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Neurovascular complications

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https://www.readbyqxmd.com/read/28208961/fracture-supracondylar-humerus-a-review
#1
REVIEW
Vineet Kumar, Ajai Singh
Fracture supracondylar humerus is one of the most common fractures encountered in pediatric age group at all levels (both rural and urban). Thus it needs a special review in its management protocol as per the changing trend. Modified Gartland classification is the most accepted classification and has its importance in decision making regarding management and prognosis. Neurovascular complications are mostly associated with Type III A, III B and Type IV variety and they most of the time need surgical intervention for stabilization, exploration of brachial artery, sometimes median nerve exploration and reduction of fracture...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28204931/postero-inferior-pedicle-surgical-technique-for-the-treatment-of-grade-iii-gynecomastia
#2
Sophie Thiénot, Nicolas Bertheuil, Raphaël Carloni, Cécile Méal, Sylvie Aillet, Christian Herlin, Eric Watier
INTRODUCTION: Surgical treatment of Grade III gynecomastia generally utilizes mastectomy techniques and free transplantation of the nipple-areola complex. Moreover, with rising obesity rates and the development of bariatric surgery, an increasing demand for correctional surgery for pseudogynecomastia has been observed, which is comparable to Grade III gynecomastia in terms of its surgical management. Here, we describe an innovative technique to deal with these new demands: fascio-cutaneous flap by postero-inferior pedicle...
February 15, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28204844/safe-placement-of-lateral-mass-screw-in-the-subaxial-cervical-spine-a-case-series
#3
Di Zhang, Xianda Gao, Jiang Jiang, Fanlong Kong, Yong Shen, Wenyuan Ding, Xiufang Hao, Huixian Cui
PURPOSE: Laminectomy with lateral mass screw fixation has been proven to be an effective method to treat the multilevel cervical degenerative myelopathy and severe cervical spondylosis. However, accurate and safe insertion of the lateral mass screw is technically demanding due to the individual variations of the anatomy of the lateral mass of the subaxial cervical spine. Misplaced lateral mass screw is not uncommon, and operation-related complications still beset the surgeons, which may impair the clinical outcomes...
February 15, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28202211/the-risk-of-postoperative-complications-and-functional-impairment-after-multimodality-treatment-for-limb-and-trunk-wall-soft-tissue-sarcoma-long-term-results-from-a-monocentric-series
#4
E Stoeckle, A Michot, L Rigal, F Babre, P Sargos, B Henriques de Figueiredo, V Brouste, A Italiano, M Toulmonde, F Le Loarer, M Kind
BACKGROUND AND OBJECTIVES: Conservative surgery for soft-tissue sarcoma (STS) within multimodality treatment attempts to reconcile two contradictory requirements: assuring a good oncological outcome through a wide resection and preserving the function. The aim of our study is to verify whether our conservative approach to STS met these objectives. METHODS: A retrospective database analysis was performed in adults with primary limb or trunk wall STS operated in a single center from 1989 to 2012...
February 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28195898/ultrasound-guided-glossopharyngeal-nerve-block-a-cadaver-and-a-volunteer-sonoanatomy-study
#5
Josip Ažman, Tatjana Stopar Pintaric, Erika Cvetko, Kamen Vlassakov
BACKGROUND AND OBJECTIVES: Glossopharyngeal nerve (GPN) blocks are usually performed by topical, intraoral, or peristyloid approaches, which carry significant complication risks due to the proximity of important neurovascular structures. This study presents a proof of concept for a new ultrasound (US)-guided technique, which would block the GPN distally, in the parapharyngeal space, away from the immediate vicinity of high-risk collateral structures. METHODS: Five cadaver heads were dissected, and the location of the GPN was explored bilaterally...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28195750/dosimetric-analysis-of-neural-and-vascular-structures-in-skull-base-tumors-treated-with-stereotactic-radiosurgery
#6
Yarah M Haidar, Jay M Bhatt, Yaser Ghavami, Omid Moshtaghi, Amanda Schwer, Stafford Chenery, Hamid R Djalilian
Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Subjects Twenty patients with vestibular schwannomas treated at the center from 2011 to 2013. Methods Twenty patients with vestibular schwannomas were included. The average radiation dose delivered to healthy neurovascular structures (eg, carotid artery, basilar artery, facial nerve, trigeminal nerve, and cochlea) was analyzed...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28194322/sural-artery-perforator-flap-with-posterior-tibial-neurovascular-decompression-for-recurrent-foot-ulcer-in-leprosy-patients
#7
Hossam El-Din Ali Ismail, Mohamed Hassan El Fahar
Introduction: The sensory loss and alteration of the shape of the foot make the foot liable to trauma and pressure, and subsequently cause more callus formation, blisters, and ulcers. Foot ulcers usually are liable to secondary infection as cellulitis or osteomyelitis, and may result in amputations. Foot ulcers are a major problem and a major cause of handicaps in leprosy patients. The current study is to present our clinical experience and evaluate the use of sural flap with posterior tibial neurovascular decompression (PTND) in recurrent foot ulcers in leprosy patients...
