1/8. A case of peroneal neuropathy-induced footdrop. Correlated and compensatory lower-extremity function.This article reports on the case of a man with peroneal neuropathy-induced footdrop who was seen at the authors' institution 3 years after open reduction and internal fixation of a proximal fibular fracture and a distal, spiral, oblique tibial fracture of the right leg. A comprehensive gait analysis was conducted. A significant footdrop in gait resulted in a "reverse check mark" center-of-pressure pattern, an increased transverse-plane rotation of the foot, and excessive knee and hip flexion in the sagittal plane. These objective findings documented significant dysfunction within the involved lower extremity; in addition, aberrant biomechanics were observed in structures other than the site of initial injury within both limbs.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/8. Primary pelvic hydatid cyst: an unusual cause of sciatica and foot drop.STUDY DESIGN: A case report of primary pelvic hydatid cyst causing sciatica and foot drop. OBJECTIVE: To document the occurrence of primary pelvic hydatid cyst as one of the hidden causes of lower limb weakness and foot drop, and to recommend inclusion of the pelvic cavity when assessing sciatica and foot drop. SUMMARY OF BACKGROUND DATA: It is common to see foot drop caused by peripheral lesions around the knee or disc herniation in the lumbar spine, but if these sites were excluded, the pelvic cavity must be examined for hidden disease that may explain the cause of foot drop and sciatica. methods: The authors involved in the care and management of this patient were interviewed and all medical records, radiologic investigations, and related literature were reviewed. RESULTS: After exclusion of spinal and peripheral causes of foot drop, computed tomography of the pelvis showed a well-localized cystic swelling in the right side of the pelvis over the lumbosacral plexus roots. Surgical excision of the cyst resulted in partial recovery of the foot drop at 3 years of follow-up. CONCLUSION: Primary pelvic hydatid cyst rarely causes pressure on the lumbosacral plexus. This was a case of hydatid cyst in the pelvis causing sciatica and foot drop, and it indicates the pelvis as a hidden source of sciatica and foot drop. After surgical excision followed by 4 months' mebendazole therapy, there was no evidence of recurrence on long-term follow-up.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/8. Occurrence of subdural hematoma and resolution of gait disturbance in a patient treated with shunting for normal pressure hydrocephalus.A 66-year-old man with gait disturbance was diagnosed with normal pressure hydrocephalus (NPH) and treated with ventriculoperitoneal shunting using a programmable valve. The valve ultimately set at a pressure of 40 mm H(2)O after higher settings no longer relieved symptoms. However, this pressure setting was excessively low and was associated with occurrence of bilateral subdural hematomas. Paradoxically, this event was associated with stable improvement of gait. Our patient's gait disturbance was unassociated with muscle weakness, spasticity, cerebellar ataxia, or Romberg's sign, and, therefore, was consistent with a frontal gait disorder. Cerebral cortical blood flow as measured after shunting by single photon emission computed tomography (SPECT) was slightly increased from the value before shunting, possibly because of intracranial hypotension related to the valve setting. Lasting improvement of gait in our case may be a result of increased blood flow in the supplementary motor area (SMA).- - - - - - - - - - ranking = 7keywords = pressure (Clic here for more details about this article) |
4/8. Idiopathic normal pressure hydrocephalus predominantly with prolonged fever and hyponatremia.Described is a patient with hydrocephalus and a gait disorder with associated prolonged fever and hyponatremia. The authors made a diagnosis of normal pressure hydrocephalus (NPH) and performed a ventriculoperitoneal shunt, which improved the gait disturbance, accompanied by resolution of the fever and hyponatremia.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
5/8. Hereditary neuropathy with liability to pressure palsies (HNPP) in a toddler presenting with toe-walking, pain and stiffness.The typical clinical presentation of hereditary neuropathy with liability to pressure palsies is an adult-onset recurrent, painless monoparesis. Electrophysiological abnormalities--decreased nerve conduction velocities and delayed distal latencies--can be detected even in asymptomatic patients. We describe a toddler, who presented with asymmetric toe walking, painful cramps and stiffness in the legs. He had calf hypertrophy, brisk tendon reflexes and bilateral Babinski signs and the electrophysiological examination was normal. The unlikely diagnosis of hereditary neuropathy with liability to pressure palsies was reached 5 years later, when the boy started to complain of episodic numbness and weakness in the upper extremities. His father, paternal aunt and grandmother had similar symptoms, but they had never been investigated. The typical 1.5 Mb deletion on chromosome 17p11.2-12 was found in our patient and his affected relatives.- - - - - - - - - - ranking = 6keywords = pressure (Clic here for more details about this article) |
6/8. Real-time measurement of frozen gait in patient with parkinsonism using a sensor-controlled walker.patients with Parkinson's disease develop gait disturbances. Although the use of walkers is very effective for maintaining locomotive ability, patients who have symptoms such as frozen gait (FG) and festinating gait may fall even with a walker equipped with a brake as they cannot use the brake well in an emergency and fail to follow the accelerating walker. None of the studies on walking aids to date have addressed real-time detection of FG or the use of this information for the control of the walking aid, monitoring of the state of improvement in the ambulatory function, or evaluation of the effect of the use of a walker. In this study, we evaluated whether the state called FG, a characteristic symptom of Parkinson's disease, can be detected by the use of a sensor-controlled walker with heel-to-toe pressure sensors. The following two measurements were carried out in one male healthy and a one male patient with stage 3 Parkinson's disease by the Hoehn-Yahr scale showing mild muscle rigidity, hypokinesia, and FG. In the healthy subject, the heel-to-toe pressure showed smooth heel-to-toe shifts during the standing phase. In the patient with Parkinson's disease, the heel-to-toe response time was about 2.4 times longer than in the healthy subject at the beginning of walking, and FG could be recorded as the difficulty in lifting the foot by the toes. Also, when FG was observed during walking, the pressure waves recorded by the same sensors showed two peaks occurring at short interval, indicating double landings.- - - - - - - - - - ranking = 3keywords = pressure (Clic here for more details about this article) |
7/8. Giant popliteal aneurysm presenting with foot drop.Popliteal aneurysms are the most common peripheral arterial aneurysm and occur most commonly among older men with established cardiovascular disease. Popliteal aneurysms are asymptomatic or otherwise present with intermittent claudication, pressure symptoms in the popliteal fossa, distal embolization, and, rarely, rupture. We present a patient with a remarkably large popliteal aneurysm of 10 cm presenting as a popliteal swelling with foot drop and no signs of limb ischemia. According to our literature search, it is the largest reported popliteal aneurysm, and its corresponding symptoms are unusual. The diagnostic workup and treatment are presented.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/8. arachnoid cyst mimicking normal pressure hydrocephalus. A case report and review of the literature.A case of a 61-year-old female patient who presents with the clinical triad of normal pressure hydrocephalus (NPH), abnormal gait, urinary incontinence and dementia. On CT scanning, she is found to have a large arachnoid cyst which mimicked the syndrome of NPH. This is also the 60th published case of arachnoid cyst presenting over the age of 60.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |