Cases reported "Trauma, Nervous System"

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1/12. median nerve damage from brachial artery puncture: a case report.

    This report describes a case in which puncture of the brachial artery to obtain a sample for blood-gas analysis resulted in damage to the median nerve with a persisting neuropathy and apparent loss of function. Errors in judgment and contributions to possible negligence included (1) inappropriate choice of sampling site; (2) lack of knowledge of precautions and possible complications; (3) incomplete/inadequate description of optimal procedure in departmental procedure manual; (4) arbitrary selection of the dominant hand.
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2/12. Bilateral multiple cervical root avulsions without skeletal or ligamentous damage resulting from blast injury: case report.

    OBJECTIVE AND IMPORTANCE: We describe a unique case of multiple bilateral cervical root injuries without ligamentous or bony injury secondary to a sandblast accident. CLINICAL PRESENTATION: A 19-year-old man sustained a sandblast injury to his face, neck, chest, and upper extremities, with immediate loss of motor and sensory function occurring in both of his upper extremities. Cervical spine x-rays, computed tomography, and magnetic resonance imaging demonstrated no fracture, soft tissue abnormality, or malalignment. The restriction of deficits to the patient's upper extremities suggested a central cervical spinal cord injury, bilateral brachial injuries, or a conversion disorder. INTERVENTION: Cervical computed tomographic myelography revealed multiple bilateral nerve root injuries. CONCLUSION: This case report is unique in the literature in that it describes a patient with multiple cervical nerve root injuries secondary to sandblast injury without ligamentous or bony injury. Although magnetic resonance imaging remains the diagnostic modality of choice in patients with acute spinal cord injury, it is deficient in demonstrating cervical root injury in the acute setting. In this setting, computed tomographic myelography is superior.
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3/12. How safe is blood sampling? Anterior interosseus nerve injury by venepuncture.

    All invasive procedures carry some degree of risk of damage to the normal structures in the proximity of the region where the procedure is performed. The risk is, however, minimal for venous cannulation. A case is reported of an injury to the anterior interosseus nerve sustained during venepunture for routine blood sampling at the cubital fossa.
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4/12. Injury to the deep branch of the ulnar nerve in association with dislocated fractures of metacarpals II-IV.

    The deep branch of the ulnar nerve may be injured at the same time as fracture dislocations of the fifth metacarpal. We describe injuries to that nerve in two patients with dislocated fractures of the second or third and fourth metacarpals. The fractures were treated by open reduction and fixation with plates and screws, and it is possible that the repositioning and fixing caused the injury.
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5/12. The prevention of nerve injury in aortic arch aneurysmal surgery.

    In a case of aortic arch aneurysm associated with adhesion to the surrounding structures, we devised an operative technique to avoid nerve injury during the surgical procedure. By preserving the adventitial layer of the aortic arch aneurysm to which the phrenic and recurrent nerves were attached, injury to the nerves was avoided, and the aneurysmectomy was completed with the distal anastomosis being performed intraluminally.
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ranking = 1.4
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6/12. Transulnar styloid palmar scapho-lunate dislocation with median nerve injury.

    A patient with a transulnar styloid palmar scapho-lunate dislocation with median nerve injury is described. The dislocation could be reduced by closed manipulation under anaesthesia, and the scapho-lunate ligament was repaired subsequently using a Mytek Micro bone anchor. This case is reported for its rarity and its management. Although closed reduction can be achieved by manipulation, scapho-lunate ligament repair is essential to prevent rotatory instability of the scaphoid with this pattern of injury.
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7/12. Traumatic musculocutaneous neuropathy: a case report.

    Isolated injury of the musculocutaneous nerve is a rare disorder. Reported cases are claimed to present with loss of biceps and brachialis power without a disturbing pain. The injury generally occurs after strenuous exercise and could be demonstrated by electrophysiological examination. We report a case of musculocutaneous nerve injury which occurred after a vigorous push and which presented with unusual symptoms and findings. The patient complained of episodic severe pain attacks which started from the axilla and radiated over the musculocutaneous nerve distribution including the lateral antebrachial cutaneous nerve area. He did not respond to 3 months of conservative treatment including multiple corticosteroid injections and finally required surgical release. Surgical epineurotomy resulted in immediate relief. This is the first reported case of acute musculocutaneous nerve injury presenting with unusual symptoms and findings. The operative release procedure performed was also not required in any of the other reported cases. An excellent result was obtained with epineurotomy.
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8/12. myoclonus of the scapula after acute long thoracic nerve lesion: a case report.

    We describe a patient who presented myoclonus in the left scapula 3 months after a traumatic lesion of the left long thoracic nerve. Myoclonic activity was recorded as pseudorhythmic electromyographic bursts repeated at a frequency of 2 to 4 Hz, each lasting between 100 and 200 msec, in the left serratus-dorsalis muscle region, trapezius, and deltoid muscles. A combination of peripheral and central mechanisms may have induced the myoclonus in this case.
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9/12. phrenic nerve injury after blunt trauma.

    phrenic nerve injury resulting from blunt trauma is unusual and may closely mimic diaphragmatic rupture. diagnosis remains difficult and is often delayed. A prompt diagnosis requires a high index of suspicion. We describe one patient with phrenic nerve injury in whom the diagnosis was made late at the time of injury. Radiograph, ultrasonography, and computed tomography were helpful in the diagnosis. Video-assisted thoracic surgery was performed on our patient for diagnostic purposes. Left phrenic nerve injury and pericardial injury were found. Diaphragmatic plication was performed through a miniature left posterolateral thoracotomy. This case was presented to show the unusual nature of phrenic nerve injury.
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ranking = 1.6
keywords = nerve
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10/12. Vascularized ulnar nerve graft for reconstruction of a large defect of the median or radial nerves after severe trauma of the upper extremity.

    We report 3 cases of successful vascularized ulnar nerve graft for reconstructing a large median or radial nerve defect after severe trauma of the upper extremity.
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