1/219. An uncommon mechanism of brachial plexus injury. A case report.PURPOSE: To report a case of brachial plexus injury occurring on the contralateral side in a patient undergoing surgery for acoustic neuroma through translabrynthine approach. CLINICAL FEATURES: A 51-yr-old woman underwent surgery for acoustic neuroma through translabrynthine approach in the left retroauricular area. She had a short neck with a BMI of 32. Under anesthesia, she was placed in supine position with Sugita pins for head fixation. The head was turned 45 degrees to the right side and the neck was slightly flexed for access to the left retroauricular area, with both arms tucked by the side of the body. Postoperatively, she developed weakness in the right upper extremity comparable with palsy of the upper trunk of the brachial plexus. hematoma at the right internal jugular vein cannulation site was ruled out by CAT scan and MRI. The only remarkable finding was considerable swelling of the right sternocleidomastoid and scalene muscle group, with some retropharyngeal edema. An EMG confirmed neuropraxia of the upper trunk of brachial plexus. She made a complete recovery of sensory and motor power in the affected limb over the next three months with conservative treatment and physiotherapy. CONCLUSIONS: brachial plexus injury is still seen during anesthesia despite the awareness about its etiology. Malpositioning of the neck during prolonged surgery could lead to compression of scalene muscles and venous drainage impedance. The resultant swelling in the structures surrounding the brachial plexus may result in a severe compression.- - - - - - - - - - ranking = 1keywords = palsy (Clic here for more details about this article) |
2/219. Posterior interosseous nerve syndrome due to pseudogout.Posterior interosseous nerve palsy associated with pseudogout of the elbow joint in a 71-year-old woman is described. Local steroid injection and administration of a nonsteroidal anti-inflammatory drug was effective in treatment.- - - - - - - - - - ranking = 1keywords = palsy (Clic here for more details about this article) |
3/219. Post-traumatic distal nerve entrapment syndrome.Eleven patients with paralysis of muscle groups in the upper or lower extremity were clinically diagnosed after previous proximal direct trauma to the corresponding peripheral nerves, without complete nerve disruption. patients were seen within an average of 8 months after trauma (minimum 3 months and maximum 2 years after). Nerve lesions were caused either by gunshot, motor-vehicle accident, and other direct trauma or, in one case, after tumor excision. All patients presented with complete sensory and motor loss distal to the trauma site, but demonstrated a positive Tinel sign and pain on testing over the "classic" (distal) anatomic nerve entrapment sites only. After surgical release through decompression of the nerve compression site distal to the trauma, a recovery of sensory function was achieved after surgery in all cases. Good-to-excellent restoration of motor function (M4/M5) was achieved in 63 percent of all cases. Twenty-five percent had no or only poor improvement in motor function, despite a good sensory recovery. Those patients in whom nerve compression sites were surgically released before 6 months after trauma had an improvement in almost all neural functions, compared to those patients who underwent surgery later than 9 months post trauma. A possible explanation of traumatically caused neurogenic paralysis with subsequent distal nerve compressions is provided, using the "double crush syndrome" hypothesis.- - - - - - - - - - ranking = 1.3923959035883keywords = paralysis (Clic here for more details about this article) |
4/219. Anterior interosseous nerve compression after supracondylar fracture of the humerus: a metaanalysis.OBJECT: The authors conducted a metaanalysis of reports of anterior interosseous nerve syndrome, a rare nerve compression neuropathy that affects only the motor branch of the median nerve. This syndrome is characterized by paralysis of the flexor pollicis longus, the flexor digitorum profundus to the index finger, and the pronator quadratus, with weakness on flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger without sensory loss. methods: The authors reviewed reports of 34 cases of anterior interosseous nerve syndrome combined with supracondylar fractures of the humerus in children. They have added a new case identified in a 7-year-old boy in whom a diagnosis was made from the clinical findings and whose treatment and outcome are analyzed. The ages of patients reported in the literature ranged from 4 to 10 years. Ten patients (29%) were treated with closed reduction and application of a cast, whereas 25 patients (71%) were treated with open reduction and fixation of the fracture. CONCLUSIONS: All patients regained full flexion and strength after 4 to 17 weeks. The fractures that were surgically treated showed no entrapment of the anterior interosseous nerve.- - - - - - - - - - ranking = 0.69619795179414keywords = paralysis (Clic here for more details about this article) |
