1/67. Selective motor hyperreinnervation by using contralateral C-7 motor rootlets in the reconstruction of an avulsion injury of the brachial plexus. Case report.brachial plexus avulsion injuries are a clinical challenge. In recent experimental studies the authors have demonstrated the high degree of muscle reinnervation attained when a C-4 motor rootlet was directly connected to the musculocutaneous nerve. This degree of reinnervation was attributed to the good chance that a muscle fiber can be reinnervated by a motor fiber when the number of regenerating motor neurons is increased and when competitive sensory fibers are excluded from the process. The authors present the first clinical case in which this phenomenon has been observed. This 26-year-old man, who was involved in an automobile accident, presented with an upper brachial plexus avulsion, for which he underwent operation 4 months later. The axillary and suprascapular nerves were directly surgically connected to the motor rootlets of the C-7 contralateral root by using two cables of sural nerve graft. Two years postsurgery, the patient was able to perform shoulder abduction of 120 degrees and hold an 800-g weight at 90 degrees. These results are encouraging, and in selected patients motor rootlet transfer might prove to be a useful surgical strategy.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/67. Corneal laceration and forehead erythema: a syndrome in infants.PURPOSE: To illustrate a syndrome of transient erythema in the first division of the fifth cranial nerve caused by minor corneal laceration, occurring in infants. methods: case reports are presented, together with photographs. These must, of necessity, usually be obtained by the general practitioner because of the short duration of the signs. RESULTS/CONCLUSIONS: Opinion is sought as to whether other practitioners have recognized this association and whether it has been described elsewhere.- - - - - - - - - - ranking = 0.33333333333333keywords = nerve (Clic here for more details about this article) |
3/67. Multivascular trauma on an adolescent. Perioperative management.Penetrating vascular injury, in particular at the neck, is a life-threatening trauma not only of the nature and the anatomic proximity of cardiovascular, aerodigestive, glandular and neurologic system but also of the development of early and late complications. The following case report describes our experience with a penetrating wound patient, who was admitted to our emergencies twelve hours after the accident. The only demonstrable objective signs included a large hematoma at the right-side of the neck and distended mediastinum on the chest X-ray. As the patient was cardiovascularly unstable he was immediately transported to the theater without any angiography. The mandatory operative exploration was initially unsuccessful and a median sternotomy with a standard cardiopulmonary bypass and deep hypothermia circulatory arrest was established to restore all the vascular lesions. Actually, the patient was in critical condition with a rupture of the right internal jugular vein, a large pseudoaneurysm of the innominate artery and an avulsion of the ascending aorta with the suspicion of a cardiac tamponade. The postoperative period lasted two full months, while complications appeared. The substantial message from this multivascular trauma is the early diagnosis of the life-threatening complications as exsanguinations, ventricular fibrillation and the ability to minimize postoperative complications, which will impair the normal functional life of the patient.- - - - - - - - - - ranking = 0.18817039052678keywords = median (Clic here for more details about this article) |
4/67. Complete transection of the median and radial nerves during arthroscopic release of post-traumatic elbow contracture.Arthroscopic debridement and capsular release was performed in a 57-year-old woman because of post-traumatic stiffness in the dominant right elbow joint. During this procedure, the median and radial nerves were completely transected. A few recent reports of small series have described encouraging results after arthroscopic capsular release of post-traumatic elbow contracture, but the present case demonstrates the inherent risk of damage to neurovascular structures.- - - - - - - - - - ranking = 2.6075186193006keywords = nerve, median (Clic here for more details about this article) |
5/67. optic nerve avulsion from a golfing injury.PURPOSE: To describe a patient with optic nerve avulsion after being struck in the eye with a golf club. methods: A 10-year-old male was hit in the left eye by a golf club. The patient underwent full ophthalmoscopic evaluation and neuroimaging. RESULTS: The patient had no light perception in the left eye when first seen. Avulsion of the optic nerve with vitreous hemorrhage was apparent on examination. Computed tomographic imaging of the brain and orbits revealed no abnormalities. CONCLUSIONS: optic nerve avulsion from golf-related injury is more likely to occur when the impact site is between the globe and the orbital rim. rupture of the globe is more likely to occur with direct impact to it.- - - - - - - - - - ranking = 2.3333333333333keywords = nerve (Clic here for more details about this article) |