2017: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#8
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/28186477/bilateral-sagittal-split-mandibular-osteotomies-for-enhanced-exposure-of-the-anterior-cervical-spine-in-children-technical-note
#9
Michael Karsy, Neal Moores, Faizi Siddiqi, Douglas L Brockmeyer, Robert J Bollo
The bilateral sagittal split mandibular osteotomy (BSSMO), a common maxillofacial technique for expanding the oropharynx during treatment of micrognathia, is a rarely employed but useful adjunct to improve surgical access to the ventral cervical spine in children. Specifically, it provides enhanced exposure of the craniocervical junction in the context of midface hypoplasia, and of the subaxial cervical spine in children with severe kyphosis. The authors describe their technique for BSSMO and evaluate long-term outcomes in patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28183511/proposed-standardized-neurological-endpoints-for-cardiovascular-clinical-trials-an-academic-research-consortium-initiative
#10
REVIEW
Alexandra J Lansky, Steven R Messé, Adam M Brickman, Michael Dwyer, H Bart van der Worp, Ronald M Lazar, Cody G Pietras, Kevin J Abrams, Eugene McFadden, Nils H Petersen, Jeffrey Browndyke, Bernard Prendergast, Vivian G Ng, Donald E Cutlip, Samir Kapadia, Mitchell W Krucoff, Axel Linke, Claudia Scala Moy, Joachim Schofer, Gerrit-Anne van Es, Renu Virmani, Jeffrey Popma, Michael K Parides, Susheel Kodali, Michel Bilello, Robert Zivadinov, Joseph Akar, Karen L Furie, Daryl Gress, Szilard Voros, Jeffrey Moses, David Greer, John K Forrest, David Holmes, Arie P Kappetein, Michael Mack, Andreas Baumbach
Surgical and catheter-based cardiovascular procedures and adjunctive pharmacology have an inherent risk of neurological complications. The current diversity of neurological endpoint definitions and ascertainment methods in clinical trials has led to uncertainties in the neurological risk attributable to cardiovascular procedures and inconsistent evaluation of therapies intended to prevent or mitigate neurological injury. Benefit-risk assessment of such procedures should be on the basis of an evaluation of well-defined neurological outcomes that are ascertained with consistent methods and capture the full spectrum of neurovascular injury and its clinical effect...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28182332/challenging-the-great-vascular-wall-can-we-envision-a-simple-yet-comprehensive-therapy-for-stroke
#11
Marta Machado-Pereira, Tiago Santos, Lino Ferreira, Liliana Bernardino, Raquel Ferreira
Stroke is a leading cause of death in adult life, closely behind ischemic heart disease, and causes a significant and abiding socioeconomic burden. However, current therapies are not able to ensure full neurologic and/or sequelae-free recovery to all stroke survivors. We believe treatment efficacy and patient rehabilitation could be enhanced significantly by targeting blood-brain barrier (BBB) deregulation and inflammation-induced barrier loss occurring after stroke. In this pathological context, bone marrow-derived endothelial progenitor cells (EPC) enter the bloodstream towards the lesion site but their insufficient numbers and impaired angiogenic ability compromise neurovascular regeneration...
February 9, 2017: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/28176597/the-risk-of-iatrogenic-injury-to-anterior-tibial-artery-variations-during-tibial-nail-distal-interlocking
#12
Nathan J Fanter, Sandra E Inouye, Christopher W Beiser
INTRODUCTION: Tibial intramedullary nailing remains a common tibial fracture fixation method. Tibial nailing indications continue to expand. Neurovascular complications from tibial nailing have been described; however, the proximity of distal tibial locking bolts to the anterior tibial artery (ATA) variants has not. MATERIALS AND METHODS: 52 cadaveric legs were dissected identifying three common ATA variants. Each ATA variant received an intraluminal wire to facilitate fluoroscopic identification...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28169904/endoscopic-transnasal-transpterygoid-excision-of-an-infratemporal-dermoid-cyst
#13
Gökhan Kuran, Demet Yazici
OBJECTIVE: Intracranial dermoid cysts are rare, slow-growing masses of sellar, parasellar regions, and posterior cranial fossa. The symptomatology of these cysts depends on the localization and presence of rupture. The preoperative diagnosis of these cysts by imagining techniques is distinctive as they have characteristic appearances. PATIENT: Endoscopic transnasal transpterygoid approach to infratemporal fossa for an extradural dermoid cyst of a 24 year-old woman is presented in this clinical report...
