1/185. Injection injury of the radial nerve.Four cases of radial nerve palsy following intra-muscular injections into the arm are reported. Recovery occurred in all 4 cases--1 after neurolysis and 3 spontaneously. The mechanism of nerve damage and its treatment are discussed.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/185. An uncommon mechanism of brachial plexus injury. A case report.PURPOSE: To report a case of brachial plexus injury occurring on the contralateral side in a patient undergoing surgery for acoustic neuroma through translabrynthine approach. CLINICAL FEATURES: A 51-yr-old woman underwent surgery for acoustic neuroma through translabrynthine approach in the left retroauricular area. She had a short neck with a BMI of 32. Under anesthesia, she was placed in supine position with Sugita pins for head fixation. The head was turned 45 degrees to the right side and the neck was slightly flexed for access to the left retroauricular area, with both arms tucked by the side of the body. Postoperatively, she developed weakness in the right upper extremity comparable with palsy of the upper trunk of the brachial plexus. hematoma at the right internal jugular vein cannulation site was ruled out by CAT scan and MRI. The only remarkable finding was considerable swelling of the right sternocleidomastoid and scalene muscle group, with some retropharyngeal edema. An EMG confirmed neuropraxia of the upper trunk of brachial plexus. She made a complete recovery of sensory and motor power in the affected limb over the next three months with conservative treatment and physiotherapy. CONCLUSIONS: brachial plexus injury is still seen during anesthesia despite the awareness about its etiology. Malpositioning of the neck during prolonged surgery could lead to compression of scalene muscles and venous drainage impedance. The resultant swelling in the structures surrounding the brachial plexus may result in a severe compression.- - - - - - - - - - ranking = 1.5keywords = injury (Clic here for more details about this article) |
3/185. Transient peroneal nerve palsies from injuries placed in traction splints.Two patients thought to have distal femur fractures presented to the emergency department (ED) of a level 1 trauma center with traction splints applied to their lower extremities. Both patients had varying degrees of peroneal nerve palsies. Neither patient sustained a fracture, but both had a lateral collateral ligament injury and one an associated anterior cruciate ligament tear. One patient had a sensory and motor block, while the other had loss of sensation on the dorsum of his foot. After removal of the traction splint both regained peroneal nerve function within 6 hours. Although assessment of ligamentous knee injuries are not a priority in the trauma setting, clinicians should be aware of this possible complication in a patient with a lateral soft tissue injury to the knee who is placed in a traction splint that is not indicated for immobilization of this type of injury.- - - - - - - - - - ranking = 0.75keywords = injury (Clic here for more details about this article) |
4/185. hypoglossal nerve injury as a complication of anterior surgery to the upper cervical spine.Injury to the hypoglossal nerve is a recognised complication after soft tissue surgery in the upper part of the anterior aspect of the neck, e.g. branchial cyst or carotid body tumour excision. However, this complication has been rarely reported following surgery of the upper cervical spine. We report the case of a 35-year-old woman with tuberculosis of C2-3. She underwent corpectomy and fusion from C2 to C5 using iliac crest bone graft, through a left anterior oblique incision. She developed hypoglossal nerve palsy in the immediate postoperative period, with dysphagia and dysarthria. It was thought to be due to traction neurapraxia with possible spontaneous recovery. At 18 months' follow-up, she had a solid fusion and tuberculosis was controlled. The hypoglossal palsy persisted, although with minimal functional disability. The only other reported case of hypoglossal lesion after anterior cervical spine surgery in the literature also failed to recover. It is concluded that hypoglossal nerve palsy following anterior cervical spine surgery is unlikely to recover spontaneously and it should be carefully identified.- - - - - - - - - - ranking = 34.376583696736keywords = nerve injury, injury (Clic here for more details about this article) |
5/185. Case report. Recovery of shoulder movement in patients with complete axillary nerve palsy.Classical anatomical teaching suggests that the deltoid muscle is the main abductor of the shoulder. We present three cases of proven complete paralysis of the deltoid with an almost full range of movement of the shoulder owing to the compensatory action of accessory muscles. The mechanisms by which this occurs are described.- - - - - - - - - - ranking = 1.4397221150142keywords = accessory (Clic here for more details about this article) |
