1/22. Jefferson fracture resulting in Collet-Sicard syndrome.STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To increase awareness of and add to the spectrum of injury that can result from Jefferson fractures, to suggest a possible mechanism of injury, and to give a brief review of pertinent facts regarding C1 burst fractures and the Collet-Sicard Syndrome. SUMMARY OF BACKGROUND DATA: To the author's knowledge, this is the first reported case of a Jefferson fracture resulting in Collet-Sicard Syndrome. It represents only the second reported case of cranial nerve palsy caused by Jefferson fracture. methods: A 56-year-old man sustained a C1 burst fracture in a rollover motor vehicle accident. Repeated neurologic examinations over the ensuing days revealed lesions of cranial nerves IX, X, XI, and XII on the left side. RESULTS: Two weeks of traction, 10 weeks in a halo vest, and 2 weeks in a cervical collar resulted in adequate fracture healing and almost complete resolution of the patient's neurologic symptoms. CONCLUSION: Although this is the first reported case of Collet-Sicard Syndrome caused by Jefferson fracture, the authors' review of the literature suggests that cranial nerve injuries may go unrecognized in some patients with C1 burst fractures. The importance of a thorough neurologic examination, including examination of the cranial nerves, in all cases of cervical spine injury cannot be overemphasized.- - - - - - - - - - ranking = 1keywords = nerve, cranial nerve (Clic here for more details about this article) |
2/22. Neurogenic tumors of the cervical vagus nerve: report of four cases and review of the literature.OBJECTIVE AND IMPORTANCE: Nerve sheath tumors arising from the cervical vagus nerve are extremely rare. These tumors most often present as asymptomatic, slowly enlarging, lateral neck masses and therefore often come initially to the attention of otolaryngologists and general surgeons. Because they are nerve tumors, however, neurosurgeons must be able to recognize and treat these rare entities. We report three cases of schwannoma and one case of neurofibroma of the cervical vagus nerve that were encountered at our center (louisiana State University Medical Center) during a 31-year period. CLINICAL PRESENTATION: The patients ranged from 31 to 61 years of age at the time of presentation to louisiana State University Medical Center. Presenting complaints included hoarseness, Horner's syndrome, and palpation of an enlarging, asymptomatic, cervical mass. Reviews of systems revealed episodes of aspiration for one patient and frequent respiratory illnesses for two patients. These episodes were possibly related to their tumors. Imaging studies demonstrated well-circumscribed masses in the region of the carotid sheath. INTERVENTION: Using microsurgical techniques, gross total resection of all four tumors was accomplished. For one patient, the vagus nerve needed to be divided and an end-to-end anastomosis was performed. For the other three patients, resection of the tumor was achieved with the vagus nerve in continuity. CONCLUSION: Vagal nerve schwannomas and neurofibromas in the neck are rare neoplasms. We present four cases of these benign tumors. The pathological features, epidemiological characteristics, presentation, differential diagnosis, and management are discussed. Gross total resection with preservation of the vagus nerve remains the treatment of choice.- - - - - - - - - - ranking = 2.0026417435153keywords = nerve (Clic here for more details about this article) |
3/22. Vagal paraganglioma. Report of a case surgically treated and review of the literature.The authors report the observation of one case of vagal paraganglioma occurred in a young woman. The tumor manifested itself as a left sub-mandibular tumescence; the very first diagnostic approach was achieved through echography, which showed a mass behind the internal carotid artery and compressing the internal jugular vein. The following examinations, represented by neck CT, NMR, angiography and fine needle aspiration initially directed towards the suspicion of chemodectoma. Only at operation, the anatomical situation of the tumor, which encapsulated the vagus nerve and the subsequent results of the hystological examination revealed the correct diagnosis of vagal paraganglioma.- - - - - - - - - - ranking = 0.18205834031957keywords = nerve (Clic here for more details about this article) |
4/22. Identification and management of intravagal parathyroid adenoma.Intravagal parathyroid adenomas are rare, with only three cases reported in the English literature. The objective of this report is to describe two additional patients with hyperfunctioning parathyroid glands found within the vagus nerve and to define the anatomy of this finding. Both patients presented with a history of persistent hyperparathyroidism despite multiple therapeutic interventions. A high cervical localization was established in both cases by selective venous sampling. In each patient successful removal of the intravagal parathyroid gland was achieved with subsequent resolution of calcium and parathyroid levels. Each adenoma was located within the vagus nerve below the level of the carotid bifurcation and was enucleated without sacrificing the vagus nerve. In our cases and those reported previously, the parathyroid glands were supernumerary, representing parathyroid tissue embryologically derived from the third branchial pouch. Exploration for hyperparathyroidism requires a complete, meticulous surgical dissection to identify all parathyroid glands and to search for possible accessory tissue in selected cases. Our experience and a review of the literature serve to emphasize that, although rare, intravagal parathyroid adenomas do occur. Examination of the vagus nerve should therefore be strongly considered when four normal glands are found, as intravagal adenomas appear to represent accessory ectopically located parathyroid tissue.- - - - - - - - - - ranking = 0.7282333612783keywords = nerve (Clic here for more details about this article) |
