1/21. Post-stripping sclerodermiform dermatitis.BACKGROUND: Cutaneous sclerosis, a process that results in hardening of the skin, is the hallmark of scleroderma and sclerodermoid disorders. Cutaneous sclerosis is usually classified as secondary or primary, depending on the presence or absence of underlying diseases. Primary cutaneous sclerosis is a feature of idiopathic inflammatory processes that are often associated with autoimmune disorders, whereas secondary cutaneous sclerosis arises in the context of many pathological processes of varying causes, including chronic graft-vs-host disease, defined metabolic or genetic disorders, and exposure to certain infectious organisms, drugs, or chemicals. OBSERVATIONS: Three patients had localized cutaneous sclerosis overlying the site of a surgically removed (stripped) great saphenous vein. In all 3 patients, lesions were clinically characterized by multiple hypopigmented and indurated plaques distributed linearly along the path of the preexisting vein. Extensive history, physical examination, and diagnostic tests did not reveal known predisposing factors for cutaneous sclerosis. CONCLUSIONS: Although the observed association of sclerodermiform dermatitis and venous stripping in these 3 patients does not imply a causal relationship, the absence of other identifiable predisposing factors and the striking linear distribution of the cutaneous lesions along the path of the preexisting vein are suggestive. This poststripping sclerodermiform dermatitis may be a rare late complication of saphenous vein stripping.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/21. Neurophysiological and ultrasound findings in sural nerve lesions following stripping of the small saphenous vein.We describe the neurophysiological and ultrasound (US) findings in two patients with right sural nerve lesions following stripping of the small saphenous vein for varicose vein treatment. In the first case, US showed a tear of the nerve proximal to the lateral malleolus and a hypoechoic swelling of the proximal stump, likely related to a terminal bulb neuroma. A sural conduction study performed distally and proximally to the lesion through a near-nerve needle technique showed absent responses. In the second case, US showed a deep subcutaneous extension of a postsurgical scar placed behind the lateral malleolus close to the sural nerve, but no nerve discontinuity. Sural conduction study showed absent responses distal to the scar. Sural stimulation immediately above the scar yielded a small response at the sciatic nerve. A subsequent investigation performed 15 months after the operation showed absent proximal and distal responses. The combination of US and sural conduction study, including recording at the sciatic nerve, to our knowledge has not been described previously, and may yield important complementary information in the diagnosis of sural nerve lesions.- - - - - - - - - - ranking = 307.98633973089keywords = nerve (Clic here for more details about this article) |
3/21. Spinal intradural perimedullary arteriovenous fistula with varix in infant.A rare occurrence of type IV spinal arteriovenous malformation (intradural perimedullary arteriovenous fistula) is described in an 18-month-old boy initially misdiagnosed with guillain-barre syndrome. An intramedullary mixed-intensity mass lesion at Th1 was demonstrated by magnetic resonance imaging together with flow voids over the dorsal aspect of the swollen spinal cord. angiography demonstrated an intradural perimedullary arteriovenous fistula including an intraparenchymal vascular pocket. After partial embolisation of the posterior spinal arteries through the left intercostal-radicular artery, the arteriovenous fistula was removed completely together with an organised haematoma. The fistula directly opened into a vascular pocket, which was confirmed pathologically to be a varix. The postoperative course was uneventful, and the patient resumed ambulation within 4 months. The case, subclassifiable as a type IVb spinal perimedullary AVF, was unique given its location and the patient's age at presentation.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/21. Complications in subfascial endoscopic perforating vein surgery: a report of two cases.Subfascial endoscopic perforating vein surgery is a safe method for the division of incompetent perforating veins. Nevertheless, we report two cases with unfortunate complications: the posterior tibial artery and tibial nerve were damaged during the procedures. In one patient this resulted in a reintervention, but in both patients it resulted in permanent discomfort. We then present a guideline that may prevent damage to these critical structures.- - - - - - - - - - ranking = 25.665528310908keywords = nerve (Clic here for more details about this article) |
5/21. Symptomatic spinal epidural varices presenting with nerve impingement: report of two cases and review of the literature.STUDY DESIGN: Two cases of symptomatic epidural varices are presented and the literature was reviewed on this entity. OBJECTIVE: To raise awareness of this rare condition in the interpretation of preoperative magnetic resonance imaging scans and to assess the results of surgical treatment. BACKGROUND: Symptomatic epidural varices presenting with radiculopathy are extremely rare, and the diagnosis is often missed in the preoperative evaluation. This condition commonly masquerades as a herniated nucleus pulposus. diagnosis is often only made intraoperatively. MATERIALS AND methods: Case 1 is a 40-year-old man presenting with acute exacerbation of lower back pain associated with radiculopathy down his right lower limb. magnetic resonance imaging showed a paracentral disc prolapse. At operation, a congested epidural vein impinging on the L5 nerve root was noted with no intervertebral foramens stenosis. Excision of the vein was performed. The second case, a 50-year-old man with previous spinal instrumentation, was admitted for acute onset of radiculopathy down his left lower limb. At operation, an epidural varix compressing on the L4 nerve root was noted. Retrospectively, features of epidural varices were noted in the preoperative magnetic resonance imaging scans. Both patients reported resolution of symptoms after surgery. RESULTS: Excision was done for the first patient, and coagulative ablation was done in the second patient. Both patients had symptomatic relief and neurologic recovery on follow-up. CONCLUSION: Our experience and the literature demonstrated that a favorable outcome with resolution of neurologic symptoms can often be achieved after excision or ablation of the epidural varices.