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Verena Clarissa Samara, Adam de Havenon
Acute myelopathy is a rare presentation of systemic T-cell lymphoma. We present the case of a man aged 68 years with a diffuse erythematous maculopapular rash, followed by lower extremity paresthesias and progressive lower extremity weakness. Spinal MRI showed longitudinally extensive T2 hyperintensity with diffuse contrast enhancement. An atypical clonal T-lymphocyte population was identified in cerebrospinal fluid, peripheral blood and bone marrow aspirate, indicating a malignant T-cell lymphoproliferative disorder...
October 21, 2016: BMJ Case Reports
Kristin L Garlanger, Elena J Jelsing, Jonathan T Finnoff
A 33-year-old elite female runner presented to a tertiary care sports medicine clinic with a 2-year history of progressive anterior thigh and circumferential leg pain with associated foot paresthesias brought on by high-intensity running. She had both external iliac artery vasospasm and chronic exertional compartment syndrome. External iliac artery vasospasm is a rare cause of exertional leg pain, particularly in the running population. This case highlights the unique features of this condition, addresses the multidisciplinary approach that led to the accurate diagnoses, and demonstrates that more than 1 etiology for exertional leg pain can coexist in an athlete...
October 19, 2016: Sports Health
Nathan D Crosby, John J Janik, Warren M Grill
Kilohertz-frequency spinal cord stimulation (KHF-SCS) is a potential paresthesia-free treatment for chronic pain. However, the effects of KHF-SCS on spinal dorsal column (DC) axons and its mechanisms of action remain unknown. The objectives of this study were to quantify activation and conduction block of DC axons by KHF-SCS across a range of kHz frequencies (1, 5, 10, or 20 kHz) and waveforms (biphasic pulses or sinusoids). Custom platinum electrodes delivered SCS to the T10/T11 DCs of anesthetized male Sprague-Dawley rats...
October 19, 2016: Journal of Neurophysiology
Fang Meng, Pei-Bei Duan, Junya Zhu, Qing-Qing Lou, Zhao-Hui Fang, Hong-Li An, Lan-Ying Liu, Yue Hu, Qian Hu
OBJECTIVE: This study aims to evaluate the effectiveness and safety of Gua sha therapy on perimenopausal symptoms, quality of life, and serum female hormones in participants with perimenopausal syndrome. METHODS: A prospective, randomized, controlled clinical trial was conducted at the First Affiliated Hospital of Nanjing University of Chinese Medicine in China. Eighty women with perimenopausal syndrome were recruited and randomized into an intervention group or a control group...
October 10, 2016: Menopause: the Journal of the North American Menopause Society
Tommy Y Kim, Kristin Ratnayake
Minor cervical spine injury is a common cause of pediatric emergency department visits. We present a case of a 10-year-old boy with transient paresthesia after minor cervical trauma found to have a rare cervical spine abnormality requiring surgical fusion. We present and discuss the management options for os odontoideum.
October 8, 2016: Pediatric Emergency Care
Degala Sai Krishna, Dey Soumadip
PURPOSE: The main aim of our study was to assess and evaluate the efficacy, long standing outcome and infection of porous polyethylene implants in treatment of orbital floor fractures. PATIENT AND METHODS: Twelve patients with fractures of orbital floor were included in the study. The cause of fracture was road traffic accident, self fall and cow hit respectively. They also complained of enophthalmos (n = 9), diplopia (n = 3), restricted eye movement (n = 2), impairment of infraorbital nerve (n = 3) and dystopia (n = 6)...
September 2016: Journal of Maxillofacial and Oral Surgery
Max O Krucoff, Steven Cook, Owoicho Adogwa, Jessica Moreno, Siyun Yang, Jichun Xie, Alexander O Firempong, Nandan Lad, Carlos A Bagley
OBJECT: To examine the role of race, gender, and socioeconomics on presentations and outcomes of adult Chiari 1 malformations. METHODS: The charts of 638 adult patients with Chiari 1 malformations were reviewed, and 287 patients were included. Race, gender, insurance status, symptoms, depth of cerebellar tonsillar herniation, and presence of syringomyelia were examined as covariates in multivariate logistic regression models to identify independent predictors of presentation and outcome...
