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1

Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome)  

MedlinePLUS

... ibuprofen, to help reduce swelling around the nerve. Steroid injections. Steroids, like cortisone, are very e? ective anti-in? ammatory medicines. Injecting steroids around the ulnar nerve is generally not used ...

2

Compression of the Deep Palmar Branch of the Ulnar Nerve by a Ganglion  

PubMed Central

A ganglion originating from the pisotriquetral joint is the most common cause of distal ulnar nerve compression. Midpalmar ganglions causing ulnar nerve compression are rare. This case describes a ganglion arising from the third carpometacarpal joint causing compression of the deep motor branch of the ulnar nerve. PMID:18780033

Anastakis, D. J.; Salonen, D.; Becker, E.

2006-01-01

3

Diffusion-weighted magnetic resonance imaging of the ulnar nerve in cubital tunnel syndrome.  

PubMed

Diffusion-weighted images based on magnetic resonance reveal the microstructure of tissues by monitoring the random movement of water molecules. In this study, we investigated whether this new technique could visualize pathologic lesions on ulnar nerve in cubital tunnel. Six elbows in six healthy males without any symptoms and eleven elbows in ten patients with cubital tunnel syndrome underwent on diffusion-weighted MRI. No signal from the ulnar nerve was detected in normal subjects. Diffusion-weighted MRI revealed positive signals from the ulnar nerve in all of the eleven elbows with cubital tunnel syndrome. In contrast, conventional T2W-MRI revealed high signal intensity in eight elbows and low signal intensity in three elbows. Three elbows with low signal MRI showed normal nerve conduction velocity of the ulnar nerve. Diffusion-weighted MRI appears to be an attractive technique for diagnosis of cubital tunnel syndrome in its early stages which show normal electrophysiological and conventional MRI studies. PMID:20422721

Iba, K; Wada, T; Tamakawa, M; Aoki, M; Yamashita, T

2010-01-01

4

Three tendon transfer methods in reconstruction of ulnar nerve palsy  

Microsoft Academic Search

Purpose: This study was designed to investigate the efficacy of 3 different tendon transfer techniques in restoring grip strength, correcting claw hand deformity, and improving hand function after irreparable ulnar nerve palsy. Method: A total of 44 patients were assessed 14 to 96 months after surgery. Twenty-four patients were reconstructed with the flexor digitorum 4-tail (FDS 4-tail) procedure, 11 with

Türker Özkan; Ka?an Özer; Ayan Gülgönen

2003-01-01

5

Anterior translation and morphologic changes of the ulnar nerve at the elbow in adolescent baseball players.  

PubMed

The effect of repetitive throwing on the ulnar nerve is not clear. There are no published imaging studies regarding this issue in adolescent baseball players. The purpose of this cross-sectional ultrasonographic study was to use 5- to 10-MHz frequency ultrasonography to define the anterior translation and flattening of the ulnar nerve in different elbow positions. We divided 39 adolescent baseball players into two groups, 19 pitchers and 20 fielders, according to the amount of throwing. Twenty-four non-athlete junior high school students were also included as controls. We ultrasonographically examined each participant's ulnar nerve in the cubital tunnel with the elbow extended and at 45°, 90° and 120° of flexion. Anterior translation and flattening of the ulnar nerve occurred in all groups. Pitchers had larger-scale anterior translation than did controls. In pitchers, the ulnar nerve exhibited more anterior movement on the dominant side than on the non-dominant side. The anterior subluxation of the ulnar nerve occurred in players without ulnar nerve palsy and was not correlated with elbow pain. In addition to the known musculoskeletal adaptations of pitchers' elbows, ultrasonography revealed new changes in the ulnar nerve, anterior translation and subluxation, after repetitive throwing. These changes might also be physiologic adaptations of throwing elbows. PMID:24139913

Tai, Ta-Wei; Kuo, Li-Chieh; Chen, Wen-Chau; Wang, Lin-Hwa; Chao, Shu-Yi; Huang, Christine Nai-Hui; Jou, I-Ming

2014-01-01

6

An anatomical study of transfer of the anterior interosseous nerve for the treatment of proximal ulnar nerve injuries.  

PubMed

We conducted an anatomical study to determine the best technique for transfer of the anterior interosseous nerve (AIN) for the treatment of proximal ulnar nerve injuries. The AIN, ulnar nerve, and associated branches were dissected in 24 cadaver arms. The number of branches of the AIN and length available for transfer were measured. The nerve was divided just proximal to its termination in pronator quadratus and transferred to the ulnar nerve through the shortest available route. Separation of the deep and superficial branches of the ulnar nerve by blunt dissection alone, was also assessed. The mean number of AIN branches was 4.8 (3 to 8) and the mean length of the nerve available for transfer was 72 mm (41 to 106). The transferred nerve reached the ulnar nerve most distally when placed dorsal to flexor digitorum profundus (FDP). We therefore conclude that the AIN should be passed dorsal to FDP, and that the deep and superficial branches of the ulnar nerve require approximately 30 mm of blunt dissection and 20 mm of sharp dissection from the point of bifurcation to the site of the anastomosis. The use of this technique for transfer of the AIN should improve the outcome for patients with proximal ulnar nerve injuries. PMID:24891580

Sukegawa, K; Kuniyoshi, K; Suzuki, T; Ogawa, Y; Okamoto, S; Shibayama, M; Kobayashi, T; Takahashi, K

2014-06-01

7

Anomalies of ulnar nerve conduction in different carpal tunnel syndrome stages.  

PubMed

Impairment of ulnar sensory fibers at the wrist has recently been documented in moderate/severe carpal tunnel syndrome (CTS). This has been interpreted as a consequence of compressive forces transmitted to Guyon's canal by high pressure in the carpal tunnel or comorbidity between ulnar neuropathy and CTS. The main aim of the present study was to identify any ulnar nerve conduction impairment in the early stages of CTS. The relation between ulnar and median nerve conduction in all CTS severity stages was also assessed. Ulnar nerve sensory conduction at the wrist was investigated in 580 hands with CTS. Significant changes in ulnar nerve conduction were present even in the early stages of CTS. A significant, positive correlation was also found between CTS severity and conduction abnormalities of ulnar sensory fibers. These findings make the hypothesis of comorbidity weak. Based on the above results and on reports of high pressure in Guyon's canal in CTS, ulnar nerve conduction abnormalities may be caused in part by compressive forces progressively transmitted to the canal by increasing pressure in the carpal tunnel with increasing CTS severity. This does not exclude other causative factors such as subclinical traumatic damage acting on median and ulnar fibers. PMID:18671289

Ginanneschi, F; Milani, P; Rossi, A

2008-09-01

8

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome  

PubMed Central

Objective Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was 41.8±15.2 m/s and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment (57.8±6.9 m/s) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from 39.8±12.1 m/s to 47.8±12.1 m/s (p<0.05). After an average follow-up of 4.8±5.3 months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome. PMID:19096574

Cho, Sung-Min; Sheen, Seung-Hoon; Choi, Jong-Hun; Huh, Dong-Hwa; Song, Joon-Ho

2007-01-01

9

Neural fibrolipoma of the ulnar nerve in the hand: a case report.  

PubMed

The author reports an unusual case of neural fibrolipoma (lipofibromatous hamartoma) of the ulnar nerve in the hand. A 20-year-old man presented with a fusiform soft tissue mass in his right hand. Neurological examination was normal except to minimal pain on palpation. Surgical exploration revealed that ulnar nerve and its digital branches were infiltrated by fibrofatty tissues. Fibrofatty tissues were dissected and removed from the nerve by microsurgical technique. Histological examination confirmed the diagnosis as a lipofibromatous hamartoma of the nerve. The result of surgical debulking was satisfactory. PMID:16568537

Yildirim, Serkan

2005-01-01

10

Recurrent ulnar nerve entrapment at the elbow: Correlation of surgical findings and 3-Tesla magnetic resonance neurography  

PubMed Central

The authors describe the correlation between 3-Tesla magnetic resonance neurography (MRN) and surgical findings in two patients who underwent multiple previous failed ulnar nerve surgeries. MRN correctly localized the site of the abnormality. Prospectively observed MRN findings of perineural fibrosis, ulnar nerve re-entrapment abnormalities, medial antebrachial cutaneous neuroma and additional median nerve entrapment were confirmed surgically. PMID:24421652

Chhabra, Avneesh; Wadhwa, Vibhor; Thakkar, Rashmi S; Carrino, John A; Dellon, A Lee

2013-01-01

11

Recurrent ulnar nerve entrapment at the elbow: Correlation of surgical findings and 3-Tesla magnetic resonance neurography.  

PubMed

The authors describe the correlation between 3-Tesla magnetic resonance neurography (MRN) and surgical findings in two patients who underwent multiple previous failed ulnar nerve surgeries. MRN correctly localized the site of the abnormality. Prospectively observed MRN findings of perineural fibrosis, ulnar nerve re-entrapment abnormalities, medial antebrachial cutaneous neuroma and additional median nerve entrapment were confirmed surgically. PMID:24421652

Chhabra, Avneesh; Wadhwa, Vibhor; Thakkar, Rashmi S; Carrino, John A; Dellon, A Lee

2013-01-01

12

Granular Cell Tumor of the Ulnar Nerve: MR Neurography Characterization  

PubMed Central

The authors report an unusual case of ulnar neuropathy caused by granular cell tumor. The report describes the anatomic 3 Tesla MR Neurography and functional diffusion tensor findings of the case, which was subsequently confirmed on surgical excision and histopathology.

Wadhwa, Vibhor; Salaria, Safia N; Chhabra, Avneesh

2014-01-01

13

Dislocation of the ulnar nerve at the elbow in an elite wrestler  

PubMed Central

Dislocation of the ulnar nerve is uncommon among the general population, but it has been reported more frequently in athletes who use their upper limbs to make forceful and resisted flexion of elbow joint. The authors report a unique case of ulnar nerve dislocation in an elite wrestler treated by partial epicondylectomy and subcutaneous transposition of the ulnar nerve. Following the surgery, a supervised and well-designed sport-specific rehabilitation program is a necessary requirement for a rapid return to sport. Such a program requires a bilateral consultation and collaboration between treating physician and trainer of the wrestler. The athlete regained his full function and returned to wrestling after a 3-month sport-specific functional rehabilitation program. PMID:22693274

Molnar, Szabolcs Lajos; Lang, Peter; Skapinyecz, Janos; Shadgan, Babak

2011-01-01

14

[The modified Lamberty and Cormack's flap for neuropathies of the ulnar nerve at the elbow].  

PubMed

Surgical treatment of ulnar nerve syndrome at the elbow gives good results in the majority of cases but there are sometimes incomplete results or recurrences that can lead to iterative procedures. This iterative surgery is responsible for painful neurological sequelae often resistant to pharmacological treatments. In these selected resistant cases, we made the choice of a surgical treatment associating a neurolysis of the ulnar nerve and wrapping with a vascularized flap modified from Lamberty and Cormack. This retrospective study focused on six cases with an average follow-up of 30 months. The results showed an improvement in all patients, especially for the two criteria which best reflect the neuropathic pain: DN4 questionnaire and the visual analog scale of pain. Even if it is a short study, it commits us to continue to apply the principle of covering ulnar neuropathy at the elbow by a vascularized flap. PMID:24200947

Haloua, J-P; Claise, J-M; Guigal, V

2013-12-01

15

Ulnar Nerve Dislocation at the Elbow: Review of the Literature and Report of Three Cases  

PubMed Central

Ulnar nerve instability without compression at the cubital tunnel is not common and even more rare is a dislocating nerve. We review the literature regarding the etiology of instability, its incidence and treatment. Snapping around the medial humeral epicondyle can also be caused by a subluxing medial head of the triceps. This pathology may be accompanied by symptoms from the ulnar nerve. Differential diagnosis even intraoperatively is therefore essential if effective treatment is to be given. We also present our own experience on the subject consisting of three cases, one of them with bilateral instability. In only one case there were clinical findings suggesting nerve compression. All laboratory and screening tests were normal, except for the nerve conduction studies in this one case. The main symptom was strong pain, especially during manual activities. Only two of the four subluxing nerves required surgical treatment which in our case was by anterior submuscular or subcutaneous transposition of the ulnar nerve. As diagnosis is not always easy and is usually made on clinical grounds, we also present a clinical test that we believe to be diagnostic for the situation. PMID:19461901

Xarchas, K.C; Psillakis, I; Koukou, O; Kazakos, K.J; Ververidis, A; Verettas, D.A

2007-01-01

16

Ulnar Nerve Conduction Study of the First Dorsal Interosseous Muscle in Korean Subjects  

PubMed Central

Objective To derive normative values for ulnar nerve conduction study of the active recording electrode on the first dorsal interosseous muscle (FDI) and the reference electrode on the proximal phalanx of the thumb. Method Ulnar nerve motor conduction study with FDI and abductor digiti minimi muscle (ADM) recording was performed in 214 hands of 107 healthy subjects. Ulnar NCS was performed with 2 different recording electrode montages (ADM-base of 5th finger; FDI-thumb) and differences in latency and amplitude were compared. Using this technique, the initial positivity of ulnar compound muscle action potential (CMAP) was not observed in any response with FDI recording. Results The maximal values for distal motor latency to the ADM and FDI muscle were 3.8 ms and 4.4 ms, respectively. The maximal difference of distal motor latency between the bilateral FDI recordings was 0.6 ms. The maximal ipsilateral latency difference between ADM and FDI was 1.4 ms. Conclusion Placement of the reference electrode on the thumb results in a CMAP without an initial positivity and the normative values obtained may be useful in the diagnosis of ulnar neuropathy at the wrist. PMID:22506188

2011-01-01

17

Ultrasonographic reference sizes of the median and ulnar nerves and the cervical nerve roots in healthy Japanese adults.  

PubMed

The objective of this study was to identify, for practical use, ultrasonographic reference values for nerve sizes at multiple sites, including entrapment and non-entrapment sites along the median and ulnar nerves and among the cervical nerve roots. We verified reliable sites and site-based differences between the reference values. In addition, we found associations between the reference nerve sizes and several physical characteristics (gender, dominant hand, age, height, weight, body mass index [BMI] and wrist circumference). Nerves were measured bilaterally at 26 sites or levels in 60 healthy Japanese adults (29 males; age, 35.4 ± 9.7 y; BMI, 22.3 ± 3.6 kg/m(2); wrist circumference, 16.0 ± 1.3 cm on the right side and 15.9 ± 1.2 cm on the left side). The mean reference nerve sizes were 5.6-9.1 mm(2) along the median nerve, 4.1-6.7 mm(2) along the ulnar nerve and 2.14-3.39 mm among the cervical nerve roots. Multifactorial regression analyses revealed that the physical characteristics most strongly associated with nerve size were age, BMI and wrist circumference at the entrapment sites (F = 7.6, p < 0.01, at the pisiform bone level of the carpal tunnel; F = 15.1, p < 0.001, at the level of Guyon's canal), as well as wrist circumference and gender at the non-entrapment sites (F = 70.6, p < 0.001, along the median nerve; F = 24.7, p < 0.001, along the ulnar nerve). Our results suggest that the factors with the greatest influence on nerve size differed between entrapment and non-entrapment sites. Site-based differences in nerve size were determined using one-way analyses of variance (p < 0.001). Intra- and inter-observer reliability was highest for the median nerve, at both the distal wrist crease and mid-humerus; at the arterial split along the ulnar nerve; and at the fifth cervical nerve root level. No systematic error was indicated by Bland-Altman analysis; the coefficients of variation were 5.5%-9.2% for intra-observer reliability and 7.1%-8.7% for inter-observer reliability. PMID:23830101

Sugimoto, Takamichi; Ochi, Kazuhide; Hosomi, Naohisa; Mukai, Tomoya; Ueno, Hiroki; Takahashi, Tetsuya; Ohtsuki, Toshiho; Kohriyama, Tatsuo; Matsumoto, Masayasu

2013-09-01

18

Case report: Double nerve transfer of the anterior and posterior interosseous nerves to treat a high ulnar nerve defect at the elbow.  

PubMed

Double neurotization of the deep branch of ulnar nerve (DBUN) and superficial branch of ulnar nerve using the anterior interosseous nerve (AIN) and the recurrent (thenar) branch of the median nerve was first described by Battiston and Lanzetta. This article details the postoperative results after 18months of a patient who underwent this technique using the posterior interosseous nerve (PIN) instead of the recurrent branch of the median nerve for sensory reconstruction. A 35-year-old, right-handed man suffered major trauma to his right upper limb following a serious motor vehicle accident. One year later, a pseudocystic neuroma of the ulnar nerve was evident on ultrasound examination and MRI. After the neuroma had been resected, the nerve defect was estimated at 8cm. One and a half years after the initial trauma, with the patient still at M0/S0, we transferred the AIN and PIN onto the deep and superficial branches of the ulnar nerve respectively. Nerve recovery was monitored clinically every month and by electromyography (EMG) every three months initially and then every six months. At 18months postoperative, 5th digit abduction/adduction was 28mm. Sensation was present at the base of the 5th digit. The patient was graded M3/S2. Clear re-innervation of the abductor digiti minimi was demonstrated by EMG (motor conduction velocity 50m/s). Given that the ulnar nerve could not be excited at the elbow, this re-innervation had to be the result of the double nerve transfer. Neurotization of the DBUN using the AIN produces functional results as early as 1year after surgery. Using PIN for sensory neurotization is easy to perform, has no negative consequences for the donor site, and leads to good recovery of sensation (graded as S2) after 18months. PMID:25260763

Delclaux, S; Aprédoaei, C; Mansat, P; Rongičres, M; Bonnevialle, P

2014-10-01

19

T2-Signal of Ulnar Nerve Branches at the Wrist in Guyon's Canal Syndrome  

PubMed Central

Objective To evaluate T2-signal of high-resolution MRI in distal ulnar nerve branches at the wrist as diagnostic sign of guyon’s-canal-syndrome (GCS). Materials and Methods 11 GCS patients confirmed by clinical/electrophysiological findings, and 20 wrists from 11 asymptomatic volunteers were prospectively included to undergo the following protocol: axial T2-weighted-fat-suppressed and T1-weighted-turbo-spin-echo-sequences (3T-MR-scanner, Magnetom/Verio/Siemens). Patients were examined in prone position with the arm extended and wrist placed in an 8-channel surface-array-coil. Nerve T2-signal was evaluated as contrast-to-noise-ratios (CNR) from proximal-to-distal in ulnar nerve trunk, its superficial/sensory and deep/motor branch. Distal motor-nerve-conduction (distal-motor-latency (dml)) to first dorsal-interosseus (IOD I) and abductor digiti minimi muscles was correlated with T2-signal. Approval by the institutional review-board and written informed consent was given by all participants. Results In GCS, mean nerve T2-signal was strongly increased within the deep/motor branch (11.7±4.8 vs.controls:?5.3±2.4;p?=?0.001) but clearly less and not significantly increased in ulnar nerve trunk (6.8±6.4vs.?7.4±2.5;p?=?0.07) and superficial/sensory branch (?2.1±4.9vs.?9.7±2.9;p?=?0.08). Median nerve T2-signal did not differ between patients and controls (?9.8±2.5vs.?6.7±4.2;p?=?0.45). T2-signal of deep/motor branch correlated strongly with motor-conduction-velocity to IOD I in non-linear fashion (R2?=??0.8;p<0.001). ROC-analysis revealed increased nerve T2-signal of the deep/motor branch to be a sign of excellent diagnostic performance (area-under-the-curve 0.94, 95% CI: 0.85–1.00; specificity 90%, sensitivity 89.5%). Conclusions Nerve T2-signal increase of distal ulnar nerve branches and in particular of the deep/motor branch is highly accurate for the diagnostic determination of GCS. Furthermore, for the first time it was found in nerve entrapment injury that T2-signal strongly correlates with electrical-conduction-velocity. PMID:23071777

Kollmer, Jennifer; Baumer, Philipp; Milford, David; Dombert, Thomas; Staub, Frank; Bendszus, Martin; Pham, Mirko

2012-01-01

20

Nerve lesioning with direct current  

NASA Astrophysics Data System (ADS)

Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

2011-02-01

21

Anterior intramuscular transposition of the ulnar nerve for cubital tunnel syndrome  

Microsoft Academic Search

Forty-five sequential cubital tunnel releases with anterior transposition of the ulnar nerve in an intramuscular fashion were performed over a 4-year period. All patients had a positive Tinel's sign at the cubital tunnel and reported numbness and tingling in the ring and small finger of the affected arm. Thirty-three cases had preoperative electrodiagnostic studies performed. Twenty-three cases had positive electromyographic

Keith A Glowacki; Arnold-Peter C Weiss

1997-01-01

22

Ulnar nerve neuropraxia after extracorporeal shock wave lithotripsy: a case report  

PubMed Central

A case is presented that illustrates and discusses the clinical presentation, diagnosis and chiropractic management of a 50-year-old male presenting with a case of ulnar neuropraxia following extracorporal shockwave lithotripsy. Onset is believed to be due to the patient’s arm position in full abduction and external rotation during the lithotripsy procedure. Motor abnormalities related to the ulnar nerve were noted in the absence of distinct sensory findings. Chiropractic treatment focused on relief of the patient’s pain during the course of the condition. Treatment may have helped in the rapid and complete resolution of his symptoms in this case. Poor patient positioning on hard surfaces, for extended periods may place pressure on superficial nerves resulting in nerve injury. In this case, the outcome was excellent, with complete resolution of symptoms less than one week later. The prognosis for this type of neuropraxia is usually good with conservative management. The patient history and chronological clinical course strongly suggest a causal association between the patient’s position during the procedure and the development of the ulnar neuropraxia. PMID:17549150

Konczak, Clark R

2005-01-01

23

Characterization of tests of functional recovery after median and ulnar nerve injury and repair in the rat forelimb.  

PubMed

The majority of human peripheral nerve injuries occur in the upper limb but the majority of studies in the rat are performed in the hindlimb. The upper and lower limbs differ in dexterity and control by supraspinal systems, so an upper limb model is a better representation of the common form of human injury. The purpose of this study was to further develop a rat model involving lesions of the median and ulnar nerves. To produce different degrees of misdirection of axons following nerve repair, we studied nerve crush, cut and repair of the two nerves, and cut and repair with crossover. Assessment of functional recovery was performed using a battery of motor and sensory tests: the staircase test, which assesses skilled forepaw reaching; grip strength meter, which assesses grip strength; pawprint analysis, which assesses toe spread and print length; horizontal ladder, which assesses forepaw placement during skilled locomotion; modified Randall-Selitto device and electronic von Frey probes, which assess fine touch; and cold probes, which assess temperature sensation. All tests revealed deficits in forepaw function after nerve injury except the print length and modified Randall-Selitto device. The time course of functional recovery was observed over 15 weeks. The final degree of functional recovery achieved was related to the misdirection of axon regeneration. The tests that most clearly revealed the effects of axon misdirection on function were the skilled paw reaching and grip strength tests. The lesion model and functional tests that we have developed will be useful in testing therapeutic strategies for treating the consequences of inaccurate axon regeneration following peripheral nerve injury in humans. PMID:17374098

Galtrey, Clare M; Fawcett, James W

2007-03-01

24

Endometriotic lesions of the lower troncular nerves.  

PubMed

Although exceptional, endometriotic lesions of the troncular nerves of the lower limb may occur and are often diagnosed with delay. We report, hereby, the first case of femoral nerve endometriosis the treatment of which consisted of radical resection with femoral nerve transplant. We completed a review of the literature on sciatic nerve endometriotic lesions and discussed the physiopathology and surgical treatment. PMID:25267476

Niro, J; Fournier, M; Oberlin, C; Le Tohic, A; Panel, P

2014-10-01

25

Correlation between the lengths of the upper limb and cubital tunnel: potential use in patients with proximal ulnar nerve entrapment  

Microsoft Academic Search

Introduction  We hypothesized that a correlation may exist between the length of the upper limb and the length of the cubital tunnel, which\\u000a transmits the ulnar nerve from the arm to the forearm. If true, this association might aid in predicting individuals at greater\\u000a risk of developing ulnar nerve compression at this site.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods  A total of 46 cadaveric upper

R. Shane Tubbs; Marios Loukas; Nihal Apaydin; Tiffany D. Cossey; Bulent Yalçin; Mohammadali M. Shoja; Aaron A. Cohen-Gadol

2010-01-01

26

Ulnar shortening after TFCC suture repair of Palmer type 1B lesions  

Microsoft Academic Search

Purpose  The objective of this study was to determine functional and subjective outcomes of an ulnar shortening procedure elected by\\u000a patients who experienced persistent ulno-carpal symptoms following arthroscopic suture repair of a Palmer type 1B lesion.\\u000a All patients had a dynamic ulna positive variance.\\u000a \\u000a \\u000a \\u000a Methods  Five patients (3 males and 2 females) with arthroscopic repair of Palmer type 1B tears who subsequently

Maya B. Wolf; Markus W. Kroeber; Andreas Reiter; Susanne B. Thomas; Peter Hahn; Raymund E. Horch; Frank Unglaub

2010-01-01

27

Comparison of anterior subcutaneous and submuscular transposition of ulnar nerve in treatment of cubital tunnel syndrome: A prospective randomized trial  

PubMed Central

Background: This study was designed to compare two methods of surgery, anterior subcutaneous transposition (ASCT) and anterior submuscular transposition (ASMT) of the ulnar nerve in treatment of cubital tunnel syndrome. Materials and Methods: This randomized trial study was conducted from October 2008 to March 2009 in the Department of Orthopedic Surgery at University Hospital. Forty-eight patients with confirmed cubital tunnel syndrome were randomized in two groups, and each patient received one of two different surgical treatment methods, either ASCT (n = 24) or ASMT (n = 24). In the ASCT technique, the ulnar nerve was transposed and retained in the subcutaneous bed, whereas in the ASMT, the nerve was retained deep in the transected muscular complex, near the median nerve. Patient outcomes, including pain, sensation, muscle strength, and muscle atrophy were compared between groups. Results: The two groups were similar in baseline characteristics. However, those treated with ASMT had a statistically significant reduction in their pain levels compared with ASCT (21 (87.5%) vs 8 (33.3%), P < 0.05). There were no statistically significant differences between the two groups relative to sensation (11 (45.8%) vs 12 (50%)), muscle strength (17 (70.8%) vs 15 (62.5%)), or muscle atrophy (15 (62.5%) vs 17 (70.8%)) (P > 0.05). Conclusions: Our results indicate that ASMT are more efficient than ASCT for managing cubital tunnel syndrome. In patients who had ASMT, there were significant reductions of pain compared with ASCT. PMID:23798941

Zarezadeh, Abolghassem; Shemshaki, Hamidreza; Nourbakhsh, Mohsen; Etemadifar, Mohammad R.; Moeini, Malihe; Mazoochian, Farhad

2012-01-01

28

Clinical features and electrodiagnosis of ulnar neuropathies.  

PubMed

In this review, we delineate clinical, electrodiagnostic, and radiographic features of ulnar mononeuropathies. Ulnar neuropathy at the elbow (UNE) is most commonly due to lesions at the level of the retroepicondylar groove (RTC), with approximately 25% at the humeroulnar arcade (HUA). The term 'cubital tunnel syndrome' should be reserved for the latter. The diagnostic accuracy of nerve conduction studies is limited by biological (e.g. low elbow temperature) and technical factors. Across-elbow distance measurements greater than 10 cm improve diagnostic specificity at the expense of decreased sensitivity. Short-segment incremental studies can differentiate lesions at the HUA from those at the RTC. PMID:23177030

Landau, Mark E; Campbell, William W

2013-02-01

29

[Ulnar nerve neuropathy in the elbow region: surgical findings and conclusions about the etiologic mechanism and indications for surgery].  

PubMed

The operative findings of 191 cases of so-called tardy ulnar neuritis are demonstrated. They may be divided into 2 groups, neuropathies associated with (67 cases) and without dislocation or subluxation of the nerve (124 cases). Cases of ulnar neuritis associated with dislocation of the nerve showing no other pathologic changes indicate that dislocation of the nerve alone may account for clinical signs. The next step is the formation of adhesions followed at a later date by formation of a pseudoneuroma. As this condition is mostly of congenital origin an additional factor is needed for including clinical manifestations such as direct or chronic professional trauma. Not enough importance has been attached to the strong triceps, with large muscle mass reaching far down to the olecranon, which might cause irritation of the nerve by pressing it against the wall of the sulcus or dislocating it over the epicondyle. In cases of neuropathy without dislocation/subluxation there is always a pathological finding even when there is no pseudoneuroma. The m. epitrochleoanconaeus is found in this category (14 cases, 11%). The cubital tunnel syndrom of OSBORNE in a very large sense (all possible causes of compression distal to the sulcus) has been found 28 times. Therapeutic measures aim at taking the nerve away from the causative irritation (anterior transposition) or at erradicating the cause (resection of the epicondyle, section of the arcus tendineus, excision of a tumor etc.). OSBORNE's operation has been performed only thrice. Subluxation or dislocation of the nerve may follow this procedure or the nerve is left more exposed to pressure than before. Deep submuscular transposition is preferred in patients less than 50 years old but other factors may determine the choice between deep and subcutaneous transposition such as the cause of the neuropathy, arthritis of the elbow joint, strength of the flexor muscle mass etc. PMID:186363

Nigst, H

1976-01-01

30

Effects of compression and devascularisation on ulnar nerve function. A quantitative study of regional blood flow and nerve conduction in monkeys.  

PubMed

This study investigated the effects of compression, devascularisation and ischaemia with compression on blood flow and function of the ulnar nerve in monkeys. The hydrogen washout technique assessed blood flow; nerve conduction tests determined nerve function. 100 g of external compression produced a significant but incomplete reduction of intraneural blood flow, when conduction velocity decreased significantly and response amplitude deteriorated to zero 28 minutes after the onset of compression. Short-segment devascularisation stopped blood flow but did not influence response latency or velocity. Amplitude was diminished significantly 44 minutes after devascularisation. Tourniquet ischaemia followed by compression produced temporary variability in latency and velocity, while amplitude was diminished only during the compression phase following ischaemia. The overall results suggested that compression and ischaemia influence the nerve conduction response differently and that the effects of compression are potentiated by previous ischaemia, even if this was of short duration. PMID:2007800

Ogata, K; Shimon, S; Owen, J; Manske, P R

1991-02-01

31

Subclinical Ulnar Neuropathy at the Elbow in Diabetic Patients  

PubMed Central

Objective To demonstrate the prevalence and characteristics of subclinical ulnar neuropathy at the elbow in diabetic patients. Methods One hundred and five patients with diabetes mellitus were recruited for the study of ulnar nerve conduction analysis. Clinical and demographic characteristics were assessed. Electrodiagnosis of ulnar neuropathy at the elbow was based on the criteria of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM1 and AANEM2). The inching test of the ulnar motor nerve was additionally performed to localize the lesion. Results The duration of diabetes, the existence of diabetic polyneuropathy (DPN) symptoms, the duration of symptoms, and HbA1C showed significantly larger values in the DPN group (p<0.05). Ulnar neuropathy at the elbow was more common in the DPN group. There was a statistically significant difference in the number of cases that met the three diagnostic criteria between the no DPN group and the DPN group. The most common location for ulnar mononeuropathy at the elbow was the retrocondylar groove. Conclusion Ulnar neuropathy at the elbow is more common in patients with DPN. If the conduction velocities of both the elbow and forearm segments are decreased to less than 50 m/s, it may be useful to apply the AANEM2 criteria and inching test to diagnose ulnar neuropathy. PMID:24639928

Jang, Ji Eun; Kim, Yun Tae; Park, Byung Kyu; Cheong, In Yae

2014-01-01

32

MR Neurography in Ulnar Neuropathy as Surrogate Parameter for the Presence of Disseminated Neuropathy  

PubMed Central

Purpose Patients with ulnar neuropathy of unclear etiology occasionally present with lesion extension from elbow to upper arm level on MRI. This study investigated whether MRI thereby distinguishes multifocal neuropathy from focal-compressive neuropathy at the elbow. Methods This prospective study was approved by the institutional ethics committee and written informed consent was obtained from all participants. 122 patients with ulnar mononeuropathy of undetermined localization and etiology by clinical and electrophysiological examination were assessed by MRI at upper arm and elbow level using T2-weighted fat-saturated sequences at 3T. Twenty-one patients were identified with proximal ulnar nerve lesions and evaluated for findings suggestive of disseminated neuropathy (i) subclinical lesions in other nerves, (ii) unfavorable outcome after previous decompressive elbow surgery, and (iii) subsequent diagnosis of inflammatory or other disseminated neuropathy. Two groups served as controls for quantitative analysis of nerve-to-muscle signal intensity ratios: 20 subjects with typical focal ulnar neuropathy at the elbow and 20 healthy subjects. Results In the group of 21 patients with proximal ulnar nerve lesion extension, T2-w ulnar nerve signal was significantly (p<0.001) higher at upper arm level than in both control groups. A cut-off value of 1.92 for maximum nerve-to-muscle signal intensity ratio was found to be sensitive (86%) and specific (100%) to discriminate this group. Ten patients (48%) exhibited additional T2-w lesions in the median and/or radial nerve. Another ten (48%) had previously undergone elbow surgery without satisfying outcome. Clinical follow-up was available in 15 (71%) and revealed definitive diagnoses of multifocal neuropathy of various etiologies in four patients. In another eight, diagnoses could not yet be considered definitive but were consistent with multifocal neuropathy. Conclusion Proximal ulnar nerve T2 lesions at upper arm level are detected by MRI and indicate the presence of a non-focal disseminated neuropathy instead of a focal compressive neuropathy. PMID:23166762

Baumer, Philipp; Weiler, Markus; Ruetters, Maurice; Staub, Frank; Dombert, Thomas; Heiland, Sabine; Bendszus, Martin; Pham, Mirko

2012-01-01

33

Pathomechanisms of ulnar ligament lesions of the wrist in a cadaveric distal radius fracture model  

PubMed Central

Background and purpose Mechanisms of injury to ulnar-sided ligaments (stabilizing the distal radioulnar joint and the ulna to the carpus) associated with dorsally displaced distal radius fractures are poorly described. We investigated the injury patterns in a human cadaver fracture model. Methods Fresh frozen human cadaver arms were used. A dorsal open-wedge osteotomy was performed in the distal radius. In 8 specimens, pressure was applied to the palm with the wrist in dorsiflexion and ulnar-sided stabilizing structures subsequently severed. Dorsal angulation was measured on digitized radiographs. In 8 other specimens, the triangular fibrocartilage complex (TFCC) was forced into rupture by axially loading the forearm with the wrist in dorsiflexion. The ulnar side was dissected and injuries were recorded. Results Intact ulnar soft tissues limited the dorsal angulation of the distal radius fragment to a median of 32o (16–34). A combination of bending and shearing of the distal radius fragment was needed to create TFCC injuries. Both palmar and dorsal injuries were observed simultaneously in 6 of 8 specimens. Interpretation A TFCC injury can be expected when dorsal angulation of a distal radius fracture exceeds 32o. The extensor carpi ulnaris subsheath may be a functionally integral part of the TFCC. Both dorsal and palmar structures can tear simultaneously. These findings may have implications for reconstruction of ulnar sided soft tissue injuries. PMID:21504313

2011-01-01

34

Ruptured ulnar artery pseudoaneurysm  

Microsoft Academic Search

Ulnar artery aneurysms and pseudoaneurysms are rare lesions that usually occur distal to the wrist and cause symptoms as a result of embolization and not rupture. An elderly woman presented with acute rupture of an ulnar artery pseudoaneurysm proximal to the wrist, which caused severe neurologic compromise as a result of bleeding into Guyon's canal and the carpal tunnel. The

Luke S. Erdoes; William C. Brown

1995-01-01

35

Ulnar Neuropathy at the Wrist in a Patient with Carpal Tunnel Syndrome after Open Carpal Tunnel Release  

PubMed Central

Ulnar neuropathy at the wrist is rarely reported as complications of carpal tunnel release. Since it can sometimes be confused with recurrent median neuropathy at the wrist or ulnar neuropathy at the elbow, an electrodiagnostic study is useful for detecting the lesion in detail. We present a case of a 51-year-old woman with a two-week history of right ulnar palm and 5th digit tingling sensation that began 3 months after open carpal tunnel release surgery of the right hand. Electrodiagnostic tests such as segmental nerve conduction studies of the ulnar nerve at the wrist were useful for localization of the lesion, and ultrasonography helped to confirm the presence of the lesion. After conservative management, patient symptoms were progressively relieved. Combined electrodiagnostic studies and ultrasonography may be helpful for diagnosing and detecting ulnar neuropathies of the wrist following carpal tunnel release surgery. PMID:22639758

Kim, Nack Hwan

2012-01-01

36

High-resolution MR neurography of diffuse peripheral nerve lesions.  

PubMed

High-resolution MR imaging of peripheral nerves is becoming more common and practical with the increasing availability of 3T magnets. There are multiple reports of MR imaging of peripheral nerves in compression and entrapment neuropathies. However, there is a relative paucity of literature on MRN appearance of diffuse peripheral nerve lesions. We attempted to highlight the salient imaging features of myriad diffuse peripheral nerve disorders and imaging techniques for MRN. Using clinical and pathologically proved relevant examples, we present the MRN appearance of various types of diffuse peripheral nerve lesions, such as traumatic, inflammatory, infectious, hereditary, radiation-induced, neoplastic, and tumor variants. PMID:20966057

Thawait, S K; Chaudhry, V; Thawait, G K; Wang, K C; Belzberg, A; Carrino, J A; Chhabra, A

2011-09-01

37

Nerve compression syndromes of the hand and forearm associated with tumours of non-neural origin and tumour-like lesions.  

PubMed

Nerve compression syndromes caused by non-neural tumours or tumour-like lesions are rare. We retrospectively reviewed 541 consecutive patients operated on by the same surgeon to study nerve compression syndromes in the forearm and hand. There were 414 due to nerve compression and 127 caused by tumours. Twenty-two patients showed compression neuropathy associated with 17 tumours and six tumour-like lesions, with 13 different pathological types. The most common types were fatty and vascular tumours. Twenty-one tumours were extraneural and one was intraneural. The median nerve was affected in nine cases, the ulnar nerve or the dorsal sensory branch of the ulnar nerve in five cases, the posterior interosseous nerve or the superficial radial branch in four cases and the common digital nerves in two cases. There was a concomitant involvement of the median and ulnar nerves in two other patients. Clinically, there were eight different compression neuropathies, of which the most frequent was the carpal tunnel syndrome. The postoperative histology was consistent with preoperative magnetic resonance imaging findings in the vascular and fatty tumours. Pain disappeared completely in 15 out of 16 patients with preoperative pain. All patients had preoperative paraesthesia, which persisted after tumour excision in three patients: attenuated in two patients and unchanged in one. In three patients, we did not observe any change in paresis or amyotrophy. The mean postoperative follow-up was 31 months, without tumour recurrence. The quick Disabilities of the Arm, Shoulder and Hand (DASH) score went from 49.9 points preoperatively to 10.2 points after surgery. PMID:24593940

Martínez-Villén, G; Badiola, J; Alvarez-Alegret, R; Mayayo, E

2014-06-01

38

Ulnar neuropathy caused by a widespread synovial cyst of the elbow joint in a patient with rheumatoid arthritis.  

PubMed

A 53-year-old man with rheumatoid arthritis presented with radiating pain, numbness, and diminished motor strength in the right hand according to the ulnar nerve functions. Magnetic resonance imaging and peripheral nerve ultrasound revealed a widespread cystic lesion descending from the elbow joint along the ulnar nerve over a length of 8 cm. After relapse under a therapeutic attempt with antirheumatic drugs, neurosurgical exploration was done using peripheral nerve ultrasound. A synovial cyst of the elbow was extirpated as a whole with subsequent anterior synovectomy. The postoperative course was uneventful with gradual recovery of function. PMID:24819623

Scholz, Christoph; Gierthmuehlen, Mortimer; Egger, Karl; Hauschild, Oliver; van Velthoven-Wurster, V

2014-11-01

39

Inhibitory Effect of Acupuncture on Vibration-Induced Finger Flexion Reflex in Humans: Comparisons Among Radial, Median, and Ulnar Nerve Stimulation  

PubMed Central

Abstract Background Vibration-induced finger flexion reflex (VFR) is inhibited with acupuncture to TE 5 or LI 4 at the skin innervated by the radial nerve. Objective The aim of this study was to determine if acupoints in regions innervated by the radial nerve are specific to inhibit VFR. Materials and Methods This experiment was performed using a crossover design with 3 acupuncture groups (needle insertion to the right LU 11, PC 9, or SI 1) and a control group (no needle treatment). Each acupoint was randomly needled on separate days. Ten healthy volunteers were recruited for this study. VFR was induced by applying vibration on the volar side of the right middle fingertip. An acupuncture needle was inserted in the acupoint and retained for 5 minutes. For the main outcome measure, maximum finger flexion force (MFFF) was measured during vibration and was compared among four groups. Results MFFFs in the acupuncture groups were significantly lower (p<0.05) than that in the control group. However, no significant difference was observed in MFFFs in the three intervention groups after acupuncture to LU 11, PC 9, and SI 1. Conclusions Acupuncture to the right LU 11, PC 9, or SI 1 point inhibited the ipsilateral VFR, which suggests that afferent inputs from the radial nerve with needle insertion were not specific, compared with those from the median and ulnar nerves to suppress neuronal activities in the VFR reflex circuits. PMID:24761176

Takayama, Miho; Kawase, Akiko; Takakura, Nobuari; Izumizaki, Masahiko; Homma, Ikuo

2013-01-01

40

Clinical and Electrodiagnostic Work-up of Peripheral Nerve Lesions  

Microsoft Academic Search

Diagnostic work-up of patients with peripheral nerve lesions includes a detailed evaluation of the clinical history, a thorough\\u000a search for predisposing factors and trigger events, palpation at the suspected lesion site, specific provocation maneuvers\\u000a and assessment of motor deficits (distribution, muscle power and atrophy), sensory disturbances (distribution and quality)\\u000a and autonomic impairment (sudomotor activity) — all embedded in a careful

Stefan Kiechl

41

Microsurgical repair of nerve lesions with nerve grafts: the effect of nerve growth factor 7S  

Microsoft Academic Search

This study investigated the effect of local administration of nerve growth factor 7S (NGF-7S) on the axonal regrowth of mixed peripheral nerves through nerve grafts. Sixty male Wistar rats were randomized into two groups (n=30). A defect 12 mm long in the right sciatic nerve was created and repaired with a nerve autograft. NGF-7S (group A) or normal saline (group

Andreas I. Gravvanis; Efstathios G. Lykoudis; George A. Tagaris; Charalampos G. Patralexis; Apostolos E. Papalois; Petros N. Panayotou; Constantinos N. Stamatopoulos; John D. Ioannovich

2002-01-01

42

Altered thermal sensitivity in neurons injured by infraorbital nerve lesion.  

PubMed

Nerve lesions are common injuries. While peripheral sensitivity is lost, the partially regenerating nerve undergoes a complex transformation, occasionally leading to persistent pain syndromes. Changes of thermal perception following nerve injury have received little attention. This study investigates the sensitivity of trigeminal neurons after infraorbital nerve lesion in guinea-pigs. Cultured trigeminal neurons innervating the area of denervation were identified by retrograde transport of DiI deposited at the site of the lesion. The standardized protocol consisted of cold and heat stimulation starting from body temperature as well as application of menthol and capsaicin, while activation was quantified by Fura-2-based calcium microfluorimetry. Compared to neurons from control animals, DiI-positive neurons were similar in the percentage and extend of the responses to menthol and capsaicin. However, DiI-positive neurons were less responsive to cold stimulation and had a lower cold threshold when compared to DiI-negative or control neurons. At the same time, DiI-positive neurons were more responsive to heat stimulation and had a lower heat threshold compared to control neurons. In summary, the percentage of trigeminal neurons responsive to thermal or chemical stimulation did not change after axotomy. However, thermal sensitivity of these neurons was altered. PMID:21078368

Schmid, Damaris; Messlinger, Karl; Belmonte, Carlos; Fischer, Michael J M

2011-01-20

43

Examination of Postoperative Peripheral Nerve Lesions with High-Resolution Sonography  

Microsoft Academic Search

OBJECTIVE . Peripheral nerve lesions after surgery are common and are related either to direct compromise of the nerve by the surgical procedure (iatrogenic lesions) or to postopera- tive events such as scar formation. Despite a high sensitivity, electrodiagnosis may not reveal the exact location and cause of a nerve lesion. We hypothesized that high-resolution sonogra- phy could be helpful

Siegfried Peer; Gerd Bodner; Romed Meirer; Johann Willeit; Hildegunde Piza-Katzer

2001-01-01

44

The use of thoracodorsal nerve transfer in restoration of irreparable C5 and C6 spinal nerve lesions.  

PubMed

There are only a few reports on the use of thoracodorsal nerve (TDN) transfer to the musculocutaneous or axillary nerves in cases of directly irreparable brachial plexus injuries. In this study, we analysed outcome and time-course of recovery in correlation with recipient nerves and type of nerve transfer (isolated or in combination with other collateral branches) for 27 patients with transfer to the musculocutaneous or axillary nerves. Using this nerve as donor, we obtained useful functional recovery in all 12 cases for the musculocutaneous nerve, and in 14 (93.3%) of 15 nerve transfers for the axillary nerve. Although, we found no significant statistical difference between analysed patients according to the percentage of recoveries and mean values, we established a better quality and shorter time of recovery for the musculocutaneous nerve. According to obtained results, we consider that transfer may be a valuable method in reconstruction after directly irreparable C5 and C6 spinal nerve lesions. PMID:15897040

Samardzic, M M; Grujicic, D M; Rasulic, L G; Milicic, B R

2005-06-01

45

Dermatological and immunological conditions due to nerve lesions.  

PubMed

Some syndromes are of interest to both neurologists and dermatologists, because cutaneous involvement may harbinger symptoms of a neurological disease. The aim of this review is to clarify this aspect. The skin, because of its relationships with the peripheral sensory nervous system, autonomic nervous system and central nervous system, constitutes a neuroimmunoendocrine organ. The skin contains numerous neuropeptides released from sensory nerves. Neuropeptides play a precise role in cutaneous physiology and pathophysiology, and in certain skin diseases. A complex dysregulation of neuropeptides is a feature of some diseases of both dermatological and neurological interest (e.g. cutaneous and nerve lesions following herpes zoster infection, cutaneous manifestations of carpal tunnel syndrome, trigeminal trophic syndrome). Dermatologists need to know when a patient should be referred to a neurologist and should consider this option in those presenting with syndromes of unclear etiology. PMID:24125557

Bove, D; Lupoli, A; Caccavale, S; Piccolo, V; Ruocco, E

2013-01-01

46

Dermatological and immunological conditions due to nerve lesions  

PubMed Central

Summary Some syndromes are of interest to both neurologists and dermatologists, because cutaneous involvement may harbinger symptoms of a neurological disease. The aim of this review is to clarify this aspect. The skin, because of its relationships with the peripheral sensory nervous system, autonomic nervous system and central nervous system, constitutes a neuroimmunoendocrine organ. The skin contains numerous neuropeptides released from sensory nerves. Neuropeptides play a precise role in cutaneous physiology and pathophysiology, and in certain skin diseases. A complex dysregulation of neuropeptides is a feature of some diseases of both dermatological and neurological interest (e.g. cutaneous and nerve lesions following herpes zoster infection, cutaneous manifestations of carpal tunnel syndrome, trigeminal trophic syndrome). Dermatologists need to know when a patient should be referred to a neurologist and should consider this option in those presenting with syndromes of unclear etiology. PMID:24125557

Bove, Domenico; Lupoli, Amalia; Caccavale, Stefano; Piccolo, Vincenzo; Ruocco, Eleonora

2013-01-01

47

The Nerve of Henle: An Anatomic and Immunohistochemical Study  

Microsoft Academic Search

The topography of the nerve of Henle was reviewed. Fifty-two human cadaveric upper extremities were studied. In 30 (58%) the nerve was well defined; in 22 (42%) its origin from the ulnar nerve was unidentifiable. The palmar cutaneous branch of the ulnar nerve separated from the ulnar nerve 5 to 11 cm distal to the medial epicondyle of the humerus

Brigitta Balogh; Julia Valencak; Michael Vesely; Martina Flammer; Helmut Gruber; Hildegunde Piza-Katzer

1999-01-01

48

Anatomy of the ulnar artery as it relates to the transverse carpal ligament  

Microsoft Academic Search

The anatomic relationship between the ulnar artery and transverse carpal ligament (TCL) as an aid in planning for minimally invasive carpal tunnel surgery was investigated. The anatomic course of the ulnar artery and its branches toward the TCL and the location of the median nerve were determined in 24 fresh cadaver hands perfused with a silicone compound. The ulnar artery

Shohei Omokawa; Yasuhito Tanaka; Jaiyoung Ryu; Junzo Suzuki; Vincent L. Kish

2002-01-01

49

Electrodiagnostic evaluation of carpal tunnel syndrome and ulnar neuropathies.  

PubMed

Carpal tunnel syndrome (CTS) and ulnar mononeuropathies at the elbow and wrist are the most common nerve entrapments in the upper extremities. Electrodiagnostic studies are a valid and reliable means of confirming the clinical diagnosis. This review addresses various electrodiagnostic techniques to evaluate the median and ulnar nerves at the wrist and elbow. It also discusses the limitations of electrodiagnostic studies with regard to the sensitivity and specificity of such testing. PMID:23542773

Werner, Robert A

2013-05-01

50

Radial nerve lesions associated with fractures of the humeral shaft.  

PubMed

Radial nerve palsy associated with a fracture of the shaft of the humerus is a relatively common injury. Out of 91 radial nerve injuries, operated upon in the Neurosurgical University Clinic in Belgrade from 1979 to 1988, 37 were associated with fractures of the humeral shaft or their surgical treatment. These fractures were previously treated in other medical units. In all cases a microsurgical reconstruction of the radial nerve was done: an interfascicular neurolysis in 24 cases and interfascicular grafting in 13 cases. A useful functional recovery was obtained in 91.9 per cent of the cases. Timing of nerve exploration and repair, as a main problem, is discussed. PMID:2228192

Samardzi?, M; Grujici?, D; Milinkovi?, Z B

1990-07-01

51

A rare human variation a major branch of the ulnar artery found in the carpal tunnel  

Microsoft Academic Search

During a routine anatomic dissection of a 60-year-old female cadaver, a large branch of the ulnar artery in the carpal tunnel was found in the left forearm. This branch crossed the median nerve anteriorly. Guyon’s canal contained another branch of the ulnar artery and the ulnar nerve. There was no superficial palmar arch in the left hand. The right forearm

I. Tcacencu

2001-01-01

52

The Ulnar Tunnel at the Wrist (Guyon's Canal): NormalMR Anatomy  

Microsoft Academic Search

The ulnar tunnel (Guyon's canal) is a fibroosseous tunnel along the anteromedial portion of the wrist that contains the ulnar nerve and artery. As with the adjacent carpal tunnel, its main clinical significance is that it may cause nerve compression. The purpose of this study was to determine whether the anatomy of this area could be depicted in sufficient detail

Jacob Zeiss

53

The effect of nerve root lesioning on various somatosensory evoked potentials in the hog.  

PubMed

Somatosensory evoked potentials (SEPs) were recorded at the lumbar spine following stimulation of the tibial nerve (mixed-nerve SEP; MSEP), the sural nerve (specific nerve SEP; SSEP), and the skin corresponding to the L6 and S1 dermatomes (dermatomal field SEP; DSEP-L and DSEP-S) in the hog. To determine the sensitivity of these three SEPs to the single nerve root (S1 root) function, the effects of nerve roots lesioning were investigated. Cutting S1 nerve root reduced the peak-to-peak amplitude of MSEP by only 28% in comparison with baseline values. The relative amplitudes of SSEP, DSEP-L, and DSEP-S were decreased by 46%, 11% and 51%, respectively. When S1 nerve root was left intact and L5, L6, and S2 nerve roots were cut, the relative amplitudes of MSEP, SSEP, DSEP-L, and DSEP-S were decreased to 68%, 73%, 31%, and 74%, respectively. These results indicate that DSEP-S is as sensitive to the function of S1 nerve root as SSEP but the sensitivities of DSEP-S and SSEP are low in the hog. MSEP is shown unsuitable to monitor the single nerve root dysfunction. PMID:8367778

Terada, K; Larson, B J; Owen, J H; Sugioka, Y

1993-06-15

54

[Lesions of the peripheral nerves: MR neurography as an innovative supplement to electrodiagnostics].  

PubMed

The diagnostic work-up of peripheral neuropathies largely depends on neurophysiological investigations. Recently, progress in magnetic resonance imaging (MRI) has lead to new perspectives in the diagnostics of disorders of the peripheral nervous system (PNS). Experimental data show how MR neurography visualises axonal and demyelinating lesions of the PNS. In clinical use, difficult cases of focal nerve compression, traumatic or inflammatory lesions can be solved by the combination of MR neurography and neurophysiology. In particular, the localisation of nerve lesions can be improved by MR techniques. Furthermore, MR neurography enables new insights in the pathophysiology of neuropathies which will be shown for diabetic polyneuropathy. PMID:22833069

Wessig, C; Bendszus, M; Reiners, K; Pham, M

2012-06-01

55

Sparing of the second lumbrical in a Riche-Cannieu anastomosis: the nearly all-ulnar hand.  

PubMed

The Riche-Cannieu anastomosis (RCA) is an anatomic variant wherein a deep branch of the distal ulnar nerve innervates muscles of the thenar eminence. A few cases in the literature describe an "all-ulnar hand" when the muscles of the thenar eminence get innervation solely from the ulnar nerve without any contribution from the median nerve. Clinically, patients with ulnar mononeuropathies in the setting of an RCA would also have weakness/atrophy of thenar muscles. Conversely, patients with median mononeuropathies would have sparing of these muscles. This case highlights RCA in the setting of carpal tunnel syndrome and documents the persistent innervation of the second lumbrical by the median nerve. No anatomic dissections have disclosed innervation of the second lumbrical by the deep ulnar nerve, negating the concept of the all-ulnar hand. PMID:23703014

Brown, Joseph V; Landau, Mark E

2013-06-01

56

Diagnosing ulnar neuropathy at the elbow using magnetic resonance neurography  

Microsoft Academic Search

Introduction  Early diagnosis of ulnar neuropathy at the elbow is important. Magnetic resonance neurography (MRN) images peripheral nerves.\\u000a We evaluated the usefulness of elbow MRN in diagnosing ulnar neuropathy at the elbow.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The MR neurograms of 21 patients with ulnar neuropathy were reviewed retrospectively. MRN was performed prospectively on 10\\u000a normal volunteers. The MR neurograms included axial T1 and axial T2

Nayela N. Keen; Cynthia T. Chin; John W. Engstrom; David Saloner; Lynne S. Steinbach

57

Diagnostic Value of Ultrasonography and Magnetic Resonance Imaging in Ulnar Neuropathy at the Elbow  

PubMed Central

Aim. To evaluate the diagnostic value of ultrasonography and magnetic resonance imaging (MRI) in patients with ulnar neuropathy at the elbow (UNE). Methods. We prospectively performed electrodiagnostic, ultrasonographic, and MRI studies in UNE patients and healthy controls. Three cross-sectional area (CSA) measurements of the ulnar nerve at multiple levels along the arm and maximum CSA(-max) were recorded. Results. The ulnar nerve CSA measurements were different between the UNE severity grades (P < 0.05). CSA-max had the greatest sensitivity (93%) and specificity (68%). Moreover, CSA-max ?10?mm2 defined the severe UNE cases (sensitivity/specificity: 82%/72%). In MRI, ulnar nerve hyperintensity had the greatest sensitivity (90%) and specificity (80%). Conclusion. Ultrasonography using CSA-max is sensitive and specific in UNE diagnosis and discriminating the severe UNE cases. Furthermore, MRI particularly targeting at increased signal of the ulnar nerve can be a useful diagnostic test of UNE. PMID:22888452

Ayromlou, Hormoz; Tarzamni, Mohammad K.; Daghighi, Mohammad Hossein; Pezeshki, Mohammad Zakaria; Yazdchi, Mohammad; Sadeghi-Hokmabadi, Elyar; Sharifipour, Ehsan; Ghabili, Kamyar

2012-01-01

58

Rat whisker movement after facial nerve lesion: evidence for autonomic contraction of skeletal muscle.  

PubMed

Vibrissal whisking is often employed to track facial nerve regeneration in rats; however, we have observed similar degrees of whisking recovery after facial nerve transection with or without repair. We hypothesized that the source of non-facial nerve-mediated whisker movement after chronic denervation was from autonomic, cholinergic axons traveling within the infraorbital branch of the trigeminal nerve (ION). Rats underwent unilateral facial nerve transection with repair (N=7) or resection without repair (N=11). Post-operative whisking amplitude was measured weekly across 10weeks, and during intraoperative stimulation of the ION and facial nerves at ?18weeks. Whisking was also measured after subsequent ION transection (N=6) or pharmacologic blocking of the autonomic ganglia using hexamethonium (N=3), and after snout cooling intended to elicit a vasodilation reflex (N=3). Whisking recovered more quickly and with greater amplitude in rats that underwent facial nerve repair compared to resection (P<0.05), but individual rats overlapped in whisking amplitude across both groups. In the resected rats, non-facial-nerve-mediated whisking was elicited by electrical stimulation of the ION, temporarily diminished following hexamethonium injection, abolished by transection of the ION, and rapidly and significantly (P<0.05) increased by snout cooling. Moreover, fibrillation-related whisker movements decreased in all rats during the initial recovery period (indicative of reinnervation), but re-appeared in the resected rats after undergoing ION transection (indicative of motor denervation). Cholinergic, parasympathetic axons traveling within the ION innervate whisker pad vasculature, and immunohistochemistry for vasoactive intestinal peptide revealed these axons branching extensively over whisker pad muscles and contacting neuromuscular junctions after facial nerve resection. This study provides the first behavioral and anatomical evidence of spontaneous autonomic innervation of skeletal muscle after motor nerve lesion, which not only has implications for interpreting facial nerve reinnervation results, but also calls into question whether autonomic-mediated innervation of striated muscle occurs naturally in other forms of neuropathy. PMID:24480367

Heaton, James T; Sheu, Shu Hsien; Hohman, Marc H; Knox, Christopher J; Weinberg, Julie S; Kleiss, Ingrid J; Hadlock, Tessa A

2014-04-18

59

Traumatic Distal Ulnar Artery Thrombosis  

PubMed Central

This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome) but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

Karaarslan, Ahmet A.; Karakasl?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, Senol

2014-01-01

60

An Unusual Cause of Pseudomedian Nerve Palsy  

PubMed Central

We describe a patient who presented with an acute paresis of her distal right hand suggesting a peripheral median nerve lesion. However, on clinical examination a peripheral origin could not be verified, prompting further investigation. Diffusion-weighted magnetic resonance imaging revealed an acute ischaemic lesion in the hand knob area of the motor cortex. Isolated hand palsy in association with cerebral infarction has been reported occasionally. However, previously reported cases presented predominantly as ulnar or radial palsy. In this case report, we present a rather rare finding of an acute cerebral infarction mimicking median never palsy. PMID:22937340

Manjaly, Zina-Mary; Luft, Andreas R.; Sarikaya, Hakan

2011-01-01

61

Synthesis and localization of ciliary neurotrophic factor in the sciatic nerve of the adult rat after lesion and during regeneration  

PubMed Central

Ciliary neurotrophic factor (CNTF) is expressed in high quantities in Schwann cells of peripheral nerves during postnatal development of the rat. The absence of a hydrophobic leader sequence and the immunohistochemical localization of CNTF within the cytoplasm of these cells indicate that the factor might not be available to responsive neurons under physiological conditions. However, CNTF supports the survival of a variety of embryonic neurons, including spinal motoneurons in culture. Moreover we have recently demonstrated that the exogenous application of CNTF protein to the lesioned facial nerve of the newborn rat rescued these motoneurons from cell death. These results indicate that CNTF might indeed play a major role in assisting the survival of lesioned neurons in the adult peripheral nervous system. Here we demonstrate that the CNTF mRNA and protein levels and the manner in which they are regulated are compatible with such a function in lesioned peripheral neurons. In particular, immunohistochemical analysis showed significant quantities of CNTF at extracellular sites after sciatic nerve lesion. Western blots and determination of CNTF biological activity of the same nerve segments indicate that extracellular CNTF seems to be biologically active. After nerve lesion CNTF mRNA levels were reduced to less than 5% in distal regions of the sciatic nerve whereas CNTF bioactivity decreased to only one third of the original before-lesion levels. A gradual reincrease in Schwann cells occurred concomitant with regeneration. PMID:1618901

1992-01-01

62

Nerve compression injuries due to traumatic false aneurysm.  

PubMed

Experience with 17 patients with delayed onset of compression neuropraxia due to hemorrhage following nonoperative treatment of penetrating arterial injuries is presented. Fifteen cases involved the arteries of the neck shoulder girdle and upper extremity and two the gluteal vessels. This resulted in dysfunction of components of the brachial plexus, median ulnar, and sciatic nerves. Follow-up extended from 3 to 18 months. Of 10 brachial plexus lesions two recovered fully, five partially, and three not at all. Of seven peripheral nerve injuries, full recovery occurred in two patients and none in five. Adverse prognostic factors for neurological recovery are sepsis, involvement of intrinsic hand innervation and the sciatic nerve. An improved prognosis may be expected for upper trunk lesions of the brachial plexus and radial nerve lesions. The complication is essentially avoidable and a careful appraisal of the circulatory status must be made in all patients with penetrating trauma in the neck and shoulder girdle and buttock. PMID:6732331

Robbs, J V; Naidoo, K S

1984-07-01

63

Degeneration and regeneration of motor and sensory nerves: a stereological study of crush lesions in rat facial and mental nerves.  

PubMed

The aim of this study was to evaluate the degeneration and regeneration of a sensory nerve and a motor nerve at the histological level after a crush injury. Twenty-five female Wistar rats had their mental nerve and the buccal branch of their facial nerve compressed unilaterally against a glass rod for 30s. Specimens of the compressed nerves and the corresponding control nerves were dissected at 3, 7, and 19 days after surgery. Nerve cross-sections were stained with osmium tetroxide and toluidine blue and analysed using two-dimensional stereology. We found differences between the two nerves both in the normal anatomy and in the regenerative pattern. The mental nerve had a larger cross-sectional area including all tissue components. The mental nerve had a larger volume fraction of myelinated axons and a correspondingly smaller volume fraction of endoneurium. No differences were observed in the degenerative pattern; however, at day 19 the buccal branch had regenerated to the normal number of axons, whereas the mental nerve had only regained 50% of the normal number of axons. We conclude that the regenerative process is faster and/or more complete in the facial nerve (motor function) than it is in the mental nerve (somatosensory function). PMID:23731889

Barghash, Z; Larsen, J O; Al-Bishri, A; Kahnberg, K-E

2013-12-01

64

Neural fibrolipoma of a digital nerve of the index finger without macrodactyly.  

PubMed

We present a case of neural fibrolipoma arising from the digital nerve in the index finger of the right hand. A 31-year-old man was referred with a soft tissue mass in the ulnar aspect of the index finger of his right hand, which had gradually enlarged during the past seven years. Histological examination of an excisional biopsy specimen identified a neural fibrolipoma, which is a differential diagnosis of a lipomatous lesion of the digits. PMID:20158413

Avci, Gülden; Akan, Mithat; Taylan, Gaye; Akoz, Tayfun

2010-11-01

65

Ulnar-sided wrist pain. II. Clinical imaging and treatment  

PubMed Central

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. PMID:20012039

Watanabe, Atsuya; Souza, Felipe; Vezeridis, Peter S.; Blazar, Philip

2009-01-01

66

Trypanosoma cruzi infection in rats induced early lesion of the heart noradrenergic nerve terminals by a complement-independent mechanism  

Microsoft Academic Search

Summary The acute phase of the experimental Chagas' disease in rats induces extensive lesion of the heart sympathetic nerve terminals. Because of evidence indicating the involvement of immune reactions in neuron destruction provoked by Chagas' disease, we tested the effects of depleting the complement system by cobra venom factor upon the sympathetic denervation. The serum hemolytic activity against sensitized sheep

C. R. S. Machado; D. A. de Oliveira; E. M. R. D. Carvalho; F. J. Ramalho-Pinto

1994-01-01

67

Usefulness of Ultrasound for Detecting Suspected Peripheral Nerve Lesions in Diagnosis of Peripheral Neuropathy : Case Report and Brief Review of the Literature  

PubMed Central

Ultrasound scanning of a peripheral nerve along its expected course is a simple and useful method for determining the cause of peripheral neuropathy. We present 3 cases of peripheral neuropathy in which the pathology was detected by simple ultrasound scanning of the affected nerve. There were 2 cases of entrapment neuropathy due to mucoid cyst and 1 case of nerve sheath tumor. All lesions were visualized by simple ultrasound scanning of the involved peripheral nerve. Our results suggest that if a lesion affecting the peripheral nerve is suspected after history and physical examination or electrophysiologic studies, ultrasound scanning of the peripheral nerve of interest throughout its course is very helpful for identifying the causative lesion. PMID:23560182

Kim, Kwang-Hai; Choi, Soon-Kyoo; Shim, Jae-Hyun

2013-01-01

68

[Ulnar head prosthesis].  

PubMed

The ulnar head prosthesis has been the subject of a prospective multicenter-study since 1995. Until 2000, it has been used in 57 patients by the study group. In 35 patients, the indication was painful instability of the distal end of the ulna following previous resection arthroplasties, and in 22 patients it was painful arthritis of the distal radioulnar joint (DRUJ). The mean follow-up was 38 months. Pronation increased from a preoperative mean of 63 degrees to a postoperative value of 78 degrees, while supination increased from 43 degrees to 76 degrees. Grip strength improved from a preoperative mean of 51% to a postoperative mean of 77% of the opposite limb. Pain, measured on the verbal pain scale (1-4), was reduced remarkably from a preoperative mean level of 3.6 to a postoperative mean of 1.7. Patient' satisfaction was evaluated using the visual analog scale (0-10) and improved from a preoperative mean of 2.1 to a postoperative mean of 7.9. With one exception of loosening, we consistently found bony integration of the shaft of the prosthesis. Stability of the DRUJ was achieved in all but three patients. This method has given reliable and excellent results as a salvage procedure for failed resection arthroplasties of the DRUJ with painful instability of the distal end of the ulna. We consider the method an alternative treatment option for the arthritically destroyed DRUJ. Sufficient soft tissue to stabilise the prosthesis is needed to successfully reconstruct the DRUJ. PMID:14508648

V Schoonhoven, J; Herbert, T J; Fernandez, D L; Prommersberger, K-J; Krimmer, H

2003-09-01

69

Repetitive common peroneal nerve stimulation increases ankle dorsiflexor motor evoked potentials in incomplete spinal cord lesions.  

PubMed

Plasticity of corticospinal tract (CST) activity likely plays a key role in motor function recovery after central nervous system (CNS) lesions. In non-injured adults, 30 min of repetitive common peroneal nerve stimulation (rCPnS) increases CST excitability by 40-50% and the effect persists for at least 30 min. The present study evaluated with transcranial magnetic stimulation (TMS) the changes in CST excitability after 30 min of rCPnS in people with foot drop due to incomplete SCI. Suprathreshold rCPnS (25 Hz, alternating 1 s on 1 s off stimulation cycle) was given for two 15-min periods, while the subject sat at rest with ankle and knee joints fixed. Before, between, and after the periods of stimulation, the tibialis anterior (TA) motor evoked potentials (MEPs) to TMS were measured at a TMS intensity that originally produced a half-maximum MEP (typically 10-20% above threshold) while the sitting subject provided 25-30% maximum voluntary TA contraction. In 10 subjects with SCI, the peak-to-peak TA MEP increased by 14 ± 3% after rCPnS and the peak increase (+21 ± 7%) occurred 15 min after the cessation of rCPnS. The TA H-reflex, measured in separate experiments in 7 subjects, did not increase after rCPnS. The results indicate that rCPnS can increase CST excitability for the TA in people with incomplete SCI, although its effects appear smaller and shorter lasting than those found in non-injured control subjects. Such short-term plasticity in the CST excitability induced by rCPnS may contribute to long-term therapeutic effects of functional electrical stimulation previously reported in people with CNS lesions. PMID:21360230

Thompson, Aiko K; Lapallo, Brandon; Duffield, Michael; Abel, Briana M; Pomerantz, Ferne

2011-04-01

70

Stress fracture of the ulnar styloid process in kendo player--a case report.  

PubMed

We present a case report of a 15-year-old kendo (Japanese fencing) player who suffered a stress fracture of the ulnar styloid process. Exercise of the kendo requires the athlete to flex his non-dominant wrist repeatedly in an ulnar direction, and causes the disorder. Excision of the osteochondral fragment relieved the symptoms. This lesion is likely to occur with other sports or activities which demand similar motion of the wrists. PMID:11677673

Itadera, E; Ichikawa, N; Hashizume, H; Inoue, H

2001-07-01

71

The detailed anatomy of the palmar cutaneous nerves and its clinical implications  

Microsoft Academic Search

The forearms and hands of 40 fresh-frozen cadavers were dissected under the microscope to study the palmar cutaneous branch of the median nerve (PCBm) and the palmar cutaneous branch of the ulnar nerve (PCBu). Branches of the PCBm innervating the scaphoid were typically found, but in no specimen did we find a ‘typical’ cutaneous branch of the ulnar nerve. According

H. S. Matloub; J. G. Yan; A. B. Mink van der Molen; L. L. Zhang; J. R. Sanger

1998-01-01

72

Digital sucking induced trophic ulcers caused by nerve deficit from amniotic constriction band.  

PubMed

Two infants presented with amniotic constriction bands (ACB) in the distal third of the forearm. After teeth eruption they developed recurrent skin ulcerations mainly in the distribution of the median nerve from digital sucking. Both patients underwent reconstruction with multiple Z-plasties, followed by neurolysis of the ulnar nerve and sural nerve grafting of the median nerve. This neurological complication presented late in ACB as ulcerative lesions and secondary infection from digital sucking on the insensate digits. Thorough physical examination of the extremities at an early stage in children with ACB is essential to exclude an occult neurological dysfunction. Exploration of peripheral nerves is warranted in cases of deep forearm ACB during their soft tissue reconstruction. PMID:20347623

Beidas, Omar; Rayan, Ghazi M; Al-Harthy, A

2010-08-01

73

Results of cable graft technique in repair of large nerve trunk lesions.  

PubMed

Cable grafting was reintroduced in the beginning of the 1980's as a modified method for repair of large polyfascicular nerves without group arrangement such as trunks and cords of the brachial plexus, sciatic nerve and its divisions, or the other main nerve trunks. We used this method in 25 patients with brachial plexus injury and 29 patients with injuries to the sciatic nerve. Results were analyzed according to the individual nerve elements and were available for 32 elements of the brachial plexus and for 19 tibial and 19 peroneal divisions of the sciatic nerve. We defined useful functional recovery according to the priorities in repair of the brachial plexus and sciatic nerve with lower limits M3 for relevant muscles and functions and S2 for sensory function. Results were especially favourable for the brachial plexus with a total rate of recovery 84% and for tibial division with the same total rate of recovery. On the basis of the results obtained we were able to conclude that the results of the modified cable grafting were at least similar to those of interfascicular nerve grafting and that this method could be useful for repair of large polyfascicular nerve trunks. However, the main advantage of this technique is a considerable gain in operative time. PMID:9870065

Samardzi?, M M; Rasuli?, L G; Grujici?, D M

1998-01-01

74

Biphasic reorganization of somatotopy in the primary motor cortex follows facial nerve lesions in adult rats  

Microsoft Academic Search

Effects of facial nerve transection were studied on muscle responses evoked by electrical stimulation in the primary motor cortex (MI) of adult rats. In intact animals, activated muscles varied according to the somatotopic representation map, and responses were restricted to the contralateral side. Unilateral transection of the facial nerve extinguished contralateral vibrissae responses, while ipsilateral vibrissae began to respond within

Jozsef Toldia; Rainer Laskawi; Michael Landgrebe; Joachim R. Wolff

1996-01-01

75

A Model for Ulnar Dysmelia  

PubMed Central

The treatment of pregnant rats with the carbonic anhydrase inhibitor, acetazolamide, produced gross limb malformations primarily affecting the forepaw, but also producing variable ulnar dysmelia. Analysis of the cytoarchitecture of the ulnar dysmelic limbs showed the presence of cartilaginous and fibrocartilaginous connections between the ulnar and radial chondroepiphyses, with variable deformation of the radial chondroepiphysis by the tethering effect (although the growth plate, per se, did not appear affected at the stage of development studied). The extremely variable experimental appearances duplicated most of the variations seen in the human disease analogue, and suggest this drug-induced embryopathy may be useful as a model for the study of postaxial forelimb deformities in the postnatal phase in order to adequately assess the structural changes of disparate growth between radius and ulna due to the presence of the cellular continuity between the two distal chondroepiphyses. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9 PMID:685300

Ogden, J.A.; Vickers, T.H.; Tauber, J.E.; Light, T.R.

1978-01-01

76

Differential effects of lesions of the vomeronasal and olfactory nerves on garter snake (Thamnophis sirtalis) responses to airborne chemical stimuli.  

PubMed

The roles of the main (MOS) and accessory (AOS) olfactory systems of garter snakes in response to airborne chemicals were investigated. Preoperatively, all snakes responded to airborne odors with increased tongue-flick rate and duration. Postoperatively, sham-operated snakes responded to airborne odors with increased tongue-flick rates, but snakes with main olfactory nerve cuts failed to respond to the odors, and snakes with vomeronasal nerve cuts responded to nonprey odors only. Preoperatively, exposure to earthworm odor produced more frequent and shorter duration tongue-flicks during locomotion compared with exposure to water. Postoperatively, only sham-lesioned snakes exhibited differential responding to earthworm odors. This study demonstrates that the MOS is critical for the initiation of tongue-flick behavior in response to airborne odors and that discrimination of odors with biological significance requires a functional AOS. PMID:12619919

Zuri, Ido; Halpern, Mimi

2003-02-01

77

Imaging the cranial nerves: Part I: Methodology, infectious and inflammatory, traumatic and congenital lesions  

Microsoft Academic Search

Many disease processes manifest either primarily or secondarily by cranial nerve deficits. Neurologists, ENT surgeons, ophthalmologists\\u000a and maxillo-facial surgeons are often confronted with patients with symptoms and signs of cranial nerve dysfunction. Seeking\\u000a the cause of this dysfunction is a common indication for imaging. In recent decades we have witnessed an unprecedented improvement\\u000a in imaging techniques, allowing direct visualization of

Alexandra Borges; Jan Casselman

2007-01-01

78

Increased slow transport in axons of regenerating newt limbs after a nerve conditioning lesion made prior to amputation  

SciTech Connect

The first part of this study shows that axonal density is constant in the limb stump of the next proximal to the area of traumatic nerve degeneration caused by limb amputation. The results of the second part of this work reveal that a nerve conditioning lesion made two weeks prior to amputation is associated with accelerated limb regeneration and that this accelerated limb regeneration is accompanied by an earlier arrival of axons. This is the first demonstration of naturally occurring limb regeneration being enhanced. In this study SCb cytoskeletal proteins were identified and measured using SDS-PAGE and liquid scintillation counting. Proteins were measured at 7, 14, 21, and 28 days after {sup 35}S-methionine injection and the normal rate of SCb transport determined to be 0.19 mm/day. A single axotomy does not enhance the rate of SCb transport but does increase the amount of labeled SCb proteins that are transported. When a conditioning lesion is employed prior to limb amputation and SCb proteins are measured at 7, 14, and 21 days after injection, there is a twofold acceleration in the rate of SCb transport and an increase in the amount of SCb proteins transported in conditioned axons.

Maier, C.E.

1989-01-01

79

Arthroscopic Wafer Procedure for Ulnar Impaction Syndrome  

PubMed Central

Ulnar impaction syndrome is abutment of the ulna on the lunate and triquetrum that increases stress and load, causing ulnar-sided wrist pain. Typically, ulnar-positive or -neutral variance is seen on a posteroanterior radiograph of the wrist. The management of ulnar impaction syndrome varies from conservative, symptomatic treatment to open procedures to shorten the ulna. Arthroscopic management has become increasingly popular for management of ulnar impaction with ulnar-positive variance of less than 3 mm and concomitant central triangular fibrocartilage complex tears. This method avoids complications associated with open procedures, such as nonunion and symptomatic hardware. The arthroscopic wafer procedure involves debridement of the central triangular fibrocartilage complex tear, along with debridement of the distal pole of the ulna causing the impaction. Debridement of the ulna arthroscopically is taken down to a level at which the patient is ulnar neutral or slightly ulnar negative. Previous studies have shown good results with relief of patient symptoms while avoiding complications seen with open procedures. PMID:24749031

Colantoni, Julie; Chadderdon, Christopher; Gaston, R. Glenn

2014-01-01

80

Methyl group deficiency in nerve tissue: A hypothesis to explain the lesion of subacute combined degeneration  

Microsoft Academic Search

Summary  The pattern of degeneration induced in the spinal cords and peripheral nerves of 4 monkeys exposed to nitrous oxide resembles\\u000a subacute combined degeneration found in man with untreated vitamin B12 deficiency. Our findings indicate that nitrous oxide directly inhibits the folate dependent methionine synthetase reaction.\\u000a This ultimately results in ‘methyl group deficiency’ with consequent defective remethylation of essential constituents of

J. J. Dinn; D. G. Weir; S. McCann; B. Reed; P. Wilson; J. M. Scott

1980-01-01

81

Permanent lesion of the lateral femoral cutaneous nerve after low-volume ethanol 96%application on the lumbar sympathetic chain.  

PubMed

Lumbar sympathetic blocks and chemical sympathectomies are used for the pain treatment of peripheral arterial occlusive disease or sympathetically maintained pain syndrome after nerve injury or complex regional pain syndrome (CRPS). A 30-year-old patient was referred to the pain department with all the clinical signs and symptoms of a CRPS of the right foot one and a half years after being surgically treated for rupture of the achilles tendon. An inpatient admission was necessary due to insufficient pain reduction upon the current treatment, strong allodynia in the medial distal right lower leg and decreased load-bearing capacity of the right foot. A computed tomography (CT)-guided lumbar sympathetic block at the right L3 (Bupivacaine 0.5%, 4 mL) led to a skin temperature increase from 21° C before block to > 34° C for about 5 hours after the intervention. The patient experienced significant pain relief, indicating sympathetically maintained pain. Thus, we performed a CT-guided lumbar sympathetic neurolysis at the same level (ethanol 96%, 2 mL) 5 days later, achieving again a significant skin temperature increase of the right foot and a slight reduction of his pain intensity from numeric rating scale (NRS) 7 prior to the intervention to NRS 4 after 8 hours (NRS, 0 = no pain, 10 = strongest pain imaginable). Eight months later a repeated inpatient admission was necessary due to considerable pain relapse and decreased load-bearing capacity of his right foot. A CT-guided lumbar sympathetic neurolysis was repeated at the L4 level on the right side and was successful, inducing a significant skin temperature increase. Despite a temporary irritation of the genitofemoral nerve 8 hours after the intervention, a delayed irritation of the lateral femoral cutaneous nerve occurred. This was a long-lasting lesion of the lateral femoral cutaneous nerve following a CT-guided chemical sympathectomy with a low-volume ethanol 96% application - a complication which has not been described in literature until now. This is probably caused by broad dissemination of the neurolytic agent along the psoas muscle despite a correct needle position and spread of contrast agent. The development of this nerve injury even after injection of a small volume of ethanol (2 mL) may be delayed. PMID:23877455

Pennekamp, Werner; Krumova, Elena K; Feigl, Georg Pd; Frombach, Elke; Nicolas, Volkmar; Schwarzer, Andreas; Maier, Christoph

2013-01-01

82

The Parameters of Transcutaneous Electrical Nerve Stimulation Are Critical to Its Regenerative Effects When Applied Just after a Sciatic Crush Lesion in Mice  

PubMed Central

We investigated the effect of two frequencies of transcutaneous electrical nerve stimulation (TENS) applied immediately after lesion on peripheral nerve regeneration after a mouse sciatic crush injury. The animals were anesthetized and subjected to crushing of the right sciatic nerve and then separated into three groups: nontreated, Low-TENS (4?Hz), and High-TENS (100?Hz). The animals of Low- and High-TENS groups were stimulated for 2?h immediately after the surgical procedure, while the nontreated group was only positioned for the same period. After five weeks the animals were euthanized, and the nerves dissected bilaterally for histological and histomorphometric analysis. Histological assessment by light and electron microscopy showed that High-TENS and nontreated nerves had a similar profile, with extensive signs of degeneration. Conversely, Low-TENS led to increased regeneration, displaying histological aspects similar to control nerves. High-TENS also led to decreased density of fibers in the range of 6–12??m diameter and decreased fiber diameter and myelin area in the range of 0–2??m diameter. These findings suggest that High-TENS applied just after a peripheral nerve crush may be deleterious for regeneration, whereas Low-TENS may increase nerve regeneration capacity. PMID:25147807

Martins Lima, Emyle; Teixeira Goes, Bruno; Zugaib Cavalcanti, Joao; Vannier-Santos, Marcos Andre; Martinez, Ana Maria Blanco; Baptista, Abrahao Fontes

2014-01-01

83

Axonal Transport Proteomics Reveals Mobilization of Translation Machinery to the Lesion Site in Injured Sciatic Nerve*  

PubMed Central

Investigations of the molecular mechanisms underlying responses to nerve injury have highlighted the importance of axonal transport systems. To obtain a comprehensive view of the protein ensembles associated with axonal transport in injured axons, we analyzed the protein compositions of axoplasm concentrated at ligatures following crush injury of rat sciatic nerve. LC-MS/MS analyses of iTRAQ-labeled peptides from axoplasm distal and proximal to the ligation sites revealed protein ensembles transported in both anterograde and retrograde directions. Variability of replicates did not allow straightforward assignment of proteins to functional transport categories; hence, we performed principal component analysis and factor analysis with subsequent clustering to determine the most prominent injury-related transported proteins. This strategy circumvented experimental variability and allowed the extraction of biologically meaningful information from the quantitative neuroproteomics experiments. 299 proteins were highlighted by principal component analysis and factor analysis, 145 of which correlate with retrograde and 154 of which correlate with anterograde transport after injury. The analyses reveal extensive changes in both anterograde and retrograde transport proteomes in injured peripheral axons and emphasize the importance of RNA binding and translational machineries in the axonal response to injury. PMID:19955087

Michaelevski, Izhak; Medzihradszky, Katalin F.; Lynn, Aenoch; Burlingame, Alma L.; Fainzilber, Mike

2010-01-01

84

Dynamic organization of primary motor cortex output to target muscles in adult rats I. Long-term patterns of reorganization following motor or mixed peripheral nerve lesions  

Microsoft Academic Search

These experiments examined the ability of the adult motor cortex to reorganize its relationship with somatic musculature following nerve lesions. Cortical motor output organization was assessed by mapping the areal extent of movements evoked by intracortical electrical stimulation in anesthetized rats. Output patterns of the motor cortex of normal rats were compared with those of adult rats that had received

J. N. Sanes; S. Suner; J. P. Donoghue

1990-01-01

85

Nerve lesioning with direct current This article has been downloaded from IOPscience. Please scroll down to see the full text article.  

E-print Network

in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e/016005 Abstract Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use

Prochazka, Arthur

86

Medial antebrachial cutaneous nerve conduction study, a new tool to demonstrate mild lower brachial plexus lesions. A report of 16 cases  

Microsoft Academic Search

Objective: This was to demonstrate the ability to electrodiagnosed mild lower brachial plexus lesion only through abnormal medial antebrachial cutaneous nerve (MABCN) conduction study.Methods: We report 16 cases of unilateral, atypical pains and paresthesias of the upper limbs without motor deficit or atrophy. Patients were referred as carpal tunnel syndrome in 12 cases. All patients had needle examination of the

P. Seror

2004-01-01

87

Perioperative lesions of the facial nerve: follow-up investigations using transcranial magnetic stimulation  

Microsoft Academic Search

Peripheral facial palsy can occur after aural surgery and neurosurgery. Routine neurophysiological investigation (utilizing\\u000a electrical stimulation and the blink reflex) does not allow the direct assessment of the site of a lesion. In the present\\u000a study transcranial magnetic stimulation (TMS) was applied in order to evaluate the usefulness of this method for prognosis.\\u000a Twenty-three patients with postoperative facial pareses (after

S. Kotterba; M. Tegenthoff; J.-P. Malin

1997-01-01

88

The athlete's wrist: ulnar-sided pain.  

PubMed

Ulnar-sided wrist pain is one of the most common symptoms in athletes of baseball, racket sports, golf, and wrestling where there is frequent use of the hands as well as in soccer and running, where hand use is minimal. Compared with all wrist injuries, ulnar-sided wrist injury is a relatively serious condition for athletes because it plays an important role in performing a strong grip and in the rotation of the forearm. Ulnar-sided wrist pain in athletes can be related to acute trauma or chronic overuse. Acute trauma can lead to bone fractures and sprains/tears of ligaments. Repetitive mechanical stresses to tendons, ligaments, and the joint structures can lead to tendinitis or osteoarthrosis. Diagnosis of the ulnar-sided wrist pain is challenging both for hand surgeons and radiologists because of the small and complex anatomy. In the present article, we discuss mechanisms of wrist injury, sports-specific ulnar-sided wrist injuries, and the differential diagnosis of ulnar-sided wrist pain. PMID:23047280

Yamabe, Eiko; Nakamura, Toshiyasu; Pham, Peter; Yoshioka, Hiroshi

2012-09-01

89

Ulnar Head Replacement and Related Biomechanics  

PubMed Central

A stable distal radioulnar joint (DRUJ) is mandatory for the function and load transmission in the wrist and forearm. Resectional salvage procedures such as the Darrach procedure, Bowers arthroplasty, and Sauvé-Kapandji procedure include the potential risk of radioulnar instability and impingement, which can lead to pain and weakness. Soft tissue stabilizing techniques have only limited success rates in solving these problems. In an attempt to stabilize the distal forearm mechanically following ulnar head resection, various endoprostheses have been developed to replace the ulnar head. The prostheses can be used for secondary treatment of failed ulnar head resection, but they can also achieve good results in the primary treatment of osteoarthritis of the DRUJ. Our experience consists of twenty-five patients (follow-up 30 months) with DRUJ osteoarthritis who were treated with an ulnar head prosthesis, with improvement in pain, range of motion, and grip strength. An ulnar head prosthesis should be considered as a treatment option for a painful DRUJ. PMID:24436786

Sauerbier, Michael; Arsalan-Werner, Annika; Enderle, Elena; Vetter, Miriam; Vonier, Daniel

2013-01-01

90

Low-energy laser action on median and radial nerve post-traumatic lesion after surgical suture  

NASA Astrophysics Data System (ADS)

The low energy laser (LEL) biostimulatory effects on nervous tissue regeneration are well known. Thirty two patients with medial and/or radial nerve traumatic forearm lesion after surgical suture were divided into two groups: A-18 patients were treated with LEL; B-14 patients, witness, were treated with placebo lasers and classical medical and physical therapy. Lasers used were: HeNe, 632.5 nm wavelength, 2 mW power, and GaAlAs diode laser, 880 nm wavelength, pulsed emission with an output power 2 mW. Before, during, and after treatment EMG was done in order to measure objectively the efficiency of the treatment. We obtained good results after 4 - 5 months at 14 patients (77.7%) from group A and about the same results at 10 patients (71.3%) from group B, but after at least 8 months the good results were noticed concerning the improvements of EMG registration and on movements and force of the fingers. Finally we can say that the favorable results were obtained in at least twice shorter time with LEL treatment than with classical therapy.

Antipa, Ciprian; Bunila, Daniela; Crangulescu, Nicolae; Nacu, Mihaela; Podoleanu, Adrian Gh.; Stanciulescu, Viorica; Vasiliu, Virgil V.

1996-01-01

91

Nerve injuries about the elbow in the athlete.  

PubMed

The athlete's elbow is a remarkable example of motion, strength, and durability. The stress placed on the elbow during sport, including the throwing motion, may lead to soft-tissue ligamentous and nerve injury. The thrower's elbow illustrates one example of possible nerve injury about the elbow in sport, related to chronic repetitive tensile and compressive stresses to the ulnar nerve associated with elbow flexion and valgus position. Besides the throwing athlete, nerve injury from high-energy direct-impact forces may also damage nerves around the elbow in contact sports. Detailed history and physical examination can often make the diagnosis of most upper extremity neuropathies. The clinician must be aware of the possibility of isolated or combined nerve injury as far proximal as the cervical nerve roots, through the brachial plexus, to the peripheral nerve terminal branches. Electrodiagnostic studies are occasionally beneficial for diagnosis with certain nerves. Nonoperative management is often successful in most elbow and upper extremity neuropathies. If conservative treatment fails, then surgical treatment should address all potentially offending structures. In the presence of medial laxity and concurrent ulnar neuritis, the medial ulnar collateral ligament warrants surgical treatment, in addition to transposition of the ulnar nerve. The morbidity of open surgical decompression of nerves in and around the elbow is potentially career threatening in the throwing athlete. This mandates an assessment of the adequacy of the nonsurgical treatment and a thorough preoperative discussion of the risks and benefits of surgery. PMID:25077754

Harris, Joshua D; Lintner, David M

2014-09-01

92

Fibrolipoma of multiple nerves in the wrist.  

PubMed

We report fibrolipoma involving the median nerve, its palmar cutaneous branch as well as the ulnar nerve in the same hand of a 25-year-old woman. The patient presented with a lump in the wrist with signs of carpal tunnel syndrome. Multiple nerve involvement was detected on magnetic resonance imaging and further confirmed at surgical exploration and decompression. Imaging is recommended in the management of an unusual lump in the wrist. PMID:19710960

Pang, H N; Puhaindran, M; Yong, F C

2009-08-01

93

On the number and nature of regenerating myelinated axons after lesions of cutaneous nerves in the cat.  

PubMed Central

1. Electrophysiological and anatomical techniques were used to investigate normal and regenerating sural and posterior femoral cutaneous nerve fibres in the cat. 2. One and a half years after transection of these nerves it was found that the regenerating neurones supported multiple sprouts in the distal stump of the nerve. The branching occurred at or beyond the level of the neuroma and some of the branched fibres innervated split receptive fields on the skin. 3. Counts of the number of axons in the proximal stumps of transected nerves showed that the whole original population of myelinated fibres persisted for at least 18 months. About 75% of these fibres successfully crossed the unrepaired transection site and regenerated into the distal stump of the nerve to re-form functional connexions in the skin. 4. After nerve crush all the myelinated axons regenerated. None showed signs of abnormal branching. 5. After crush the conduction velocities of the regenerated axons in the distal stump of the nerve reached nearly normal values by 6 months. After nerve transection the distal conduction velocities were reduced to 50% of normal even 18 months after the injury. 6. The implications of these findings for the recovery of function after nerve injury in man are discussed. PMID:7277219

Horch, K W; Lisney, S J

1981-01-01

94

Granulocyte colony-stimulating factor (G-CSF) positive effects on muscle fiber degeneration and gait recovery after nerve lesion in MDX mice  

PubMed Central

Background G-CSF has been shown to decrease inflammatory processes and to act positively on the process of peripheral nerve regeneration during the course of muscular dystrophy. Aims The aims of this study were to investigate the effects of treatment of G-CSF during sciatic nerve regeneration and histological analysis in the soleus muscle in MDX mice. Methods Six-week-old male MDX mice underwent left sciatic nerve crush and were G-CSF treated at 7 days prior to and 21 days after crush. Ten and twenty-one days after surgery, the mice were euthanized, and the sciatic nerves were processed for immunohistochemistry (anti-p75NTR and anti-neurofilament) and transmission electron microscopy. The soleus muscles were dissected out and processed for H&E staining and subsequent morphologic analysis. Motor function analyses were performed at 7 days prior to and 21 days after sciatic crush using the CatWalk system and the sciatic nerve index. Results Both groups treated with G-CSF showed increased p75NTR and neurofilament expression after sciatic crush. G-CSF treatment decreased the number of degenerated and regenerated muscle fibers, thereby increasing the number of normal muscle fibers. Conclusions The reduction in p75NTR and neurofilament indicates a decreased regenerative capacity in MDX mice following a lesion to a peripheral nerve. The reduction in motor function in the crushed group compared with the control groups may reflect the cycles of muscle degeneration/regeneration that occur postnatally. Thus, G-CSF treatment increases motor function in MDX mice. Nevertheless, the decrease in baseline motor function in these mice is not reversed completely by G-CSF. PMID:25328849

Simoes, Gustavo F; Benitez, Suzana U; Oliveira, Alexandre L R

2014-01-01

95

Cutaneous sensory nerve fibers are decreased in number after peripheral and central nerve damage  

Microsoft Academic Search

Two dermatologic patients displaying peripheral and central nerve damage, respectively, are described. Cutaneous nerve fibers in both patients were studied in skin biopsy specimens taken from neuropathic areas and from the contralateral side, immunocytochemistry being applied to a pan-neuronal marker, a protein gene-product (PGP 9.5). One of the patients, suffering from compression of the ulnar nerve, had dyshidrotic eczema of

Joanna Wallengren; Eva Tegner; Frank Sundler

2002-01-01

96

Low-power laser biostimulation enhances nerve repair after end-to-side neurorrhaphy: a double-blind randomized study in the rat median nerve model  

Microsoft Academic Search

Previous studies have shown that low-power laser biostimulation (lasertherapy) promotes posttraumatic nerve regeneration. The objective of the present study was to investigate the effects of postoperative lasertherapy on nerve regeneration after end-to-side neurorrhaphy, an innovative technique for peripheral nerve repair. After complete transection, the left median nerve was repaired by end-to-side neurorrhaphy on the ulnar “donor” nerve. The animals were

D. Gigo-Benato; S. Geuna; A. de Castro Rodrigues; P. Tos; M. Fornaro; E. Boux; B. Battiston; M. G. Giacobini-Robecchi

2004-01-01

97

21 CFR 888.3810 - Wrist joint ulnar (hemi-wrist) polymer prosthesis.  

Code of Federal Regulations, 2011 CFR

...Wrist joint ulnar (hemi-wrist) polymer prosthesis. 888.3810 Section...Wrist joint ulnar (hemi-wrist) polymer prosthesis. (a) Identification...wrist joint ulnar (hemi-wrist) polymer prosthesis is a...

2011-04-01

98

Diffusion Tensor Imaging of Forearm Nerves in Humans  

PubMed Central

Purpose To implement diffusion tensor imaging (DTI) protocol for visualization of peripheral nerves in human forearm. Materials and Methods This HIPAA-compliant study was approved by our institutional review board and written informed consent was obtained from 10 healthy participants. T1-and T2-weighted turbo spin echo with fat saturation, short tau inversion recovery (STIR), and DTI sequences with 21 diffusion encoding directions were implemented to acquire images of the forearm nerves with an 8 channel knee coil on a 3T MRI scanner. Identification of the nerves was based on T1-weighted, T2-weighted, STIR and DTI-derived fractional anisotropy (FA) images. Maps of the DTI derived indices, FA, mean diffusivity (MD), longitudinal diffusivity (?//) and radial diffusivity (??) along the length of the nerves were generated. Results DTI-derived maps delineated the forearm nerves more clearly than images acquired with other sequences. Only ulnar and median nerves were clearly visualized on the DTI-derived FA maps. No significant differences were observed between the left and right forearms in any of the DTI-derived measures. Significant variation in the DTI measures was observed along the length of the nerve. Significant differences in the DTI measures were also observed between the median and ulnar nerves. Conclusion DTI is superior in visualizing the median and ulnar nerves in the human forearm. The normative data could potentially help distinguish normal from diseased nerves. PMID:22689475

Zhou, Yuxiang; Kumaravel, Manickam; Patel, Vipulkumar S; Sheikh, Kazim A; Narayana, Ponnada A

2012-01-01

99

[An original technique for stabilizing the metacarpopharyngeal joints of the ulnar hand: "The transosseous capsuloplasty with anterior-posterior drilling"].  

PubMed

In reconstructive surgery of the ulnar clawhand deformity, the metacarpophalangeal joints of the digits and the thumb must be stabilised. The "capsuloplasty with anteroposterior drilling", which is described in this paper is an original technique whose first goal is to make this stabilisation easier and with an effectiveness at least equal to the classic and difficult Zancolli techniques. It consists, after a longitudinal opening of the volar plate, of drilling an anteroposterior hole at the level of the metacarpal neck using a square point awl, a small dorsal incision allowing protection of the extensor tendons. A needle with a non absorbable thread takes the first half of the palmar plate, goes through the hole and is brought out on the dorsal aspect of the hand, then a Halsted forceps is passed keeping close to the metacarpal neck to bring the needle to the palmar side and finally take the second half of the palmar plate. The knots are tied with the metacarpophalangeal joints in 25 degrees flexion. From June 1997 to April 2001, 25 patients suffering from ulnar nerve palsy and ten patients suffering from combined ulnar and median nerve palsy have benefited from this technique to correct the clawhand deformity and Froment's sign. No pre or postoperative complications were reported. With a mean follow-up of 24 months all the metacarpophalangeal joints operated have very good stability and improved strength. PMID:11723778

Belmahi, A M; Gharib, N; Abbassi, A

2001-10-01

100

Symmetric Lipofibromatous Hamartoma Affecting Digital Nerves  

PubMed Central

Lipofibromatous hamartoma of the nerve is a benign tumor, which affects the major nerves and their branches in the human body. It is often found in the median nerve of the hand and is commonly associated with macrodactyly, but it is rarely found in the digital nerves at the peripheral level. This tumor is often found in young adults and may go through a self-limiting course. However, operation is indicated when the tumor size is large or when the associated nerve compressive symptoms are present. We have experienced a rare case of lipofibromatous hamartoma that symmetrically involved the volar digital nerves of both index fingers on the ulnar side. With the aid of a microscope, we dissected and removed the tumor as much as possible without sacrificing the nerve. No sensory change occurred in both fingers and no sign of recurrence was observed upon follow-up. PMID:15744823

Jung, Sung-No; Yim, Youngmin

2005-01-01

101

Clinical Strategies to Enhance Nerve Regeneration in Composite Tissue Allotransplantation  

PubMed Central

Synopsis Reinnervation of a hand transplant ultimately dictates functional recovery but provides a significant regenerative challenge. The authors present a review highlighting interventions to enhance nerve regeneration through acceleration of axonal regeneration or augmentation of Schwann cell supportand discuss their relevance to composite tissue allotransplantation. Surgical techniques that may be performed at the time of transplantation to optimize intrinsic muscle recovery—including appropriate alignment of ulnar nerve motor and sensory components, transfer of the distal anterior interosseous nerve to the recurrent motor branch of the median nerve, and prophylactic release of potential nerve entrapment points—are also presented. PMID:22051390

Glaus, Simone W.; Johnson, Philip J.; Mackinnon, Susan E.

2011-01-01

102

Limitations of nerve repair of segmental defects using acellular conduits.  

PubMed

The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient underwent reexploration, excision of the "regenerated cable," and rerepair of the ulnar nerve with sural nerve autografts. Histology of the cable demonstrated minimal axonal regeneration at the midpoint of the repair. At the 6- and 12-month follow-ups of the sural nerve graft repair, clinical and electrophysiological evidence of both sensory and motor reinnervation of the ulnar nerve and associated hand muscles was demonstrated. In this report, the authors describe a single case of failed acellular nerve allograft and correlate the results with basic science and human studies reporting length and diameter limitations in human nerve repair utilizing grafts or conduits devoid of viable Schwann cells. PMID:23746100

Berrocal, Yerko A; Almeida, Vania W; Levi, Allan D

2013-09-01

103

Anterior interosseous nerve syndrome  

PubMed Central

Objective: We sought to determine lesion sites and spatial lesion patterns in spontaneous anterior interosseous nerve syndrome (AINS) with high-resolution magnetic resonance neurography (MRN). Methods: In 20 patients with AINS and 20 age- and sex-matched controls, MRN of median nerve fascicles was performed at 3T with large longitudinal anatomical coverage (upper arm/elbow/forearm): 135 contiguous axial slices (T2-weighted: echo time/repetition time 52/7,020 ms, time of acquisition: 15 minutes 48 seconds, in-plane resolution: 0.25 × 0.25 mm). Lesion classification was performed by visual inspection and by quantitative analysis of normalized T2 signal after segmentation of median nerve voxels. Results: In all patients and no controls, T2 lesions of individual fascicles were observed within upper arm median nerve trunk and strictly followed a somatotopic/internal topography: affected were those motor fascicles that will form the anterior interosseous nerve further distally while other fascicles were spared. Predominant lesion focus was at a mean distance of 14.6 ± 5.4 cm proximal to the humeroradial joint. Discriminative power of quantitative T2 signal analysis and of qualitative lesion rating was high, with 100% sensitivity and 100% specificity (p < 0.0001). Fascicular T2 lesion patterns were rated as multifocal (n = 17), monofocal (n = 2), or indeterminate (n = 1) by 2 independent observers with strong agreement (kappa = 0.83). Conclusion: It has been difficult to prove the existence of fascicular/partial nerve lesions in spontaneous neuropathies using clinical and electrophysiologic findings. With MRN, fascicular lesions with strict somatotopic organization were observed in upper arm median nerve trunks of patients with AINS. Our data strongly support that AINS in the majority of cases is not a surgically treatable entrapment neuropathy but a multifocal mononeuropathy selectively involving, within the main trunk of the median nerve, the motor fascicles that continue distally to form the anterior interosseous nerve. PMID:24415574

Baumer, Philipp; Meinck, Hans-Michael; Schiefer, Johannes; Weiler, Markus; Bendszus, Martin; Kele, Henrich

2014-01-01

104

Ulnar shortening osteotomy with a new sliding-hole plate.  

PubMed

Ulnar shortening osteotomy represents a common procedure for surgical treatment of the ulnar impaction syndrome but is still associated with complications like malrotation, angulation, or malunion because of incomplete closure of the osteotomy gap. Therefore, the authors developed a special 7-hole compression plate that allows fixation of the ulna before the osteotomy is carried out to prevent rotation. With this plate, a shortening of up to 10 mm is possible and the compression holes allow closure of the osteotomy gap. The plate has been used in 23 ulnar shortening cases at their center with good results. The authors describe the technique and report their results of ulnar shortening with this device. PMID:16518225

Kitzinger, Hugo B; Löw, Steffen; Krimmer, Hermann

2003-09-01

105

Injury to the Ulnar Collateral Ligament of the Thumb  

PubMed Central

Injury to the ulnar collateral ligament of the thumb is very common and can be disabling when missed or left untreated. We present a review of literature and our preferred way of management. PMID:18975032

Hayton, Michael J.; Baratz, Mark

2008-01-01

106

The impact and specificity of nerve perturbation on novel vibrotactile sensory letter learning.  

PubMed

Abstract The purposes of this study were to determine if induced radiating paresthesia interferes with (a) acquisition and/or (b) utilization of complex tactile information, and (c) identify whether interference reflects tactile masking or response competition. Radiating ulnar (experiment 1) and median (experiment 2) nerve paresthesia was quantified on ulnar innervated vibrotactile Morse code letter acquisition and recollection tasks. Induced paresthesia differentially impacted letter acquisition and recollection, but only when presented to the same anatomical spatial location. PMID:24844345

Passmore, Steven R; Bosse, Jessica; Murphy, Bernadette; Lee, Timothy D

2014-12-01

107

Upper extremity peripheral nerve entrapments among wheelchair athletes: prevalence, location, and risk factors.  

PubMed

Wheelchair athletes commonly experience hand pain and numbness. This investigation studied the prevalence, location, and risk factors of upper extremity peripheral nerve entrapment among wheelchair athletes. Clinical and electrodiagnostic assessments were performed on both upper extremities of 28 wheelchair athletes and 30 able-bodied controls. Included in the assessment were short-segment stimulation techniques of the median nerve across the carpal tunnel and the ulnar nerve across the elbow. By clinical criteria, the prevalence of nerve entrapment among the wheelchair athletes was 23%, whereas it was 64% electrodiagnostically. The most common electrodiagnostic dysfunction was of the median nerve at the carpal tunnel (46%), and the portion of the nerve within the proximal carpal tunnel was most frequently affected. Ulnar neuropathy was the second most common entrapment electrodiagnostically (39%) and occurred at the wrist and forearm segments. Disability duration correlated significantly with electrophysiologic median nerve dysfunction. PMID:8185443

Burnham, R S; Steadward, R D

1994-05-01

108

Epithelioid Lesions  

Microsoft Academic Search

Epithelioid variants have been described for most mesenchymal tumors, including leiomyosarcoma, pleomorphic liposarcoma, epithelioid fibrous histiocytoma, and myxofibrosarcoma. Soft tissue tumors that commonly show epithelioid morphology include epithelioid vascular lesions, epithelioid sarcoma, sclerosing epithelioid fibrosarcoma, and epithelioid malignant peripheral nerve sheath tumor. Many of the entities described in this review were originally described as “simulating carcinoma” or “often mistaken for

Andrea T. Deyrup

2011-01-01

109

Nerve conduction, tactile sensibility, and the electromyogram after suture or compression of peripheral nerve: a longitudinal study in man.  

PubMed Central

In three patients sequential studies were performed of sensory and motor conduction after complete section and suture of the median nerve at the wrist and in one patient after partial section of the nerve. The sensory potential evoked by stimuli to digits III and I and recorded proximal to the suture line at the wrist appeared after a delay of three to four months, corresponding to a growth rate of 1.5-2.0 mm per day. From early in the course of regeneration the sensory potential was dispersed in 40 components. In the adult patient the cumulative amplitude increased for two years slowly and thereafter at a two times faster rate. Amplitude and tactile sensibility were normal after 40 months, but the sensory potential was still five times more dispersed than normal. The overall increase in the amplitude of the sensory potentials in children aged 10 and 12 years was three times faster than in adults. In the adults and in the children the maximum sensory conduction velocity was 10-25% of normal. It then increased at 3% per month during the first two years, and thereafter 10 times slower. Forty months after suture in the adults and 13-19 months after suture in the children the conduction velocity had reached 65-75% of normal. The pattern of discrete electrical activity during voluntary effort and the prolonged duration of motor unit potentials indicate persistent enlargement of the reinnervated motor units by peripheral sprouting. The sensory potential recovered five times faster after a compressive nerve lesion than after section and suture as seen in another patient with an affection of the ulnar nerve at the elbow. Normal tactile sensibility was attained 10 times faster than after section and suture. Maximum sensory and motor condution velocity recovered within one year from 60-70% to 80-90% of normal. PMID:448383

Buchthal, F; Kuhl, V

1979-01-01

110

Oral administration of idebenone induces nerve growth factor in the brain and improves learning and memory in basal forebrain-lesioned rats  

Microsoft Academic Search

Nerve growth factor plays an important role in the survival and maintenance of cholinergic neurons in the central neuronal system. In senile dementia of the Alzheimer type, learning and memory are impaired by the loss of neurons in the magnocellular cholinergic neuronal system. It is, therefore, of interest to investigate the role of nerve growth factor in this degenerative disorder.

Atsumi Nitta; Yutaka Murakami; Yoshiko Furukawa; Wataru Kawatsura; Kyozo Hayashi; Kiyofumi Yamada; Takaaki Hasegawa; Toshitaka Nabeshima

1994-01-01

111

Ulnar artery thrombosis: A sports-related injury  

Microsoft Academic Search

A case of ulnar artery thrombosis following a sports- related injury is reported. Treatment by resection of the thrombosed segment and replacement with a reversed vein graft resulted in complete relief of symptoms. An extensive review of the literature is presented.

Gary L. Porubsky; Samuel I. Brown; James R. Urbaniak

1986-01-01

112

Transverse ultrasound assessment of median nerve deformation and displacement in the human carpal tunnel during wrist movements.  

PubMed

The symptoms of carpal tunnel syndrome, a compression neuropathy of the median nerve at the wrist, are aggravated by wrist motion, but the effect of these motions on median nerve motion are unknown. To better understand the biomechanics of the abnormal nerve, it is first necessary to understand normal nerve movement. The purpose of this study was to evaluate the deformation and displacement of the normal median nerve at the proximal carpal tunnel level on transverse ultrasound images during different wrist movements, to have a baseline for comparison with abnormal movements. Dynamic ultrasound images of both wrists of 10 asymptomatic volunteers were obtained during wrist maximal flexion, extension and ulnar deviation. To simplify the analysis, the initial and final shape and position of the median nerve were measured and analyzed. The circularity of the median nerve was significantly increased and the aspect ratio and perimeter were significantly decreased in the final image compared with the first image during wrist flexion with finger extension, wrist flexion with finger flexion and wrist ulnar deviation with finger extension (p < 0.01). There were significant differences in median nerve displacement vector between finger flexion, wrist flexion with finger extension and wrist ulnar deviation with finger extension (all p's < 0.001). The mean amplitudes of median nerve motion in wrist flexion with finger extension (2.36 ± 0.79 normalized units [NU]), wrist flexion with finger flexion (2.46 ± 0.84 NU) and wrist ulnar deviation with finger extension (2.86 ± 0.51 NU) were higher than those in finger flexion (0.82 ± 0.33 NU), wrist extension with finger extension (0.77 ± 0.46 NU) and wrist extension with finger flexion (0.81 ± 0.58 NU) (p < 0.0001). In the normal carpal tunnel, wrist flexion and ulnar deviation could induce significant transverse displacement and deformation of the median nerve. PMID:24210862

Wang, Yuexiang; Zhao, Chunfeng; Passe, Sandra M; Filius, Anika; Thoreson, Andrew R; An, Kai-Nan; Amadio, Peter C

2014-01-01

113

Peripheral nerve lengthening as a regenerative strategy  

PubMed Central

Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial financial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, including a novel internal fixator device that enables rapid and distal reconnection of proximal and distal nerve stumps.

Vaz, Kenneth M.; Brown, Justin M.; Shah, Sameer B.

2014-01-01

114

Peripheral nerve surgery: primer for the imagers.  

PubMed

Peripheral nerve surgery represents a broad field of pathologic conditions, medical specialties, and anatomic regions of the body. Anatomic understanding of hierarchical nerve structure and the peripheral nervous system aids diagnosis and management of nerve lesions. Many peripheral nerves coalesce into organized arrays, including the cervical, brachial, and lumbosacral plexuses, controlling motor and sensory functions of the trunk and extremities. Individual or groups of nerves may be affected by various pathologic conditions, including trauma, entrapment, tumor, or iatrogenic damage. Current research efforts focus on enhancing the peripheral nerve regenerative process by targeting Schwann cells, nerve growth factors, and nerve allografts. PMID:24210320

Pindrik, Jonathan; Belzberg, Allan J

2014-02-01

115

Differential effects of distal and proximal nerve lesions on carbonic anhydrase activity in rat primary sensory neurons, ventral and dorsal root axons  

Microsoft Academic Search

The effect of proximal and distal peripheral nerve injuries on the histochemistry of carbonic anhydrase (CA) in rat dorsal root ganglion (DRG) neurons, and myelinated (MyF) dorsal and ventral root fibers was studied. Sciatic neurectomy induced no change. Contrariwise, 7 days after lumbar spinal nerve section the numbers of CA-stained ventral root MyF and DRG cells at the L4 and

J. M. Peyronnard; L. F. Charron; J. P. Messier; J. Lavoie

1988-01-01

116

Excision of the ulnar head in patients with rheumatoid arthritis.  

PubMed Central

In 40 patients with rheumatoid arthritis 43 operations for excision of the ulnar head were performed. A follow-up study was performed after 35 months. In 38 patients wrist pain had disappeared completely or almost completely. The function in use, supination and pronation of the wrists, and wrist strength had all much improved. The stability of the radiocarpal joint was good after operation. Only minor complications were seen. PMID:7416818

Rasker, J J; Veldhuis, E F; Huffstadt, A J; Nienhuis, R L

1980-01-01

117

Dermatomal and mixed nerve somatosensory evoked potentials in the diagnosis of neurogenic thoracic outlet syndrome  

Microsoft Academic Search

To evaluate the diagnostic utility of dermatomal and mixed nerve somatosensory evoked potentials (SEPs) in patients with thoracic outlet syndrome (TOS) and to compare their value with routine electrodiagnostic methods, we studied a group of 44 patients with neurogenic TOS and 30 healthy controls. In addition to bilateral median and ulnar SEPs, evoked potentials were recorded after stimulation of C6

Raif Cakmur; Fethi Idiman; Elif Akalin; Ahmet Genç; Görsev G Yener; Vesile Öztürk

1998-01-01

118

Nerve biopsy  

MedlinePLUS

Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site will be sore for a few days ...

119

Ulnar-sided wrist pain. Part I: anatomy and physical examination  

PubMed Central

Ulnar-sided wrist pain is a common complaint, and it presents a diagnostic challenge for hand surgeons and radiologists. The complex anatomy of this region, combined with the small size of structures and subtle imaging findings, compound this problem. A thorough understanding of ulnar-sided wrist anatomy and a systematic clinical examination of this region are essential in arriving at an accurate diagnosis. In part I of this review, ulnar-sided wrist anatomy and clinical examination are discussed for a more comprehensive understanding of ulnar-sided wrist pain. PMID:19722104

Vezeridis, Peter S.; Han, Roger; Blazar, Philip

2009-01-01

120

Tumors of the peripheral nerves and plexuses  

Microsoft Academic Search

Opinion statement  Peripheral nerve tumors are a diverse group of lesions histologically and in their clinical behavior. The genetic disorders\\u000a neurofibromatosis type 1 and 2 and schwannomatosis are significant risk factors for the development of peripheral nerve tumors.\\u000a An understanding of these disorders is important in allowing appropriate management. Active treatment of peripheral nerve\\u000a tumors is reserved for lesions that are

Jason H. Huang; Victoria E. Johnson; Eric L. Zager

2006-01-01

121

Inflammatory pseudotumor of nerve.  

PubMed

Two cases of inflammatory pseudotumor are described. The first patient, a 35-year-old white man, developed a progressive sensorimotor deficit in the right leg associated with a fusiform sciatic nerve mass in the posterior thigh. The lesion, compressive in nature and situated entirely within the epineurium, was totally resected. Histology revealed lymphocytic and plasmacellular inflammation as well as extensive fibrosis and collagen deposition. The patchy infiltrate consisted equally of CD2, CD3, CD5, and CD7 positive T-lymphocytes as well as CD20-and CD22-positive B-lymphocytes expressing both kappa and lambda immunoglobulin light chains. A selective biopsy of the encompassed and compressed nerve fascicles demonstrated both myelin loss and axonal injury. The second case was that of an 18-year-old woman with focal enlargement of a radial nerve by an epineurial infiltrate of multinucleate histiocytes and T as well as occasional B lymphocytes. No etiology was apparent in either case. The differential diagnosis includes non-neoplastic processes (amyloidoma and tuberculoid leprosy) as well as tumors (benign and malignant peripheral nerve sheath tumors, lymphoma). Although rare, inflammatory pseudotumors must be included in the differential diagnosis of tumor-like lesions of peripheral nerve. PMID:8827027

Weiland, T L; Scheithauer, B W; Rock, M G; Sargent, J M

1996-10-01

122

Use of intercostal nerves for different target neurotization in brachial plexus reconstruction  

PubMed Central

Intercostal nerve transfer is a valuable procedure in devastating plexopathies. Intercostal nerves are a very good choice for elbow flexion or extension and shoulder abduction when the intraplexus donor nerves are not available. The best results are obtained in obstetric brachial plexus palsy patients, when direct nerve transfer is performed within six months from the injury. Unlike the adult posttraumatic patients after median and ulnar nerve neurotization with intercostal nerves, almost all obstetric brachial plexus palsy patients achieve protective sensation in the hand and some of them achieve active wrist and finger flexion. Use in combination with proper muscles, intercostal nerve transfer can yield adequate power to the paretic upper limb. Reinnervation of native muscles (i.e., latissimus dorsi) should always be sought as they can successfully be transferred later on for further functional restoration. PMID:23878776

Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Korompilias, Ananstasios V; Vekris, Marios D; Beris, Alexandros E

2013-01-01

123

Unusual cases of cervical nerves schwannomas: phrenic and vagus nerve involvement  

Microsoft Academic Search

Benign neurogenic tumors (neurilemmoma) arising from the cervical phrenic or vagus nerve are relatively rare. These lesions are benign, asymptomatic and incidentally found. We describe two cases considering different surgical techniques adopted. In the case of phrenic nerve schwannoma we performed a total excision of the tumor including the maternal nerve fiber to prevent tumor recurrence, also in regard to

Emilio Mevio; E. Gorini; M. Sbrocca; L. Artesi; M. Mullace; A. Castelli; L. Migliorini

2003-01-01

124

Ultrasonographic reference values for assessing normal radial nerve ultrasonography in the normal population  

PubMed Central

High-resolution ultrasound has been used recently to characterize median and ulnar nerves, but is seldom used to characterize radial nerves. The radial nerve is more frequently involved in entrapment syndromes than the ulnar and median nerves. However, the reference standard for normal radial nerves has not been established. Thus, this study measured the cross-sectional areas of radial nerves of 200 healthy male or female volunteers, aged 18 to 75, using high-resolution ultrasound. The results showed that mean cross-sectional areas of radial nerves at 4 cm upon the lateral epicondyle of the humerus and mid-humerus (midpoint between the elbow crease and axilla) were 5.14 ± 1.24 and 5.08 ± 1.23 mm2, respectively. The age and the dominant side did not affect the results, but the above-mentioned cross-sectional areas were larger in males (5.31 ± 1.25 and 5.19 ± 1.23 mm2) than in females (4.93 ± 1.21 and 4.93 ± 1.23 mm2, respectively). In addition, the cross-sectional areas of radial nerves were positively correlated with height and weight (r = 0.38, 0.36, respectively, both P < 0.05). These data provide basic clinical data for the use of high-resolution ultrasound for the future diagnosis, treatment, and prognostic evaluation of peripheral neuropathies.

Chen, Jun; Wu, Shan; Ren, Jun

2014-01-01

125

Multifocal motor neuropathy: correlation of nerve ultrasound, electrophysiological, and clinical findings.  

PubMed

We present nerve ultrasound findings in multifocal motor neuropathy (MMN) and examine their correlation with electrophysiology and functional disability. Eighty healthy controls and 12 MMN patients underwent clinical, sonographic, and electrophysiological evaluation a mean of 3.5?years (standard deviation [SD] ± 2.1) after disease onset. Nerve ultrasound revealed significantly higher cross-sectional area (CSA) values of the median (forearm, p?ulnar (p?nerve (ankle, p?nerves (median, ulnar, radial, p?nerve at the upper arm (r?=?0.851, p?nerve sonography nor electrophysiology correlated with functional disability. MMN seems to show inhomogeneous CSA enlargement in various peripheral nerves, with weak correlation to electrophysiological findings. Neither nerve sonography nor electrophysiology correlated with functional disability. Multicentre, prospective studies are required to prove the applicability and diagnostic values of these findings. PMID:24862982

Kerasnoudis, Antonios; Pitarokoili, Kalliopi; Behrendt, Volker; Gold, Ralf; Yoon, Min-Suk

2014-06-01

126

Piriformis syndrome surgery causing severe sciatic nerve injury.  

PubMed

Piriformis syndrome is a controversial entrapment neuropathy in which the sciatic nerve is thought to be compressed by the piriformis muscle. Two patients developed severe left sciatic neuropathy after piriformis muscle release. One had a total sciatic nerve lesion, whereas the second had a predominantly high common peroneal nerve lesion. Follow-up studies showed reinnervation of the hamstrings only. We conclude that piriformis muscle surgery may be hazardous and result in devastating sciatic nerve injury. PMID:22922582

Justice, Phillip E; Katirji, Bashar; Preston, David C; Grossman, Gerald E

2012-09-01

127

Functional Recovery Following an End to Side Neurorrhaphy of the Accessory Nerve to the Suprascapular Nerve: Case Report  

PubMed Central

The use of end-to-side neurrorhaphy remains a controversial topic in peripheral nerve surgery. The authors report the long-term functional outcome following a modified end-to-side motor reinnervation using the spinal accessory to innervate the suprascapular nerve following a C5 to C6 avulsion injury. Additionally, functional outcomes of an end-to-end neurotization of the triceps branch to the axillary nerve and double fascicular transfer of the ulnar and medial nerve to the biceps and brachialis are presented. Excellent functional recoveries are found in respect to shoulder abduction and flexion and elbow flexion. Electronic supplementary material The online version of this article (doi:10.1007/s11552-009-9242-3) contains supplementary material, which is available to authorized users. PMID:19902308

Ray, Wilson Z.; Kasukurthi, Rahul; Yee, Andrew

2009-01-01

128

Nerve and Nerve Root Biomechanics  

Microsoft Academic Search

\\u000a Together, the relationship between the mechanical response of neural tissues and the related mechanisms of injury provide\\u000a a foundation for defining relevant thresholds for injury. The nerves and nerve roots are biologic structures with specific\\u000a and important functions, and whose response to mechanical loading can have immediate, long-lasting and widespread consequences.\\u000a In particular, when nerves or nerve roots are mechanically

Kristen J. Nicholson; Beth A. Winkelstein

129

Current Concepts in Rehabilitation Following Ulnar Collateral Ligament Reconstruction  

PubMed Central

Injuries to the ulnar collateral ligament (UCL) in throwing athletes frequently occurs from the repetitive valgus loading of the elbow during the throwing motion, which often results in surgical reconstruction of the UCL requiring a structured postoperative rehabilitation program. Several methods are currently used and recommended for UCL reconstruction using autogenous grafts in an attempt to reproduce the stabilizing function of the native UCL. Rehabilitation following surgical reconstruction of the UCL begins with range of motion and initial protection of the surgical reconstruction, along with resistive exercise for the entire upper extremity kinetic chain. Progressions for resistive exercise are followed that attempt to fully restore strength and local muscular endurance in the rotator cuff and scapular stabilizers, in addition to the distal upper extremity musculature, to allow for a return to throwing and overhead functional activities. Rehabilitation following UCL reconstruction has produced favorable outcomes, allowing for a return to throwing in competitive environments. PMID:23015887

Ellenbecker, Todd S.; Wilk, Kevin E.; Altchek, David W.; Andrews, James R.

2009-01-01

130

Ulnar collateral ligament in the overhead athlete: a current review.  

PubMed

Ulnar collateral ligament (UCL) injuries are most commonly reported in baseball players (particularly in pitchers) but have also been observed in other overhead athletes including javelin, softball, tennis, volleyball, water polo, and gymnastics. Partial injuries have been successfully treated with appropriate nonoperative measures but complete tears and chronic injuries have shown less benefit from conservative measures. In these cases, surgical reconstruction has become the treatment modality for overhead athlete who wishes to continue to play. This article discusses the functional anatomy and biomechanics of the UCL as related to the pathophysiology of overhead throwing, as well as the important clinical methods needed to make accurate and timely diagnosis. It also gives an updated review of the current clinical outcomes and complications of surgical reconstruction. PMID:25077747

Dugas, Jeffrey; Chronister, Justin; Cain, E Lyle; Andrews, James R

2014-09-01

131

Nerve conduits for nerve reconstruction  

Microsoft Academic Search

Although autogenous nerve grafting remains the gold standard for repair of peripheral nerve defects, the use of various conduits can be a substitute provided these conduits meet the above-mentioned prerequisites. For the moment, autogenous vein grafts or denatured muscle grafts can be used to bridge short defects, especially in distal sensory nerves. Incorporation of muscle into a vein graft expands

Huan Wang; William C. Lineaweaver

2002-01-01

132

Cranial Nerve II  

PubMed Central

This article contains a brief review of the anatomy of the visual system, a survey of diseases of the retina, optic nerve and lesions of the optic chiasm, and other visual field defects of special interest to the psychiatrist. It also includes a presentation of the corticothalamic mechanisms, differential diagnosis, and various manifestations of visual illusions, and simple and complex visual hallucinations, as well as the differential diagnoses of these various visual phenomena. PMID:19855858

Gillig, Paulette Marie; Sanders, Richard D.

2009-01-01

133

Peripheral Nerve Tumors  

Microsoft Academic Search

\\u000a Peripheral nerve tumors (PNTs) are rare soft tissue lesions that can arise anywhere on the body and as a result have a wide\\u000a differential diagnosis, which is often confirmed to be a PNT only at surgery. PNTs occur both sporadically and within the\\u000a context of genetically predisposing syndromes; hence, a thorough history of the mass and associated symptoms, with a

Joseph Wiley; Asis Kumar Bhattacharyya; Gelareh Zadeh; Patrick Shannon; Abhijit Guha

134

Vascular Anatomy and Clinical Application of the Free Proximal Ulnar Artery Perforator Flaps  

PubMed Central

Background: There is a dearth of detailed published work on the anatomy of ulnar artery perforators. The objective of this study was to fully document the vascular basis of the free proximal ulnar artery perforator flap and report its use in reconstruction of the hand. Methods: (1) The ulnar artery perforators were studied in 25 fresh cadavers and 10 cast preparations. Cadavers were injected with lead oxide for 3-dimensional reconstruction. The origin, course, and distribution of the ulnar artery perforators were comprehensively documented. (2) Between August 2011 and January 2013, 29 free proximal ulnar artery perforator flaps were utilized for reconstruction of soft-tissue defects of the hand in 25 patients. Flap size varied from 3.5 × 2.0 cm to 24.0 × 4.0 cm, with a consistent thickness of approximately 3 mm. Results: (1) There were 7 ± 2.0 ulnar artery perforators. The average external diameter was 0.6 ± 0.2 mm. Each perforator supplied an average area of 26 ± 7.0 cm2. Extensive anastomoses were found between the ulnar artery perforators and multiple adjacent source arteries. (2) All flaps survived. The clinical results were satisfactory after 10.2 ± 5.3 months of follow-up. The flaps were considered cosmetically acceptable by both patients and doctors. Conclusions: The main advantage of the proximal ulnar artery perforator flap is that it is a thin flap that is ideal for upper extremity reconstruction, either as proximally or distally based local perforator flap or as a free flap. The donor site is excellent, and the vascular anatomy is very consistent.

Wei, Yitao; Shi, Xiaotian; Yu, Yaling; Zhong, Guiwu; Tang, Maolin

2014-01-01

135

In vivo nerve-macrophage interactions following peripheral nerve injury  

PubMed Central

In vertebrates, the peripheral nervous system has retained its regenerative capacity, enabling severed axons to reconnect with their original synaptic targets. While it is well documented that a favorable environment is critical for nerve regeneration, the complex cellular interactions between injured nerves with cells in their environment, as well as the functional significance of these interactions, have not been determined in vivo and in real time. Here we provide the first minute-by-minute account of cellular interactions between laser transected motor nerves and macrophages in live intact zebrafish. We show that macrophages arrive at the lesion site long before axon fragmentation, much earlier than previously thought. Moreover, we find that axon fragmentation triggers macrophage invasion into the nerve to engulf axonal debris, and that delaying nerve fragmentation in a Wlds model does not alter macrophage recruitment but induces a previously unknown ‘nerve scanning’ behavior, suggesting that macrophage recruitment and subsequent nerve invasion are controlled by separate mechanisms. Finally, we demonstrate that macrophage recruitment, thought to be dependent on Schwann cell derived signals, occurs independently of Schwann cells. Thus, live cell imaging defines novel cellular and functional interactions between injured nerves and immune cells. PMID:22423110

Rosenberg, Allison; Wolman, Marc A.; Franzini-Armstrong, Clara; Granato, Michael

2012-01-01

136

Ulnar Wrist Pain in Athletes Caused by Erosion of the Floor of the Sixth Dorsal CompartmentA Case Series  

Microsoft Academic Search

Background: Ulnar-side wrist pain can be disabling for athletes because of limitation of pronation-supination during sports such as tennis and golf. Erosion of the floor of the sixth dorsal space should be considered for unresponsive ulnar-side wrist pain.Study Design: Case series; Level of evidence, 4.Methods: Four athletes with severe unresponsive ulnar-side wrist pain were identified. Because the usual treatment regimens

Ronaldo S. Carneiro; Rosana Fontana; Nilton Mazzer

2005-01-01

137

[Iatrogenic surgical injuries of the peripheral nerves].  

PubMed

Iatrogenic nerve injuries in operative area are undesirable but relatively common complications in relation to the total number of nerve injuries. These injuries are mostly caused by objective factors, especially by the nature of surgical lesion. Unfortunately, the role of surgeon is not irrelevant in large number of cases. The authors analyze a series of 39 iatrogenic surgical nerve injuries and the results of 30 repaired cases. PMID:1792573

Pajevi?, N; Grujici?, D; Samardzi?, M

1991-01-01

138

Extracranial lower cranial nerve sheath tumors  

Microsoft Academic Search

Objective: The purpose of this article is to review the clinicoradiographic features of lower cranial nerve sheath tumors and to outline surgical approaches that allow the safe and complete resection of these lesions. Methods: Thirteen patients with lower cranial nerve sheath tumors of the infratemporal fossa were surgically treated between 7\\/88 and 10\\/99. A retrospective chart analysis provided details pertaining

John P. Leonetti; Bryan Wachter; Sam J. Marzo; Guy Petruzzelli

2001-01-01

139

Primary ulnar superficial slip resection in complicated trigger finger.  

PubMed

Long standing trigger finger, often present for 6 months to years before consulting, can result in a lack of extension, which is often painful and may persist after section of the A1 pulley. The ulnar superficial slip resection (USSR) was introduced by Le Viet to address this problem. It is hypothesised that primary section of the A1 pulley with USSR resolves both extension lack and pain in longstanding trigger fingers with a painful extension lack. This retrospective study reviewed the results of primary USSR for longstanding trigger fingers (6 months or more) with painful extension lack in 18 patients. Locking was resolved and full extension was acquired in all cases (100%). Satisfaction rate was high (89%) and disability returned to normal after surgery. In two patients, satisfaction was low due to residual loss of flexion as a result of osteoarthritis and cold intolerance in another. It is concluded that the USSR procedure is a valuable primary surgical option in complicated trigger finger with painful extension lack caused by flexor tendon tendinosis. PMID:24679115

Degreef, Ilse; Devlieger, Benjamin; De Smet, Luc

2014-10-01

140

Isokinetic training increases ulnar bending stiffness and bone mineral in young women.  

PubMed

Numerous studies have investigated the effects of physical activity on bone health; however, little is known about the effects of isokinetic strength training on bone. While bone mineral density (BMD) is widely used to assess bone health and fracture risk, there are several limitations of this measure that warrant new technology development to measure bone strength. The mechanical response tissue analyzer (MRTA) assesses bone strength by measuring maximal bending stiffness (EI). We hypothesized that isokinetic strength training of the elbow flexors and extensors would increase ulnar EI, BMD, and bone mineral content (BMC) in young women. Fifty-four women trained the nondominant arm 3 times per week for 20 weeks; 32 trained concentrically (CON) and 22 trained eccentrically (ECC). Subjects were assessed for the following variables pre- and post-training: CON and ECC peak torque of the elbow flexors and extensors with isokinetic dynamometry, ulnar mineral content and density using dual-energy X-ray absorptiometry, and ulnar EI using MRTA. Isokinetic training increased CON (17%) and ECC (17%) peak torque, even when controlling for changes in the untrained arm. Eccentric training increased CON and ECC peak torque while CON training improved CON peak torque only. Isokinetic training increased ulnar EI 28%, which was statistically greater than the untrained arm. Ulnar EI increased 25% with CON training and 32% with ECC training. Both training modes resulted in greater EI gains compared to the untrained limb. Isokinetic training increased ulnar BMC (2.7%) and BMD (2.3%), even when controlling for untrained ulna changes. Both training modalities resulted in BMC and BMD increases; however, only CON training yielded gains when controlling for changes in the untrained limb. In conclusion, isokinetic strength training increases ulnar EI, BMC, and BMD in young women; no statistical differences were noted between CON and ECC training modes. PMID:17693150

Miller, Larry E; Wootten, David F; Nickols-Richardson, Sharon M; Ramp, Warren K; Steele, Charles R; Cotton, John R; Carneal, James P; Herbert, William G

2007-10-01

141

Improvement in nerve regeneration through a decellularized nerve graft by supplementation with bone marrow stromal cells in fibrin.  

PubMed

Acellular nerve grafting is often inferior as well as an inadequate alternative to autografting for the repair of long gaps in peripheral nerves. Moreover, the injection method is not perfect. During the injection of cells, the syringe can destroy the acellular nerve structure and the limited accumulation of seed cells. To resolve this problem, we constructed a nerve graft by acellular nerve grafting. Bone marrow-mesenchymal stromal cells (BM-MSCs) were affixed with fibrin glue and injected inside or around the graft, which was then used to repair a 15-mm nerve defect in rats. The acellular nerve graft maintained its structure and composition, and its tensile strength was decreased, as determined by two-photon microscopy and a tensile testing device. In vitro, MSCs embedded in fibrin glue survived and secreted growth factors such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF). We repaired 15-mm Sprague-Dawley rat sciatic nerve defects using this nerve graft construction, and MSCs injected around the graft helped improve nerve regeneration and functional recovery of peripheral nerve lesions as determined by functional analysis and histology. Therefore, we conclude that supplying MSCs in fibrin glue around acellular nerves is successful in maintaining the nerve structure and can support nerve regeneration similar to the direct injection of MSCs into the acellular nerve for long nerve defects but may avoid destroying the nerve graft. The technique is simple and is another option for stem cell transplantation. PMID:23128095

Zhao, Zhe; Wang, Yu; Peng, Jiang; Ren, Zhiwu; Zhang, Li; Guo, Quanyi; Xu, Wenjing; Lu, Shibi

2014-01-01

142

Melanocytic Malignant Peripheral Nerve Sheath Tumor of the Male Breast  

Microsoft Academic Search

SummaryBackground: Malignant peripheral nerve sheath tumors are rare tumor entities that originate from peripheral nerve sheaths and have an unfavorable prognosis. Common sites include deeper soft tissues, usually in the proximity of a nerve trunk. Breast is an absolutely rare location of this lesion, and presentation as a breast lump in the male breast is even rarer. Case Report: A

Haijun Wang; Jing Ge; Lirong Chen; Panpan Xie; Fangfang Chen; Yiding Chen

2009-01-01

143

Ultrasound imaging of the rabbit peroneal nerve.  

PubMed

Ultrasound imaging of peripheral nerves is increasingly used in the clinic for a wide range of applications. Although yet unapplied for experimental neuroscience, it also has potential value in this research area. This study explores the feasibility, possibilities and limitations of this technique in rabbits, with special focus on peripheral nerve regeneration after trauma. The peroneal nerve of 25 New Zealand White rabbits was imaged at varying time intervals after a crush lesion. The ultrasonic appearance of the nerve was determined, and recordings were validated with in vivo anatomy. Nerve swelling at the lesion site was estimated from ultrasound images and compared with anatomical parameters. The peroneal nerve could reliably be identified in all animals, and its course and anatomical variations agreed perfectly with anatomy. Nerve diameters from ultrasound were related to in vivo diameters (p < 0.001, R(2) = 77%), although the prediction interval was rather wide. Nerve thickenings could be visualized and preliminary results indicate that ultrasound can differentiate between neuroma formation and external nerve thickening. The value of the technique for experimental neuroscience is discussed. We conclude that ultrasound imaging of the rabbit peroneal nerve is feasible and that it is a promising tool for different research areas within the field of experimental neuroscience. PMID:16279986

de Kool, B S; van Neck, Johan W; Blok, Joleen H; Walbeehm, Erik T; Hekking, Ineke; Visser, Gerhard H

2005-12-01

144

A study of ulnar collateral ligament of the thumb metacarpophalangeal joint.  

PubMed

The current study examined the biomechanical properties of intact and repaired ulnar collateral ligaments of the metacarpophalangeal joint of the thumb to determine a safe rehabilitation protocol after repair. In the first part of the study mechanical properties of the ligament were examined and the induced stress and strain were determined during simulated pinch and grip. In the second part of the study the strength and limitations of ulnar collateral ligament repair using a mini-Mitek bone suture anchor was determined. The biomechanical study was done on 16 fresh-frozen thumbs from male cadavers. Failure load, maximum stress, and Young's modulus of intact ulnar collateral ligament were 294.3 +/- 28.2 N, 11.4 +/- 1.2 MPa, and 37.3 +/- 5.1 MPa, respectively. There was no significant correlation between the low grip force and the ligament strain. There was, however, a significant correlation between the pinch force and the ligament strain. The failure load and joint rigidity of intact ulnar collateral ligaments were significantly higher (3.1 and 2.3 times, respectively) than the mini-Mitek repaired ligaments. The current study suggests that pinch activity during the rehabilitative process after repair or reattachment of the ulnar collateral ligament should be eliminated. Repaired ligaments with mini-Mitek bone suture anchors may be able to do a moderate range of motion during postoperative rehabilitation; however, additional in vivo studies are necessary before any clinical recommendation is made. PMID:12360033

Firoozbakhsh, Keikhosrow; Yi, In Sok; Moneim, Moheb S; Umada, Yuji

2002-10-01

145

Ulnar aplasia, dysplastic radius and preaxial oligodactyly: Rare longitudinal limb defect in a sporadic male child  

PubMed Central

Ulnar hypoplasia is a rare longitudinal limb deficiency in which the ulna shows various degrees of deficiency. The condition is normally associated with radial defects, and in severe cases there is a reduction of postaxial/ulnar digits. Ulnar deficiency is an integral part of several syndromic malformations like Weyer's oligodactyly syndrome, limb/pelvis hypoplasia/aplasia syndrome, and ulnar-mammary syndrome. Here, we report an isolated unilateral ulnar deficiency in a boy who was a product of a consanguineous marriage. The subject demonstrated mesomelic shortening of the left arm with reduced zeugopod and autopod, and preaxial absence of two fingers. Additional findings in the affected limb were severe flexion contracture at the elbow joint, reduced and narrow palm, hypoplastic digits, and clinodactyly. Roentgenographic study revealed rudimentary ulna, dysplastic and posteriorly dislocated radius, crowding of carpals, and complete absence of digit rays of the thumb and index finger. Despite this anomaly, the subject could manage his daily life activities well. We present detailed clinical features and differential diagnosis of this rare limb malformation. PMID:24381628

Malik, Sajid; Afzal, Muhammad

2013-01-01

146

A rare anatomical variation of the Berrettini anastomosis and third common palmar digital branch of the median nerve.  

PubMed

Variations in the origin and distribution of Berrettini anastomosis between the digital branches of the ulnar and median nerves exist and are well described in the literature. During regular dissections by medical students, we encountered a rare variation in the left hand of an approximately 50-year-old male cadaver. Berrettini anastomosis connecting the third common palmar digital branch of the median nerve with the fourth common palmar and proper palmar digital branches of the ulnar nerve presented a plexiform nature. This communicating branch and the third common palmar digital branch of the median nerve were perforated by the superficial palmar arch. Further, the superficial palmar arch was incomplete, and it was solely formed by the superficial branch of the ulnar artery. The unusual relationship of Berrettini anastomosis with the superficial palmar arch is very rare, and knowledge about such a variation is important when performing carpal tunnel release, flexor tendon surgery, and Dupuytren's fasciectomy and when dealing with arterial repairs and vascular graft applications in the hand. PMID:23325577

Sirasanagandla, Srinivasa Rao; Patil, Jyothsna; Potu, Bhagath Kumar; Nayak, B Satheesha; Shetty, Surekha D; Bhat, Kumar M R

2013-06-01

147

Influence of recreational activity and muscle strength on ulnar bending stiffness in men  

NASA Technical Reports Server (NTRS)

Bone bending stiffness (modulus of elasticity [E] x moment of inertia [I]), a measure of bone strength, is related to its mineral content (BMC) and geometry and may be influenced by exercise. We evaluated the relationship of habitual recreational exercise and muscle strength to ulnar EI, width, and BMC in 51 healthy men, 28-61 yr of age. BMC and width were measured by single photon absorptiometry and EI by mechanical resistance tissue analysis. Maximum biceps strength was determined dynamically (1-RM) and grip strength isometrically. Subjects were classified as sedentary (S) (N = 13), moderately (M) (N = 18), or highly active (H) (N = 20) and exercised 0.2 +/- 0.2; 2.2 +/- 1.3; and 6.8 +/- 2.3 h.wk-1 (P < 0.001). H had greater biceps (P < 0.0005) and grip strength (P < 0.05), ulnar BMC (P < 0.05), and ulnar EI (P = 0.01) than M or S, who were similar. Amount of activity correlated with grip and biceps strength (r = 0.47 and 0.49; P < 0.001), but not with bone measurements, whereas muscle strength correlated with both EI and BMC (r = 0.40-0.52, P < 0.005). EI also correlated significantly with both BMC and ulnar width (P < 0.0001). Ulnar width and biceps strength were the only independent predictors of EI (r2 = 0.67, P < 0.0001). We conclude that levels of physical activity sufficient to increase arm strength influence ulnar bending stiffness.

Myburgh, K. H.; Charette, S.; Zhou, L.; Steele, C. R.; Arnaud, S.; Marcus, R.

1993-01-01

148

Quantitative determination of proximal radial and ulnar growth rates in foals using orthopedic markers  

E-print Network

OF PROXIMAL RADIAL AND ULNAR GROWTH RATES IN FOALS USING ORTHOPEDIC MARKERS Literature Review 1-5 Ulnar fractures are common injuries in the horse. The incidence reported was 1 in 100 fractures, 5 out of 5 12, 536 horses, 3 in 99 fractures, 4 cases in 3... markers (nos. 3-4) were used to evaluate the effects of radiographic magnification. Longitudinal bone growth should not have occurred in the mid-diaphyseal area of the ulna, and the difference between the 2 markers here did not change significantly (p...

Smith, Barbara Lynn

2012-06-07

149

Peripheral Nerve Disorders  

MedlinePLUS

... spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain ... body. There are more than 100 kinds of peripheral nerve disorders. They can affect one nerve or many nerves. ...

150

OPTICAL INHIBITION OF MOTOR NERVE AND MUSCLE ACTIVITY IN VIVO Holly Liske, MS,1  

E-print Network

neuron pathways.1 These lesions, which occur with cerebral palsy, stroke, and other cerebrospinal inhibition of motor nerve and muscle activity for treatment of spastic hypertonia. Methods: We used for spastic hypertonia. Key words: electromyography, halorhodopsin, optogenetics, sciatic nerve, spastic

Quake, Stephen R.

151

Pisotriquetral joint disorders: an under-recognized cause of ulnar side wrist pain.  

PubMed

Pisotriquetral joint disorders are often under-recognized in routine clinical practice. They nevertheless represent a significant cause of ulnar side wrist pain. The aim of this article is to present the main disorders of this joint and discuss the different imaging modalities that can be useful for its assessment. PMID:24687844

Moraux, A; Lefebvre, G; Pansini, V; Aucourt, J; Vandenbussche, L; Demondion, X; Cotten, A

2014-06-01

152

THE GYMNAST'S WRIST: ACQUIRED POSITIVE ULNAR VARIANCE FOLLOWING CHRONIC EPIPHYSEAL INJURY  

Microsoft Academic Search

Five cases of symptomatic acquired positive ulnar variance are described. All cases occurred due to premature physeal closure of the growth plate in teenage girl gymnasts. All cases demonstrated ulnocarpal impingement, for which we describe a clinical test.Arthroscopic assessment of the wrist allowed us to assess the integrity of the TFCC (triangular fibrocartilaginous complex) and decide on the most appropriate

A. R. TOLAT; P. L. SANDERSON; L. DE SMET; J. K. STANLEY

1992-01-01

153

MR neurography of sciatic nerve injection injury.  

PubMed

We report on magnetic resonance neurography (MRN) as a supplementary diagnostic tool in sciatic nerve injection injury. The object of the study was to test if T2-weighted (w) contrast within the sciatic nerve serves as an objective criterion for sciatic injection injury. Three patients presented with acute sensory and/or motor complaints in the distribution of the sciatic nerve after dorsogluteal injection and underwent MRN covering gluteal, thigh and knee levels. Native and contrast-enhanced T1-w images were employed to identify the tibial and peroneal division of the sciatic nerve while T2-w images with fat suppression allowed visualization of the site and extent of the nerve lesion. MRN in the two patients with clinically severe sensory and motor impairment correctly depicted sciatic injury: continuity of the T2-w lesion within the nerve at the lesion site and distal to it corresponded well to severe injury confirmed by NCS/EMG as axonotmetic or neurotmetic. Topography of the T2-w lesion on cross-section corresponded to predominant peroneal involvement; moreover, associated denervation patterns of distal target muscles were revealed. One of these patients completely recovered with concomitant complete regression of MRN abnormalities on follow-up. The third patient experienced transient sensory and mild motor impairment with complete recovery after 2 weeks. In this patient, T2-w signal within the nerve and distal target muscles remained normal indicating only mild, non-axonal nerve affliction. Our case series shows that MRN can be very useful in precisely determining the site of sciatic injection injury and may provide diagnostic criteria for the assessment of lesion severity and recovery. PMID:21225276

Pham, Mirko; Wessig, Carsten; Brinkhoff, Jörg; Reiners, Karlheinz; Stoll, Guido; Bendszus, Martin

2011-06-01

154

Nerve Racking  

NSDL National Science Digital Library

This lesson describes the function and components of the human nervous system. It helps students understand the purpose of our brain, spinal cord, nerves and the five senses. How the nervous system is affected during spaceflight is also discussed in this lesson.

Integrated Teaching And Learning Program

155

Regeneration of sutured human peripheral nerves: an electrophysiological study.  

PubMed Central

Electrophysiological and clinical assessment of recovery of function was undertaken on 34 median and 33 ulnar nerve which had been resutured after complete section three and a half months to 24 years previously. An evaluation of different methods of repair was attempted. Our results suggested that re-exploration of the site of suture is indicated in the absence of voluntary activity on needle EMG by seven months (12 months for grafts), of an electrically evoked muscle action potential, measurable distal motor latency, or motor nerve conduction velocity by 10 months (14 months for grafts), or of clinically detectable voluntary muscle movement by 10 months after suture. By present techniques of repair useful prognostic information cannot be obtained by a consideration of sensory parameters either clinical or electrophysiological. PMID:422969

Donoso, R S; Ballantyne, J P; Hansen, S

1979-01-01

156

Macrodactyly-Lipofibromatous Hamartoma of Nerves  

Microsoft Academic Search

\\u000a Lipofibromatous hamartoma of nerve (LFHN) is a very uncommon benign lipomatous tumor with specific clinicopathological characteristics which may present with\\u000a or without macrodactyly. This tumor-like lesion is composed of fibrous and fatty tissues arising from the epi- and perineurium\\u000a that surrounds and infiltrates the major nerves and their branches in the body (Enzinger and Weiss 1994). It is believed to

Carola Durŕn-Mckinster; Luz Orozco-Covarrubias; Marimar Saez-De-Ocariz; Ramňn Ruiz-Maldonado

157

Brachial Plexus Injuries Peripheral Nerve Injuries  

Microsoft Academic Search

\\u000a Evolving microsurgical techniques have significantly changed our attitude to surgical reconstruction of peripheral nerve lesions,\\u000a including those of the brachial plexus. However, because of the considerable distance the nerves have to regenerate after\\u000a restoring anatomical continuity in the brachial plexus, the results in adults have been modest, despite the more sophisticated\\u000a methods available. In contrast, similar methods in children give

Alain L. Gilbert; Rolfe Birch

158

Radius graft pedicled on the anterior interosseous artery for recurrent ulnar nonunion.  

PubMed

Recurrent ulnar nonunion challenges the functional prognosis and raises major problems concerning the best therapeutic strategy to follow. The case of a female patient presenting recurrent nonunion of the ulnar diaphysis despite successive treatments is reported. The radius graft pedicled on the anterior interosseous artery from a retrograde approach obtained bone union in 3 months with no functional sequelae. For the first time, we propose a therapeutic alternative calling on a proximally pedicled anterior interosseous flap. This technique can be performed under locoregional anesthesia and does not sacrifice the main artery of the forearm. However, the size of the graft does not entirely compensate for segmentary bone loss. The radius graft pedicled on the anterior interosseus artery is an inventive technique that can solve the problem of difficult ulna nonunions without the disadvantages of vascularized fibula harvesting. PMID:21530439

Andro, C; Richou, J; Schiele, P; Hu, W; Le Nen, D

2011-06-01

159

Transfixation pinning and casting of radial-ulnar fractures in calves: A review of three cases  

PubMed Central

We reviewed the medical records of three calves with radial-ulnar fractures which were reduced and stabilized by transfixation pinning and casting. Multiple Steinmann pins were placed transversely through proximal and distal fracture fragments and the pin ends were incorporated in fiberglass cast material after fracture reduction. Cast material was placed from proximal to distal radius and served as an external frame to maintain pin position and fracture reduction. At the time of injury, the calves ranged in age from one day to two months and weighed from 37-102 kg. Two fractures were comminuted and one was transverse. All fractures were closed. After surgery, all calves could walk within 24 hours. Radiographic and clinical evidence of fracture healing was present five to seven weeks (mean 6) after surgery. At that time, the pins and cast material were removed. Return to normal function was rapid and judged to be excellent at follow-up evaluation five to nine months later. Advantages of transfixation pinning and casting in management of radial-ulnar fractures include flexibility in pin positioning, adequate maintenance of reduction, early return to weight-bearing status, preservation of joint mobility, and ease of ambulation. The inability to adjust fixation and alignment after cast application is a disadvantage of this technique compared with other external fixators. We concluded that transfixation pinning is a useful means of stabilizing radial-ulnar fractures in pediatric bovine patients. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5. PMID:17423985

St-Jean, Guy; Debowes, Richard M.

1992-01-01

160

Detection of peripheral nerve pathology  

PubMed Central

Objective: To compare accuracy of ultrasound and MRI for detecting focal peripheral nerve pathology, excluding idiopathic carpal or cubital tunnel syndromes. Methods: We performed a retrospective review of patients referred for neuromuscular ultrasound to identify patients who had ultrasound and MRI of the same limb for suspected brachial plexopathy or mononeuropathies, excluding carpal/cubital tunnel syndromes. Ultrasound and MRI results were compared to diagnoses determined by surgical or, if not performed, clinical/electrodiagnostic evaluation. Results: We identified 53 patients who had both ultrasound and MRI of whom 46 (87%) had nerve pathology diagnosed by surgical (n = 39) or clinical/electrodiagnostic (n = 14) evaluation. Ultrasound detected the diagnosed nerve pathology (true positive) more often than MRI (43/46 vs 31/46, p < 0.001). Nerve pathology was correctly excluded (true negative) with equal frequency by MRI and ultrasound (both 6/7). In 25% (13/53), ultrasound was accurate (true positive or true negative) when MRI was not. These pathologies were typically (10/13) long (>2 cm) and only occasionally (2/13) outside the MRI field of view. MRI missed multifocal pathology identified with ultrasound in 6 of 7 patients, often (5/7) because pathology was outside the MRI field of view. Conclusions: Imaging frequently detects peripheral nerve pathology and contributes to the differential diagnosis in patients with mononeuropathies and brachial plexopathies. Ultrasound is more sensitive than MRI (93% vs 67%), has equivalent specificity (86%), and better identifies multifocal lesions than MRI. In sonographically accessible regions ultrasound is the preferred initial imaging modality for anatomic evaluation of suspected peripheral nervous system lesions. PMID:23553474

Seelig, Michael J.; Baker, Jonathan C.; Mackinnon, Susan E.; Pestronk, Alan

2013-01-01

161

[Fibrolipoma of the median nerve. A case report].  

PubMed

The authors report a case of fibrolipoma of the median nerve in a 6-year old boy presenting as macrodactyly with clinodactyly. The causal relationship between the nerve lesion and the deformities is discussed. The difficulties of diagnosis of the condition are presented as are the difficulties of management where a balance has to be struck between conservative treatment and amputation. PMID:18842445

Kossoko, H; Allah, C K; Richard Kadio, M; Yéo, S; Assi-Djč Bi Djč, V; Gueu, M

2008-12-01

162

Computer Simulation of Antidromic Facial Nerve Response Waveform  

Microsoft Academic Search

Conclusion: An assessment of facial nerve (FN) damage on the basis of antidromic facial nerve response (AFNR) was established by computer simulation analysis. Computer simulation has the advantage of being able to assume any type of lesion. In the near future, computer analysis should provide another experimental method which displaces animal experiments, thus circumventing the ethical dilemma associated with animal

Mitsuru Iwai; Taizo Takeda; Hiroaki Nakatani; Akinobu Kakigi

2009-01-01

163

Malignant peripheral nerve sheath tumor of the breast: case report  

Microsoft Academic Search

BACKGROUND: Malignant peripheral nerve sheath tumor is a rare soft tissue sarcoma of ectomesenchymal origin. It is the malignant counterpart of benign soft tissue tumors like neurofibromas and schwannomas and may often follow them. Common sites include deeper soft tissues, usually in the proximity of a nerve trunk. Breast is an extremely rare location of this lesion and presentation as

Kajal Kiran Dhingra; Shramana Mandal; Somak Roy; Nita Khurana

2007-01-01

164

Magnetic resonance appearance of peripheral nerve sheath tumors  

Microsoft Academic Search

Magnetic resonance imaging (MRI) was used to evaluate 22 histologically proven peripheral nerve sheath tumors, approximately two-thirds of which arose in the lower extremity. The histologic distribution was as follows: 12 schwannomas, 7 neurofibromas, and 3 malignant peripheral nerve sheath tumors (2 of which occurred in patients with neurofibromatosis). Most lesions demonstrated an intermediate to moderately bright signal on T1-weighted

Margaret A. Stull; Richard P. Moser; Mark J. Kransdorf; George P. Bogumill; Martha C. Nelson

1991-01-01

165

Myelinated sensory and alpha motor axon regeneration in peripheral nerve neuromas  

NASA Technical Reports Server (NTRS)

Histochemical staining for carbonic anhydrase and cholinesterase (CE) activities was used to analyze sensory and motor axon regeneration, respectively, during neuroma formation in transected and tube-encapsulated peripheral nerves. Median-ulnar and sciatic nerves in the rodent model permitted testing whether a 4 cm greater distance of the motor neuron soma from axotomy site or intrinsic differences between motor and sensory neurons influenced regeneration and neuroma formation 10, 30, and 90 days later. Ventral root radiculotomy confirmed that CE-stained axons were 97% alpha motor axons. Distance significantly delayed axon regeneration. When distance was negligible, sensory axons grew out sooner than motor axons, but motor axons regenerated to a greater quantity. These results indicate regeneration differences between axon subtypes and suggest more extensive branching of motor axons within the neuroma. Thus, both distance from injury site to soma and inherent motor and sensory differences should be considered in peripheral nerve repair strategies.

Macias, M. Y.; Lehman, C. T.; Sanger, J. R.; Riley, D. A.

1998-01-01

166

Cavernous nerve regeneration using acellular nerve grafts  

Microsoft Academic Search

Introduction  The restoration of erectile function following complete transection of nerve tissue during surgery remains challenging. Recently,\\u000a graft procedures using sural nerve grafts during radical prostatectomy have had favorable outcomes, and this has rekindled\\u000a interest in the applications of neural repair in a urologic setting. Although nerve repair using autologous donor graft is\\u000a the gold standard of treatment currently, donor nerve

Stephen S. Connolly; James J. Yoo; Mohamed Abouheba; Shay Soker; W. Scott McDougal; Anthony Atala

2008-01-01

167

Sabin attenuated LSc\\/2ab strain of poliovirus spreads to the spinal cord from a peripheral nerve in bonnet monkeys (Macaca radiata)  

Microsoft Academic Search

Vaccine-associated paralytic poliomyelitis is a serious concern while using the live attenuated oral polio vaccine for the eradication of poliomyelitis. The bonnet monkey model of poliovirus central nervous system (CNS) infection following experimental inoculation into the ulnar nerve allows the comparative study of wild-type and attenuated poliovirus invasiveness. Dosages & 104 TCID50 of Mahoney strain of poliovirus type 1 (PV1(M))

Esther M. Ponnuraj; T. Jacob John; Myron J. Levin; Eric A. F. Simoes

2001-01-01

168

Accumulation of F-Spondin in Injured Peripheral Nerve Promotes the Outgrowth of Sensory Axons  

Microsoft Academic Search

F-spondin, an extracellular matrix protein, is present in periph- eral nerve during embryonic development, but its amount di- minishes by birth. Axotomy of adult rat sciatic nerve, however, causes a massive upregulation of both F-spondin mRNA and protein distal to the lesion. F-spondin in the distal stump of axotomized nerve promotes neurite outgrowth of sensory neu-

Tal Burstyn-Cohen; Ayala Frumkin; Yi-Tian Xu; Steven S. Scherer; Avihu Klar

1998-01-01

169

Upregulation of Ryk expression in rat dorsal root ganglia after peripheral nerve injury  

Microsoft Academic Search

To study changes of Ryk expression in dorsal root ganglia (DRG) after peripheral nerve injury, we set up an animal model of unilateral sciatic nerve lesioned rats. Changes of Ryk protein expression in DRG neurons after unilateral sciatic nerve injury were investigated by immunostaining. Changes of Ryk mRNA were also tested by semi-quantitative PCR concurrently. We found, both at the

Xin Li; Yao-hua Li; Shun Yu; Yaobo Liu

2008-01-01

170

Intrasellar malignant peripheral nerve sheath tumor (MPNST)  

Microsoft Academic Search

Summary  Intracranial malignant peripheral nerve sheath tumors (MPNST) and intrasellar schwannomas are rare tumors. We describe a case\\u000a of an intrasellar schwannoma with progression to a MPNST, a finding that, although very rare, extends the differential diagnosis\\u000a of intrasellar lesions.

N. Krayenbühl; F. Heppner; Y. Yonekawa; R. L. Bernays

2007-01-01

171

Lipofibromatous hamartoma (neural fibrolipoma) of a flexor nerve of the index finger.  

PubMed

A 24 year old woman presented with a painless fusiform mass in her right index finger. Exploration showed an enlargement of the nerve by fibrofatty tissue and microsurgical intraneural dissection was done. Histological examination identified the lesion as a lipofibromatous hamartoma of the nerve, which is both rare and benign. There are different options for treatment of this lesion. PMID:9646375

Kronberger, P; Rainer, C; Hittmair, A; Anderl, H

1998-06-01

172

Thyroid Hormones and Peripheral Nerve Regeneration  

PubMed Central

Peripheral nerve regeneration is a unique process in which cellular rather than tissue response is involved. Depending on the extent and proximity of the lesion and the age and type of the neuronal soma, the cell body may either initiate a reparative response or may die. Microsurgical intervention may alter the prognosis after a peripheral nerve injury but to a certain extent. By altering the biochemical microenvironment of the neuron, we can increase the proportion of neurons that survive the injury and initiate the reparative response. Thyroid hormone critically regulates tissue growth and differentiation and plays a crucial role during organ development. Furthermore, recent research has provided new insight into thyroid hormone cellular action. Thyroid hormone regulates stress response intracellular signaling and targets molecules important for cytoskeletal stability and cell integrity. Changes in thyroid hormone signaling occur in nerve and other tissues, with important physiological consequences. The interest in thyroid hormone in the context of nerve regeneration has recently been revived. PMID:23607046

Papakostas, Ioannis D.; Macheras, George A.

2013-01-01

173

Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions.  

PubMed

Peripheral nerve enlargement may be seen in multiple conditions including hereditary or inflammatory neuropathies, sporadic or syndromic peripheral nerve sheath tumors, perineurioma, posttraumatic neuroma, and intraneural ganglion. Malignancies such as neurolymphoma, intraneural metastases, or sarcomas may also affect the peripheral nervous system and result in nerve enlargement. The imaging appearance and differentiating factors become especially relevant in the setting of tumor syndromes such as neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. This article reviews the typical magnetic resonance neurography imaging appearances of neurogenic as well as nonneurogenic neoplasms and tumorlike lesions of peripheral nerves, with emphasis on distinguishing factors. PMID:24210319

Ahlawat, Shivani; Chhabra, Avneesh; Blakely, Jaishri

2014-02-01

174

Supplemental Data Chronically CNS-Injured Adult Sensory Neurons Gain Regenerative Competence upon a Lesion of Their Peripheral Axon  

Microsoft Academic Search

(A) In conditioning after CNS injury, initially a dorsal column lesion (DCL) was made, followed by a peripheral sciatic nerve injury (PL) after two, four or eight weeks. Three days later, DRGs were dissected out. (B) In conditioning lesion before CNS injury, the sciatic nerve was cut and three days later the dorsal columns were lesioned. Subsequently, DRGs were dissected

Bhavna Ylera; Ali Ertürk; Farida Hellal; Fabien Nadrigny; Andres Hurtado; Sabina Tahirovic; Martin Oudega; Frank Kirchhoff; Frank Bradke

175

Primary Repair of Ulnar Collateral Ligament Injuries of the Elbow in Young AthletesA Case Series of Injuries to the Proximal and Distal Ends of the Ligament  

Microsoft Academic Search

Background: Little data exist regarding the treatment of young high school and college athletes with medial ulnar collateral ligament insufficiency of the elbow. It would be logical to assume that younger patients would have less damage to the ligament, allowing the possibility of repair.Hypothesis: Many young athletes with injuries to the medial ulnar collateral ligament have proximal or distal injuries

Felix H. Savoie; Scott W. Trenhaile; John Roberts; Larry D. Field; J. Randall Ramsey

2008-01-01

176

Radiocephalic Fistula Complicated by Distal Ischemia: Treatment by Ulnar Artery Dilatation  

SciTech Connect

Hand ischemic steal syndrome due to a forearm arteriovenous fistula is a rare occurrence. However, its frequency is increasing with the rise in numbers of elderly and diabetic patients. This complication, which is more common for proximal than for distal accesses, can be very severe and may cause loss of hand function, damage to fingers, and even amputation of fingers or the hand. Its treatment is difficult and often leads to access loss. We report here a case of severe hand ischemia related to a radiocephalic fistula successfully treated by ulnar artery dilatation.

Raynaud, Alain; Novelli, Luigi, E-mail: sfanfy@gmail.com; Rovani, Xavier; Carreres, Thierry [Clinique Alleray Labrouste, Department of Cardiovascular and Interventional Radiology (France); Bourquelot, Pierre [Clinique Jouvenet (France); Hermelin, Alain; Angel, C.; Beyssen, B. [Clinique Alleray Labrouste, Department of Cardiovascular and Interventional Radiology (France)

2010-02-15

177

Imaging features on sonography and MRI in a case of lipofibromatous hamartoma of the median nerve  

PubMed Central

Lipofibromatous hamartomas are rare benign tumours of Peripheral nerves. Median nerve is most common affected nerve involved in about 80 percent of the cases. Approximately 92 cases have been reported so far. We present a case of lipofibromatous hamartoma of median nerve diagnosed on sonography and magnetic resonance imaging (MRI). These rare lesions are an important entity to be known to radiologists because their imaging features are quite pathognomonic and allow for confident diagnosis negating the need for biopsy. PMID:24914422

Arora, Abhishek J.

2014-01-01

178

Malignant epithelioid cranial nerve sheath tumor: case report of a radiation response  

Microsoft Academic Search

Summary  Malignant epithelioid nerve sheath tumors (MESs) especially those involving intracranial cranial nerves are rare and thought\\u000a to be radioresistant. We report a case of a MES involving the Vth and VIIth cranial nerves responsive to radiotherapy. A 41-year-old\\u000a man with progressive left facial weakness underwent an MRI that disclosed an enhancing lesion involving both V3 cranial nerve and the distal

Barbara J. Fisher; Kristopher E. B. Dennis

2006-01-01

179

Peripheral Nerve Regeneration by Artificial Nerve Guides  

Microsoft Academic Search

It is more than 20 years since artificial nerve guides (or conduits) were introduced into clinical practice as a reliable\\u000a alternative to autograft. They are basically cylindrical conduits inside which a regenerating nerve stump may find protection\\u000a and guidance. Early guides were made of silicone and were not biodegradable; they were shown to support nerve regeneration\\u000a but, subsequently, were considered

A. Merolli; L. Rocchi

180

Sciatic Nerve Injury Related to Hip Replacement Surgery: Imaging Detection by MR Neurography Despite Susceptibility Artifacts  

PubMed Central

Sciatic nerve palsy related to hip replacement surgery (HRS) is among the most common causes of sciatic neuropathies. The sciatic nerve may be injured by various different periprocedural mechanisms. The precise localization and extension of the nerve lesion, the determination of nerve continuity, lesion severity, and fascicular lesion distribution are essential for assessing the potential of spontaneous recovery and thereby avoiding delayed or inappropriate therapy. Adequate therapy is in many cases limited to conservative management, but in certain cases early surgical exploration and release of the nerve is indicated. Nerve-conduction-studies and electromyography are essential in the diagnosis of nerve injuries. In postsurgical nerve injuries, additional diagnostic imaging is important as well, in particular to detect or rule out direct mechanical compromise. Especially in the presence of metallic implants, commonly applied diagnostic imaging tests generally fail to adequately visualize nervous tissue. MRI has been deemed problematic due to implant-related artifacts after HRS. In this study, we describe for the first time the spectrum of imaging findings of Magnetic Resonance neurography (MRN) employing pulse sequences relatively insensitive to susceptibility artifacts (susceptibility insensitive MRN, siMRN) in a series of 9 patients with HRS procedure related sciatic nerve palsy. We were able to determine the localization and fascicular distribution of the sciatic nerve lesion in all 9 patients, which clearly showed on imaging predominant involvement of the peroneal more than the tibial division of the sciatic nerve. In 2 patients siMRN revealed direct mechanical compromise of the nerve by surgical material, and in one of these cases indication for surgical release of the sciatic nerve was based on siMRN. Thus, in selected cases of HRS related neuropathies, especially when surgical exploration of the nerve is considered, siMRN, with its potential to largely overcome implant related artifacts, is a useful diagnostic addition to nerve-conduction-studies and electromyography. PMID:24558483

Wolf, Marcel; Baumer, Philipp; Pedro, Maria; Dombert, Thomas; Staub, Frank; Heiland, Sabine; Bendszus, Martin; Pham, Mirko

2014-01-01

181

Sciatic nerve injury related to hip replacement surgery: imaging detection by MR neurography despite susceptibility artifacts.  

PubMed

Sciatic nerve palsy related to hip replacement surgery (HRS) is among the most common causes of sciatic neuropathies. The sciatic nerve may be injured by various different periprocedural mechanisms. The precise localization and extension of the nerve lesion, the determination of nerve continuity, lesion severity, and fascicular lesion distribution are essential for assessing the potential of spontaneous recovery and thereby avoiding delayed or inappropriate therapy. Adequate therapy is in many cases limited to conservative management, but in certain cases early surgical exploration and release of the nerve is indicated. Nerve-conduction-studies and electromyography are essential in the diagnosis of nerve injuries. In postsurgical nerve injuries, additional diagnostic imaging is important as well, in particular to detect or rule out direct mechanical compromise. Especially in the presence of metallic implants, commonly applied diagnostic imaging tests generally fail to adequately visualize nervous tissue. MRI has been deemed problematic due to implant-related artifacts after HRS. In this study, we describe for the first time the spectrum of imaging findings of Magnetic Resonance neurography (MRN) employing pulse sequences relatively insensitive to susceptibility artifacts (susceptibility insensitive MRN, siMRN) in a series of 9 patients with HRS procedure related sciatic nerve palsy. We were able to determine the localization and fascicular distribution of the sciatic nerve lesion in all 9 patients, which clearly showed on imaging predominant involvement of the peroneal more than the tibial division of the sciatic nerve. In 2 patients siMRN revealed direct mechanical compromise of the nerve by surgical material, and in one of these cases indication for surgical release of the sciatic nerve was based on siMRN. Thus, in selected cases of HRS related neuropathies, especially when surgical exploration of the nerve is considered, siMRN, with its potential to largely overcome implant related artifacts, is a useful diagnostic addition to nerve-conduction-studies and electromyography. PMID:24558483

Wolf, Marcel; Bäumer, Philipp; Pedro, Maria; Dombert, Thomas; Staub, Frank; Heiland, Sabine; Bendszus, Martin; Pham, Mirko

2014-01-01

182

Electromechanical Nerve Stimulator  

NASA Technical Reports Server (NTRS)

Nerve stimulator applies and/or measures precisely controlled force and/or displacement to nerve so response of nerve measured. Consists of three major components connected in tandem: miniature probe with spherical tip; transducer; and actuator. Probe applies force to nerve, transducer measures force and sends feedback signal to control circuitry, and actuator positions force transducer and probe. Separate box houses control circuits and panel. Operator uses panel to select operating mode and parameters. Stimulator used in research to characterize behavior of nerve under various conditions of temperature, anesthesia, ventilation, and prior damage to nerve. Also used clinically to assess damage to nerve from disease or accident and to monitor response of nerve during surgery.

Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

1993-01-01

183

Optic Nerve Imaging  

MedlinePLUS

... Tomography (OCT) , which measures the reflection of laser light much like an ultrasound measures the reflection of sound, can directly measure the thickness of the nerve fiber layer and create a three dimensional representation of the optic nerve. ...

184

Engineering Peripheral Nerve Repair  

PubMed Central

Current approaches for treating peripheral nerve injury have resulted in promising, yet insufficient functional recovery compared to the clinical standard of care, autologous nerve grafts. In order to design a construct that can match the regenerative potential of the autograft, all facets of nerve tissue must be incorporated in a combinatorial therapy. Engineered biomaterial scaffolds in the future will have to promote enhanced regeneration and appropriate reinnervation by targeting the highly sensitive response of regenerating nerves to their surrounding microenvironment. PMID:23790730

Marquardt, Laura; Sakiyama-Elbert, Shelly E.

2013-01-01

185

Middle ear osteoma causing progressive facial nerve weakness: a case report  

PubMed Central

Introduction Facial nerve weakness is most commonly due to Bell’s palsy or cerebrovascular accidents. Rarely, middle ear tumor presents with facial nerve dysfunction. Case presentation We report a very unusual case of middle ear osteoma in a 49-year-old Caucasian woman causing progressive facial nerve deficit. A subtle middle ear lesion was observed on otoscopy and computed tomographic images demonstrated an osseous middle ear tumor. Complete surgical excision resulted in the partial recovery of facial nerve function. Conclusions Facial nerve dysfunction is rarely caused by middle ear tumors. The weakness is typically due to a compressive effect on the middle ear portion of the facial nerve. Early recognition is crucial since removal of these lesions may lead to the recuperation of facial nerve function.

2014-01-01

186

Pink lesions.  

PubMed

Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions. PMID:24075552

Giacomel, Jason; Zalaudek, Iris

2013-10-01

187

Optic nerve trauma.  

PubMed

Trauma to the optic nerve may be direct, such as from a penetrating object, or indirect, which may result despite lack of direct contact of an object with the nerve. Although indirect injury initially causes no change in the appearance of the nerve head, within a matter of weeks optic atrophy will be manifest. The pathophysiology of nerve damage is incompletely understood. Management is controversial; steroid therapy has been advocated, as has surgical decompression of the nerve. Indirect injuries affecting the optic nerve may also result from torsional rotation of the globe (avulsion) and from subdural or subarachnoid hemorrhage (Terson's syndrome). There is no treatment for optic nerve avulsion; the unaffected eye should be protected with appropriate eyewear. Hemorrhaging in the retina and vitreous in Terson's syndrome should be monitored for resolution and risk of retinal detachment. Computed tomography may be necessary if subarachnoid or intracranial hemorrhages are suspected. PMID:8268699

Dul, M W

1993-01-01

188

Humeral diaphyseal osteochondroma causing median nerve injury.  

PubMed

Osteochondromas are the most common benign tumours of the bone. They are solitary or multiple, pedunculated or sessile exophytic outgrowths from the bone surface that are composed of cortical and medullary component with an overlying hyaline cartilage cap. Marrow and cortical continuity with the underlying parent bone is the characteristic of the lesion; they mostly arise from the metaphysis of the bone. Osteochondromas arising from the diaphysis are rare; and nerve palsy arising in the setting of a diaphyseal osteochondroma is even rarer. This is a report of solitary osteochondroma arising from diaphysis of left humerus in a 10 years old boy, which resulted in median nerve palsy. Surgical excision relieved the symptoms completely. The aim of this case report was to draw attention to an unusual etiology of median nerve palsy caused by an osteochondroma arising from the diaphysis of humerus which is a rare site, and to emphasize its importance. PMID:24718003

Mohindra, Mukul; Tiwari, Anurag; Gogna, Paritosh; Thora, Ankit

2014-03-01

189

The ulnar digital artery perforator flap: A new flap for little finger reconstruction - A preliminary report  

PubMed Central

An ulnar digital artery perforator flap was used for little finger reconstruction. The flap has a reliable blood supply, being perfused by a constant sizeable perforator. This paper describes a study of a cadaveric dissection with methylene blue dye that was conducted to prove the rationality and reliability of the blood supply. The position of the perforator is confirmed intraoperatively by an exploratory incision before committing to the distal incision. The flap used to cover the flexor aspect of the little finger in three cases yielded positive results. To our knowledge, a digital artery perforator flap of this nature is unprecedented. We propose to call this flap the B.J. Flap after our institute. PMID:21217979

Panse, Nikhil; Sahasrabudhe, Parag

2010-01-01

190

[Electroneuromyographic study of the radial nerve at the brachium level: standard values and conduction block].  

PubMed

A study aims to design an electroneuromyographic technique of radial nerve investigation and conduction block (CB) definition at the spiral groove level using surface electrodes. Eight healthy volunteers, 17 patients with focal radial nerve neuropathy in the spiral groove, 4 patients with a complete injury of the radial nerve aged from 22 to 54 years have been studied. The M-response was recorded from the extensor digitorum communis. Stimulation was performed at (1) the lateral brachium; (2) the Erb's point; (3) the medical brachium (stimulation of the median and ulnar nerves). Normal values have been determined. CB was calculated as follows: 100-A2/(A1+A3)*100%, where A1--a value of the M-response area amplitude at first point stimulation, A2--the second one, A3--the third one. The proximal M-response is the sum of motor unit action potentials of posterior and anterior groups of forearm muscles. Proximal M-response in patients with a complete injury of the radial nerve did not differ from the third one. The correlation between CB and the paresis degree as well as surface EMG were revealed in patients with radial neuropathy. Besides, there was correlation between CB and the percentage contribution of the third M-response in proximal one in this group. PMID:16921717

Khodulev, V I

2006-01-01

191

Surgical utility of the Lanz classification of median nerve ramification.  

PubMed

The authors comment on the Lanz classification of the median nerve ramification at wrist level. The authors outline the importance of having very good knowledge of this classification for hand surgeons, plastic surgeons and neurosurgeons, in order to prevent iatrogenic lesions of the median nerve branches at wrist level. The regional anatomy is of utmost importance for carpal tunnel syndrome surgery, especially the mini-invasive and endoscopic techniques. PMID:23958082

B?doiu, Sc; Strâmbu, V; Lasc?r, I

2013-01-01

192

Neural fibrolipoma of the digital nerve: a case report.  

PubMed

A 32-year-old woman underwent microsurgical resection of a neural fibrolipoma of the digital nerve of the ring finger. At the 6-month follow-up, the patient had good recovery, no recurrence, and preservation of neural function. Caution should be exercised while planning microsurgical dissection on soft-tissue masses of fingers and hands. Total resection of the lesion and nerve grafting should be avoided. PMID:21519094

Gundes, Hakan; Alici, Tugrul; Sahin, Mustafa

2011-04-01

193

The Furcal Nerve Revisited  

PubMed Central

Atypical sciatica and discrepancy between clinical presentation and imaging findings is a dilemma for treating surgeon in management of lumbar disc herniation. It also constitutes ground for failed back surgery and potential litigations thereof. Furcal nerve (Furcal = forked) is an independent nerve with its own ventral and dorsal branches (rootlets) and forms a link nerve that connects lumbar and sacral plexus. Its fibers branch out to be part of femoral and obturator nerves in-addition to the lumbosacral trunk. It is most commonly found at L4 level and is the most common cause of atypical presentation of radiculopathy/sciatica. Very little is published about the furcal nerve and many are unaware of its existence. This article summarizes all the existing evidence about furcal nerve in English literature in an attempt to create awareness and offer insight about this unique entity to fellow colleagues/professionals involved in spine care.

Dabke, Harshad V.

2014-01-01

194

Electromyographic response persists after peripheral transection: endorsement of current concepts in recurrent laryngeal nerve monitoring in a porcine model  

Microsoft Academic Search

Background  Recurrent laryngeal nerve palsy is a serious complication of endocrine surgery to the neck. Permanent lesions are still occurring\\u000a in about one in a hundred, despite standardized surgical approach to the nerve and the availability of recurrent laryngeal\\u000a nerve monitoring. Intraoperative recurrent laryngeal nerve monitoring is based on the visual or acoustic registration of evoked\\u000a electromyography of the laryngeal muscles.

Torsten Birkholz; Andrea Irouschek; Dirk Labahn; Peter Klein; Joachim Schmidt

2010-01-01

195

Nerve and Blood Vessels  

Microsoft Academic Search

From the histologic point of view, nerves are round or flattened cords, with a complex internal structure made of myelinated\\u000a and unmyelinated nerve fibers, containing axons and Schwann cells grouped in fascicles (Fig. 4.1a) (Erickson 1997). Along the course of the nerve, fibers can traverse from one fascicle to another and fascicles can split and merge. Based\\u000a on the fascicular

Maura Valle; Maria Pia Zamorani

196

The Mouse Median Nerve Experimental Model in Regenerative Research  

PubMed Central

Sciatic nerve crush injury in rat animal model is one of the most common experimental models used in regenerative research. However, the availability of transgenic mouse for nerve regeneration studies is constantly increasing and, therefore, the shift from rat model to mouse model is, in some cases, necessary. Moreover, since most of the human nerve lesions occur in the upper limb, it is also advantageous to shift from sciatic nerve to median nerve. In this study we described an experimental model which involves lesions of the median nerve in the mouse. Data showed that the finger flexor muscle contraction strength, assessed to evaluate the motor function recovery, and reached values not different from the control already 20 days after injury. The degree of nerve regeneration evaluated with stereological methods in light microscopy showed that, 25 days after injury, the number of regenerated myelinated fibers was comparable to the control, but they were smaller with a thinner myelin thickness. Stereological analysis made in electron microscopy confirmed these results, although the total number of fibers quantified was significantly higher compared to light microscopy analysis, due to the very small size of some fibers that can be detected only in electron microscopy.

Buskbjerg Jager, Sara

2014-01-01

197

Major peripheral nerve injuries.  

PubMed

Major peripheral nerve injuries in the upper extremities can result in significant morbidity. Understanding the pathophysiology of these injuries aids in the assessment and planning of appropriate treatment. With limited nerve mobilization, tension-free repairs can often be performed using sutures, fibrin glue, or nerve connectors. Acellular allograft and autograft reconstruction are better for bridging any gaps greater than a few millimeters. Adherence to proper principles of nerve repair improves the chances of achieving a favorable result, although in general these injuries portend a guarded prognosis. PMID:23895717

Isaacs, Jonathan

2013-08-01

198

Combined surgical treatment for missed rupture of triceps tendon associated with avulsion of the ulnar collateral ligament and flexor-pronator muscle mass  

Microsoft Academic Search

Triceps tendon ruptures are rare injuries. Coexistence of ipsilateral ulnar collateral ligament injury is even rarer. Here,\\u000a we describe an unusual combination injury to elbow of a 39-year-old male construction worker consisting of triceps tendon\\u000a rupture, avulsion of elbow ulnar collateral ligament and flexor pronator muscle origin ipsilaterally. A simultaneous repair\\u000a and reconstruction of all damaged structures was proposed with

Bulent Daglar; Onder M. Delialioglu; Erman Ceyhan; Okyar Altas; Kenan Bayrakci; Ugur Gunel

2009-01-01

199

Midbrain infarction causing oculomotor nerve palsy and ipsilateral cerebellar ataxia.  

PubMed

We herein report the case of an 81-year-old woman with midbrain infarction causing pupil-sparing oculomotor nerve palsy with ipsilateral cerebellar ataxia. The lesion was located at the rostral end of the decussation of the superior cerebellar peduncle touching the dorsal side, further caudal and dorsal to causal lesions of Claude's syndrome, which presented as oculomotor palsy and contralateral cerebellar ataxia. This is the third report of midbrain infarction causing partial oculomotor nerve palsy with ipsilateral cerebellar ataxia. It may be possible to establish this entity as a new syndrome following the accumulation of more cases. PMID:25224204

Tokunaga, Makoto; Fukunaga, Kimiko; Nakanishi, Ryoji; Watanabe, Susumu; Yamanaga, Hiroaki

2014-01-01

200

High-Frequency Transcutaneous Peripheral Nerve Stimulation Induces a Higher Increase of Heat Pain Threshold in the Cutaneous Area of the Stimulated Nerve When Confronted to the Neighbouring Areas  

PubMed Central

Background. TENS (transcutaneous electrical nerve stimulation) is probably the most diffused physical therapy used for antalgic purposes. Although it continues to be used by trial and error, correct targeting of paresthesias evoked by the electrical stimulation on the painful area is diffusely considered very important for pain relief. Aim. To investigate if TENS antalgic effect is higher in the cutaneous area of the stimulated nerve when confronted to neighbouring areas. Methods. 10 volunteers (4 males, 6 females) underwent three different sessions: in two, heat pain thresholds (HPTs) were measured on the dorsal hand skin before, during and after electrical stimulation (100?Hz, 0.1?msec) of superficial radial nerve; in the third session HPTs, were measured without any stimulation. Results. Radial nerve stimulation induced an increase of HPT significantly higher in its cutaneous territory when confronted to the neighbouring ulnar nerve territory, and antalgic effect persisted beyond the stimulation time. Conclusions. The location of TENS electrodes is crucial for obtaining the strongest pain relief, and peripheral nerve trunk stimulation is advised whenever possible. Moreover, the present study indicates that continuous stimulation could be unnecessary, suggesting a strategy for avoiding the well-known tolerance-like effect of prolonged TENS application. PMID:24027756

Buonocore, M.; Camuzzini, N.; Cecini, M.; Dalla Toffola, E.

2013-01-01

201

Common peroneal nerve palsy due to hematoma at the fibular neck.  

PubMed

Common peroneal nerve palsy is an infrequent pathology mostly related to endogenous or exogenous compression. The exogenous compression is frequently related to trauma: knee fractures or hematoma arisen after a direct blow. Fractures may cause a direct lesion of the nerve; hematoma causes a compression of the nerve at the fibular neck causing pain and functional loss. Lesions of the common peroneal nerve can also be related to total knee arthroplasty. The clinical evaluation is characterized by muscle weakness with or without sensory abnormality. The etiopathogeneses of the compression have to be confirmed by ultrasound or magnetic resonance imaging before the surgical treatment. The purpose of this article is to describe a case of common peroneal nerve palsy due to a posttraumatic hematoma after a sport-related injury. We evaluated this case with dynamic ultrasound with good visualization of the morphology of the lesion and of the compression. PMID:23283631

Girolami, Mauro; Galletti, Stefano; Montanari, Giorgio; Mignani, Giuseppe; Schuh, Reinhard; Ellis, Scott; Di Motta, Daniele; D'Apote, Giulia; Bevoni, Roberto

2013-12-01

202

Intravenous Transplantation of Mesenchymal Stromal Cells to Enhance Peripheral Nerve Regeneration  

PubMed Central

Peripheral nerve injury is a common and devastating complication after trauma and can cause irreversible impairment or even complete functional loss of the affected limb. While peripheral nerve repair results in some axonal regeneration and functional recovery, the clinical outcome is not optimal and research continues to optimize functional recovery after nerve repair. Cell transplantation approaches are being used experimentally to enhance regeneration. Intravenous infusion of mesenchymal stromal cells (MSCs) into spinal cord injury and stroke was shown to improve functional outcome. However, the repair potential of intravenously transplanted MSCs in peripheral nerve injury has not been addressed yet. Here we describe the impact of intravenously infused MSCs on functional outcome in a peripheral nerve injury model. Rat sciatic nerves were transected followed, by intravenous MSCs transplantation. Footprint analysis was carried out and 21 days after transplantation, the nerves were removed for histology. Labelled MSCs were found in the sciatic nerve lesion site after intravenous injection and regeneration was improved. Intravenously infused MSCs after acute peripheral nerve target the lesion site and survive within the nerve and the MSC treated group showed greater functional improvement. The results of study suggest that nerve repair with cell transplantation could lead to greater functional outcome. PMID:24459671

Matthes, Stella M.; Reimers, Kerstin; Janssen, Insa; Kocsis, Jeffery D.; Vogt, Peter M.; Radtke, Christine

2013-01-01

203

Efficacy and safety of transient ulnar artery compression to recanalize acute radial artery occlusion after transradial catheterization.  

PubMed

Radial artery occlusion (RAO) can result from transradial catheterization. We compared the incidence of RAO with 2 heparin dosage regimens after transradial coronary angiography, and we evaluated the efficacy and safety of transient homolateral ulnar artery compression to achieve acute radial artery recanalization. Patients referred for coronary angiography were randomized to very-low-dose heparin (2,000 IU) or low-dose heparin (5,000 IU). On sheath removal, hemostasis was obtained using the TR band with a plethysmography-guided patent hemostasis technique. In the case of RAO as assessed by duplex ultrasonography 3 to 4 hours after hemostasis, immediate 1-hour ulnar artery compression was applied. Hematomas >15 cm(2) were also assessed. We randomized 465 patients, 222 in the 2,000-IU group and 243 in the 5,000-IU group. The baseline and procedural characteristics were comparable in both groups. The incidence of initial RAO was 5.9% in the 2,000-IU group and 2.9% in the 5,000-IU group (p = 0.17), with a compression time of 2.10 ± 0.78 hours and 2.25 ± 0.82 hours, respectively (p = 0.051). After ulnar artery compression, the final incidence of RAO was 4.1% in the 2,000-IU group and 0.8% in the 5,000-IU group (p = 0.03). The incidence of local hematoma was 2.3% and 3.7% in the 2,000- and 5,000-IU groups, respectively (p = 0.42). In conclusion, acute RAO after transradial catheterization can be recanalized by early 1-hour homolateral ulnar artery compression. This simple nonpharmacologic method was effective and safe in patients with very-low- and low-dose heparin. Nevertheless, the incidence of final RAO remained significantly lower after a higher anticoagulation level. PMID:21439528

Bernat, Ivo; Bertrand, Olivier F; Rokyta, Richard; Kacer, Martin; Pesek, Jan; Koza, Jiri; Smid, Michal; Bruhova, Hana; Sterbakova, Gabriela; Stepankova, Lucie; Costerousse, Olivier

2011-06-01

204

Vagus nerve stimulation for standardized monitoring: technical notes for conventional and endoscopic thyroidectomy.  

PubMed

Standardization of the intraoperative neuromonitoring (IONM) technique is an essential aspect of modern monitored thyroid surgery. The standardized technique involves vagal nerve stimulation. VN stimulation is useful for technical problem solving, detecting non-recurrent laryngeal nerve (non-RLN), recognizing any recurrent laryngeal nerve (RLN) lesions, and precisely predicting RLN postoperative function. Herein, we present technical notes for the VN identification to achieve the critical view of safety of the VN stimulation with or without dissection. PMID:23860931

Dionigi, Gianlorenzo; Kim, Hoon Yub; Wu, Che-Wei; Lavazza, Matteo; Ferrari, Cesare; Leotta, Andrea; Spampatti, Sebastiano; Rovera, Francesca; Rausei, Stefano; Boni, Luigi; Chiang, Feng-Yu

2013-09-01

205

Effects of Electrical Stimulation and Testosterone in Translational Models of Facial Nerve Injury  

Microsoft Academic Search

Among the various peripheral nervous system injuries seen clinically, facial nerve lesions are prevalent and have significant functional and emotional impact on patients. As injuries can occur in different segments of the facial nerve and lead to different pathophysiological outcomes, animal models that mimic the common sites of injury need to be developed so that potential therapies can be appropriately

Nijee Sharma

2011-01-01

206

Malignant peripheral nerve sheath tumor in neurobifromatosis type-1: two case reports  

Microsoft Academic Search

INTRODUCTION: Malignant peripheral nerve sheath tumors are rare soft tissue sarcomas. They are considered to carry a poor prognosis with current therapeutic approaches. Successful treatment depends on a multimodal approach. CASE PRESENTATION: The authors report two cases with malignant peripheral nerve sheath tumors arising from pre-existing neurofibromas in the grounds of neurofibromatis-type I. Complete surgical removal of all lesions is

Christos Kosmas; George Tsakonas; Katerina Evgenidi; Argyris Gassiamis; Lefkothea Savva; Nikolaos Mylonakis; Athanasios Karabelis

2009-01-01

207

Ultrasound Neurography in the Evaluation of Sciatic Nerve Injuries  

PubMed Central

[Purpose] The aim of this clinical study was to investigate the benefits and the basic principles of ultrasonographic examination in the evaluation of sciatic nerve injuries. [Subjects and Methods] Patients with sciatic nerve injury were evaluated using a real-time utrasonographic examination. The capabilty of ultrasonography in terms of determination of the type and the localization of injury, the position of the proximal and distal nerve segments, the presence or absence of a neuroma, and perilesional scar tissue were evaluated in all cases. [Results] Ten cases with sciatic nerve injury were evaluated with real time sonography. Perilesional scar tissue formation was found in 4 (40%) cases. Two (20%) cases had stump neuroma diagnosed by sonographic examination. The capability of ultrasonographic examination was satisfactory for all evaluation parameters. [Conclusion] Ultrasonographic examination of sciatic nerve lesions may be used for the description of the degree of injury, determination of complete or incomplete nerve sectioning, the presence of hematoma and foreign body, the continuity of nerve, determination of nerve stumps, formation of perilesional scar tissue, and the presence of neuroma. PMID:24259759

Bilgici, Ayhan; Cokluk, Cengiz; Ayd?n, Keramettin

2013-01-01

208

[Malignant peripheral nerve sheath tumour of the infra-orbital nerve].  

PubMed

A malignant peripheral nerve sheath tumour (MPNST) is an uncommon neoplasm that rarely involves the head and neck region. It is even more infrequent for these tumours to affect cranial nerves. We report the case of a 53-year-old man who presented a MPNST involving the infra-orbital nerve, which extended through the orbit and the base of the skull, progressing intracranially. Histological studies identified the tumour as an MPNST. Response to radiotherapy was not complete and radical surgical resection was impossible, so the patient died 10months later. This rare case of MPNST with intracranial involvement illustrates the dismal prognosis for patients with these lesions. Prognosis is poor because of the difficulty of performing radical surgery with free margins in these locations. PMID:24930860

González-Orús Álvarez-Morujo, Ricardo; García Leal, Roberto; Lasso Vázquez, José María; Scola Yurrita, Barolomé

2014-01-01

209

Painful legs and moving toes: evidence on the site of the lesion.  

PubMed Central

A condition of painful legs with moving toes was described in 1971. Further examples of this condition are now reported, showing lesions in the posterior root ganglion, cauda equina, nerve roots, or a peripheral nerve of the lower limb. It is concluded that this syndrome is caused by a lesion of the afferent fibres of the posterior nerve roots. It is likely that this lesion causes frequent spontaneous impulses in the posterior roots which activate local circuits of interneurones and motoneurones and result in co-ordinated movements involving local muscles. Images PMID:215727

Nathan, P W

1978-01-01

210

[Transplantation in peripheral nerve injuries].  

PubMed

Autologous nerve grafting is the most commocommnlynly used operative technique in delayed primary, or secondary nerve repair after the peripheral nerve injuries. The aim of this procedure is to overcome nerve gaps that results from the injury itself, fibrous and elastic retraction forces, resection of the damaged parts of the nerve, position of the articulations and mobilisation of the nerve. In this study we analyse the results of operated patients with transections and lacerations of the peripheral nerves from 1979 to 2000 year. Gunshot injuries have not been analyzed in this study. The majority of the injuries were in the upper extremity (more than 87% of cases). Donor for nerve transplantation had usually been sural nerve, and only occasionally medial cutaneous nerve of the forearm was used. In about 93% of cases we used interfascicular nerve grafting, and cable nerve grafting was performed in the rest of them. Most of the grafts were 1 do 5 cm long (70% of cases). Functional recovery was achieved in more than 86% of cases, which is similar to the results of the other authors. Follow up period was minimum 2 years. We analyzed the influence of different factors on nerve recovery after the operation: patient's age, location and the extent (total or partial) of nerve injury, the length of the nerve graft, type of the nerve, timing of surgery, presence of multiple nerve injuries and associated osseal and soft tissue injuries of the upper and lower extremities. PMID:14619715

Grujici?, D; Samardzi?, M; Rasuli?, L; Savi?, D; Cvrkota, I; Simi?, V

2003-01-01

211

TBX3 Regulates Splicing In Vivo: A Novel Molecular Mechanism for Ulnar-Mammary Syndrome  

PubMed Central

TBX3 is a member of the T-box family of transcription factors with critical roles in development, oncogenesis, cell fate, and tissue homeostasis. TBX3 mutations in humans cause complex congenital malformations and Ulnar-mammary syndrome. Previous investigations into TBX3 function focused on its activity as a transcriptional repressor. We used an unbiased proteomic approach to identify TBX3 interacting proteins in vivo and discovered that TBX3 interacts with multiple mRNA splicing factors and RNA metabolic proteins. We discovered that TBX3 regulates alternative splicing in vivo and can promote or inhibit splicing depending on context and transcript. TBX3 associates with alternatively spliced mRNAs and binds RNA directly. TBX3 binds RNAs containing TBX binding motifs, and these motifs are required for regulation of splicing. Our study reveals that TBX3 mutations seen in humans with UMS disrupt its splicing regulatory function. The pleiotropic effects of TBX3 mutations in humans and mice likely result from disrupting at least two molecular functions of this protein: transcriptional regulation and pre-mRNA splicing. PMID:24675841

Kumar P., Pavan; Franklin, Sarah; Emechebe, Uchenna; Hu, Hao; Moore, Barry; Lehman, Chris; Yandell, Mark; Moon, Anne M.

2014-01-01

212

A rare case of greater petrosal nerve schwannoma  

PubMed Central

Background: Facial nerve schwannomas include only 0.8% of all intrapetrous mass lesions, and schwannomas originating exclusively from the greater petrosal nerve (GPN) are extremely rare. To date, only 13 reports have been described. In this case, the tumor was thought to originate from the GPN on the basis of clinical, radiological, and operative findings. Case Description: A 23-year-old girl presented an acute left facial palsy, a disturbance in tear secretion of the ipsilateral eye, and a left-sided conductive hypoacusia. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an extradural mass in the left middle fossa. A subtemporal approach was performed and the lesion, originating from the proximal portion of the GPN, was excised. The post-operative course was satisfactory, except for a xerophtalmia, which was treated with artificial teardrops. Conclusion: GPN schwannomas can originate anywhere alongside the course of the nerve, from its proximal segment near the facial hiatus to its distal segment near the foramen lacerum. For these reasons, it requires differential diagnosis with trigeminal nerve schwannomas or with injuries arising from the geniculate ganglion, because it can be easily confused with those lesions. However, in less severe cases, an early diagnosis can be able to preserve the function of the facial nerve by reducing iatrogenic injuries caused by surgical maneuvers. PMID:21697967

Paulis, Danilo De; Di Cola, Francesco; Marzi, Sara; Ricci, Alessandro; Coletti, Gino; Galzio, Renato J.

2011-01-01

213

Advances in nerve repair.  

PubMed

Patients with peripheral nerve injuries face unpredictable and often suboptimal functional outcome, even following standard microsurgical nerve repair. The challenge of improving such outcomes following nerve surgical procedures has interested many research teams, in both clinical and fundamental fields. Some innovative treatments are presently being applied to a widening range of patients, whereas others will require further development before translation to human subjects. This article presents several recent advances in emerging therapies at various stages of clinical application. Nerve transfers have been successfully used in clinical settings, but new indications are being described, enlarging the range of patients who might benefit from them. Brief direct nerve electrical stimulation has been shown to improve nerve regeneration and outcome in animal models and in a small cohort of patients. Further clinical trials are warranted to prove the efficacy of this exciting and easily applicable approach. Animal studies also suggest a tremendous potential for stem and precursor cell therapy. Further studies will lead to a better understanding of their mechanisms of action in nerve repair and potential applications for human patients. PMID:23250767

Khuong, Helene T; Midha, Rajiv

2013-01-01

214

Glossopharyngeal Nerve Schwannoma  

PubMed Central

Complete resection with conservation of cranial nerves is the primary goal of contemporary surgery for lower cranial nerve tumors. We describe the case of a patient with a schwannoma of the left glossopharyngeal nerve, operated on in our Neurosurgical Unit. The far lateral approach combined with laminectomy of the posterior arch of C1 was done in two steps. The procedure allowed total tumor resection and was found to be better than classic unilateral suboccipital or combined supra- and infratentorial approaches. The advantages and disadvantages of the far lateral transcondylar approach, compared to the other more common approaches, are discussed. ImagesFigure 1Figure 2 PMID:17171083

Puzzilli, F.; Mastronardi, L.; Agrillo, U.; Nardi, P.

1999-01-01

215

Diabetic Nerve Problems  

MedlinePLUS

... at the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. ... you change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling ...

216

Lower cranial nerves.  

PubMed

Imaging evaluation of cranial neuropathies requires thorough knowledge of the anatomic, physiologic, and pathologic features of the cranial nerves, as well as detailed clinical information, which is necessary for tailoring the examinations, locating the abnormalities, and interpreting the imaging findings. This article provides clinical, anatomic, and radiological information on lower (7th to 12th) cranial nerves, along with high-resolution magnetic resonance images as a guide for optimal imaging technique, so as to improve the diagnosis of cranial neuropathy. PMID:24210311

Soldatos, Theodoros; Batra, Kiran; Blitz, Ari M; Chhabra, Avneesh

2014-02-01

217

Inflammatory pseudotumor of the peroneal nerve: case report and literature review.  

PubMed

Inflammatory pseudotumors (IPTs) are a group of lesions of obscure etiology. Although they are presumably reactive, their exact pathogenesis is unknown. Inflammatory pseudotumors are identified in different organs; however, IPTs of the peripheral nerves have been rarely reported in the English literature. We report a 44-year-old woman who presented with left foot drop. Examination revealed a thickening in the posterolateral aspect of the popliteal fossa and features consistent with peroneal nerve palsy. Magnetic resonance imaging revealed a mass that may represent a Baker cyst or perineural sheath mass that was excised. After pathological examination, the case was diagnosed as IPT of peroneal nerve, and the patient received no further therapy. Inflammatory pseudotumors of the peripheral nerves, although rare, should always be of consideration in the differential diagnosis of peripheral nerve nodular mass lesions. They can mimic neoplastic nerve sheath lesions, clinically and radiologically. However, they are amenable to surgical cure with nerve-sparing surgery. Thus, despite their rarity, on dealing with neural S100 negative lesion, their inclusion is mandatory to avoid an unnecessary and a rather aggressive surgery. PMID:18164415

El Demellawy, Dina; Bain, James; Algawad, Hameed; Provias, John P

2008-02-01

218

A new system for continuous recurrent laryngeal nerve monitoring.  

PubMed

Existing nerve monitoring devices in thyroid surgery are - except for one - mainly intermittently working nerve identification tools. We present a new vagal electrode which allows true continuous monitoring of the recurrent laryngeal nerve (RLN). The electrode was designed as a tripolar hybrid cuff electrode consisting of polyimide, gold and platinum layers embedded in a flexible silicon cuff which can be opened at the long side for introducing the nerve. It is fully implantable and atraumatic. The evoked potentials are sensed by standard thyroid electrodes. Real-time signal analysis and audio feedback are achieved by specially designed software. Homogeneous and stable signals were recorded throughout the operations. Thus real-time computer-based signal analysis was possible. Evoked potentials reached 300-900 mV. Mean time to place the cuff electrode was 5.5 min. The nerve was stimulated a mean of 63 min (range 55-99 min). No RLN lesions were detected postoperatively. The new vagal electrode was easy to handle and led to stable and reproducible signals. The stimulation current could be kept extremely low due to the special geometry of the electrode. It offers the possibility for uninterrupted, continuous laryngeal nerve monitoring in thyroid surgery. In an ongoing clinical trial its compatibility as an add-on for existing nerve monitoring devices is being tested. PMID:17573619

Lamadé, Wolfram; Ulmer, Christoph; Seimer, Andreas; Molnar, Viktor; Meyding-Lamadé, Uta; Thon, Klaus-Peter; Koch, Klaus Peter

2007-01-01

219

High-resolution magnetic resonance imaging of the lower extremity nerves.  

PubMed

Magnetic resonance (MR) imaging of the nerves, commonly known as MR neurography is increasingly being used as noninvasive means of diagnosing peripheral nerve disease. High-resolution imaging protocols aimed at imaging the nerves of the hip, thigh, knee, leg, ankle, and foot can demonstrate traumatic or iatrogenic injury, tumorlike lesions, or entrapment of the nerves, causing a potential loss of motor and sensory function in the affected area. A thorough understanding of normal MR imaging and gross anatomy, as well as MR findings in the presence of peripheral neuropathies will aid in accurate diagnosis and ultimately help guide clinical management. PMID:24210318

Burge, Alissa J; Gold, Stephanie L; Kuong, Sharon; Potter, Hollis G

2014-02-01

220

Stress Sonography of the Ulnar Collateral Ligament of the Elbow in Professional Baseball Pitchers  

PubMed Central

Background An injury to the ulnar collateral ligament (UCL) of the elbow is potentially career threatening for elite baseball pitchers. Stress ultrasound (US) of the elbow allows for evaluation of both the UCL and the ulnohumeral joint space at rest and with stress. Hypothesis Stress US can identify morphological and functional UCL changes and may predict the risk of a UCL injury in elite pitchers. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 368 asymptomatic professional baseball pitchers underwent preseason stress US of their dominant and non-dominant elbows over a 10-year period (2002-2012). Stress US examinations were performed in 30° of flexion at rest and with 150 N of valgus stress by a single musculoskeletal radiologist. Ligament thickness, ulnohumeral joint space width, and ligament abnormalities (hypoechoic foci and calcifications) were documented. Results There were 736 stress US studies. The mean UCL thickness in the dominant elbow (6.15 mm) was significantly greater than that in the nondominant elbow (4.82 mm) (P < .0001). The mean stressed ulnohumeral joint space width in the dominant elbow (4.56 mm) was significantly greater than that in the nondominant elbow (3.72 mm) (P < .02). In the dominant arm, hypoechoic foci and calcifications were both significantly more prevalent (28.0% vs 3.5% and 24.9% vs 1.6%, respectively; P < .001). In the 12 players who incurred a UCL injury, there were nonsignificant (P > .05) increases in baseline ligament thickness, ulnohumeral joint space gapping with stress, and incidence of hypoechoic foci and calcifications. More than 1 stress US examination was performed in 131 players, with a mean increase of 0.78 mm in joint space gapping with subsequent evaluations. Conclusion Stress US indicates that the UCL in the dominant elbow of elite pitchers is thicker, is more likely to have hypoechoic foci and/or calcifications, and has increased laxity with valgus stress over time. PMID:24473498

Ciccotti, Michael G.; Atanda, Alfred; Nazarian, Levon N.; Dodson, Christopher C.; Holmes, Laurens; Cohen, Steven B.

2014-01-01

221

Investigation of cranial and other nerves in the mouse with muscular dystrophy.  

PubMed Central

In the muscular dystrophic mouse mutant there is an absence of Schwann cells over circumscribed lengths of all cranial nerves except for II (I was not examined) and the lesion involves the sympathetic system. Where present, Schwann cells do not produce myelin of normal thickness. The lesion is similar to that described for the spinal roots. Causation is discussed. Images PMID:1141926

Biscoe, T J; Caddy, K W; Pallot, D J; Pehrson, U M

1975-01-01

222

Repair of sciatic nerve defects using tissue engineered nerves.  

PubMed

In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acellular nerve allografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle; regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acellular nerve allografts. The hind limb motor function at the affected side was significantly improved, indicating that acellular nerve allografts combined with bone marrow mesenchymal stem cell bridging could promote functional recovery of rats with sciatic nerve defects. PMID:25206507

Zhang, Caishun; Lv, Gang

2013-07-25

223

Arm span and ulnar length are reliable and accurate estimates of recumbent length and height in a multiethnic population of infants and children under 6 years of age.  

PubMed

Surrogate measures are needed when recumbent length or height is unobtainable or unreliable. Arm span has been used as a surrogate but is not feasible in children with shoulder or arm contractures. Ulnar length is not usually impaired by joint deformities, yet its utility as a surrogate has not been adequately studied. In this cross-sectional study, we aimed to examine the accuracy and reliability of ulnar length measured by different tools as a surrogate measure of recumbent length and height. Anthropometrics [recumbent length, height, arm span, and ulnar length by caliper (ULC), ruler (ULR), and grid (ULG)] were measured in 1479 healthy infants and children aged <6 y across 8 study centers in the United States. Multivariate mixed-effects linear regression models for recumbent length and height were developed by using ulnar length and arm span as surrogate measures. The agreement between the measured length or height and the predicted values by ULC, ULR, ULG, and arm span were examined by Bland-Altman plots. All 3 measures of ulnar length and arm span were highly correlated with length and height. The degree of precision of prediction equations for length by ULC, ULR, and ULG (R(2) = 0.95, 0.95, and 0.92, respectively) was comparable with that by arm span (R(2) = 0.97) using age, sex, and ethnicity as covariates; however, height prediction by ULC (R(2) = 0.87), ULR (R(2) = 0.85), and ULG (R(2) = 0.88) was less comparable with arm span (R(2) = 0.94). Our study demonstrates that arm span and ULC, ULR, or ULG can serve as accurate and reliable surrogate measures of recumbent length and height in healthy children; however, ULC, ULR, and ULG tend to slightly overestimate length and height in young infants and children. Further testing of ulnar length as a surrogate is warranted in physically impaired or nonambulatory children. PMID:25031329

Forman, Michele R; Zhu, Yeyi; Hernandez, Ladia M; Himes, John H; Dong, Yongquan; Danish, Robert K; James, Kyla E; Caulfield, Laura E; Kerver, Jean M; Arab, Lenore; Voss, Paula; Hale, Daniel E; Kanafani, Nadim; Hirschfeld, Steven

2014-09-01

224

In vivo effect of methylcobalamin on the peripheral nerve structure in streptozotocin diabetic rats.  

PubMed

To study in vivo effect of methylcobalamin (CH3-B12) on the peripheral nerve structures, rats with experimental diabetes induced by streptozotocin were administered with daily intramuscular injection of CH3-B12 (500 microgram/kg) for 16 weeks. By isolated nerve fiber studies, CH3-B12-treated diabetic rats showed less incidence of paranodal demyelination as an early sign of segmental demyelination than non-treated diabetic rats. From morphometrical analysis on sural nerves, the reduction in the density of myelinated nerve fibers, nerve fiber size and axon size of myelinated fibers was definitely protected in treated diabetic rats. The results suggested that continuous treatment with CH3-B12 had an ameliorative effect on the peripheral nerve lesions in experimental diabetic neuropathy. PMID:6460676

Yagihashi, S; Tokui, A; Kashiwamura, H; Takagi, S; Imamura, K

1982-01-01

225

[MR neurography for lesion localization in the peripheral nervous system. Why, when and how?].  

PubMed

Peripheral neuropathies are frequent disorders which are often challenging in the diagnostic work-up. Diagnostic difficulties first and foremost arise with regard to lesion localization and the precise definition of spatial lesion patterns. Magnetic resonance (MR) neurography as a diagnostic imaging tool directly visualizes nerve lesions thereby facilitating lesion localization not only in traumatic nerve lesions but also in the large and heterogeneous group of intrinsic, spontaneously occurring non-focal neuropathies. The major diagnostic sign for lesion detection and localization is the T2 lesion which can be evaluated with high spatial resolution at the anatomical level of nerve fascicles. Lesion detection at the fascicular level by MR neurography advances the diagnostic work-up in the peripheral nervous system (PNS), because fascicular and partial nerve lesions of spontaneously occurring intrinsic neuropathies and polyneuropathies present a classical diagnostic pitfall for traditional localization by means of physical findings and electrophysiology. With the appropriate techniques and strategies MR neurography can now cover large anatomical areas of the PNS in a single examination session. PMID:24519060

Pham, M

2014-02-01

226

Laryngeal nerve monitoring.  

PubMed

Intraoperative neurophysiological monitoring of the vagus and recurrent laryngeal nerves is increasingly used during thyroidectomy, parathyroidectomy, skull base surgery, and cervical discectomy with fusion. Monitoring can assist in nerve localization and in reducing the incidence of neural trauma. To be effective, however, monitoring must be correctly implemented and the results interpreted based on an in-depth understanding of technique and the surgical structures at risk. Because "poor monitoring is worse than no monitoring" all members of the surgical monitoring team must have training specific to laryngeal recording to maximize its benefit and minimize pitfalls. This publication will review pertinent anatomy and neurophysiology as well as technical and interpretative factors. PMID:25351033

Kartush, Jack M; Naumann, Ilka

2014-09-01

227

Bilateral Optic Nerve Sheath Meningioma with Intracanalicular and Intracranial Component in a 25-year-old Saudi Patient  

PubMed Central

Bilateral optic nerve sheath meningioma is rare. A meningioma is a benign neoplastic lesion from meningothelial cells of the meninges. They usually involve the intracanalicular portion of the optic nerve but may extend into the optic canal and through it to occupy the intracranial space. We present a case of 25-year-old Saudi female with bilateral optic nerve sheath meningioma. The diagnosis was delayed more than six years from initial symptoms. PMID:21369471

Badr, Maha A.; Elkhamary, Sahar M.; Al Sabbagh, Samira; Al Turjoman, Abdulsalam

2008-01-01

228

Open repair of the ulnar disruption of the triangular fibrocartilage complex with double three-dimensional mattress suturing technique.  

PubMed

Open repair technique of the ulnar disruption of the triangular fibrocartilage complex is described. This technique is indicated for a fresh or a relatively fresh (less than 1 year after the initial injury) ulnar foveal detachment tear, horizontal tear, and proximal slit tear of the triangular fibrocartilage complex, all of which are accompanied by severe dorsal, palmar, or multidirectional instability of the distal radioulnar joint. A chronic tear greater than 1 year from initial injury and a fresh triangular fibrocartilage complex tear without distal radioulnar joint instability, such as central slit tear, are excluded from our indications. A dorsal C-shaped skin incision, a longitudinal incision of the radial edge of the extensor carpi ulnaris subsheath and the dorsal distal radioulnar joint capsule, exposes the distal radioulnar joint. A small, 5-mm longitudinal incision at the origin of the radioulnar ligament exposes its fovea detachment and/or the proximal slit tear of the triangular fibrocartilage complex. The disrupted radioulnar ligament is sutured in a pullout fashion to the ulna with a 3-dimensional double mattress technique through 2 bone tunnels that is precisely made at the central portion of the fovea with 1.2-mm K-wire. An additional horizontal mattress suture is used for closure of the small incision made at the radioulnar ligament, then the extensor carpi ulnaris is repaired. This open-repair technique is complex and requires precise technical skills; however, early results have been more rewarding than the conservative treatment. PMID:16518123

Nakamura, Toshiyasu; Nakao, Yasushi; Ikegami, Hiroyasu; Sato, Kazuki; Takayama, Shinichiro

2004-06-01

229

Proximal congenital radial-ulnar synostosis and synchondrosis; pathogenic concept and a new therapeutic method  

PubMed Central

Abstract Background context: Proximal congenital radial-ulnar synostosis (PCRUS) is defined by the development before birth of a bony bridge between the radius and ulna, usually at the proximal level, which blocks forearm rotation. This anomaly is rarely reported in the medical literature, because of its low prevalence, and treatment usually yields unsatisfactory results. The most commonly used surgical interventions are: forearm repositioning osteotomies with derotation of the radius and ulna, segmental resections of the middle third of the radius with muscular interposition, resection of the synostosis with the interposition of fatty tissue, tendons or fascia lata and resection of the proximal radius along with the transfer of the distal extensor carpi ulnaris tendon on the lateral edge of the radius. Purpose: To describe a new treatment method for PCRUS, which we based on a new pathogenic concept, and to present our preliminary results. Materials and method: Between 2011 and 2013 our team performed two myo-osteo-arthroplastic reconstructions of the elbow and forearm for PCRUS. The intervention involves the extraperiosteal stripping of the origins of the ventral forearm musculature, release of the interosseous membrane, resection of the proximal two thirds of the radius, reshaping of the synostosis, a double osteotomy of the ulna and the transfer and fixation of a proximal fibular graft, including the head with its articular cartilage, in place of the resected segment of the radius. Results: Our preliminary study reveals favorable postoperative results, in comparison with other published methods. At the latest follow-up, one case had -10 degrees of pronation and 68 degrees of supination, and the other had 10 degrees of pronation and 66 degrees of supination. Conclusions: Compared with other techniques, myo-osteo-arthroplastic reconstruction may seem overly invasive. However, the extent of this intervention is mandated by the pathogenic concepts of helical distortion, muscular retraction and anomalous configuration of the interosseous membrane. Benign cases do not require surgery. When there is no helical distortion, the intervention may be limited to the transfer of the proximal extremity of the fibula for the infant and small child. PMID:24701253

Burnei, G; Ghita, RA; Parvan, AA; Japie, E; Gavriliu, S; Georgescu, I; El Nayef, T; Tiripa, I; Hamei, S

2013-01-01

230

Histopathological features of bone regeneration in a canine segmental ulnar defect model  

PubMed Central

Background Today, finding an ideal biomaterial to treat the large bone defects, delayed unions and non-unions remains a challenge for orthopaedic surgeions and researchers. Several studies have been carried out on the subject of bone regeneration, each having its own advantages. The present study has been designed in vivo to evaluate the effects of cellular auto-transplantation of tail vertebrae on healing of experimental critical bone defect in a dog model. Methods Six indigenous breeds of dog with 32?±?3.6 kg average weight from both sexes (5 males and 1 female) received bilateral critical-sized ulnar segmental defects. After determining the health condition, divided to 2 groups: The Group I were kept as control I (n?=?1) while in Group II (experimental group; n?=?5) bioactive bone implants were inserted. The defects were implanted with either autogeneic coccygeal bone grafts in dogs with 3-4 cm diaphyseal defects in the ulna. Defects were stabilized with internal plate fixation, and the control defects were not stabilized. Animals were euthanized at 16 weeks and analyzed by histopathology. Results Histological evaluation of this new bone at sixteen weeks postoperatively revealed primarily lamellar bone, with the formation of new cortices and normal-appearing marrow elements. And also reformation cortical compartment and reconstitution of marrow space were observed at the graft-host interface together with graft resorption and necrosis responses. Finally, our data were consistent with the osteoconducting function of the tail autograft. Conclusions Our results suggested that the tail vertebrae autograft seemed to be a new source of autogenous cortical bone in order to supporting segmental long bone defects in dogs. Furthermore, cellular autotransplantation was found to be a successful replacement for the tail vertebrae allograft bone at 3-4 cm segmental defects in the canine mid- ulna. Clinical application using graft expanders or bone autotransplantation should be used carefully and requires further investigation. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2028232688119271. PMID:24636669

2014-01-01

231

Surgical anatomy and neurophysiology of the vagus nerve (VN) for standardised intraoperative neuromonitoring (IONM) of the inferior laryngeal nerve (ILN) during thyroidectomy  

Microsoft Academic Search

Background  Standardisation of the intraoperative neuromonitoring (IONM) technique is a fundamental aspect in monitored thyroid surgery.\\u000a Vagal nerve (VN) stimulation is essential for problem solving, recognition of any inferior laryngeal nerve (ILN) lesions and\\u000a prediction of ILN post-operative function. Issues that have been overlooked in the literature, particularly in terms of prospective\\u000a approaches, are the topographic relationship of the VN with

Gianlorenzo Dionigi; Feng-Yu Chiang; Stefano Rausei; Che-Wei Wu; Luigi Boni; Ka-Wo Lee; Francesca Rovera; Giovanni Cantone; Alessandro Bacuzzi

2010-01-01

232

Brain metastases as primary manifestation of a melanocytic malignant peripheral nerve sheath tumor in a 60-year-old man  

Microsoft Academic Search

BACKGROUND: Malignant peripheral nerve sheath tumors are rare tumor entities that originate from peripheral nerve sheaths and have an unfavorable prognosis. Metastatic spread to the cerebral parenchyma is absolutely rare. This case report describes the clinical course in a 60-year-old man whose tumor came to medical attention because of a seizure. CASE PRESENTATION: Magnetic resonance imaging demonstrated two intracerebral lesions.

Johannes Tilgner; Klaus Müller; Nadir Ghanem; Johannes Lutterbach; Jan Vesper

2007-01-01

233

Airway nerves: in vivo electrophysiology  

Microsoft Academic Search

Information about the activity of airway sensory afferent nerves in vivo can be obtained electrophysiologically by extracellular recording of action potentials. Apart from data capture, the basic techniques used for recording sensory nerve activity have not advanced greatly in 50 years. However, clearly they continue to contribute vastly to our understanding of the role of these nerves in the control

John J Adcock

2002-01-01

234

Fibrolipoma of the median nerve  

Microsoft Academic Search

Neural fibrolipoma or fibrolipomatous hamartoma is an uncommon benign tumor that usually arises in the median nerve. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We report a case of fibrolipomatous hamartoma of the left median nerve in an 18-year-old woman. Our objective was to describe the pathognomonic magnetic resonance imaging features, whose presence obviates the

Kais Nouira; Hend Belhiba; Sofične Baccar; Anissa Miaaoui; Monia Ben Messaoud; Imčne Turki; Ilhem Cheour; Emna Menif

2007-01-01

235

Intra-temporal facial nerve centerline segmentation for navigated temporal bone surgery  

NASA Astrophysics Data System (ADS)

Approaches through the temporal bone require surgeons to drill away bone to expose a target skull base lesion while evading vital structures contained within it, such as the sigmoid sinus, jugular bulb, and facial nerve. We hypothesize that an augmented neuronavigation system that continuously calculates the distance to these structures and warns if the surgeon drills too close, will aid in making safe surgical approaches. Contemporary image guidance systems are lacking an automated method to segment the inhomogeneous and complexly curved facial nerve. Therefore, we developed a segmentation method to delineate the intra-temporal facial nerve centerline from clinically available temporal bone CT images semi-automatically. Our method requires the user to provide the start- and end-point of the facial nerve in a patient's CT scan, after which it iteratively matches an active appearance model based on the shape and texture of forty facial nerves. Its performance was evaluated on 20 patients by comparison to our gold standard: manually segmented facial nerve centerlines. Our segmentation method delineates facial nerve centerlines with a maximum error along its whole trajectory of 0.40+/-0.20 mm (mean+/-standard deviation). These results demonstrate that our model-based segmentation method can robustly segment facial nerve centerlines. Next, we can investigate whether integration of this automated facial nerve delineation with a distance calculating neuronavigation interface results in a system that can adequately warn surgeons during temporal bone drilling, and effectively diminishes risks of iatrogenic facial nerve palsy.

Voormolen, Eduard H. J.; van Stralen, Marijn; Woerdeman, Peter A.; Pluim, Josien P. W.; Noordmans, Herke J.; Regli, Luca; Berkelbach van der Sprenkel, Jan W.; Viergever, Max A.

2011-03-01

236

Ischemic Nerve Block.  

ERIC Educational Resources Information Center

This experiment investigated the capability for movement and muscle spindle function at successive stages during the development of ischemic nerve block (INB) by pressure cuff. Two male subjects were observed under six randomly ordered conditions. The duration of index finger oscillation to exhaustion, paced at 1.2Hz., was observed on separate…

Williams, Ian D.

237

Iatrogenic nerve injuries  

PubMed Central

Thirty-one examples of iatrogenic peripheral nerve injuries have been collected from a review of the case records of one neurological referral centre over a 7-year period. The clinical details are described to call attention to the special care needed with the management of patients subjected to certain invasive procedures. PMID:7100035

Winer, J. B.; Harrison, M. J. G.

1982-01-01

238

Segmental thoracic lipomatosis of nerve with nerve territory overgrowth.  

PubMed

Lipomatosis of nerve (LN), or fibrolipomatous hamartoma, is a rare condition of fibrofatty enlargement of the peripheral nerves. It is associated with bony and soft tissue overgrowth in approximately one-third to two-thirds of cases. It most commonly affects the median nerve at the carpal tunnel or digital nerves in the hands and feet. The authors describe a patient with previously diagnosed hemihypertrophy of the trunk who had a history of large thoracic lipomas resected during infancy, a thoracic hump due to adipose proliferation within the thoracic paraspinal musculature, and scoliotic deformity. She had fatty infiltration in the thoracic spinal nerves on MRI, identical to findings pathognomonic of LN at better-known sites. Enlargement of the transverse processes at those levels and thickened ribs were also found. This case appears to be directly analogous to other instances of LN with overgrowth, except that this case involved axial nerves rather than the typical appendicular nerves. PMID:24506247

Mahan, Mark A; Amrami, Kimberly K; Howe, B Matthew; Spinner, Robert J

2014-05-01

239

Bone dysplasia in the radial and ulnar metaphysis of a Newfoundland dog.  

PubMed

A recently described metaphyseal irregularity of the radius and ulna was diagnosed radiographically in a significant proportion of Newfoundland dogs during the course of a large study. This case report describes the pathological picture of a Newfoundland dog with these radiographic changes. The lesions in the distal radius and ulna were characterized by focal, longitudinal striations of sclerosis of the bone marrow cavity, surrounding thin trabeculae of primary spongiosa of the distal metaphysis. It is suggested that these lesions represent a sclerosing dysplasia not previously described in dogs, but with some similarities to the human disorder, osteopathia striata. PMID:18424833

Trangerud, C; Grřndalen, J; Ytrehus, B

2008-03-01

240

Stress fracture at the junction of the middle and distal third of the ulnar diaphysis in a spinner bowler: a case report and a review of the literature  

Microsoft Academic Search

Stress fractures of the ulnar shaft are uncommon injuries, which have been documented in a variety of sports. The location of the fracture is influenced by the activity and mechanism of injury with which it is associated. The combined traditional approach of clinical history, physical examination, plain radiographs and nuclear scintigraphy for unusual stress fracture may be troublesome. This report

Ming-Cheng Hsu; Ko-Huang Lue; Zong-I Lin; Ko-Hsiu Lu

2005-01-01

241

Bone Dysplasia in the Radial and Ulnar Metaphysis of a Newfoundland Dog  

Microsoft Academic Search

A recently described metaphyseal irregularity of the radius and ulna was diagnosed radiographically in a significant proportion of Newfoundland dogs during the course of a large study. This case report describes the pathological picture of a Newfoundland dog with these radiographic changes. The lesions in the distal radius and ulna were characterized by focal, longitudinal striations of sclerosis of the

C. Trangerud; J. Grondalen; B. Ytrehus

2008-01-01

242

Chemotherapy-induced bone marrow nerve injury impairs hematopoietic regeneration.  

PubMed

Anticancer chemotherapy drugs challenge hematopoietic tissues to regenerate but commonly produce long-term sequelae. Chemotherapy-induced deficits in hematopoietic stem or stromal cell function have been described, but the mechanisms mediating hematopoietic dysfunction remain unclear. Administration of multiple cycles of cisplatin chemotherapy causes substantial sensory neuropathy. Here we demonstrate that chemotherapy-induced nerve injury in the bone marrow of mice is a crucial lesion impairing hematopoietic regeneration. Using pharmacological and genetic models, we show that the selective loss of adrenergic innervation in the bone marrow alters its regeneration after genotoxic insult. Sympathetic nerves in the marrow promote the survival of constituents of the stem cell niche that initiate recovery. Neuroprotection by deletion of Trp53 in sympathetic neurons or neuroregeneration by administration of 4-methylcatechol or glial-derived neurotrophic factor (GDNF) promotes hematopoietic recovery. These results demonstrate the potential benefit of adrenergic nerve protection for shielding hematopoietic niches from injury. PMID:23644514

Lucas, Daniel; Scheiermann, Christoph; Chow, Andrew; Kunisaki, Yuya; Bruns, Ingmar; Barrick, Colleen; Tessarollo, Lino; Frenette, Paul S

2013-06-01

243

Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques  

SciTech Connect

Malignant peripheral nerve-sheath neoplasms frequently complicate neurofibromatosis causing pain, enlarging masses, or neurologic deficits. However, similar findings sometimes also occur with benign nerve neoplasms. Our study was done retrospectively to determine if imaging techniques can differentiate malignant from benign nerve tumors in neurofibromatosis. Eight patients with symptomatic neoplasms (three benign, five malignant) were studied by CT in eight, MR in six, and /sup 67/Ga-citrate scintigraphy in seven. Uptake of /sup 67/Ga occurred in all five malignant lesions but not in two benign neoplasms studied. On CT or MR, all eight lesions, including three benign neoplasms, showed inhomogeneities. Of five lesions with irregular, infiltrative margins on CT or MR, four were malignant and one was benign. Of three lesions with smooth margins, one was malignant and two were benign. One malignant neoplasm caused irregular bone destruction. Accordingly, CT and MR could not generally distinguish malignant from benign lesions with certainty. However, both CT and MR provided structural delineation to help surgical planning for both types of lesion. /sup 67/Ga scintigraphy appears promising as a screening technique to identify lesions with malignant degeneration in patients with neurofibromatosis. Any area of abnormal radiogallium uptake suggests malignancy warranting further evaluation by CT or MR. Biopsy of any questionable lesion is essential.

Levine, E.; Huntrakoon, M.; Wetzel, L.H.

1987-11-01

244

Ultrasound of Peripheral Nerves  

PubMed Central

Over the last decade, neuromuscular ultrasound has emerged as a useful tool for the diagnosis of peripheral nerve disorders. This article reviews sonographic findings of normal nerves including key quantitative ultrasound measurements that are helpful in the evaluation of focal and possibly generalized peripheral neuropathies. It also discusses several recent papers outlining the evidence base for the use of this technology, as well as new findings in compressive, traumatic, and generalized neuropathies. Ultrasound is well suited for use in electrodiagnostic laboratories where physicians, experienced in both the clinical evaluation of patients and the application of hands-on technology, can integrate findings from the patient’s history, physical examination, electrophysiological studies, and imaging for diagnosis and management. PMID:23314937

Suk, Jung Im; Walker, Francis O.; Cartwright, Michael S.

2013-01-01

245

Optic nerve hypoplasia  

PubMed Central

Optic nerve hypoplasia (ONH) is a congenital anomaly of the optic disc that might result in moderate to severe vision loss in children. With a vast number of cases now being reported, the rarity of ONH is obviously now refuted. The major aspects of ophthalmic evaluation of an infant with possible ONH are visual assessment, fundus examination, and visual electrophysiology. Characteristically, the disc is small, there is a peripapillary double-ring sign, vascular tortuosity, and thinning of the nerve fiber layer. A patient with ONH should be assessed for presence of neurologic, radiologic, and endocrine associations. There may be maternal associations like premature births, fetal alcohol syndrome, maternal diabetes. Systemic associations in the child include endocrine abnormalities, developmental delay, cerebral palsy, and seizures. Besides the hypoplastic optic nerve and chiasm, neuroimaging shows abnormalities in ventricles or white- or gray-matter development, septo-optic dysplasia, hydrocephalus, and corpus callosum abnormalities. There is a greater incidence of clinical neurologic abnormalities in patients with bilateral ONH (65%) than patients with unilateral ONH. We present a review on the available literature on the same to urge caution in our clinical practice when dealing with patients with ONH. Fundus photography, ocular coherence tomography, visual field testing, color vision evaluation, neuroimaging, endocrinology consultation with or without genetic testing are helpful in the diagnosis and management of ONH. (Method of search: MEDLINE, PUBMED). PMID:24082663

Kaur, Savleen; Jain, Sparshi; Sodhi, Harsimrat B. S.; Rastogi, Anju; Kamlesh

2013-01-01

246

Near nerve potential of sural nerve in leprosy.  

PubMed

Leprosy neuropathy is characterized by initial involvement of the small nerve fibers, later followed by involvement of the large fibers, when routine nerve conduction studies become abnormal. To increase the diagnostic yield and precocity of these studies, we applied the near nerve technique to the sural nerve of 8 leprosy patients. Contrary to our expectations, the main component of the sural nerve sensory action potential was abnormal in all patients, but the minimum conduction velocity originating from small 3-6 mm fibers was normal or only mildly involved in three patients. Also, although Schwann cells are the first to be involved in leprosy, the results are suggestive of axonal degeneration instead of demyelination. To better understand the neurophysiology and physiology of leprosy and to increase the accuracy and precocity of the diagnosis, it will be necessary to investigate patients in the very early stages of the disease and to correlate these findings with the corresponding nerve pathology. PMID:15334210

Arruda, Ana Paula M; Marques, Wilson; Foss, Norma T; Garbino, José A; Virmond, Marcos; Barreira, Amilton A

2004-09-01

247

Malignant Peripheral Nerve Sheath Tumors: Use of 18FDG-PET\\/CT  

Microsoft Academic Search

\\u000a Malignant Peripheral Nerve Sheath Tumors (MPNST) are rare but lethal lesions. They are more often found in patients with the\\u000a cancer pre-disposition syndrome, Neurofibromatosis 1 (NF1). NF1 patients harbor many peripheral nerve tumors, the majority\\u000a of which are benign. Early detection of these benign plexiform neurofibromas (PNf), which may have transformed to a MPNST,\\u000a is of paramount importance in the

Andre A. le Roux; Abhijit Guha

248

Vertebral rim lesions in the dorsolumbar spine.  

PubMed Central

The frequency, distribution, and histological characteristics of vertebral rim lesions have been studied at D11 and L4 in 117 post-mortem spines in subjects aged 13-96 years. Only one lesion was found in patients less than 30 years, but thereafter the frequency increased with age. At least one rim was affected in the majority of patients greater than or equal to 50 years. They were found more frequently in the upper than the lower rim and they were also more common anteriorly than posteriorly. Lesions were associated with focal avulsion of the annulus in an otherwise healthy disc or with annular tears running into the rim. Rim lesions can be recognised radiographically by the presence of the vacuum phenomenon, vertebral rim sclerosis with or without a cup-shaped defect in the rim and osteophytes confined to one side of the disc. The histological appearances suggest a traumatic aetiology, and since bone is known to be supplied with pain sensitive nerve endings the lesions may be important in the general context of low back pain. Images PMID:6712302

Hilton, R C; Ball, J

1984-01-01

249

Peripheral nerve injury triggers noradrenergic sprouting within dorsal root ganglia  

Microsoft Academic Search

IN humans, trauma to a peripheral nerve may be followed by chronic pain syndromes which are only relieved by blockade of the effects of sympathetic impulse traffic1-4. It is presumed that, after the lesion, noradrenaline released by activity of sympathetic postganglionic axons excites primary afferent neurons by activating alpha-adrenoceptors2,5, generating signals that enter the 'pain pathways' of the central nervous

Elspeth M. McLachlan; Wilfrid Jänig; Marshall Devor; Martin Michaelis

1993-01-01

250

Malignant peripheral nerve sheath tumor of the cauda equina  

Microsoft Academic Search

.   Only one case of malignant peripheral nerve sheath tumor (MPNST) affecting the cauda equina region has been reported earlier.\\u000a A 32-year-old male with congenital multiple subcutaneous swellings presented with low back pain, progressive paraparesis and\\u000a bladder-bowel dysfunction. Magnetic resonance imaging (MRI) demonstrated a heterogenously enhancing intradural lesion at L2–L4.\\u000a At operation, on opening the dura, multiple nodular, firm matted

R. Acharya; S. Bhalla; A. D. Sehgal

2001-01-01

251

Bone Lesions and Damage  

MedlinePLUS

... NOW Home » About Multiple Myeloma » Symptoms » Bone Damage Bone Lesions and Damage Bone lesions from multiple myeloma ... have some degree of bone loss. Causes of bone destruction in myeloma Normally, osteoclasts function with bone- ...

252

Radius neck-to-humerus trochlea transposition elbow reconstruction after proximal ulnar metastatic tumor resection: case and literature review.  

PubMed

Wide en bloc excision of proximal ulna sections is used to treat traumatic and pathological fractures of the ulna, though poor standardization of clinical treatment often results in long-term failure of such reconstructed biomechanical structures. In order to provide insight into effective ulnar reconstructive treatments, the case of an 80-year-old Chinese Han male presenting with pathological fracture caused by a proximal ulnar metastatic tumor concurrent with metastatic renal cancer complicated by occurrence in the brain and lungs is reported and contrasted with alternative treatment techniques. Wide resectioning of the proximal ulna and reconstruction with local radius neck-to-humerus trochlea transposition resulted in preservation of functionality, sensitivity, and biomechanical integrity after postsurgical immobilization, 6 weeks of passive- and active-assisted flexion, and extension with a hinged brace. The resultant Musculoskeletal Tumor Society rating score was 25 of 30 (83 %). Full sensitivity and mobility of the left hand and elbow (10° to 90° with minimally impaired supination and pronation) was restored with minimal discomfort. No evidence of local recurrence or other pathological complications were observed within a 1-year follow-up period. Efficient reconstruction of osseous and capsuloligamentous structures in the elbow is often accomplished by allografts, prosthesis, and soft tissue reconstruction, though wide variations in risk and prognosis associated with these techniques has resulted in disagreements regarding the most effective standards for clinical treatment. Current findings suggest that radius neck-to-humerus trochlea transposition offers a superior range of elbow movement and fewer complications than similar allograft and prosthetic techniques for patients with multiple metastatic cancers. PMID:22800611

Chen, Feiyan; Xia, Jun; Wei, Yibing; Wang, Siqun; Wu, Jianguo; Huang, Gangyong; Chen, Jie; Shi, Jingsheng

2012-01-01

253

Relationship of estimated dietary intake of n-3 polyunsaturated fatty acids from fish with peripheral nerve function after adjusting for mercury exposure  

PubMed Central

Background Some clinical studies have suggested that ingestion of n-3 polyunsaturated fatty acids (PUFA) has neuroprotective effects on peripheral nerve function. However, few epidemiological studies have examined the effect of dietary n-3 PUFA intake from fish consumption on peripheral nerve function, and none have controlled for co-occurrence of methylmercury exposure from fish consumption. Objectives We evaluated the effect of estimated dietary n-3 PUFA intake on peripheral nerve function after adjusting for biomarkers of methylmercury and elemental mercury in a convenience sample of 515 dental professionals. Methods We measured sensory nerve conduction (peak latency and amplitude) of the median, ulnar and sural nerves and total mercury concentrations in hair and urine samples. We estimated daily intake (mg/day) of the total n-3 PUFA, n-3 docosahexaenoic acid (DHA), and n-3 eicosapentaenoic acid (EPA) based on a self-administrated fish consumption frequency questionnaire. We also collected information on mercury exposure, demographics and other covariates. Results The estimated median intakes of total n-3 PUFA, n-3 EPA, and n-3 DHA were 447, 105, and 179 mg/day, respectively. The mean mercury concentrations in urine (1.05?g/L) and hair (0.49?g/g) were not significantly different from the US general population. We found no consistent association between n-3 PUFA intake and sensory nerve conduction after adjusting for mercury concentrations in hair and urine although some positive associations were observed with the sural nerve. Conclusions In a convenience sample of dental professionals, we found little evidence suggesting that dietary intake of n-3 PUFAs from fish has any impact on peripheral nerve function after adjustment for methylmercury exposure from fish and elemental mercury exposure from dental amalgam. PMID:23538138

Wang, Yi; Goodrich, Jaclyn M.; Werner, Robert; Gillespie, Brenda; Basu, Niladri; Franzblau, Alfred

2013-01-01

254

Review of Literature of Radial Nerve Injuries Associated with Humeral Fractures—An Integrated Management Strategy  

PubMed Central

Background Radial nerve palsy associated with fractures of the shaft of the humerus is the most common nerve lesion complicating fractures of long bones. However, the management of radial nerve injuries associated with humeral fractures is debatable. There was no consensus between observation and early exploration. Methods and Findings The PubMed, Embase, Cochrane Central Register of Controlled Trials, Google Scholar, CINAHL, International Bibliography of the Social Sciences, and Social Sciences Citation Index were searched. Two authors independently searched for relevant studies in any language from 1966 to Jan 2013. Thirty studies with 2952 humeral fractures participants were identified. Thirteen studies favored conservative strategy. No significant difference between early exploration and no exploration groups (OR, 1.03, 95% CI 0.61, 1.72; I2?=?0.0%, p?=?0.918 n.s.). Three studies recommend early radial nerve exploration in patients with open fractures of humerus with radial nerve injury. Five studies proposed early exploration was performed in high-energy humeral shaft fractures with radial nerve injury. Conclusions The conservative strategy was a good choice for patients with low-energy closed fractures of humerus with radial nerve injury. We recommend early radial nerve exploration (within the first 2 weeks) in patients with open fractures or high-energy closed fractures of humerus with radial nerve injury. PMID:24250799

Wu, Qiang; Wu, QiuLi; Li, Yan; Feng, ShiQing

2013-01-01

255

Nerve Regenerative Effects of GABA-B Ligands in a Model of Neuropathic Pain  

PubMed Central

Neuropathic pain arises as a direct consequence of a lesion or disease affecting the peripheral somatosensory system. It may be associated with allodynia and increased pain sensitivity. Few studies correlated neuropathic pain with nerve morphology and myelin proteins expression. Our aim was to test if neuropathic pain is related to nerve degeneration, speculating whether the modulation of peripheral GABA-B receptors may promote nerve regeneration and decrease neuropathic pain. We used the partial sciatic ligation- (PSL-) induced neuropathic model. The biochemical, morphological, and behavioural outcomes of sciatic nerve were analysed following GABA-B ligands treatments. Simultaneous 7-days coadministration of baclofen (10?mg/kg) and CGP56433 (3?mg/kg) alters tactile hypersensitivity. Concomitantly, specific changes of peripheral nerve morphology, nerve structure, and myelin proteins (P0 and PMP22) expression were observed. Nerve macrophage recruitment decreased and step coordination was improved. The PSL-induced changes in nociception correlate with altered nerve morphology and myelin protein expression. Peripheral synergic effects, via GABA-B receptor activation, promote nerve regeneration and likely ameliorate neuropathic pain. PMID:25165701

Cavalli, Erica; Pajardi, Giorgio

2014-01-01

256

Benign breast lesions: Ultrasound  

PubMed Central

Benign breast diseases constitute a heterogeneous group of lesions arising in the mammary epithelium or in other mammary tissues, and they may also be linked to vascular, inflammatory or traumatic pathologies. Most lesions found in women consulting a physician are benign. Ultrasound (US) diagnostic criteria indicating a benign lesion are described as well as US findings in the most frequent benign breast lesions. PMID:23396888

Masciadri, N.; Ferranti, C.

2011-01-01

257

Nerve allografts and conduits in peripheral nerve repair.  

PubMed

Since the last update on nerve conduits and allograft in 2000, investigations have established the efficacy of these alternatives to autograft in the repair of small sensory neural gaps. However, limited insights into the biology of the regenerating nerve continue to preclude intelligent conduit design. Ongoing discoveries in neuroscience and biomaterial engineering hold promise for the eventual development of allograft and conduits with potential of surpassing nerve autografts in clinical efficacy. In this review, we summarize the history, recent advances, and emerging developments in nerve conduits and allograft. PMID:23895714

Lin, Michael Y; Manzano, Givenchy; Gupta, Ranjan

2013-08-01

258

Atorvastatin is beneficial for muscle reinnervation after complete sciatic nerve section in rats.  

