1/180. A case of referred pain evoked by remote light touch after partial nerve injury.An unusual case of referred pain is presented in which a 63-year-old man, who suffered a severe injury to his right hand and arm during young adulthood, describes the later development of dysesthesia and shooting pain in his arm subsequent to stimulation of the ipsilateral scalp, the temporal and infrazygomatic region of the face, and the back. Referred sensations of this type are usually reported following amputation of an arm. Clinical examination of the sensory and motor function of the arm and hand revealed partial damage to the radial, ulnar and median nerves as well as possible brachial plexus involvement. Interestingly, pain could be evoked by repeated light touches applied to the remote trigger areas suggesting the involvement of a 'wind-up'-like process.- - - - - - - - - - ranking = 1keywords = plexus (Clic here for more details about this article) |
2/180. Axillary schwannoma masquerading as cervical radiculopathy.A 58-year-old woman, suffering from radicular-like pain in the left arm for 3 years, presented an entirely negative cervical imaging. Careful clinical examination disclosed Tinel's sign in the axilla. This clinical finding led to further investigation of this region. Computed tomography and magnetic resonance imaging disclosed a small tumour highly suggestive of a schwannoma. Surgical exploration and microscopic examination confirmed a diagnosis of schwannoma located on the radial trunk of the left brachial plexus. After tumour excision, the patient had immediate relief of pain without sensitive or motor sequelae. No recurrence has been observed after 3 years.- - - - - - - - - - ranking = 1keywords = plexus (Clic here for more details about this article) |
3/180. Tumor-induced osteomalacia and symptomatic looser zones secondary to mesenchymal chondrosarcoma.Tumor-induced osteomalacia is a rare clinical entity that is associated with soft-tissue or skeletal tumors. We present a case report of a patient with a chest wall mesenchymal chondrosarcoma who presented with bone pain. The patient had skeletal changes in the femoral neck and fibula consistent with osteomalacia and laboratory values suggesting phosphate diabetes. The patient was treated with tumor resection and phosphate supplementation with reversal of the signs and symptoms of osteomalacia. Tumor-induced osteomalacia is vitamin-D-resistant and often reversed by complete removal of the tumor. Most commonly, the causative tumors are of vascular, mesenchymal, or fibrous origin. The osteomalacia is associated with bone pain, muscle weakness, and radiographic changes. Tumor-induced humoral factors have been implicated in causing the osteomalacia, but the definite etiology has yet to be determined. Current treatment includes complete tumor resection and electrolyte supplementation.- - - - - - - - - - ranking = 0.072512880171397keywords = chest (Clic here for more details about this article) |
4/180. Thoracic epidural pain control for chest trauma patient.Epidural pain control is used widely in different fields, such as after surgery, during labour, and for the patients with terminal cancer. It can also be used in patients with severe pain due to chest trauma to improve the pulmonary condition and shorten the period of hospitalization.- - - - - - - - - - ranking = 0.36256440085698keywords = chest (Clic here for more details about this article) |
5/180. The use of patient-controlled boluses of local anaesthetic via a psoas sheath catheter in the management of malignant pain.patients who develop malignant infiltration of the psoas muscle and the lumbar plexus often experience a severe complex pain syndrome characterised by deep somatic pain, neuropathic pain and psoas spasm. Conventional analgesic regimes may not relieve these symptoms adequately. We describe the use of patient-controlled boluses of local anaesthetic via a psoas sheath catheter in this scenario. The recent availability of portable infusion pumps with the capability to deliver large volume boluses with long lockout times made this intervention possible and allowed the patient to be discharged home with effective relief of pain.- - - - - - - - - - ranking = 1keywords = plexus (Clic here for more details about this article) |
6/180. Painful pectoralis major myospasm as a result of sternal wound reconstruction: complete resolution with bilateral pectoral neurectomies.We report a patient with a highly unusual and previously unreported complication with the use of the pectoralis major muscle to treat the infected median sternotomy. The diagnosis of painful myospasm was made by a combination of physical findings and exclusion of other conditions such as recurrent infection. Treatment by pectoral denervation was relatively simple and highly successful. patients with chest-wall pain after sternal wound reconstruction should have myospasm entertained as a possible cause.- - - - - - - - - - ranking = 0.072512880171397keywords = chest (Clic here for more details about this article) |
7/180. Peripheral pulmonary migration of a retained pacemaker lead.We report a case of lead migration into the right middle pulmonary lobe. The migrated electrode reached the pleura and produced severe pleural symptoms, therefore, surgical removal of the retained lead was required. This case report demonstrates the importance of a chest X ray in the follow-up of patients with an implanted pacemaker to detect complications like lead fracture or migration.- - - - - - - - - - ranking = 0.072512880171397keywords = chest (Clic here for more details about this article) |
8/180. Anginal pain referred to the teeth. Report of a case.A case is reported in which initial anginal pain was localized to the area of the left posterior teeth. Subsequently the patient reported that at certain times he experienced pain in the area of the left posterior teeth with concomitant chest pain while at other times the pain was confined to the teeth.- - - - - - - - - - ranking = 0.97043773853668keywords = chest pain, chest (Clic here for more details about this article) |
9/180. brachial plexus catheter reservoir for the treatment of upper-extremity cancer pain: technical case report.OBJECTIVE AND IMPORTANCE: Infiltration of the brachial plexus with anesthetics can provide relief of upper-extremity pain from invasive cancer. Because the analgesia is short-lived, however, repeated invasive treatments are necessary. We describe the implantation of a catheter reservoir system, in which anesthetic injections through a subcutaneous port resulted in anesthetic infiltration of the brachial plexus. CLINICAL PRESENTATION: A 47-year-old Hispanic man with squamous cell carcinoma of the larynx had undergone surgical resection, radiation treatment, and chemotherapy. Two years later, he had locally recurrent disease involving the brachial plexus, neck, and chest wall. The patient's pain was minimally responsive to narcotics, which also caused severe nausea and anorexia. TECHNIQUE: The brachial plexus was localized percutaneously with a needle electrode stimulator. Contrast injection under fluoroscopy confirmed entry into the plexus sheath. With use of the Seldinger technique, two Silastic catheters were placed within the brachial plexus and attached with a "Y" connector to a reservoir. The patient experienced complete relief of upper-extremity pain after a test injection with xylocaine. Thereafter, serial injections of bupivacaine with triamcinolone at 1-week intervals provided complete pain relief. After the treatments were initiated, the patient reported improved sleep and an improvement in his quality of life. CONCLUSION: A catheter reservoir system for brachial plexus analgesia can provide safe and effective analgesia for upper-extremity pain. This technique negates the need for repeated invasive procedures and avoids the complications of neurolysis.- - - - - - - - - - ranking = 11.072512880171keywords = plexus, chest (Clic here for more details about this article) |
10/180. Lumbosacral nerve root avulsion: report of a case and review of the literature.The 14th myelographically demonstrated case of lumbosacral nerve root avulsion is presented with a summary of the previously reported cases. In most cases lumbosacral nerve root avulsion is associated with pelvic fractures and sacroiliac dislocation, which cause a stretching force to be applied to the nerves of the lumbar and sacral plexuses, and in turn to the nerve roots intradurally. This force causes nerve root avulsion in the intradural course of the nerve root. The myelographic defect is a pseudomeningocele or diverticulum-like outpouching created by the tearing of the arachnoid covering of the nerve roots. myelography clearly indicates nerve root avulsion and surgical exploration is not indicated.- - - - - - - - - - ranking = 1keywords = plexus (Clic here for more details about this article) |
| | Next -> |