October 14, 2016: World Neurosurgery
Jin-Gyu Choi, Sang-Woo Ha, Byung-Chul Son
OBJECTIVES: The authors investigated the difference in clinical outcome and the position of paddle lead spinal cord stimulation (SCS) between three-column and five-column paddle lead SCS in patients with FBSS. MATERIALS AND METHODS: In 21 patients who underwent paddle lead SCS at T9 (three-column, n = 9; five-column, n =12) for FBSS, a 12-month follow-up numerical rating scale, percent pain relief, and CT assessment of contact angle and percent reduction of T9 canal area were investigated...
October 12, 2016: World Neurosurgery
Adolfo Ramirez-Zamora, Heather Smith, Vignessh Kumar, Julia Prusik, Sujoy Phookan, Julie G Pilitsis
BACKGROUND: Although thalamic deep brain stimulation (DBS) has been established as an effective therapy for refractory tremor in Parkinson's disease and essential tremor, reports investigating the efficacy of posterior subthalamic area (PSA) DBS for severe, debilitating tremors continue to emerge. However, questions regarding the optimal anatomical target, surgical approach, programming paradigms and effectiveness compared to other targets remain. OBJECTIVES: In this report, we aimed to review the current literature to assess different stereotactic techniques, anatomical considerations, adverse effects and stimulation settings in PSA DBS...
October 12, 2016: Stereotactic and Functional Neurosurgery
Ilaria Paolasso, Chiara Cambise, Daniele Coraci, Filippo M Del Tedesco, Carmen Erra, Eduardo Fernandez, Luca Padua
Ultrasound is helpful to identify nerve suffering cause. We report a case of pain at leg associated with burning paresthesia. Ultrasound found tibialis muscle herniation, close to superficial fibular nerve. The morphological alteration was supposed to be the cause of symptoms. Neurolysis, based on ultrasonographic findings, allowed symptoms relief.
October 6, 2016: Clinical Neurology and Neurosurgery
Brittany Oliver, Manfred Boehm, Douglas R Rosing, Lee S Shapiro, Daniel T Dempsey, Peter A Merkel, Chyi-Chia Richard Lee, Edward W Cowen
October 4, 2016: Journal of the American Academy of Dermatology
M L Avila, L R Brandão, S Williams, M I Montoya, J Stinson, A Kiss, B M Feldman
BACKGROUND: Postthrombotic syndrome (PTS) is a complication of deep vein thrombosis defined by the presence of characteristic signs and symptoms. We developed a discriminative and evaluative index for the assessment of upper and lower extremity (UE/LE) pediatric PTS. METHODS: The items to be included in the index were voted for by 26 pediatric thrombosis experts invited to participate in a Delphi survey. Subsequent item weighting was based on item importance elicited using multi-criteria decision analysis (MCDA); 122 health care providers and patients/parents participated in item weighting...
October 6, 2016: Journal of Thrombosis and Haemostasis: JTH
J Abram, J Klocker, N Innerhofer-Pompernigg, M Mittermayr, M C Freund, N Gravenstein, V Wenzel
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible...
October 5, 2016: Der Anaesthesist
Nicolas Majunke, Norman Mangner, Axel Linke, Enno Boudriot, Sandra Erbs, Franziska Tietz, Sabrina Wolff, Stephan Schürer, Gerhard Schuler, Marcus Sandri
OBJECTIVE: Surgical femoral cutdown for decannulation after veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is considered standard practice. However, access-site complications with this technique are not rare. The objective of this study is to evaluate feasibility, safety, and efficacy of a complete percutaneous decannulation procedure after VA-ECMO compared with the conventional surgical cutdown approach. METHODS: In 35 patients who were successfully weaned from VA-ECMO support, femoral artery and vein access sites were closed using a completely percutaneous approach in 15 patients, whereas 20 patients had conventional surgical cutdown for access-site closure...