6/185. Common peroneal nerve palsy following a surgical procedure--a case report.Common peroneal nerve injury may occur during surgery, particularly when patients are placed in lithotomy position. We report a case of common peroneal nerve palsy following a surgical procedure. Incorrect posture of a surgical assistant which made him lean his body against the patient's knee support might possibly be the cause of this injury. The patient reported that she had a left drop foot and a numbness of her left lower extremity following surgery. Electromyographic and nerve conduction studies revealed a left common peroneal nerve palsy. Physical therapy was started immediately. Patient's neurologic function of the leg totally recovered 3 months later.- - - - - - - - - - ranking = 8.8441459241839keywords = nerve injury, injury (Clic here for more details about this article) |
7/185. Extensor pollicis longus paralysis following thoracoscopic sympathectomy.Thoracoscopic sympathectomy is an acceptable form of treatment for palmar hyperhidrosis. Many authors have reported favourable results. Complications range from pneumo-haemothorax, Horner's syndrome, compensatory hyperhidrosis and bleeding. Plas et al reported 2.7% of the procedures had complications requiring intervention and 9.7% had non-interventive complications. There have been isolated reports of other rare complications including false aneurysm of intercostal artery, inferior brachial plexus injury and abnormal suntanning. We report an unusual case of isolated extensor pollicis longus paralysis after a thoracoscopic sympathectomy for palmar hyperhidrosis, in a fit young male. Such complications have not been previously reported. We recognise that such isolated nerve injury is uncommon.- - - - - - - - - - ranking = 8.8441459241839keywords = nerve injury, injury (Clic here for more details about this article) |
8/185. hypoventilation after high unilateral cervical chordotomy in a patient with preexisting injury of the phrenic nerve.Unilateral cervical chordotomy for the relief of intractable pain is a well accepted procedure but is not without hazard. Postoperative respiratory failure is not an uncommon occurrence, but the likelihood increases with a number of factors, particularly preexisting pulmonary abnormalities or previous contralateral cervical chordotomy. Preoperative assessment of the pulmonary function of patients who are about to have cervical chordotomy is emphasized to predict and anticipate potential postoperative respiratory failure.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
9/185. Physical therapy in a patient with bilateral obturator nerve paralysis after surgery. A case report.obturator nerve injury can result from surgical procedures. Bilateral obturator nerve injury developed in our patient as a result of edema in the obturator fossa after a debulking operation. In the postoperative period, neuromuscular electrical stimulation, electromyographic (EMG) biofeedback, exercise and a home treatment program were used as the physical therapy approach. The patient became symptom-free after the physiotherapy program.- - - - - - - - - - ranking = 17.188291848368keywords = nerve injury, injury (Clic here for more details about this article) |
10/185. Cruciate paralysis, hypothesis for injury and recovery.STUDY DESIGN: Case report and review of the literature. OBJECTIVES: Discuss a case of cruciate paralysis, a review of the literature and the hypotheses regarding the pathogenesis and recovery in spinal cord injuries that cause disproportionate weakness of the upper extremities. SETTING: Thomas Jefferson University Hospital, philadelphia, PA, USA. methods: Case report. RESULTS: A case of cruciate paralysis is presented involving a 59-year-old female who experienced a gunshot wound to the face. Initial motor exams revealed mild lower limb weakness and absent upper limb function with an upper limb modified American Spinal Injury association motor score of 0/50 (a modified impairment scale using half point muscle grades). Spinal imaging revealed fractures of the C1 anterior ring and the odontoid process, both associated with multiple bullet fragments. No spinal surgery was performed and she was placed in halo fixation. By 3 weeks she had regained enough upper limb function to manipulate large objects with her left hand and move her right hand. At that time, her upper limb asia score was 16/50. By 5 weeks, her upper limb modified asia motor score had improved to 31.5/50 and she began manipulating feeding utensils, writing legibly, and brushing her teeth with her left hand. CONCLUSIONS: In this case report we present a patient's motor and functional recovery. We also discuss the hypothesis that the acute central cord syndrome and cruciate paralysis are a likely result of similar pathologic mechanisms and that good functional outcome resulted from an initially disabling trauma.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
| | Next -> |