6/67. Paediatric hand injuries caused by spiked railings.We report five cases of hand injuries caused by spiked palisade railings. One patient sustained an open fracture of the distal phalanx with a disruption of the nail bed, and two patients had digital nerve injuries. Two patients presented with the railing still impaled in the fingers, one of whom had an ischaemic digit at presentation. All patients were male, between 9 and 12 years of age, and presented in the course of 1 month. Railings of this type would appear to be a significant cause of hand injuries, which may be prevented by legislation or a change in railing design.- - - - - - - - - - ranking = 0.33333333333333keywords = nerve (Clic here for more details about this article) |
7/67. Unusual parotid gland foreign body.A foreign body in the parotid gland whether from the oral cavity or through the skin is extremely uncommon. A case is described of the tip of a golden-colored pencil accidentally piercing the deep lobe after a fall. Emergency surgical removal was performed, and the diagnosis of the foreign body was quite easy. In contrast, determination of the location in the gland had to be done by a microscope, with fluoroscopy during the operation and was quite difficult. During removal, great attention was paid to avoiding facial nerve injury. This was done by identifying the facial trunk at the pointer using a microscope. The dissolved material including copper and zinc metal powder, paste, and clay, was found in the deep lobe associated with the surrounding abscess. Although these materials are assumed to be harmless to human tissues, the complete and immediate removal is to prevent salivary fistule resulting from inflammation.- - - - - - - - - - ranking = 0.33333333333333keywords = nerve (Clic here for more details about this article) |
8/67. Penetrating knife injury to the heart.A 39-year-old man attempted to kill himself using a small knife to penetrate the left anterior chest wall because of trouble at work and with his girlfriend. On arrival at the emergency room, his consciousness was not clear and vital signs were unstable. The knife remained vertically located in the left anterior chest wall. A large left hemothorax was identified by chest X-ray, and moderate cardiac tamponade was detected by echocardiography. Left-sided chest drainage was performed by inserting a chest drainage tube, and about 2500 ml of hemorrhagic effusion was drained. An emergency operation was performed to relieve the cardiac tamponade and repair the penetrating cardiac injury. About an hour after arrival at the emergency room, a median sternotomy was performed in the operating room. The knife had injured the surface of the right ventricular outflow tract, the left lung, and the 3rd intercostal artery and vein. cardiopulmonary bypass was immediately prepared for the repair of the cardiac injury. The wounds were successfully repaired with pledgeted sutures under cardiac beating. The postoperative course was uneventful with no sign of infection. The patient was discharged at 9 days after the operation. Here we have reported a case of successful surgical repair of a penetrating knife injury to the heart, which was managed by immediate resuscitation and emergency surgery.- - - - - - - - - - ranking = 0.18817039052678keywords = median (Clic here for more details about this article) |
9/67. Glossopharyngeal neuralgia following foreign body impaction in the neck.Glossopharyngeal neuralgia is rare, typically idiopathic and treated with carbamazepine. Surgery to decompress or transect the glossopharyngeal nerve root may be performed if conservative management fails. We present a case following trauma to the neck with foreign body impaction. To our knowledge this is the first case of glossopharyngeal neuralgia due to neck trauma.- - - - - - - - - - ranking = 0.33333333333333keywords = nerve (Clic here for more details about this article) |
10/67. The farmer's wife and the salmon fork: a near miss for the median nerve.This case history illustrates how a farmer's wife accidentally impaled her forearm on a salmon fork with barbs. Despite the fact that the barbs were not obvious to the rescuing firemen, they had the good sense to transfer the patient with the fork in situ and well supported to prevent traction injury. Any effort to remove the fork at the time of injury would have resulted in complete division of the median nerve.- - - - - - - - - - ranking = 74.219210608425keywords = median nerve, nerve, median (Clic here for more details about this article) |
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