5/219. Common peroneal nerve palsy in a UH-60 aviator.A case of common peroneal nerve palsy in a UH-60 Blackhawk U.S. Army helicopter pilot is reported. A review of the literature revealed several reports of common peroneal nerve palsy, although there were no published reports of this injury secondary to performing flight duties in the UH-60 cockpit. A common practice among Blackhawk pilots is to brace the "collective" with their left knee, subjecting the common peroneal nerve to possible injury. This action should be considered as a possible cause of common peroneal nerve palsy in this select group of aviators.- - - - - - - - - - ranking = 7keywords = palsy (Clic here for more details about this article) |
6/219. Neural compressive symptoms appearing during steroid treatment in a patient with intracranial lipoma.Intracranial lipoma is a rare condition, and it is usually asymptomatic. We describe a 67 year old woman who developed blurred vision, diplopia, left sided oculomotor palsy, and ipsilateral ptosis during steroid treatment for giant cell arteritis. These symptoms were considered to be associated with aggressive giant cell arteritis, and the steroid dose was raised. Surprisingly, the symptoms increased, and further examination revealed an intracranial lipoma situated in the Meckel's cave. During tapering of the steroids her symptoms gradually improved. This is the first report demonstrating that steroids may induce hypertrophy of the fat tissue in the intracranial lipoma, causing compression of the cranial nerves passing through the cavernous sinus thereby mimicking the ocular symptoms sometimes associated with aggressive giant cell arteritis.- - - - - - - - - - ranking = 1keywords = palsy (Clic here for more details about this article) |
7/219. Superior branch palsy of the oculomotor nerve caused by acute sphenoid sinusitis.A 52-year-old man presented with unilateral headache for 6 days. physical examination revealed an ipsilateral paresis of the superior division of the oculomotor nerve with chemosis. CT scan of the paranasal sinuses showed ipsilateral sphenoid sinusitis with cavernous sinus involvement. The symptoms were completely improved by medical treatment only.- - - - - - - - - - ranking = 4keywords = palsy (Clic here for more details about this article) |
8/219. Double vision in a child.A 10-year-old boy presented with a complete left oculomotor cranial nerve palsy. Diagnostic evaluation, including neuroimaging and cerebral angiography revealed a small intracranial aneurysm compressing the third nerve. Neurosurgical clipping of the aneurysm produced resolution of the third nerve palsy. The rarity of this presentation in a young patient is discussed, along with the importance of rapid diagnosis and treatment.- - - - - - - - - - ranking = 2keywords = palsy (Clic here for more details about this article) |
9/219. median nerve palsy presenting as absent elbow flexion: a result of a ruptured pectoralis major to biceps tendon transfer.We describe a patient with a preexisting posttraumatic brachial plexopathy who had a complete high median nerve palsy due to rupture of the pectoralis major to biceps transfer near its distal insertion at the elbow region.- - - - - - - - - - ranking = 5keywords = palsy (Clic here for more details about this article) |
10/219. Newborn radial nerve palsy: report of four cases and review of published reports.Four newborns presented with isolated radial nerve palsy during the first 2 days of life. In three, there was a history of failure of progression of labor, which may have resulted in prolonged radial nerve compression. Furthermore, three infants had fat necrosis of the upper arm above the elbow, suggestive of compression of the radial nerve in the region of the spiral groove. Significant recovery of function was evident within 1 month in all four infants. The authors review published reports about the rare condition of isolated radial nerve palsy in the newborn.- - - - - - - - - - ranking = 6keywords = palsy (Clic here for more details about this article) |
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