5/22. Sensory neuropathy of the trigeminal, glossopharyngeal, and vagal nerves in sjogren's syndrome.Isolated cranial nerve involvement in primary sjogren's syndrome (primary SS) has rarely been described. We report the case of a patient with sensory neuropathy of the trigeminal and also the glossopharyngeal and vagal nerves, which has not been identified previously. The electrophysiological findings in our patient with primary SS confirmed trigeminal sensory neuropathy with abnormal blink reflexes and abnormal cutaneous masseter inhibitory reflexes.- - - - - - - - - - ranking = 10.715543740544keywords = glossopharyngeal, nerve, cranial nerve (Clic here for more details about this article) |
6/22. Malignant peripheral nerve sheath tumors of intrathoracic vagus nerve.The authors report two cases of malignant peripheral nerve sheath tumors arising from the vagus nerve in the mediastinum in patients who had no stigmata of neurofibromatosis (von Recklinghausen's disease). Computed tomography showed homogeneous soft tissue masses, with minimal calcification seen in one patient. T2-weighted magnetic resonance images showed regions of low signal intensity caused by a dense cellular population.- - - - - - - - - - ranking = 1.8210114845305keywords = nerve, disease (Clic here for more details about this article) |
7/22. Vagal neuropathy after upper respiratory infection: a viral etiology?PURPOSE: To describe a condition that occurs following an upper respiratory illness, which represents injury to various branches of the vagus nerve. patients with this condition may present with breathy dysphonia, vocal fatigue, effortful phonation, odynophonia, cough, globus, and/or dysphagia, lasting long after resolution of the acute viral illness. The patterns of symptoms and findings in this condition are consistent with the hypothesis that viral infection causes or triggers vagal dysfunction. This so-called postviral vagal neuropathy (PVVN) appears to have similarities with other postviral neuropathic disorders, such as glossopharyngeal neuralgia and Bell's palsy. MATERIALS AND methods: Five patients were identified with PVVN. Each patient's chart was reviewed, and elements of the history were recorded. RESULTS: Each of the 5 patients showed different features of PVVN. CONCLUSIONS: Respiratory infection can trigger or cause vocal fold paresis, laryngopharyngeal reflux, and neuropathic pain.- - - - - - - - - - ranking = 2.1057287829118keywords = glossopharyngeal, nerve, neuralgia (Clic here for more details about this article) |
8/22. Isolated vagus nerve palsy probably associated with herpes simplex virus infection.vagus nerve palsy caused by herpes simplex virus (HSV) infection is rare. Here, we present a 29-year-old man with acute onset of right side otalgia and sore throat, followed by dysphonia, dysphagia and some vesicles seen on the deep soft palate. laryngoscopy revealed right vocal cord palsy. neck to chest CT did not reveal local lesion. Three months later, his serum HSV IgG antibody titer was eight times elevation and a throat swab culture for virus isolation yielded HSV type I. T2-weighted images of neck MRI showed abnormally high signal intensity on the right sub-glottis region with gadolinium enhancement that was compatible with local infection. Thereafter, one course of acyclovir; was given. Three months after finishing the acyclovir, his symptoms were almost gone and neck MRI did not show the aforementioned lesions. HSV infection should be considered as a differential diagnosis for patients with idiopathic dysphonia and dysphagia.- - - - - - - - - - ranking = 0.91029170159787keywords = nerve (Clic here for more details about this article) |
9/22. An unusual bilateral cervical paraganglioma: a case report.Paragangliomas are neoplasms originating from paraganglion tissue derived from mesoderm, the most common location being adjacent to carotid bifurcation. Rarely these tumours can be bilateral. We present here a case of bilateral paraganglioma occurring in a young woman. On one side the tumour was arising from the vagus nerve and on the other, from the carotid body. Clinical, radiological and histopathological features and treatment dilemmas are discussed.- - - - - - - - - - ranking = 0.18205834031957keywords = nerve (Clic here for more details about this article) |
10/22. Masked pseudomonal skull base osteomyelitis presenting with a bilateral Xth cranial nerve palsy.skull base osteomyelitis classically presents as a complication of severe external otitis, middle ear, mastoid or sinus infection and can lead to multiple lower cranial nerve palsies when the jugular foramen is involved as a consequence of widespread involvement of the skull base. Bilateral skull base osteomyelitis is a recognized phenomenon, but has not previously been reported secondary to pseudomonal infection in the absence of a clinically obvious focus of infection. We report the case of a 77-year-old diabetic patient who presented with dysphonia and dysphagia and had a bilateral Xth cranial nerve palsy. No focus of infection was evident on presentation. Subsequent radiological investigation confirmed the diagnosis of bilateral skull base osteomyelitis.- - - - - - - - - - ranking = 1.5keywords = nerve, cranial nerve (Clic here for more details about this article) |
| | Next -> |