- - - - - - - - - - ranking = 153.99316986545keywords = nerve (Clic here for more details about this article) |
6/21. Painful vascular compression syndrome of the sciatic nerve caused by gluteal varicosities.The authors report three patients with chronic sciatic pain without focal neurologic deficit. Sitting or lying on the affected side provoked pain, and standing and walking relieved it. MRI revealed varicotic gluteal vessels compressing the sciatic nerve. decompression of the nerve resulted in complete and permanent pain relief. Sciatic or buttock pain in patients with varicosities and pain provocation in the sitting or lying position suggests this neurovascular compression syndrome.- - - - - - - - - - ranking = 153.99316986545keywords = nerve (Clic here for more details about this article) |
7/21. Intradural venous varix: a rare cause of an intradural lumbar spine lesion.STUDY DESIGN: A case of intradural venous varix producing a mass-like lesion in the lumbar spine is reported. OBJECTIVE: To present a rare cause of an intradural mass lesion along the cauda equina. To present radiologic findings of this entity and to offer a hypothesis for its formation. SUMMARY OF BACKGROUND DATA: Epidural venous varices have been described previously in the literature. To the authors' knowledge, no cases of intradural venous varix presenting as an intradural mass have been reported previously. MATERIALS AND methods: An elongated, serpentine intradural mass was discovered on routine lumbar MRI performed for investigation of the patient's radiculopathy. The patient underwent laminectomy and intradural exploration. RESULT: On surgical exploration, a serpentine, massively dilated vein was identified, which distorted the normal nerve roots. CONCLUSION: A venous varix should be considered in the differential diagnosis of an intradural lesion in the lumbar spine in the appropriate clinical setting.- - - - - - - - - - ranking = 25.665528310908keywords = nerve (Clic here for more details about this article) |
8/21. Primary biliary cirrhosis complicated with sigmoid colonic varices: the usefulness of computed tomographic angiography.Gastroesophageal varices are the major complication of portal hypertension. Ectopic varices develop in various organs such as the duodenum, colon, and gallbladder. However, varices other than at gastroesophageal or rectal sites is a rare entity. We report a 53-year-old patient with primary biliary cirrhosis complicated by sigmoid colonic varices. Computed tomographic angiography was useful to understand the entire status of the varices.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
9/21. Neurovascular compression of the common peroneal nerve by varicose veins.Compression of the common peroneal nerve occurs sometimes, but compression caused by varicose veins has not been reported before. We report a case of common peroneal nerve compression syndrome which was confirmed and treated surgically. A 63-year-old woman complained of paraesthesia on the lateral aspect of the right leg, which was worse in the evening. A primary varicose vein arising from non-saphenous tributaries was seen in the posterior calf. Her symptoms resolved with the wearing of compression hosiery for 2 weeks. At operation, the common peroneal nerve was found to be surrounded by tortuous varicosities. After decompression the paraesthesia on the lateral aspect of the right leg resolved completely with no evidence of residual neuralgia.- - - - - - - - - - ranking = 179.65869817635keywords = nerve (Clic here for more details about this article) |
10/21. Traumatic venous varix causing sciatic neuropathy: case report.OBJECTIVE AND IMPORTANCE: sciatic neuropathy rarely presents in nonpenetrating trauma because of protection of the nerve by the pelvis, the gluteal muscles, and the tissues in the posterior thigh. We present the case of a patient who fell and subsequently developed a traumatic venous varix of the inferior gluteal vein that caused compression sciatic neuropathy. CLINICAL PRESENTATION: Seven days after a fall onto her right buttock, the patient developed a painful burning paresthesia in her leg and numbness on the dorsum of her foot. Numerous studies ruled out lumbar spine pathological abnormalities as the cause of the pain. Conventional magnetic resonance imaging revealed a lesion adjacent to the sciatic nerve. Gradient echo and two-dimensional time-of-flight magnetic resonance imaging sequences confirmed this to be a vascular lesion originating from the inferior gluteal vein and compressing the sciatic nerve. INTERVENTION: Operative resection obliterated the venous varix, thereby relieving the patient's pain and neurological deficit. CONCLUSION: No case of a traumatic venous varix of the inferior gluteal vein compressing the sciatic nerve has been reported to date. Surgical resection was successful in obliterating the lesion and relieving the symptoms.- - - - - - - - - - ranking = 102.66211324363keywords = nerve (Clic here for more details about this article) |
| | Next -> |