PubMed

Nerve regeneration and functional recovery are often incomplete after peripheral neurotmetic lesion. Atorvastatin has been shown to be neuroprotective after transient ischaemia or traumatic injury. The aim of this study was to establish if systemic administration of Atorvastatin could improve functional muscle reinnervation after complete sciatic nerve section. Sixteen female Sprague-Dawley rats were used in this study. After a complete right sciatic nerve section, end-to-end microsuture repair was performed and fibrin glue was added. Three groups were studied: (1) sutures (S) + fibrin glue (F) only + saline administration for 14 days; (2) S+F+Atorvastatin administration for 14 days; and (3) uninjured nerve. Five months later, the sciatic nerve and the gastrocnemius muscle were isolated to perform in vivo electrophysiological measurements. Better kinematics was observed in atorvastatin-treated rats 5 months after its administration. Indeed, a larger excursion of the hip-ankle-toe angle during walking was observed. This effect was associated with the preservation of electromyographic activity (2.91 mV vs 0.77 mV) and maximal muscle force (85.1 g vs 28.6 g) on stimulation of the proximal nerve section. Five months after a neurotmetic lesion, the recovery is incomplete when using suture and fibrin glue only. Furthermore, the systemic administration of Atorvastatin for 14 days after lesion was beneficial in improving locomotion capability associated with the re-establishment of muscle strength and EMG activity. PMID:23848426

Cloutier, Frédéric-Charles; Rouleau, Dominique M; Hébert-Davies, Jonah; Beaumont, Pierre H; Beaumont, Eric

2013-12-01

259

[War injuries of the femoral nerve. Apropos of a series of 27 cases].  

PubMed

The authors report a series of 27 war injuries to the femoral nerve which represent approximately 1% of all of the war injuries to peripheral nerves operated in our department since the Islamic revolution in Iran in 1978 and during the 8 years of the war between Iran and Iraq. All of the victims presented with associated lesions: abdominal (24 laparotomies, including 10 colostomies) and/or vascular (3 iliac artery by-pass grafts). We divided the cases into 3 groups. In Group 1 (18 cases), the femoral nerve had a mean defect of 8 centimetres which was grafted. In Group 2 (4 cases), the nerve was simply compressed by fibrosis and/or metallic bodies and was released. In Group 3 (5 cases), the nerve trunk had a partial loss of substance which was grafted. The motor results were very satisfactory (M3 to M5) in the 3 groups with muscular recovery in about 2 years. PMID:1726353

Gousheh, J; Razian, M

1991-01-01

260

The influence of mechanoreceptor structures on regenerating sensory axons after cutaneous nerve transection in the cat.  

PubMed

After nerve transection, cutaneous type I mechanoreceptors (Haarscheiben or tactile domes) preferentially reappear at old loci, although some do appear at new locations. The mechanism by which this topological specificity is maintained was studied by transecting the femoral cutaneous nerve in cats in which about half of the Haarscheiben were removed by cauterization. Thirteen months after nerve transection, domes were found on uncauterized sites at a rate significantly greater than that expected by chance alone, but on cauterized old dome sites at a rate expected by chance alone. It is concluded the reappearance of type I receptors at old receptor sites following nerve transection is primarily due to intrinsic properties of the receptor sites, rather than to guidance of regenerating axonal sprouts to these sites by the endoneurial matrix of the distal stump of the lesioned nerve. PMID:7177492

Horch, K

1982-10-23

261

Medial Antebrachial Cutaneous Nerve Injury After Brachial Plexus Block: Two Case Reports  

PubMed Central

Medial antebrachial cutaneous (MABC) nerve injury associated with iatrogenic causes has been rarely reported. Local anesthesia may be implicated in the etiology of such injury, but has not been reported. Two patients with numbness and painful paresthesia over the medial aspect of the unilateral forearm were referred for electrodiagnostic study, which revealed MABC nerve lesion in each case. The highly selective nature of the MABC nerve injuries strongly suggested that they were the result of direct nerve injury by an injection needle during previous brachial plexus block procedures. Electrodiagnostic studies can be helpful in evaluating cases of sensory disturbance after local anesthesia. To our knowledge, these are the first documented cases of isolated MABC nerve injury following ultrasound-guided axillary brachial plexus block. PMID:24466530

Jung, Mi Jin; Byun, Ha Young; Lee, Chang Hee; Moon, Seung Won; Oh, Min-Kyun

2013-01-01

262

Dissection of intercostal nerves by means of assisted video thoracoscopy: experimental study  

PubMed Central

In total brachial plexus preganglionic lesions (C5-C6-C7-C8 and T1) different extraplexual neurotizations are indicated for partial motor function restitution. Mostly for the flexion of the elbow. Neurotization with intercostal nerves (ICN) to musculocutaneous nerve has been known and accepted during many years with different results 2 - 5. The customary technique as described by various authors is carried out by means of a large submammary incision to harvest three or four intercostal nerves (Figure 1). Then are connected by direct suture or grafts to the musculocutaneous nerve or its motor branches 6 - 7. In this article the authors described the possibility of dissection intercostal nerves by means of assisted video thoracoscopy. (VATS-videdo assisted thoracic surgery). PMID:23406448

2013-01-01

263

Practical magnetic resonance imaging evaluation of peripheral nerves in children: magnetic resonance neurography.  

PubMed

Magnetic resonance (MR) imaging is an excellent tool for the evaluation of peripheral nerves in children not only because of its excellent soft tissue contrast resolution but also because it is noninvasive and does not use ionizing radiation. In nonconclusive cases, MR neurography can be complementary to physical examination and electromyography in identifying a specific affected nerve and the site of the lesion. This article reviews the MR imaging technique used in the evaluation of peripheral nerves (ie, MR neurography), its major indications, and the common pathologic conditions encountered in the pediatric population. PMID:23830792

Cortes, Cesar; Ramos, Yanerys; Restrepo, Ricardo; Restrepo, Jose Andres; Grossman, John A I; Lee, Edward Y

2013-07-01

264

Intraosseous malignant peripheral nerve sheath tumor of maxilla: A case report with review of the literature.  

PubMed

Malignant peripheral nerve sheath tumor (MPNST), the principle malignancy of peripheral nerve origin, though rare in the general population, occurs with excessive frequency among patients with neurofibromatosis. This tumor always arises in soft-tissues, usually found in the lower extremities and only 10-12% of all lesions occur in the head and neck region, which makes it a rare entity. The primary intraosseous MPNST is rare and has been reported most frequently in the mandible. This article discusses a case report of MPNST of the left maxilla without a history of benign nerve tissue tumor and the diagnostic difficulties associated with MPNST. PMID:25097654

Tamgadge, Sandhya; Modak, Neha; Tamgadge, Avinash P; Bhalerao, Sudhir

2014-05-01

265

Nitric oxide synthase, an essential factor in peripheral nerve regeneration.  

PubMed

Nitric oxide (NO) exerts both, pro-apoptotic and anti-apoptotic actions and appears to be acritical factor inneuronal degenerative and regenerative processes. NO is synthesized from L-arginine by NO synthase occurring in three isoforms of (neuronal, nNOS; endothelial, eNOS; inducible, iNOS). In a mice sciatic nerve model the regenerative outcome was assessed when the endogenous NO supply was deficient by knocking out the respective NOS isoform and compared to that of wild type mice after nerve transection. In nNOS knock-out mice a delay in regeneration, preceded by slowedWallerian degeneration and a disturbed pruning of uncontrolled sprouts, was observed. This was associated with a delayed recovery of sensory and motor function. Additionally, deficiency of nNOS led after nerve cut to a substantial loss of small and medium-sized dorsal root ganglia neurons, spinal cord interneurons and, to a lesser extent, spinal cord motor neurons. A lack of iNOS resulted in a delayed Wallerian degeneration and impaired regenerative outcome without consequences for neuronal survival. A lack of eNOS was well tolerated, although a delay in nerve revascularization was observed. Thus, after peripheral nerve lesion, regular NOS activity is essential for cell survival and recovery with reference to the nNOS isoform. PMID:14656046

Keilhoff, G; Fansa, H; Wolf, G

2003-09-01

266

Fibrolipoma of the median nerve.  

PubMed

Neural fibrolipoma or fibrolipomatous hamartoma is an uncommon benign tumor that usually arises in the median nerve. Fibrofatty tissue proliferates around the nerve and infiltrates the epineurium and perineurium. We report a case of fibrolipomatous hamartoma of the left median nerve in an 18-year-old woman. Our objective was to describe the pathognomonic magnetic resonance imaging features, whose presence obviates the need for a diagnostic biopsy. PMID:17178460

Nouira, Kais; Belhiba, Hend; Baccar, Sofične; Miaaoui, Anissa; Ben Messaoud, Monia; Turki, Imčne; Cheour, Ilhem; Menif, Emna

2007-01-01

267

Live-Donor Nerve Transplantation  

Microsoft Academic Search

We recently reported the first case of live-donor nerve transplantation, performed in November 2000 in an 8-month-old infant\\u000a with global obstetric brachial plexus palsy (OBPP) and four root avulsion who had undergone prior sural nerve autografting\\u000a at 3 months. Cross-chest C7 nerve transfer and temporary tacrolimus (TCL)\\/prednisone immunosuppression were utilized. The\\u000a purpose of this chapter is twofold. First, we provide

Scott A. Gruber; Pedro Mancias

268

Assessment of processed human amniotic membrane as a protective barrier in rat model of sciatic nerve injury.  

PubMed

Following nerve injury, scar formation is thought to be a considerable impediment to axonal regeneration at the nerve injury site. Nerve wrapping can protect the regenerating axons, and human amniotic membrane (HAM) derived from human placenta is an effective material for that purpose. The impact of nerve wrapping with HAM on functional recovery after nerve injuries, especially after autograft repair of long gap lesions, has not been comprehensively investigated. In the current study, we investigated whether the application of HAM as a nerve wrap to a 10mm segment of transected and repaired nerve would reduce scar formation and permit better axonal regeneration and/or functional recovery in rats. The outcome was assessed with morphological and functional measures. We found that nerves wrapped with HAM had significantly fewer adhesions and less scar formation than controls. Although the final outcome, both functionally and morphologically, was not significantly improved by wrapping the nerve with HAM, the observed decrease in adhesions and scar formation might help the nerve retain its mobility and thus prevent traction injury and ischemia, which are caused by nerve tethering to the adjacent tissue during the healing process. PMID:21511004

Meng, Hao; Li, Mo; You, Fengjian; Du, Junjie; Luo, Zhuojing

2011-05-27

269

Inflammatory pseudotumor of the median nerve. Case report and review of the literature.  

PubMed

The authors report the presence of an inflammatory pseudotumor of the median nerve in a young woman who presented with a sensorimotor deficit in the median nerve area. Magnetic resonance (MR) images revealed a fusiform mass in the nerve, and the patient underwent surgery for a suspected peripheral nerve-sheath tumor. Her clinical condition improved slowly and notably. Histological study revealed a heterogeneous lymphoid infiltration with mononuclear cells, lymphocytes (mostly T cells), and plasmocytoid cells. Because of the unknown significance of this infiltration, the patient was examined to exclude the possible diagnosis of a systemic tumoral process. All the studies yielded negative results and no systemic disease was found. Later, control MR imaging revealed no tumoral remains, and electromyography demonstrated progressive improvement of median nerve function. The follow-up period has been 8 years. The cause of the lesion is unknown. The differential diagnosis includes benign and malignant peripheral nerve-sheath tumors, lymphoma, and all tumorlike lesions of peripheral nerves. PMID:11453382

Pérez-López, C; Gutiérrez, M; Isla, A

2001-07-01

270

Malignant peripheral nerve sheath tumors of the spine: a SEER database analysis.  

PubMed

Peripheral nerve sheath tumors are uncommon neoplasms that can affect any area of the body. Spinal lesions, especially those that are malignant, pose difficult management challenges, and data regarding these lesions are limited by the disease rarity. This study provides a population-based analysis using the Surveillance, Epidemiology, and End Results (SEER) database, focusing on patient characteristics and treatments. Surgery is associated with improved survival, whereas radiation therapy is associated with decreased survival in this cohort with malignant peripheral nerve sheath tumor in the spine. PMID:24698778

Stadler, James A; Qadri, Usama; Tang, Jessica A; Scheer, Justin K; Melkonian, Stephanie C; Smith, Zachary A; Lam, Sandi K

2014-07-01

271

Diabetic Neuropathies: The Nerve Damage of Diabetes  

MedlinePLUS

... nerve damage to the bowels can cause constipation alternating with frequent, uncontrolled diarrhea, especially at night. Problems ... Nerve conduction studies check the transmission of electrical current through a nerve. Electromyography shows how well muscles ...

272

Bilateral optic nerve hypoplasia.  

PubMed

In the past 10 years, 15 children with bilateral optic nerve hypoplasia have been studied at the Royal Alexandra Hospital for Children. There were 5 boys and 10 girls. Nine were first-born and they presented at a mean age of 5 months (range: 4 days to 25 months). Five presented with suspected blindness and 7 with abnormal eye movements (nystagmus or less commonly squint). The other 3 presented because of fits or developmental delay. Eight showed evidence of neural damage--microcephaly, seizures and/or abnormalities of tone. Four appeared to be of normal or near normal intelligence, 6 were mildly retarded and 5 severely so. Two patients had already died, one suddenly. Six of the 7 cases investigated in detail had evidence of hypothalamic pituitary dysfunction. Another one had a minimal hypothalamic abnormality. Four were severely growth retarded and 2 were receiving growth hormone replacement. Two males had micropenis and a girl had precocious puberty with partial diabetes insipidus. Neuroradiological investigations showed an absent septum pellucidum in only 5 cases. Five patients had other major CNS malformations. Five patients had normal CT scans; 3 of these 5 appeared of normal intelligence and all 5 had normal neurological examinations. Bilateral optic nerve hypoplasia is frequently associated with serious brain and endocrine abnormalities. PMID:6926392

Ouvrier, R A; Lewis, D; Procopis, P G; Billson, F A; Silink, M; de Silva, M

1981-01-01

273

Intra-articular fractures of the distal radius: bridging external fixation in slight flexion and ulnar deviation along articular surface instead of radial shaft.  

PubMed

Forty-one patients with intra-articular fracture of the distal radius (AO Type C) were treated with a double joint-bridging external fixator placed radial side of the fracture site and the wrist placed in slight flexion and ulnar deviation equal to the palmar tilt and radial inclination of the uninjured wrist. The patients were evaluated according to the system of Gartland and Werley an average of 43 months (range, 34 to 53 mo) after surgery. There were 14 excellent, 18 good, 7 fair, and 2 poor results. The average flexion was 94% of the normal side, extension 91%, pronation 95%, and supination 84%. The average radial inclination was 22 ± 10 degrees, palmar tilt 8 ± 14 degrees, and maximum articular step or gap was 2 mm. Bridging external fixation with slight wrist flexion and ulnar deviation equal to preinjured palmar tilt and radial inclination provides acceptable clinical and radiologic results. PMID:24487283

Moradi, Ali; Ebrahimzadeh, Mohammad H; Jupiter, Jess B

2014-03-01

274

Temporal Adaptation Silicon Auditory Nerve  

E-print Network

Temporal Adaptation in a Silicon Auditory Nerve John Lazzaro CS Division UC Berkeley 571 Evans Hall (bottom trace), we see the envelope of the temporal adaptation superimposed on the cycle-by-cycle phase-locking). In biological auditory nerve fibers, cycle-by-cycle phase locking ceases for auditory fibers tuned

Lazzaro, John

275

Functions of the Renal Nerves.  

ERIC Educational Resources Information Center

Discusses renal neuroanatomy, renal vasculature, renal tubules, renin secretion, renorenal reflexes, and hypertension as related to renal nerve functions. Indicates that high intensitites of renal nerve stimulation have produced alterations in several renal functions. (A chart with various stimulations and resultant renal functions and 10-item,…

Koepke, John P.; DiBona, Gerald F.

1985-01-01

276

Contiguous gene deletion of TBX5 and TBX3 leads to a varible phenotype with combined features of Holt-Oram and ulnar-mammary syndromes.  

PubMed

We report on a combination of congenital malformations in a mother and her fetus harboring a heterozygous deletion encompassing the TBX5 and TBX3 genes, which are disease-causing in Holt-Oram and ulnar-mammary syndromes, respectively. This contiguous gene syndrome is reminiscent of Okihiro syndrome and emphasizes the importance of array-CGH as a diagnostic tool in atypical syndromic presentations with intrafamilial variability. PMID:23713051

Alby, Caroline; Bessieres, Bettina; Bieth, Eric; Attie-Bitach, Tania; Fermont, Laurent; Citony, Isabelle; Razavi, Ferechté; Vekemans, Michel; Escande, Fabienne; Manouvrier, Sylvie; Malan, Valérie; Amiel, Jeanne

2013-07-01

277

MRI texture heterogeneity in the optic nerve predicts visual recovery after acute optic neuritis?  

PubMed Central

Purpose To test the feasibility of using multi-scale MRI texture analysis to assess optic nerve pathology and to investigate how visual recovery relates to the severity of acute tissue damage in the optic nerve in patients after optic neuritis (ON). Materials and Methods We recruited 25 patients with acute ON. Retinal nerve fiber layer (RNFL) thickness; MRI lesion length and enhancement; optic nerve area ratio; and multi-scale MRI texture analysis, a measure of structural integrity, were used to assess tissue damage at baseline, and at 6 and 12 months. The recovery in vision was defined as the functional outcome. Eight healthy subjects were imaged for control. Results We identified 25 lesions in the affected eyes (9 enhanced) and 5 in the clinically non-affected eyes (none enhanced). At baseline, we found that RNFL values were 20% thicker and lesion texture 14% more heterogeneous in the affected eyes than in the non-affected eyes, and lesion texture ratio of affected to non-affected eyes was greater in patients than in controls. In the affected eyes, visual acuity recovered significantly over 6 (18/23 patients) and 12 months (18/21 patients) when RNFL thickness and optic nerve area ratio decreased over time. Texture heterogeneity in the standard MRI of acute optic nerve lesions was the only measure that predicted functional recovery after ON. Conclusions Tissue heterogeneity may be a potential measure of functional outcome in ON patients and advanced analysis of the texture in standard MRI could provide insights into mechanisms of injury and recovery in patients with similar disorders. PMID:25061567

Zhang, Yunyan; Metz, Luanne M.; Scott, James N.; Trufyn, Jessie; Fick, Gordon H.; Costello, Fiona

2014-01-01

278

Painful nail lesions.  

PubMed

A man, 58 years of age, presented with a 4 year history of painful lesions of his nails. His previous history included hypertension, diabetes mellitus and hyperlipidaemia. These were treated with enalapril, metformin and simvastatin respectively. He also had asymptomatic skin lesions for over 15 years that had worsened in the past 4 years. His father had similar nail lesions that had been diagnosed as onychomycosis. PMID:20369112

Vano-Galvan, Sergio; Garate, Teresa; Ma, Dong-Lai; Jaén, Pedro

2010-03-01

279

Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke.  

PubMed

Neural plasticity is widely believed to support functional recovery following brain damage. Vagus nerve stimulation paired with different forelimb movements causes long-lasting map plasticity in rat primary motor cortex that is specific to the paired movement. We tested the hypothesis that repeatedly pairing vagus nerve stimulation with upper forelimb movements would improve recovery of motor function in a rat model of stroke. Rats were separated into 3 groups: vagus nerve stimulation during rehabilitation (rehab), vagus nerve stimulation after rehab, and rehab alone. Animals underwent 4 training stages: shaping (motor skill learning), prelesion training, postlesion training, and therapeutic training. Rats were given a unilateral ischemic lesion within motor cortex and implanted with a left vagus nerve cuff. Animals were allowed 1 week of recovery before postlesion baseline training. During the therapeutic training stage, rats received vagus nerve stimulation paired with each successful trial. All 17 trained rats demonstrated significant contralateral forelimb impairment when performing a bradykinesia assessment task. Forelimb function was recovered completely to prelesion levels when vagus nerve stimulation was delivered during rehab training. Alternatively, intensive rehab training alone (without stimulation) failed to restore function to prelesion levels. Delivering the same amount of stimulation after rehab training did not yield improvements compared with rehab alone. These results demonstrate that vagus nerve stimulation repeatedly paired with successful forelimb movements can improve recovery after motor cortex ischemia and may be a viable option for stroke rehabilitation. PMID:24553102

Khodaparast, Navid; Hays, Seth A; Sloan, Andrew M; Fayyaz, Tabbassum; Hulsey, Daniel R; Rennaker, Robert L; Kilgard, Michael P

2014-09-01

280

Hemangioblastoma of the optic nerve producing bilateral optic tract edema in a patient with von Hippel-Lindau disease  

PubMed Central

Background: The authors present a novel case of a hemangioblastoma of the optic nerve producing bilateral optic tract edema in a patient with von Hippel–Lindau disease (VHL). This is the only case in the literature documenting optic tract edema secondary to a hemangioblastoma of the optic nerve. Case Description: The patient was a 34-year-old female in whom this lesion was causing retro-orbital pain and proptosis. She had previously lost vision in the symptomatic eye secondary to a retinal hemangioblastoma. The optic nerve lesion was excised by sectioning the optic nerve both proximally and distally to the lesion. There were no complications and patient's symptoms resolved postoperatively. A follow-up magnetic resonance imaging (MRI) scan revealed complete excision of the mass and resolution of the optic tract edema. Conclusion: Optic nerve hemangioblastomas in patients with VHL are rare, but are manageable with meticulous microneurosurgery and with appropriate patient expectations. This is the first known case of an optic nerve hemangioblastoma producing bilateral optic tract edema, which resolved after resection of the prechiasmal tumor. Hemangioblastoma should remain in the differential diagnosis of optic nerve tumors, especially in the setting of VHL. PMID:24778921

Staub, Blake N.; Livingston, Andrew D.; Chevez-Barrios, Patricia; Baskin, David S.

2014-01-01

281

Mice Lacking GD3 Synthase Display Morphological Abnormalities in the Sciatic Nerve and Neuronal Disturbances during Peripheral Nerve Regeneration  

PubMed Central

The ganglioside 9-O-acetyl GD3 is overexpressed in peripheral nerves after lesioning, and its expression is correlated with axonal degeneration and regeneration in adult rodents. However, the biological roles of this ganglioside during the regenerative process are unclear. We used mice lacking GD3 synthase (Siat3a KO), an enzyme that converts GM3 to GD3, which can be further converted to 9-O-acetyl GD3. Morphological analyses of longitudinal and transverse sections of the sciatic nerve revealed significant differences in the transverse area and nerve thickness. The number of axons and the levels of myelin basic protein were significantly reduced in adult KO mice compared to wild-type (WT) mice. The G-ratio was increased in KO mice compared to WT mice based on quantification of thin transverse sections stained with toluidine blue. We found that neurite outgrowth was significantly reduced in the absence of GD3. However, addition of exogenous GD3 led to neurite growth after 3 days, similar to that in WT mice. To evaluate fiber regeneration after nerve lesioning, we compared the regenerated distance from the lesion site and found that this distance was one-fourth the length in KO mice compared to WT mice. KO mice in which GD3 was administered showed markedly improved regeneration compared to the control KO mice. In summary, we suggest that 9-O-acetyl GD3 plays biological roles in neuron-glia interactions, facilitating axonal growth and myelination induced by Schwann cells. Moreover, exogenous GD3 can be converted to 9-O-acetyl GD3 in mice lacking GD3 synthase, improving regeneration. PMID:25330147

Ribeiro-Resende, Victor Tulio; Gomes, Tiago Araujo; de Lima, Silmara; Nascimento-Lima, Maiara; Bargas-Rega, Michele; Santiago, Marcelo Felipe; Reis, Ricardo Augusto de Melo; de Mello, Fernando Garcia

2014-01-01

282

Photofabricated gelatin-based nerve conduits: nerve tissue regeneration potentials.  

PubMed

There is a strong demand for development of nerve guide conduit with prompt nerve regeneration potential for injury-induced nerve defect. Prior to study on nerve tissue engineering using Schwann cells or nerve stem cells, the effectiveness of photofabricated scaffolds based on photocurable gelatin was examined. This study describes the evaluation of in vivo nerve tissue regeneration potentials of three custom-designed and -fabricated prostheses (inner diameter, 1.2 mm; outer diameter, 2.4 mm; wall thickness, 0.60 mm; and length, 15 mm) made of photocured gelatin: a plain photocured gelatin tube (model I), a photocured gelatin tube packed with bioactive substances (laminin, fibronectin, and nerve growth factor) coimmobilized in a photocured gelatin rod (model II), and a photocured gelatin tube packed with bioactive substances coimmobilized in multifilament fibers (model III). These prostheses were implanted between the proximal and distal stumps 10 mm of the dissected right sciatic nerve of 70 adult male Lewis rats for up to 1 year. The highest regenerative potentials were found using the model III prosthesis, followed by the model II prosthesis. Markedly retarded neural regeneration was observed using the model I prosthesis. These were evaluated from the viewpoints of functional recovery, electrophysiological responses, and tissue morphological regeneration. The significance of the synergistic cooperative functions of multifilaments, which serve as a platform that provides contact guidance to direct longitudinal cell movement and tissue ingrowth and as a cell adhesive matrix with high surface area, and immobilized bioactive substances, which enhance nerve regeneration via biological stimulation, is discussed. PMID:15565867

Gámez, Eduardo; Goto, Yoshinobu; Nagata, Kengo; Iwaki, Toru; Sasaki, Tomio; Matsuda, Takehisa

2004-01-01

283

Peripheral nerve regeneration with sustained release of poly(phosphoester) microencapsulated nerve growth factor within nerve guide conduits  

Microsoft Academic Search

Prolonged delivery of neurotrophic proteins to the target tissue is valuable in the treatment of various disorders of the nervous system. We have tested in this study whether sustained release of nerve growth factor (NGF) within nerve guide conduits (NGCs), a device used to repair injured nerves, would augment peripheral nerve regeneration. NGF-containing polymeric microspheres fabricated from a biodegradable poly(phosphoester)

Xiaoyun Xu; Woon-Chee Yee; Peter Y. K Hwang; Hanry Yu; Andrew C. A Wan; Shujun Gao; Kum-Loong Boon; Hai-Quan Mao; Kam W Leong; Shu Wang

2003-01-01

284

Apoptosis in leukoaraiosis lesions  

Microsoft Academic Search

Leukoaraiosis (LA), an age-related degenerative condition, appears as an area of hyperintense signal in the deep white matter on MRI. It may be caused by chronic ischemia. LA lesions are characterized by demyelination, loss of glial cells, spongy appearance, and occlusion of veins and venules by collagenous thickening of the vessel walls. Since necrosis is not obvious in LA lesions,

William R Brown; Dixon M Moody; Venkata R Challa; Clara R Thore; John A Anstrom

2002-01-01

285

Ultrastructural characterisation of the M protein in nerve biopsy of patients with POEMS syndrome  

PubMed Central

To learn more about the mechanisms of nerve lesions in POEMS syndrome, nerve specimens from four patients were studied with an immunogold method at the ultrastructural level to detect and localise the M protein in the different nerve compartments. An indirect immunolabelling technique was applied on 4% PFA fixed and LR White embedded nerve specimens. Antisera against IgG, IgA, IgM, and lambda and kappa light chains were used as primary antisera. Morphological studies disclosed an important axonal loss in association with the demyelinative process. Endoneurial deposits of immunoglobulins were found in all cases. In the patient with the most severe form of neuropathy, diffuse deposits were present in the endoneurial space, especially in the subperineurial area. In the other patients, occasional deposits of the M protein were found in the myelin sheath (n=2); or between cells (n=1). No deposit was found in the axons. The class of the M protein labelled in the nerve corresponded to that detected in the serum in three of four patients, with labelling of two heavy chains in one patient. Immunolabelling of the M protein on the myelin sheath, Schwann cells, and in the endoneurial space favour a direct role of the M component in the lesions of nerve fibres, and justify active treatment of the plasmacytic proliferation.?? PMID:9647319

Adams, D.; Said, G.

1998-01-01

286

RESIDENTS CASE REPORT: DEEP VEIN THROMBOSIS IN A HIGH SCHOOL BASEBALL PITCHER FOLLOWING ULNAR COLLATERAL LIGAMENT (UCL) RECONSTRUCTION  

PubMed Central

Background and Purpose: Accurate diagnosis of deep vein thrombosis in an outpatient setting is difficult; however, proper screening and prompt referral can be lifesaving. The purpose of this case report is to present the unusual findings of a Deep Vein Thrombosis (DVT) in an otherwise healthy young male following an upper extremity surgery. Case Description: An 18 year-old male high school baseball pitcher presented to the clinic for his four month follow up visit after Ulnar Collateral Ligament (UCL) reconstruction surgery. Patient complained of a recent “groin strain” and “calf strain” following baseball conditioning, that upon examination demonstrated signs and symptoms consistent with a deep vein thrombosis (DVT). Outcomes: Following emergent referral the patient was diagnosed with multiple emboli and was treated with Lovenox and Coumadin. Discussion: Lower extremity DVT is a serious and potentially life threatening disorder. Physical therapists need to be vigilant in their subjective and objective examination of any patient that presents with lower extremity pain and swelling. This case report presents the unlikely findings of a DVT in a young, healthy, male high school baseball pitcher after surgical repair of the UCL. Level of Evidence: 4 PMID:24175133

Garrison, Craig; Conway, John

2013-01-01

287

Nanofibrous nerve conduit-enhanced peripheral nerve regeneration.  

PubMed

Fibre structures represent a potential class of materials for the formation of synthetic nerve conduits due to their biomimicking architecture. Although the advantages of fibres in enhancing nerve regeneration have been demonstrated, in vivo evaluation of fibre size effect on nerve regeneration remains limited. In this study, we analyzed the effects of fibre diameter of electrospun conduits on peripheral nerve regeneration across a 15-mm critical defect gap in a rat sciatic nerve injury model. By using an electrospinning technique, fibrous conduits comprised of aligned electrospun poly (?-caprolactone) (PCL) microfibers (981?±?83 nm, Microfiber) or nanofibers (251?±?32 nm, Nanofiber) were obtained. At three months post implantation, axons regenerated across the defect gap in all animals that received fibrous conduits. In contrast, complete nerve regeneration was not observed in the control group that received empty, non-porous PCL film conduits (Film). Nanofiber conduits resulted in significantly higher total number of myelinated axons and thicker myelin sheaths compared to Microfiber and Film conduits. Retrograde labeling revealed a significant increase in number of regenerated dorsal root ganglion sensory neurons in the presence of Nanofiber conduits (1.93 ± 0.71 × 10(3) vs. 0.98 ± 0.30 × 10(3) in Microfiber, p?nerve regeneration. These results could provide useful insights for future nerve guide designs. PMID:22700359

Jiang, Xu; Mi, Ruifa; Hoke, Ahmet; Chew, Sing Yian

2014-05-01

288

Optic Nerve Diffusion Measurement from Diffusion-Weighted Imaging in Optic Neuritis  

Microsoft Academic Search

BACKGROUND AND PURPOSE: Increases in apparent diffusion coefficient (ADC) from diffusion-weighted (DW) imaging are thought to be due to axonal disruption, and changes have been well documented in multiple sclerosis lesions. DW imaging of the optic nerves, however, presents many challenges. The goal of this study was to measure ADC in patients with optic neuritis by using zonal oblique multisection

Simon J. Hickman; Claudia A. M. Wheeler-Kingshott; Stephen J. Jones; Katherine A. Miszkiel; Gareth J. Barker; Gordon T. Plant; David H. Miller

2005-01-01

289

Mechanisms of insulin action on sympathetic nerve activity  

NASA Technical Reports Server (NTRS)

Insulin resistance and hyperinsulinemia may contribute to the development of arterial hypertension. Although insulin may elevate arterial pressure, in part, through activation of the sympathetic nervous system, the sites and mechanisms of insulin-induced sympathetic excitation remain uncertain. While sympathoexcitation during insulin may be mediated by the baroreflex, or by modulation of norepinephrine release from sympathetic nerve endings, it has been shown repeatedly that insulin increases sympathetic outflow by actions on the central nervous system. Previous studies employing norepinephrine turnover have suggested that insulin causes sympathoexcitation by acting in the hypothalamus. Recent experiments from our laboratory involving direct measurements of regional sympathetic nerve activity have provided further evidence that insulin acts in the central nervous system. For example, administration of insulin into the third cerebralventricle increased lumbar but not renal or adrenal sympathetic nerve activity in normotensive rats. Interestingly, this pattern of regional sympathetic nerve responses to central neural administration of insulin is similar to that seen with systemic administration of insulin. Further, lesions of the anteroventral third ventricle hypothalamic (AV3V) region abolished increases in sympathetic activity to systemic administration of insulin with euglycemic clamp, suggesting that AV3V-related structures are critical for insulin-induced elevations in sympathetic outflow.

Muntzel, Martin S.; Anderson, Erling A.; Johnson, Alan Kim; Mark, Allyn L.

1996-01-01

290

Mechanisms of Nerve Damage in Leprosy  

Microsoft Academic Search

Peripheral nerve involvement is inevitable once infection progresses to disease in man with leprosy. Some of the relevant questions pertaining to mechanisms of nerve damage in leprosy are: How does M. leprae gain entry into the nerve? What is the sequence of events that follow? How early and diffused is the nerve involvement? What is the relationship between infection, inflammation

V. P. Shetty

291

The neglected cranial nerve: nervus terminalis (cranial nerve N).  

PubMed

The nervus terminalis (NT; terminal nerve) was clearly identified as an additional cranial nerve in humans more than a century ago yet remains mostly undescribed in modern anatomy textbooks. The nerve is referred to as the nervus terminalis because in species initially examined its fibers were seen entering the brain in the region of the lamina terminalis. It has also been referred to as cranial nerve 0, but because there is no Roman symbol for zero, an N for the Latin word nulla is a better numerical designation. This nerve is very distinct in human fetuses and infants but also has been repeatedly identified in adult human brains. The NT fibers are unmyelinated and emanate from ganglia. The fibers pass through the cribriform plate medial to those of the olfactory nerve fila. The fibers end in the nasal mucosa and probably arise from autonomic/neuromodulatory as well as sensory neurons. The NT has been demonstrated to release luteinizing-releasing luteinizing hormone and is therefore thought to play a role in reproductive behavior. Based on the available evidence, the NT appears to be functional in adult humans and should be taught in medical schools and incorporated into anatomy/neuroanatomy textbooks. PMID:22836597

Vilensky, Joel A

2014-01-01

292

Imaging of the facial nerve.  

PubMed

The facial nerve is responsible for the motor innervation of the face. It has a visceral motor function (lacrimal, submandibular, sublingual glands and secretion of the nose); it conveys a great part of the taste fibers, participates to the general sensory of the auricle (skin of the concha) and the wall of the external auditory meatus. The facial mimic, production of tears, nasal flow and salivation all depend on the facial nerve. In order to image the facial nerve it is mandatory to be knowledgeable about its normal anatomy including the course of its efferent and afferent fibers and about relevant technical considerations regarding CT and MR to be able to achieve high-resolution images of the nerve. PMID:20456888

Veillona, F; Ramos-Taboada, L; Abu-Eid, M; Charpiot, A; Riehm, S

2010-05-01

293

Tumors of the Cranial Nerves  

Microsoft Academic Search

\\u000a The most frequent tumors of the cranial nerves are referred to as schwannomas (formerly neuromas). They may develop in most\\u000a cranial nerves, except I and II, which do not have Schwann cells, except for very rare cases of ectopic pediatric olfactory\\u000a schwannomas. CNSs account for 8% of intracranial tumors. The incidence is rising since the distribution of MRI became widespread.

Berndt Wowra; Jörg-Christian Tonn

294

Problematic lesions in children.  

PubMed

Melanoma in childhood is rare, and appears more commonly either in association with a preexisting (congenital) nevus, or with spitzoid features than de novo. Thus, problematic melanocytic lesions in children are essentially represented by congenital nevi and Spitz nevi that can be regarded as melanoma precursors and melanoma simulators, respectively. As a consequence, clinical and dermoscopic features of melanoma in children differ from those in an adult population. Herein we describe common clinical and dermoscopic features of problematic lesions in children, focusing on congenital and Spitz/Reed nevi, and including other problematic lesions, such as atypical, blue, acral, and scalp nevi. PMID:24075543

Moscarella, Elvira; Piccolo, Vincenzo; Argenziano, Giuseppe; Lallas, Aimilios; Longo, Caterina; Castagnetti, Fabio; Pizzigoni, Stefania; Zalaudek, Iris

2013-10-01

295

Unusual Spinal Dysraphic Lesions  

PubMed Central

Human tail and multiple spinal dysraphism are unusual congenital malformations. Human tail appeared as a prominent lesion from the lumbosacrococcygeal region, generally without connection between the tail and the neurospinal axis. Spinal dysraphisms are usually isolated, reaching 0.038% of incidence of multiple spinal dysraphisms in the same child. There were three cases described of unusual spinal dysraphic lesions: two cases of human tail and a case of a multiple thoracic myelomeningocele. The literature about diagnosis and treatment was reviewed. Microsurgical technique was performed to provide better exploration of the lesions, and resection could be done in those congenital malformations, without morbidity. PMID:24194997

Pacheco, Pollyana; Wanderley, Luiz Eduardo

2013-01-01

296

Roundworm-associated median nerve compression: a case report.  

PubMed

Human dirofilariasis is a rare zoonotic infection caused by the bite of a blood-feeding mosquito infected with a filarial nematode (roundworm). these infections can manifest as stationary or migratory subcutaneous or conjunctival nodules. We report an unusual case of Dirofilaria tenuis (D.tenuis) infection that developed into a space- occupying lesion in the wrist leading to median nerve compression pathology in an otherwise healthy young woman. We also comment on the natural history of the disease and report the outcome after surgical excision. To our knowledge, we are the first to report a case of median nerve compression caused by a growing subcutaneous nodule from a D.tenuis infection. PMID:24027489

Ramirez, Jose M; Ramirez, Miguel A; Essilfie, Anthony; Taylor, Cristina E; Stearns, Harry C; Mollano, Anthony

2013-01-01

297

Roundworm-Associated Median Nerve Compression: A Case Report  

PubMed Central

Human dirofilariasis is a rare zoonotic infection caused by the bite of a blood-feeding mosquito infected with a filarial nematode (roundworm). these infections can manifest as stationary or migratory subcutaneous or conjunctival nodules. We report an unusual case of Dirofilaria tenuis (D.tenuis) infection that developed into a space- occupying lesion in the wrist leading to median nerve compression pathology in an otherwise healthy young woman. We also comment on the natural history of the disease and report the outcome after surgical excision. To our knowledge, we are the first to report a case of median nerve compression caused by a growing subcutaneous nodule from a D.tenuis infection. PMID:24027489

Ramirez, Jose M; Ramirez, Miguel A; Essilfie, Anthony; Taylor, Cristina E; Stearns, Harry C; Mollano, Anthony

2013-01-01

298

The effect of vestibular nerve section on the expression of the hyaluronan in the frog, Rana esculenta  

Microsoft Academic Search

Following postganglionic lesion of the eighth cranial nerve, the changes in the expression of hyaluronan (HA), one of the\\u000a extracellular matrix macromolecules, were examined in the medial (MVN) and lateral (LVN) vestibular nuclei and in the entry\\u000a or transitional zone (TZ) of the nerve in the frog. HA was detected in different survival times by using a specific biotinylated\\u000a hyaluronan-binding

Gábor Halasi; Ervin Wolf; Tímea Bácskai; György Székely; László Módis; Zsuzsa M. Szigeti; Zoltán Mészár; Szabolcs Felszeghy; Clara Matesz

2007-01-01

299

Uterine Vascular Lesions  

PubMed Central

Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

2013-01-01

300

Diffuse cavitary lung lesions.  