October 2016: Journal of Invasive Cardiology
Tarun Dusad, D S Meena, Narendra Saini, Yogesh Sharma, Deepak Khurana
INTRODUCTION: Schwannomas are also known as neurilemmoma that usually originate from Schwann cells located in the peripheral nerve sheaths. It usually occurs in the age group of 20 to 70 years. These are the commonest tumors of the peripheral nerves, 5% of which occur in the adults and 19% of the tumors occur in upper extremities. Schwannomas are generally presented as an asymptomatic mass. Discomfort may be the only presenting complaint of the patient. Paresthesia may be elicited on tapping the swelling...
April 2016: Journal of Orthopaedic Case Reports
Luiz Guilherme de Saboya Lenzi, Carlos Henrique Fernandes, Lia Myiamoto Meirelles, João Baptista Gomes Dos Santos, Flávio Faloppa, Jorge Raduan Neto
Background: Carpal tunnel syndrome (CTS) is the most common compressive neuropathy found in clinical practice. Recent studies evaluated which external factors could be involved in the CTS symptoms, including prolonged exposure to vibration, especially in the upper limb. This study investigated signs and symptoms in patients with CTS after using urban transport on (1) both upper limbs, (2) how long before these symptoms appear, and (3) the hands position or body reaction during the act of pressing the safety bars...
September 2016: Hand: Official Journal of the American Association for Hand Surgery
K Rammohan, Shyma M Mundayadan, Robert Mathew
CONTEXT: Nummular headache (NH) is a primary disorder characterized by head pain exclusively felt in a small-rounded area typically 2-6 cm in diameter. AIMS: The aim of this review is to study the clinical and epidemiological features of NH in a patient population of South India and to compare this with that of described in the international literature. SETTINGS AND DESIGN: A prospective, observational study conducted in a tertiary care center...
October 2016: Journal of Neurosciences in Rural Practice
Mark Riebel, Richard Westrick, Donald Goss
A 24-year-old male Marine presented to a direct-access physical therapy clinic with a chief complaint of bilateral hand paresthesia secondary to a parachuting accident when his neck was forced into lateral flexion. Due to the positive neurologic findings and history of trauma, the physical therapist ordered cervical spine imaging. The odontoid was not adequately visualized on radiographs, but computed tomography revealed an os odontoideum. J Orthop Sports Phys Ther 2016;46(10):930. doi:10.2519/jospt.2016.0417...
October 2016: Journal of Orthopaedic and Sports Physical Therapy
Justin Stull, Suneel Bhat, Andrew J Miller, Ryan Hoffman, Mark L Wang
Compartment syndrome is an orthopedic emergency with a multitude of etiologies. Although it is most commonly associated with trauma to the extremity, hematoma and infection are 2 rare etiologies of insidious compartment syndrome. Proteus mirabilis is an opportunistic gram-negative species that can infect the respiratory tract, urinary tract, and open wounds. The authors present the case of a 69-year-old woman who developed tissue necrosis and compartment syndrome secondary to an untreated hematoma infected by P mirabilis...
September 29, 2016: Orthopedics
Giovanni Salzano, Mario Turri-Zanoni, Apostolos Karligkiotis, Jacopo Zocchi, Giovanni Dell'Aversana Orabona, Luigi Califano, Paolo Battaglia, Paolo Castelnuovo
BACKGROUND: The infraorbital nerve (ION) is a terminal branch of the maxillary nerve (V2) providing sensory innervation to the malar skin. It is sometimes necessary to sacrifice the ION and its branches to obtain adequate maxillary sinus exposure for radical resection of sinonasal tumors. Consequently, patients suffer temporary or permanent paresthesia, hypoestesthia, and neuralgia of the face. We describe an innovative technique used for preservation of the ION while removing the anterior, superior, and lateral walls of the maxillary sinus through a medial endoscopic transnasal maxillectomy...
September 28, 2016: International Forum of Allergy & Rhinology
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