beverly J Field, Michael M Bottros, Ahmmad A Abuirqeba, Chandu Vemuri, Robert W Thompson
OBJECTIVE: Neurogenic thoracic outlet syndrome (NTOS) is caused by dynamic compression of the brachial plexus at the level of the supraclavicular scalene triangle or the subcoracoid (pectoralis minor) space, or both. The purpose of this study was to characterize relationships between 14 clinical diagnostic criteria (CDC) and seven pretreatment patient-reported outcomes measures (PROMs) in a prospective cohort of patients with NTOS. METHODS: There were 183 new patient referrals between July 1 and December 31, 2015, with 150 (82%) meeting an established set of predefined CDC for NTOS...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28725614/a-review-of-varicocele-repair-for-pain
#13
REVIEW
Ryan C Owen, Benjamin J McCormick, Bradley D Figler, Robert M Coward
A dilation of the pampiniform venous plexus in the scrotum above the testicle, called a varicocele, affects approximately 15% of the general male population. While the majority is asymptomatic, pain results in up to 10% of cases of varicoceles. The pain associated with varicoceles is typically mild and is described as heavy, achy, or dull-and is usually isolated to the testicle or spermatic cord. Guidelines clearly recommend varicocele repair in males with varicoceles, infertility, and an abnormal semen analysis...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28697031/epidural-injections-contraindicated-for-lumbar-radiculopathy-in-may-thurner-syndrome-a-case-report
#14
Michael Sniderman
A 59-year-old patient presented to the chronic pain clinic with a 6-week history of worsening lumbar back pain, bilateral thigh pain, and unilateral radiculopathy. Magnetic resonance imaging revealed mild discogenic and facetogenic disease, but significant epidural venous plexus engorgement compressing the thecal sac. The patient reported previous treatment by a vascular surgeon for May-Thurner Syndrome, a type of inferior vena caval obstruction, yet had not experienced these specific complaints. A discussion with the radiologist confirmed worsening of the patient's May-Thurner Syndrome was the likely cause of the patient's symptoms...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28678646/pain-areas-and-mechanosensitivity-in-patients-with-chronic-pelvic-pain-syndrome-a-controlled-clinical-investigation
#15
Jörgen Quaghebeur, Jean-Jacques Wyndaele, Stefan De Wachter
OBJECTIVE: A thorough clinical assessment including physical examination is crucial in a diagnostic work-up, including in patients with chronic pelvic pain syndrome (CPPS). This study investigated the prevalence of pain areas and the mechanosensitivity of peripheral nerves in patients with CPPS and compared the findings with a healthy control group. MATERIALS AND METHODS: Healthy volunteers and patients diagnosed with CPPS were assessed with physical examinations and neurodynamic testing...
July 5, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28676368/interventional-management-for-pelvic-pain
#16
REVIEW
Ameet S Nagpal, Erika L Moody
Interventional procedures can be applied for diagnostic evaluation and treatment of the patient with pelvic pain, often once more conservative measures have failed to provide relief. This article reviews interventional management strategies for pelvic pain. We review superior and inferior hypogastric plexus blocks, ganglion impar blocks, transversus abdominis plane blocks, ilioinguinal, iliohypogastric and genitofemoral blocks, pudendal nerve blocks, and selective nerve root blocks. Additionally, we discuss trigger point injections, sacroiliac joint injections, and neuromodulation approaches...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28665241/shunt-dependent-hydrocephalus-management-style-among-members-of-the-american-society-of-pediatric-neurosurgeons
#17
Mark R Kraemer, Carolina Sandoval-Garcia, Taryn Bragg, Bermans J Iskandar
OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS)...
September 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28659200/-an-unrecognized-cause-of-dyspnoea
#18
A Brys, A Wijers, M de Vries, N Bouwman, R Borghans
BACKGROUND: Neuralgic amyotrophy is characterised by pain in the neck or shoulder region, followed by neuropathy of both motor and sensory nerves of the brachial plexus. The incidence of this condition is estimated at 1/1000 per year. In a rare variant of the syndrome, involvement of both phrenic nerves can occur, leading to diaphragmatic paralysis and severe orthopnoea. CASE DESCRIPTION: A 67-year-old woman was referred to us with acute orthopnoea. Imaging studies showed bilateral diaphragmatic paralysis, and electromyography (EMG) confirmed neuropathy of both phrenic nerves...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28647661/can-we-make-simple-in-situ-decompression-of-the-ulnar-nerve-at-the-elbow-still-easier
#19
Vicente Vanaclocha, Trinidad Blanco, Pedro Ortiz, Javier Lopez-Trigo, Pau Capilla, Vicente Bordes-Garcia, Leyre Vanaclocha
BACKGROUND: In situ decompression and transposition are equally effective in cubital tunnel syndrome treatment. Both are traditionally performed in the supine position. OBJECTIVE: To validate our surgical technique for in situ decompression in the lateral decubitus position, comparing results with other techniques used in our institutions. METHODS: A retrospective study was performed from January 2009 to February 2016, of 188 patients with cubital tunnel syndrome 115 males, 73 females; mean age, 53...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#20
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
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