1/25. Transverse clivus fracture: case presentation and significance of clinico-anatomic correlations.BACKGROUND: Bilateral transverse basal skull fractures resulting from lateral crushing injuries involve fractures of the clivus that present clinically with multiple cranial nerve injuries and possible delayed vascular injuries due to the tight neural and vascular entry and exit routes present in this region. A case of a young patient with an extensive basal skull fracture is presented with description of the clinical signs and symptoms in relation to the neuroradiological findings. Clinico-anatomic correlations have been reiterated. CASE DESCRIPTION: A case of a young patient suffering a bilateral crush injury resulting in a basal transverse clivus and petrous bone fracture is presented. Multiple cranial nerve injuries, unilateral and bilateral, were present (CN III, VI, VII). This clinical presentation correlated well with the anatomical location and extension of the respective cranial nerves at the level of the skull base and along the fracture line extending bilaterally through the clivus and petrous bone. CONCLUSIONS: Initial neurological and neuroradiological investigations should be aimed at promptly detecting cranial nerve injuries and their correlating fracture injuries at the skull base. The possible development and progression of delayed neurological deficits should also be kept in mind and investigated.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/25. Bilateral hypoglossal nerve injury following the use of the laryngeal mask airway.A healthy 54-year-old man undergoing elective knee arthroscopy developed bilateral hypoglossal nerve palsy, lasting 6 weeks following the use of a laryngeal mask airway. He suffered impairment of speech and difficulty in swallowing, the latter resulting in almost 7 kg loss of weight within 2 weeks of surgery. We discuss the possible aetiology of the injury and review the literature describing injuries to the hypoglossal nerve.- - - - - - - - - - ranking = 5keywords = injury (Clic here for more details about this article) |
3/25. Inferior alveolar nerve injury related to mandibular third molar surgery: an unusual case presentation.Perforation of the lower third molar roots by the inferior alveolar nerve is uncommon and can be difficult to determine by conventional radiographic methods. Presented is a case of perforation that was treated by coronectomy, and showed an unusual complication in that the retained root erupted, moving the canal with it. The radiographic assessment of root perforation and the imaging modalities used to assess such cases are discussed.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
4/25. Skull-base trauma: neurosurgical perspective.Trauma to the cranial base can complicate craniofacial injuries and lead to significant neurological morbidity, related to brain and/or cranial nerve injury. The optimal management involves a multidisciplinary effort. This article provides the neurosurgeon's perspective in management of such trauma using a 5-year retrospective analysis of patients sustaining skull-base trauma. The salient features of anterior and middle skull-base (temporal bone) trauma are summarized, and the importance of frontal basilar trauma as well as brain injury is evident. With these injuries, all cranial nerves (except 9 to 12) are at risk; the olfactory nerve and the facial nerve are the first and second, respectively, to sustain injuries. This retrospective analysis provides a better understanding of cranial base trauma and its management. It emphasizes the multifaceted nature of such trauma and the need to recognize anterior skull-base complications, including cerebrospinal fluid leak and brain injury.- - - - - - - - - - ranking = 3.0793910357814keywords = injury, brain, trauma (Clic here for more details about this article) |
5/25. Tapia's syndrome following shoulder surgery.Multiple cranial palsy occurred after shoulder surgery in the sitting position. Compression by the tracheal tube, caused by displacement of the head, may have caused the injury.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
6/25. Inferior alveolar nerve injury caused by thermoplastic gutta-percha overextension.Injuries to the inferior alveolar nerve following trauma resulting in a mandibular fracture are well documented and are a well-known risk when surgical procedures are planned for the mandible in the region of the inferior alveolar canal. Such injuries are relatively rare following endodontic therapy. This article reports a case of combined thermal and pressure injury to the inferior alveolar nerve, reviews the pathogenesis of such an injury and makes suggestions for its management.- - - - - - - - - - ranking = 6.0046257150017keywords = injury, trauma (Clic here for more details about this article) |
7/25. Avellis syndrome after minor head trauma: report of two cases.Avellis syndrome is a rare condition that usually occurs in association with infarction of the medulla oblongata or mass lesions around the jugular foramen; this syndrome has rarely been reported after trauma. Two cases of Avellis syndrome that occurred following minor head trauma are presented. The mechanism by which Avellis syndrome is produced is briefly discussed. The relative resistance to damage of the spinal accessory nerve was thought to play an important role in producing the peripheral type of Avellis syndrome. The outcome was favorable in both cases.- - - - - - - - - - ranking = 0.027754290010123keywords = trauma (Clic here for more details about this article) |
8/25. Reconstruction of the spinal accessory nerve with autograft or neurotube? Two case reports.Injury to the spinal accessory nerve is most commonly iatrogenic, but can be related to cervical trauma or resection of tumor. Of the two most recent publications related to injury of the spinal accessory nerve, one describes transfer of the levator scapulae muscle to restore shoulder function, while the other reports on the results of six surgical repairs, three of which used a sural nerve graft to reconstruct a short neural defect. The present report describes the results obtained in two patients when an iatrogenic injury to the XIth nerve was reconstructed at 3 months after the loss of shoulder function. denervation of the XIth nerve was confirmed by a first EMG at 6 weeks, and a second one at 12 weeks. At surgery, each XIth nerve was found to have an in-continuity neuroma, most probably related to electrocoagulation. Intraoperative electrical stimulation did not pass the region of nerve injury. In the first patient, the XIth nerve was reconstructed with an autograft from the greater auricular nerve. In the second patient, the XIth nerve was reconstructed with a bioabsorbable conduit, the Neurotube. The patient with the Neurotube reconstruction reached M5 trapezius function by 3 months after surgery, and had no nerve graft donor-site morbidity, while the patient with the autograft reached M4 function by 6 months after reconstruction, and has persistent numbness of the ear lobe. This is the first reported case of a cranial motor nerve being reconstructed with a bioabsorbable conduit.- - - - - - - - - - ranking = 3.0046257150017keywords = injury, trauma (Clic here for more details about this article) |
9/25. Progressive cranial nerve palsy following shunt placement in an isolated fourth ventricle: case report.Cranial nerve palsy is rarely seen after shunt placement in an isolated fourth ventricle. In the few reports of this complication, neuropathies are thought to be caused by catheter injury to the brainstem nuclei either during the initial cannulations or after shrinkage of the fourth ventricle. The authors treated a child who suffered from delayed, progressive palsies of the sixth, seventh, 10th, and 12th cranial nerves several weeks after undergoing ventriculoperitoneal shunt placement in the fourth ventricle. magnetic resonance imaging revealed the catheter tip to be placed well away from the ventricular floor but the brainstem had severely shifted backward, suggesting that the pathogenesis of the neuropathies was traction on the affected cranial nerves. The authors postulated that the siphoning effect of the shunt caused rapid collapse of the fourth ventricle and while the cerebellar hemispheres were tented back by adhesions to the dura, the brainstem became the only mobile component in response to the suction forces. Neurological recovery occurred after surgical opening of the closed fourth ventricle and lysis of the basal cistern adhesions, which restored moderate ventricular volume and released the brainstem to its normal position.- - - - - - - - - - ranking = 1.0441785143527keywords = injury, brain (Clic here for more details about this article) |
10/25. role of computerized tomography in management of impacted mandibular third molars.Nerve injury following mandibular third molar (M3) removal is a rare but serious complication. The purpose of this article is to review the role of currently available imaging technologies to facilitate clinical decision-making in the setting of M3 surgery. Given findings suggestive of high risk for inferior alveolar nerve (IAN) injury, the clinician should consider additional imaging to assess better the anatomic relationship of the IAN and M3.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
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