February 6, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28164058/a-rare-case-of-morel-lavallee-syndrome-complicating-an-anterior-dislocation-of-hip-joint
#14
Supreeth Nekkanti, C Vijay, Sujana Theja, R Ravi Shankar, Anubhav Verma
INTRODUCTION: Hip dislocations are serious injuries as hip joint is an extremely stable joint. It requires a significant amount of force to produce such an injury. Anterior dislocations are uncommon. Potential complications of anterior hip dislocations are a neurovascular injury to femoral vessels or acetabular fractures. CASE REPORT: We report a rare late complication of Morel-Lavallee syndrome occurring 3 weeks after an anterior dislocation of the hip in a 43-year-old male...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28161339/amyloid-%C3%AE-related-angiitis-a-report-of-two-cases-with-unusual-presentations
#15
Denise W Ng, Shino Magaki, Kevin H Terashima, Adrienne M Keener, Noriko Salamon, Stellios Karnezis, Luke Macyszyn, Harry V Vinters
Amyloid-β related angiitis (ABRA) is a rare complication of cerebral amyloid angiopathy in which amyloid-β (Aβ) deposition in the leptomeningeal and cortical vessels is associated with vasculitis characterized by transmural lymphohistiocytic, often granulomatous, inflammation. Patients usually present with acute to subacute cognitive dysfunction, headaches, and focal neurologic deficits. We report two cases of ABRA with unusual clinical presentations, including one case with fatal cerebral edema leading to herniation and Duret hemorrhages, and another associated with both lobar and deep parenchymal hemorrhages with intraventricular extension as well as hypercoagulability...
February 1, 2017: Human Pathology
https://www.readbyqxmd.com/read/28160036/-treatment-of-recurrent-dupuytren-s-disease
#16
T Pillukat, L Walle, R Stüber, J Windolf, J van Schoonhoven
BACKGROUND: The tendency of recurrence or progression is a frequent problem in Dupuytren's disease. The management of recurrence is adapted to the individual situation and the patient's needs. In mild cases a non-operative approach is recommended. Revision surgery is reserved for disabling situations with acceptable circulation and sensation in absence of dystrophy. It is complicated by a combined formation of scar tissue and new cords. This increases the risk of soft tissue loss and injuries to the neurovascular bundles, which impair sensation and circulation and may result in loss of the finger...
February 3, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28148674/computer-hexapod-assisted-orthopaedic-surgery-provides-a-predictable-and-safe-method-of-femoral-deformity-correction
#17
A Hughes, N Heidari, S Mitchell, J Livingstone, M Jackson, R Atkins, F Monsell
AIMS: Computer hexapod assisted orthopaedic surgery (CHAOS), is a method to achieve the intra-operative correction of long bone deformities using a hexapod external fixator before definitive internal fixation with minimally invasive stabilisation techniques. The aims of this study were to determine the reliability of this method in a consecutive case series of patients undergoing femoral deformity correction, with a minimum six-month follow-up, to assess the complications and to define the ideal group of patients for whom this treatment is appropriate...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28144702/endovascular-thrombectomy-in-acute-ischemic-stroke-outcome-in-referred-versus-directly-admitted-patients
#18
Philipp Bücke, Marta Aguilar Pérez, Elisabeth Schmid, Christian H Nolte, Hansjörg Bäzner, Hans Henkes
PURPOSE: Endovascular mechanical thrombectomy (mTE) in acute ischemic stroke due to large cerebral artery occlusion is effective and safe. The procedure is currently offered by specialized hospitals. Physicians from smaller hospitals need to refer patients to stroke centers. Secondary referrals involve delays for transportation. Little is known about effects of distant referrals on outcome and complications as compared to direct admittance. METHODS: To evaluate the effects of referral patterns on outcome and safety, we analyzed 941 patients with anterior circulation stroke receiving mTE between January 2010 and December 2015...
January 31, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28132920/clinical-features-radiological-findings-and-surgical-outcomes-of-65-intracranial-psammomatous-meningiomas
#19
Zhiqin Lin, Meng Zhao, Xiaohui Ren, Junmei Wang, Zongze Li, Xiaolin Chen, Yongzhi Wang, Xiangrong Li, Chengjun Wang, Zhongli Jiang
OBJECTIVE: Intracranial psammomatous meningiomas (PMs) are rarely reported due to their extremely low incidence. Knowledge about intracranial PMs is therefore poor. This study aimed to analyze the incidence, clinical features, radiological findings, and surgical outcomes of intracranial PMs. METHODS: Approximately 5,651 intracranial meningiomas were surgically treated at Beijing Tiantan Hospital between November 2011 and December 2015. The authors identified all cases in which patients underwent resection of an intracranial tumor that was found to be pathological examination demonstrated to be PM and analyzed the data from these cases...
January 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28124074/mri-visible-fe3o4-polypropylene-mesh-3d-reconstruction-of-spatial-relation-to-bony-pelvis-and-neurovascular-structures
#20
Luyun Chen, Florian Lenz, Céline D Alt, Christof Sohn, John O De Lancey, Kerstin A Brocker
INTRODUCTION AND HYPOTHESIS: To demonstrate mesh magnetic resonance imaging (MRI) visibility in living women, the feasibility of reconstructing the full mesh course in 3D, and to document its spatial relationship to pelvic anatomical structures. METHODS: This is a proof of concept study of three patients from a prospective multi-center trial evaluating women with anterior vaginal mesh repair using a MRI-visible Fe3O4 polypropylene implant for pelvic floor reconstruction...
January 25, 2017: International Urogynecology Journal
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