PubMed

An 11-year-old girl presented with a 2-month history of progressively worsening cough, daily fevers, and weight loss. A chest radiograph revealed multiple cystic cavitary lung lesions. An extensive infectious work-up was negative. Chest CT verified multiple cavitary lung lesions bilaterally, and [F-18]2-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography with CT (PET/CT) showed increased uptake in the lung lesions as well as regional lymph nodes. Subsequent biopsy of an involved lymph node confirmed classical Hodgkin lymphoma, nodular sclerosis type. This case represents an unusual presentation for a child with Hodgkin lymphoma and demonstrates a role for (18)F-FDG PET/CT in evaluating a child with cavitary lung lesions. PMID:19779928

Grunzke, Mindy; Hayes, Kari; Bourland, Wendy; Garrington, Timothy

2010-02-01

301

Multiple Osteolytic Lesions  

PubMed Central

Several systemic diseases initially present with various oral manifestations. Investigation of these oral symptoms may at times lead to the diagnosis of grave underlying life-threatening conditions. We present one such case, where the patient manifested with gross enlargement of the mandible, along with lesions in the lower limbs. These lesions were the initial manifestation and on further investigations the patient was diagnosed with multiple myeloma. PMID:24516769

Vinayachandran, Divya; Sankarapandian, Sathasivasubramanian

2013-01-01

302

Bilateral adrenal lesions.  

PubMed

Bilateral adrenal lesions include a spectrum of disorders: neoplastic disorders (metastases, lymphoma, bilateral phaeochromocytoma, adrenocortical carcinoma and myelolipoma); longstanding congenital adrenal hyperplasia and macronodular adrenal hyperplasia; infections such as tuberculosis, histoplasmosis and blastomycosis; adrenal haemorrhage; adrenals in hypoperfusion complex and paediatric masses. Bilateral distribution in addition to other imaging characteristics can help narrow differential diagnoses in case of adrenal masses. We present a pictorial review highlighting the adrenal lesions that can present bilaterally. PMID:23210583

Gupta, Pankaj; Bhalla, Ashu; Sharma, Raju

2012-12-01

303

Peripheral Nerve Injuries and Transplantation of Olfactory Ensheathing Cells for Axonal Regeneration and Remyelination: Fact or Fiction?  

PubMed Central

Successful nerve regeneration after nerve trauma is not only important for the restoration of motor and sensory functions, but also to reduce the potential for abnormal sensory impulse generation that can occur following neuroma formation. Satisfying functional results after severe lesions are difficult to achieve and the development of interventional methods to achieve optimal functional recovery after peripheral nerve injury is of increasing clinical interest. Olfactory ensheathing cells (OECs) have been used to improve axonal regeneration and functional outcome in a number of studies in spinal cord injury models. The rationale is that the OECs may provide trophic support and a permissive environment for axonal regeneration. The experimental transplantation of OECs to support and enhance peripheral nerve regeneration is much more limited. This chapter reviews studies using OECs as an experimental cell therapy to improve peripheral nerve regeneration. PMID:23202929

Radtke, Christine; Kocsis, Jeffery D.

2012-01-01

304

[Detection of oculomotor nerve compression by 3D-FIESTA MRI in a patient with pituitary apoplexy and diabetes mellitus].  

PubMed

We report the usefulness of 3D-FIESTA magnetic resonance imaging(MRI)for the detection of oculomotor nerve palsy in a case of pituitary apoplexy. A 69-year-old man with diabetes mellitus presented with complete left-side blepharoptosis. Computed tomography of the brain showed an intrasellar mass with hemorrhage. MRI demonstrated a pituitary adenoma with a cyst toward the left cavernous sinus, which was diagnosed as pituitary apoplexy. 3D-FIESTA revealed that the left oculomotor nerve was compressed by the cyst. He underwent trans-sphenoid tumor resection at 5 days after his hospitalization. Post-operative 3D-FIESTA MRI revealed decrease in compression of the left oculomotor nerve by the cyst. His left oculomotor palsy recovered completely within a few months. Oculomotor nerve palsy can occur due to various diseases, and 3D-FIESTA MRI is useful for detection of oculomotor nerve compression, especially in the field of parasellar lesions. PMID:24501187

Yamauchi, Takahiro; Kitai, Ryuhei; Neishi, Hiroyuki; Tsunetoshi, Kenzo; Matsuda, Ken; Arishima, Hidetaka; Kodera, Toshiaki; Arai, Yoshikazu; Takeuchi, Hiroaki; Kikuta, Ken-ichiro

2014-02-01

305

A Case of Malignant Peripheral Nerve Sheath Tumor of the Hypoglossal Nerve after Stereotactic Radiosurgery Treatment  

PubMed Central

Objectives?Hypoglossal schwannomas are rare. Surgical resection has been the standard treatment modality. Radiosurgery has been increasingly used for treatment. Radiation-associated secondary malignancy/malignant transformation has not been documented in the literature for the treatment of nonvestibular schwannomas. Setting?The patient was a 52-year-old man with an enlarging high cervical/skull base lesion 8.5 years after CyberKnife treatment of a presumed vagal schwannoma. A decision was made for surgical resection, and the tumor was found to originate from the hypoglossal nerve intraoperatively. Final pathology diagnosis was malignant peripheral nerve sheath tumor. Results?Patient had a gross total resection. Three months after resection, he received fractionated radiation of 50?Gy in 25 fractions and a boost gamma knife radiosurgery of 10?Gy to the 50% isodose surface. He remained tumor free on repeat magnetic resonance imaging 9 months after the resection. Conclusion?Although extremely rare, radiation treatment of nonvestibular schwannomas can potentially cause malignant transformation. PMID:25083387

Yang, Tong; Juric-Sekhar, Gordana; Born, Donald; Sekhar, Laligam N.

2014-01-01

306

A case of malignant peripheral nerve sheath tumor of the hypoglossal nerve after stereotactic radiosurgery treatment.  

PubMed

Objectives?Hypoglossal schwannomas are rare. Surgical resection has been the standard treatment modality. Radiosurgery has been increasingly used for treatment. Radiation-associated secondary malignancy/malignant transformation has not been documented in the literature for the treatment of nonvestibular schwannomas. Setting?The patient was a 52-year-old man with an enlarging high cervical/skull base lesion 8.5 years after CyberKnife treatment of a presumed vagal schwannoma. A decision was made for surgical resection, and the tumor was found to originate from the hypoglossal nerve intraoperatively. Final pathology diagnosis was malignant peripheral nerve sheath tumor. Results?Patient had a gross total resection. Three months after resection, he received fractionated radiation of 50?Gy in 25 fractions and a boost gamma knife radiosurgery of 10?Gy to the 50% isodose surface. He remained tumor free on repeat magnetic resonance imaging 9 months after the resection. Conclusion?Although extremely rare, radiation treatment of nonvestibular schwannomas can potentially cause malignant transformation. PMID:25083387

Yang, Tong; Juric-Sekhar, Gordana; Born, Donald; Sekhar, Laligam N

2014-08-01

307

Sequence of the Essex-Lopresti lesion--a high-speed video documentation and kinematic analysis  

PubMed Central

Background and purpose The pathomechanics of the Essex-Lopresti lesion are not fully understood. We used human cadavers and documented the genesis of the injury with high-speed cameras. Methods 4 formalin-fixed cadaveric specimens of human upper extremities were tested in a prototype, custom-made, drop-weight test bench. An axial high-energy impulse was applied and the development of the lesion was documented with 3 high-speed cameras. Results The high-speed images showed a transversal movement of the radius and ulna, which moved away from each other in the transversal plane during the impact. This resulted into a transversal rupture of the interosseous membrane, starting in its central portion, and only then did the radius migrate proximally and fracture. The lesion proceeded to the dislocation of the distal radio-ulnar joint and then to a full-blown Essex-Lopresti lesion. Interpretation Our findings indicate that fracture of the radial head may be preceded by at least partial lesions of the interosseous membrane in the course of high-energy axial trauma. PMID:24479620

2014-01-01

308

Proximal Neuropathic Lesions in Distal Symmetric Diabetic Polyneuropathy  

PubMed Central

OBJECTIVE This study investigated high-resolution magnetic resonance neurography (MRN) in distal symmetric diabetic polyneuropathy (dPNP). RESEARCH DESIGN AND METHODS MRN comprised high-resolution transaxial imaging of peripheral nerves of the lower limbs in 20 patients with type 2 diabetes (10 with dPNP, type 2/dPNP[+], and 10 without dPNP, type 2/dPNP[?]), seven patients with type 1 diabetes (two with dPNP, type 1/dPNP[+], five without dPNP, type 1/dPNP[?]), and 10 nondiabetic control subjects. Intraneural T2 lesions, as the main diagnostic criterion of MRN, were detected visually by two independent observers and quantitatively by analysis of T2 contrast ratios. RESULTS Multifocal fascicular, symmetric intraneural T2 lesions occurred in the proximal trunks of sciatic nerves in four patients (three with type 2/dPNP[+] and one with type 1/dPNP[+]) but not in control subjects (type 2/dPNP[?], type 1/dPNP[?], nondiabetic control subjects), which was confirmed by quantitative analysis. Clinical severity was higher in patients with T2 lesions (neuropathy deficit score: 10 vs. 7.8; P = 0.05). CONCLUSIONS For the first time, proximal neuropathic lesions of dPNP are reported in vivo. This supports that accumulation of proximal, multifocal fascicular injury may be important in disease progression. PMID:21266652

Pham, Mirko; Oikonomou, Dimitrios; Baumer, Philipp; Bierhaus, Angelika; Heiland, Sabine; Humpert, Per M.; Nawroth, Peter P.; Bendszus, Martin

2011-01-01

309

Assessment of the Kinetic Trajectory of the Median Nerve in the Wrist by High-Frequency Ultrasound  

PubMed Central

Carpal tunnel syndrome (CTS) is typically diagnosed by physical examination or nerve conduction measurements. With these diagnostics however it is difficult to obtain anatomical information in the carpal tunnel. To further improve the diagnosis of CTS, an attempt using 30 MHz high-frequency ultrasound to noninvasively detect the local anatomical structures and the kinetic trajectory of the median nerve (MN) in the wrist was explored. Measurements were performed on the right wrist of 14 asymptomatic volunteers. The kinetic trajectory of the MN corresponding to flexion (from 0° to 90°) and extension (from 90° to 0°) movements of the fingers were detected by a cross correlation-based motion tracking technique. The average displacements of the MN according to finger movements were measured to be 3.74 and 2.04 mm for male and female subjects, respectively. Moreover, the kinetic trajectory of the MN in both the ulnar-palmar and total directions generally follows a sigmoidal curve tendency. This study has verified that the use of high-frequency ultrasound imaging and a motion tracking technique to sensitively detect the displacement and kinetic trajectory of the MN for the assessment of CTS patients is feasible. PMID:24787637

Lin, Yi-Hsun; Hsieh, Mei-Yu; Su, Fong-Chin; Wang, Shyh-Hau

2014-01-01

310

Cardiac autonomic nerve distribution and arrhythmia?  

PubMed Central

OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia. DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation as the key words. SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included. MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated. RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system. CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the occurrence, maintenance, and symptoms of arrhythmia.

Liu, Quan; Chen, Dongmei; Wang, Yonggang; Zhao, Xin; Zheng, Yang

2012-01-01

311

Facial-hypoglossal nerve anastomosis using laser nerve welding.  

PubMed

The aim of this study is to compare laser nerve welding to microsurgical suturing of hypoglossal-facial nerve anastomosis (HFA), and a result of immediate to delayed repair, and to evaluate the effect of laser nerve welding on HFA for reanimation of facial palsy. The first group of five rats underwent immediate HFA by microsurgical suturing and the second group of five rats by CO2 laser welding. The third group of five rats underwent delayed HFA by microsurgical suturing, and the fourth group of five rats by laser nerve welding. The fifth group of five rats served as controls, with intact hypoglossal and facial nerve. In all rats of the four different treatment groups, cholera toxin B subunit (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative 6th week and in the normal hypoglossal nerve in the five rats of the control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically, and the numbers were counted. In the immediate HFA groups, CTb-positive neurons were 751 +/- 247 in the laser welding group (n = 5) and 888 +/- 60 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.117). In the delayed HFA groups, CTb-positive neurons were 749 +/- 54 in the laser welding group (n = 5) and 590 +/- 169 in the microsurgical suturing group (n = 5). The difference was not significant (P = 0.116). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.600), but there was significance between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.009). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1,003 +/- 52. No dehiscence in the laser welding site of nerve anastomosis was seen at the time of re-exploration for injection of CTb in all 10 rats. This study shows that the regeneration of anastomosed hypoglossal-facial nerve was affected similarly by laser welding and microsurgical suturing, and more effective, especially in delayed repair. PMID:16877915

Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

2006-07-01

312

A triple-masked, randomized controlled trial comparing ultrasound-guided brachial plexus and distal peripheral nerve block anesthesia for outpatient hand surgery.  

PubMed

Background. For hand surgery, brachial plexus blocks provide effective anesthesia but produce undesirable numbness. We hypothesized that distal peripheral nerve blocks will better preserve motor function while providing effective anesthesia. Methods. Adult subjects who were scheduled for elective ambulatory hand surgery under regional anesthesia and sedation were recruited and randomly assigned to receive ultrasound-guided supraclavicular brachial plexus block or distal block of the ulnar and median nerves. Each subject received 15?mL of 1.5% mepivacaine at the assigned location with 15?mL of normal saline injected in the alternate block location. The primary outcome (change in baseline grip strength measured by a hydraulic dynamometer) was tested before the block and prior to discharge. Subject satisfaction data were collected the day after surgery. Results. Fourteen subjects were enrolled. Median (interquartile range [IQR]) strength loss in the distal group was 21.4% (14.3, 47.8%), while all subjects in the supraclavicular group lost 100% of their preoperative strength, P = 0.001. Subjects in the distal group reported greater satisfaction with their block procedures on the day after surgery, P = 0.012. Conclusion. Distal nerve blocks better preserve motor function without negatively affecting quality of anesthesia, leading to increased patient satisfaction, when compared to brachial plexus block. PMID:24839439

Lam, Nicholas C K; Charles, Matthew; Mercer, Deana; Soneru, Codruta; Dillow, Jennifer; Jaime, Francisco; Petersen, Timothy R; Mariano, Edward R

2014-01-01

313

A Triple-Masked, Randomized Controlled Trial Comparing Ultrasound-Guided Brachial Plexus and Distal Peripheral Nerve Block Anesthesia for Outpatient Hand Surgery  

PubMed Central

Background. For hand surgery, brachial plexus blocks provide effective anesthesia but produce undesirable numbness. We hypothesized that distal peripheral nerve blocks will better preserve motor function while providing effective anesthesia. Methods. Adult subjects who were scheduled for elective ambulatory hand surgery under regional anesthesia and sedation were recruited and randomly assigned to receive ultrasound-guided supraclavicular brachial plexus block or distal block of the ulnar and median nerves. Each subject received 15?mL of 1.5% mepivacaine at the assigned location with 15?mL of normal saline injected in the alternate block location. The primary outcome (change in baseline grip strength measured by a hydraulic dynamometer) was tested before the block and prior to discharge. Subject satisfaction data were collected the day after surgery. Results. Fourteen subjects were enrolled. Median (interquartile range [IQR]) strength loss in the distal group was 21.4% (14.3, 47.8%), while all subjects in the supraclavicular group lost 100% of their preoperative strength, P = 0.001. Subjects in the distal group reported greater satisfaction with their block procedures on the day after surgery, P = 0.012. Conclusion. Distal nerve blocks better preserve motor function without negatively affecting quality of anesthesia, leading to increased patient satisfaction, when compared to brachial plexus block. PMID:24839439

Lam, Nicholas C. K.; Mercer, Deana; Soneru, Codruta; Dillow, Jennifer; Jaime, Francisco; Petersen, Timothy R.; Mariano, Edward R.

2014-01-01

314

Nerve agent intoxication: Recent neuropathophysiological findings and subsequent impact on medical management prospects  

SciTech Connect

This manuscript provides a survey of research findings catered to the development of effective countermeasures against nerve agent poisoning over the past decade. New neuropathophysiological distinctive features as regards organophosphate (OP) intoxication are presented. Such leading neuropathophysiological features include recent data on nerve agent-induced neuropathology, related peripheral or central nervous system inflammation and subsequent angiogenesis process. Hence, leading countermeasures against OP exposure are down-listed in terms of pre-treatment, protection or decontamination and emergency treatments. The final chapter focuses on the description of the self-repair attempt encountered in lesioned rodent brains, up to 3 months after soman poisoning. Indeed, an increased proliferation of neuronal progenitors was recently observed in injured brains of mice subjected to soman exposure. Subsequently, the latter experienced a neuronal regeneration in damaged brain regions such as the hippocampus and amygdala. The positive effect of a cytokine treatment on the neuronal regeneration and subsequent cognitive behavioral recovery are also discussed in this review. For the first time, brain cell therapy and neuronal regeneration are considered as a valuable contribution towards delayed treatment against OP intoxication. To date, efficient delayed treatment was lacking in the therapeutic resources administered to patients contaminated by nerve agents. - Highlights: > This review focuses on neuropathophysiology following nerve agent poisoning in mice. > Extensive data on long-term neuropathology and related inflammation are provided here. > Delayed self-repair attempts encountered in lesioned rodent brains are also described. > Cell therapy is considered as a valuable treatment against nerve agent intoxication.

Collombet, Jean-Marc, E-mail: jmcollombet@imassa.fr

2011-09-15

315

Accumulation of non-compressive fascicular lesions underlies NF2 polyneuropathy.  

PubMed

A distinct polyneuropathy (PNP) syndrome affects up to 66 % of patients with neurofibromatosis II (NF2). Whether this is primarily a diffuse PNP or due to single, surgically amenable mass lesions has not yet been conclusively demonstrated. We aimed to solve this question by investigating the pathomorphological MR imaging correlate of this rare disorder. Eight patients with NF2-PNP were characterized by clinical examination, electrophysiological studies, and genetic analysis. All patients additionally underwent extended peripheral nerve imaging by a novel protocol of large-coverage high-resolution MRI. Quantitative analyses were performed by separately evaluating cross-sectional images, and by categorizing lesions into non-compressive fascicular microlesions (<2 mm), intermediate lesions (2-5 mm), and compressive macrolesions (>5 mm). The predominant imaging findings were non-compressive fascicular microlesions and intermediate lesions. Proximal-to-distal cumulative lesion burden of these lesions correlated strongly with the severity of clinical symptoms of NF2-PNP. In contrast, compressive macrolesions were not found at all in several symptomatic extremities. We conclude that proximal-to-distal accumulation of non-compressive fascicular lesions instead of compressive mass lesions predominantly underlies the clinical manifestation and severity of NF2-associated PNP. Diagnostic management may now be assisted by large-coverage high-resolution imaging of plexus and peripheral nerves. Additionally, the results underscore the feasibility of this new method, which may open up new diagnostic and investigative possibilities for other disseminated disorders of the peripheral nervous system. PMID:22760943

Bäumer, P; Mautner, V F; Bäumer, T; Schuhmann, M U; Tatagiba, M; Heiland, S; Kaestel, T; Bendszus, M; Pham, M

2013-01-01

316

The Effects on Locomotion of Lesions to the VisuoMotor System in Octopus  

Microsoft Academic Search

The visuo-motor system in cephalopods comprises paired eyes, paired optic lobes, paired peduncle lobes and the basal lobes. The organization of this system was investigated by observing behavioural changes immediately after surgical interference to different parts of it. Lesions were made that removed the optic and peduncle lobes and sectioned the optic nerves bilaterally, unilaterally, separately and in all the

J. B. Messenger

1967-01-01

317

Intraventricular mass lesions  

SciTech Connect

Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age, and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered.

Morrison, G.; Sobel, D.F.; Kelley, W.M.; Norman, D.

1984-11-01

318

Peripheral nerve disease in pregnancy.  

PubMed

Neuropathies during pregnancy and the postpartum period are common and are usually due to compression around pregnancy and childbirth. The most common peripheral neuropathies are Bell's palsy, carpal tunnel syndrome (CTS), and lower extremity neuropathies. Although most neuropathies are usually reversible, associated disabilities or morbidities can limit functioning and require therapy. Nerve conduction study tests and imaging should only be considered if symptoms are unusual or prolonged. Some neuropathies may be associated with preeclampsia or an inherent underlying neuropathy that increases the risk of nerve injury. All neuropathies in pregnancy should be followed as some may be persistent and require follow-up. PMID:23563878

Klein, Autumn

2013-06-01

319

Surface studies of duodenal lesions induced by thoracic irradiation  

SciTech Connect

Acute duodenal ulcers are produced in mice as a remote (abscopal) effect of irradiation to the lower mediastinum. Such lesions have been examined with scanning electron microscopy at 5, 8 and 28 days after irradiation with 18 Gy of X-rays. All the ulcers occur within the first 1 cm long segment of the duodenum which is endowed with Brunner's glands. The single lesions vary in size, shape and position. The damaged area often includes much of the duodenal circumference and is distinguished by conical or rudimentary villi, or even by the complete absence of villi. In contrast, around the periphery of the ulcer the villi are mostly vertical. Although the floor of these lesions appears to be covered with a continuous epithelial layer, during the first 4 weeks after irradiation the severity of the focal duodenal damage seems to increase gradually with time. The lesions have been compared with specimens from unirradiated mice and also with samples taken 3 days after partial thoracic irradiation when little damage is seen. The pattern of fully developed duodenal lesions differs greatly from that seen after direct irradiation where damage has not included localised ulceration in the samples of jejunum so far examined. The lesions induced by partial thoracic irradiation may be related to radiation injury to vascular or autonomic nerve targets in the lower mediastinum. Such injury could result in malfunction of the pyloric sphincter or could alter the secretion by Brunner's glands and thus lead to duodenal ulceration.

Carr, K.E.; Ellis, S.; Michalowski, A.

1986-01-01

320

Managing Chemotherapy Side Effects: Nerve Changes  

MedlinePLUS

... services national institutes of health Managing Chemotherapy Side Effects Nerve Changes “My fingers and toes felt numb ... or constipation l Stomach pain Managing Chemotherapy Side Effects: Nerve Changes Try these tips from others: “Prevent ...

321

Nerve Agents ATSDR ? General Information 1  

E-print Network

Nerve Agents ATSDR ? General Information 1 Nerve Agents Tabun (GA) CAS 77-81-6; Sarin (GB) CAS 107 are heavier thanair. Odor does not provide adequate warning of detection. The estimated LCt50 (the product

Baloh, Bob

322

Infraspinatus muscle atrophy from suprascapular nerve compression.  

PubMed

Muscle weakness without pain may signal a nerve compression injury. Because these injuries should be identified and treated early to prevent permanent muscle weakness and atrophy, providers should consider suprascapular nerve compression in patients with shoulder muscle weakness. PMID:24463748

Cordova, Christopher B; Owens, Brett D

2014-02-01

323

Growth of injured rabbit optic axons within their degenerating optic nerve  

SciTech Connect

Spontaneous growth of axons after injury is extremely limited in the mammalian central nervous system (CNS). It is now clear, however, that injured CNS axons can be induced to elongate when provided with a suitable environment. Thus injured CNS axons can elongate, but they do not do so unless their environment is altered. We now show apparent regenerative growth of injured optic axons. This growth is achieved in the adult rabbit optic nerve by the use of a combined treatment consisting of: (1) supplying soluble substances originating from growing axons to be injured rabbit optic nerves, and (2) application of low energy He-Ne laser irradiation, which appears to delay degenerative changes in the injured axons. Two to 8 weeks after this treatment, unmyelinated and thinly myelinated axons are found at the lesion site and distal to it. Morphological and immunocytochemical evidence indicate that these thinly myelinated and unmyelinated axons are growing in close association with glial cells. Only these axons are identified as being growing axons. These newly growing axons transverse the site of injury and extend into the distal stump of the nerve, which contains degenerating axons. Axons of this type could be detected distal to the lesion only in nerves subjected to the combined treatment. No unmyelinated or thinly myelinated axons in association with glial cells were seen at 6 or 8 weeks postoperatively in nerves that were not treated, or in nerves in which the two stumps were completely disconnected. Two millimeters distal to the site of injury, the growing axons are confined to a compartment comprising 5%-30% of the cross section of the nerve. A temporal analysis indicates that axons have grown as far as 6 mm distal to the site of injury, by 8 weeks postoperatively.

Lavie, V.; Murray, M.; Solomon, A.; Ben-Bassat, S.; Belkin, M.; Rumelt, S.; Schwartz, M. (Weizmann Institute of Science, Rehovot (Israel))

1990-08-15

324

Fibrolipomatous Hamartoma of the Median Nerve in the Elbow: A Case Report  

PubMed Central

A fibrolipomatous hamartoma—also known as a fibrofatty overgrowth, perineural lipoma, intraneural lipoma, and lipomatous hamartoma—is a rare, benign, congenital lesion most commonly found in the median nerve, usually at the level of the wrist or hand. To our knowledge, no published cases report a hamartoma arising from the median nerve at the level of the elbow. We report a case of a fibrolipomatous hamartoma in a 55-year-old woman that necessitated a surgical intervention because of its size and associated neurologic symptoms. PMID:22778681

Ha, Jennifer Fong; Teh, Bing Mei; Abeysuriya, Disna Thushangi Dahanayake; Luo, Daniel Y. W.

2012-01-01

325

Arthroscopic treatment of piriformis syndrome by perineural cyst on the sciatic nerve: a case report.  

PubMed

This is a case report of an arthroscopic treatment performed on a patient with piriformis syndrome due to perineural cyst on piriformis muscle and sciatic nerve. Confirmation, incision, and drainage of benign cystic lesion on the sciatic nerve below the piriformis muscle were performed following the release of the piriformis tendon through the posterior and posteroinferior arthroscopic portal. Recurrence of the symptoms has not been observed since postoperative period of 20 months. Nor did the MRI taken after the procedure reveal any such recurrence. PMID:20062971

Hwang, Deuk-Soo; Kang, Chan; Lee, Jung-Bum; Cha, Soo-Min; Yeon, Kyu-Woong

2010-05-01

326

Continuous Vagal Nerve Stimulation for Recurrent Laryngeal Nerve Protection in Thyroid Surgery  

Microsoft Academic Search

Introduction: Newly developed vagal stimulation probes permit continuous intraoperative neuromonitoring of the recurrent laryngeal nerve during thyroid resection. Complete signal loss indicates damage of the nerve. There is no other criterion so far to warn before imminent nerve function impairment. Methods: In 100 patients, thyroid resection (188 nerves at risk, 52 thyroidectomies, 21 Dunhill resections, 12 hemithyroidectomies, 5 two-sided subtotal

J. Jonas

2010-01-01

327

Video-Gait Analysis of Functional Recovery of Nerve Repaired with Chitosan Nerve Guides  

E-print Network

guides is commonly evaluated through histomorphometry and walking track analysis. We conducted a unique of nerve guide tubes is considered an alternative method to achieve nerve regeneration of transected nerves method of autografts.5­9 Currently a vast amount of research is being pursued to engineer the ideal nerve

VandeVord, Pamela

328

Supraclavicular nerve entrapment and clavicular fracture.  

PubMed

Because the supraclavicular nerve lies in close proximity to the clavicle, it is particularly vulnerable to injury in cases of clavicle fracture and in the surgical treatment of these fractures. The development of painful neuromas after iatrogenic transsection and symptomatic nerve entrapment in fracture callus after healing have previously been described. Reported here is a case of acute supraclavicular nerve entrapment and tension after fracture of the clavicle with significant pain relief after fracture fixation and nerve decompression. PMID:22430514

O?Neill, Kevin; Stutz, Christopher; Duvernay, Matthew; Schoenecker, Jonathan

2012-06-01

329

Proximal Sciatic Nerve Intraneural Ganglion Cyst  

PubMed Central

Intraneural ganglion cysts are nonneoplastic, mucinous cysts within the epineurium of peripheral nerves which usually involve the peroneal nerve at the knee. A 37-year-old female presented with progressive left buttock and posterior thigh pain. Magnetic resonance imaging revealed a sciatic nerve mass at the sacral notch which was subsequently revealed to be an intraneural ganglion cyst. An intraneural ganglion cyst confined to the proximal sciatic nerve has only been reported once prior to 2009. PMID:20069041

Swartz, Karin R.; Wilson, Dianne; Boland, Michael; Fee, Dominic B.

2009-01-01

330

Effect of elbow flexion angles on stress distribution of the proximal ulnar and radius bones under a vertical load: measurement using resistance strain gauges  

PubMed Central

Objectives This study aimed to explore the surface stress at the proximal ends of the ulna and radius at different elbow flexion angles using the resistance strain method. Methods Eight fresh adult cadaveric elbows were tested. The forearms were fixed in a neutral position. Axial load increment experiments were conducted at four different elbow flexion angles (0°, 15°, 30°, and 45°). Surface stain was measured at six sites (tip, middle, and base of the coronoid process; back ulnar notch; olecranon; and anterolateral margin of the radial head). Results With the exception of the ulnar olecranon, the load-stress curves at each measurement site showed an approximately linear relationship under the four working conditions studied. At a vertical load of 500 N, the greatest stress occurred at the middle of the coronoid process when the elbow flexion angles were 0° and 15°. When the flexion angles were 30° and 45°, the greatest stress occurred at the base of the coronoid process. The stress on the radial head was higher than those at the measurement sites of the proximal end of the ulna. Conclusion The resistance strain method for measuring elbow joint surface stress benefits biomechanics research on the elbow joint. Elbow joint surface stress distributions vary according to different elbow flexion angles. PMID:25078971

2014-01-01

331

Percutaneous bone lesion ablation.  

PubMed

Benign tumors and metastatic bone lesions can be treated by ablation techniques performed either alone or in combination with other percutaneous techniques. Ablation techniques include ethanol or acetic acid injection and thermal ablation by means of energy deposition [including laser, radiofrequency, microwave, cryoablation, radiofrequency ionization and magnetic resonance (MR)-guided high-intensity focused ultrasound (HIFU)]. Goal definition of the therapy is crucial: ablation techniques can be proposed as curative treatments in benign bone tumors or oligometastatic disease (<3 lesions). Alternatively, these techniques can be proposed as palliative treatments aiming at reduction of pain, local control of the disease and tumor decompression. Depending on the lesion's location ablation can be combined with cementation with or without further metallic augmentation; local tumor control can be enhanced by combining ablation with transarterial bland embolization or chemoembolization. Thermal ablation of bone and soft tissues is characterized by high success and relatively low rates of potential complications, mainly iatrogenic thermal damage of surrounding sensitive structures. Successful thermal ablation requires a sufficient ablation volume and thermal protection of the surrounding vulnerable structures. This article will describe the general principles governing ablation and the mechanism of action for each technique and in addition will review the literature about safety and effectiveness of percutaneous imaging-guided ablation for benign and malignant (primary and metastatic) lesions. PMID:24894924

Filippiadis, Dimitrios K; Tutton, Sean; Kelekis, Alexis

2014-07-01

332

Bifid median nerve: Report of two cases  

Microsoft Academic Search

Summary The median nerve divides into its terminal branches at or proximal to the distal edge of the flexor retinaculum. An anatomy of the median nerve within the carpal tunnel is reported in two separate cases. Emphasis has been given to the value of direct vision when incising the flexor retinaculum in order to avoid injure of the median nerve.

M. Artico; L. Cervoni; G. Stevanato; V. D. Andrea; F. Nucci

1995-01-01

333

Dissecting Aneurysm of Vertebral Artery Manifestating as Contralateral Abducens Nerve Palsy  

PubMed Central

Isolated abducens nerve paresis related to ruptured vertebral artery (VA) aneurysm is rare. It usually occurs bilaterally or ipsilaterally to the pathologic lesions. We report the case of a contralateral sixth nerve palsy following ruptured dissecting VA aneurysm. A 38-year-old man was admitted for the evaluation of a 6-day history of headache. Abnormalities were not seen on initial computed tomography (CT). On admission, the patient was alert and no signs reflecting neurologic deficits were noted. Time of flight magnetic resonance angiography revealed a fusiform dilatation of the right VA involving origin of the posterior inferior cerebellar artery. The patient suddenly suffered from severe headache with diplopia the day before the scheduled cerebral angiography. Neurologic examination disclosed nuchal rigidity and isolated left abducens nerve palsy. Emergent CT scan showed high density in the basal and prepontine cistern compatible with ruptured aneurismal hemorrhage. Right vertebral angiography illustrated a right VA dissecting aneurysm with prominent displaced vertebrobasilar artery to inferiorly on left side. Double-stent placement was conducted for the treatment of ruptured dissecting VA aneurysm. No diffusion restriction signals were observed in follow-up magnetic resonance imaging of the brain stem. Eleven weeks later, full recovery of left sixth nerve palsy was documented photographically. In conclusion, isolated contralateral abducens nerve palsy associated with ruptured VA aneurysm may develop due to direct nerve compression by displaced verterobasilar artery triggered by primary thick clot in the prepontine cistern. PMID:23634273

Jeon, Jin Sue; Son, Young-Je; Chung, Young Seob

2013-01-01

334

Olfactory stimulatory with grapefruit and lavender oils change autonomic nerve activity and physiological function.  

PubMed

This review summarizes the effects of olfactory stimulation with grapefruit and lavender oils on autonomic nerve activity and physiological function. Olfactory stimulation with the scent of grapefruit oil (GFO) increases the activity of sympathetic nerves that innervate white and brown adipose tissues, the adrenal glands, and the kidneys, decreases the activity of the gastric vagal nerve in rats and mice. This results in an increase in lipolysis, thermogenesis, and blood pressure, and a decrease in food intake. Olfactory stimulation with the scent of lavender oil (LVO) elicits the opposite changes in nerve activity and physiological variables. Olfactory stimulation with scent of limonene, a component of GFO, and linalool, a component of LVO, has similar effects to stimulation with GFO and LVO, respectively. The histamine H1-receptor antagonist, diphenhydramine, abolishes all GFO-induced changes in nerve activity and physiological variables, and the hitstamine H3-receptor antagonist, thioperamide, eliminates all LVO-induced changes. Lesions to the hypothalamic suprachiasmatic nucleus and anosmic treatment with ZnSO4 also abolish all GFO- and LVO-induced changes. These findings indicate that limonene and linalool might be the active substances in GFO and LVO, and suggest that the suprachiasmatic nucleus and histamine are involved in mediating the GFO- and LVO-induced changes in nerve activity and physiological variables. PMID:25002406

Nagai, Katsuya; Niijima, Akira; Horii, Yuko; Shen, Jiao; Tanida, Mamoru

2014-10-01

335

Intrinsic and therapeutic factors determining the recovery of motor function after peripheral nerve transection.  

PubMed

Insufficient recovery after peripheral nerve injury has been attributed to (i) poor pathfinding of regrowing axons, (ii) excessive collateral axonal branching at the lesion site and (iii) polyneuronal innervation of the neuromuscular junctions (NMJ). The facial nerve transection model has been used initially to measure restoration of function after varying therapies and to examine the mechanisms underlying their effects. Since it is very difficult to control the navigation of several thousand axons, efforts concentrated on collateral branching and NMJ-polyinnervation. Treatment with antibodies against trophic factors to combat branching improved the precision of reinnervation, but had no positive effects on functional recovery. This suggested that polyneuronal reinnervation--rather than collateral branching--may be the critical limiting factor. The former could be reduced by pharmacological agents known to perturb microtubule assembly and was followed by recovery of function. Because muscle polyinnervation is activity-dependent and can be manipulated, attempts to design a clinically feasible therapy were performed by electrical stimulation or by soft tissue massage. Electrical stimulation applied to the transected facial nerve or to paralysed facial muscles did not improve vibrissal motor performance and failed to diminish polyinnervation. In contrast, gentle stroking of the paralysed muscles (vibrissal, orbicularis oculi, tongue musculature) resulted in full recovery of function. This manual stimulation was also effective after hypoglossal-facial nerve suture and after interpositional nerve grafting, but not after surgical reconstruction of the median nerve. All these findings raise hopes that clinically feasible and effective therapies could be soon designed and tested. PMID:21458252

Skouras, Emmanouil; Ozsoy, Umut; Sarikcioglu, Levent; Angelov, Doychin N

2011-07-01

336

Nerve identification and prevention of intraneural injection in regional anesthesia  

Microsoft Academic Search

This thesis deals with techniques to more reliably identify nervous structures and subsequently prevent intraneural injection in the practice of regional anesthesia. To identify nerves of the brachial plexus and sciatic nerve, both conventional techniques such as nerve stimulation, as well as ultrasound are described. The first chapters deal with nerve identification techniques using nerve stimulation and ultrasound. Nerve stimulation

Nizar Moayeri

2010-01-01

337

SUNCT and optic nerve hypoplasia  

Microsoft Academic Search

SUNCT has been reported in association with abnormalities of the brainstem and pituitary region. We present a patient with\\u000a a history of left optic nerve hypoplasia, mild hypothalamic-pituitary dysfunction, and SUNCT starting in adolescence. SUNCT\\u000a with an early age of onset may be associated with congenital abnormality of the hypothalamic-pituitary axis.

Brett J. Theeler; Kevin R. Joseph

2009-01-01

338

The Optical Stretcher Nerve Regeneration  

E-print Network

to test their relevance and importance for biological function. Our ultimate goal is the transfer of our present after neurological trauma to see whether those pose mechanical barriers to nerve regeneration. We are also investigating the importance of mechanical cues for normal differentiation and axonal pathfinding

Steiner, Ullrich

339

Ultrasound of nerve and muscle  

Microsoft Academic Search

Over the last two decades, ultrasound has developed into a useful technology for the evaluation of diseases of nerve and muscle. Since it is currently not used at by the majority of clinicians involved in diagnosis or care of patients with neuromuscular disorders, this review briefly describes the technical aspects of ultrasound and its physical principles. It relates normal muscle

Francis O Walker; Michael S Cartwright; Ethan R Wiesler; James Caress

2004-01-01

340

Orbital masses: CT and MRI of common vascular lesions, benign tumors, and malignancies  

PubMed Central

A wide variety of space occupying lesions may be encountered in the orbit. CT and MR imaging frequently help confirm the presence of a mass and define its extent. Characteristic imaging features may help distinguish among lesions that have overlapping clinical presentations. This review focuses on some of the common orbital masses. Common vascular lesions that are reviewed include: capillary (infantile) hemangioma, cavernous hemangioma (solitary encapsulated venous-lymphatic malformation), and lymphangioma (venous-lymphatic malformation). Benign tumors that are reviewed include: optic nerve sheath meningioma, schwannoma, and neurofibroma. Malignancies that are reviewed include: lymphoma, metastasis, rhabdomyosarcoma, and optic glioma. Key imaging features that guide radiological diagnosis are discussed and illustrated. PMID:23961022

Khan, Sarah N.; Sepahdari, Ali R.

2012-01-01

341

Optic nerve regeneration with return of vision through an autologous peripheral nerve graft.  

PubMed

The optic fiber termination layer in the contralateral optic tectum was reinnervated and useful vision was recovered in the adult frog, after successful optic nerve regeneration through an autologous peripheral nerve-bridge used to replace the optic nerve and optic chiasma. During their course through the nerve-bridge, the optic fibers were associated with Schwann cells in the usual relationship observed in peripheral nerve. PMID:1511315

Scalia, F; Roca, S

1992-07-10

342

Morphological studies of the vestibular nerve  

NASA Technical Reports Server (NTRS)

The anatomy of the intratemporal part of the vestibular nerve in man, and the possible age related degenerative changes in the nerve were studied. The form and structure of the vestibular ganglion was studied with the light microscope. A numerical analysis of the vestibular nerve, and caliber spectra of the myelinated fibers in the vestibular nerve branches were studied in individuals of varying ages. It was found that the peripheral endings of the vestibular nerve form a complicated pattern inside the vestibular sensory epithelia. A detailed description of the sensory cells and their surface organelles is included.

Bergstroem, B.

1973-01-01

343

Lesion-induced insights in the plasticity of the insect auditory system  

PubMed Central

The auditory networks of Orthoptera offer a model system uniquely suited to the study of neuronal connectivity and lesion-dependent neural plasticity. Monaural animals, following the permanent removal of one ear in nymphs or adults, adjust their auditory pathways by collateral sprouting of afferents and deafferented interneurons which connect to neurons on the contralateral side. Transient lesion of the auditory nerve allows us to study regeneration as well as plasticity processes. After crushing the peripheral auditory nerve, the lesioned afferents regrow and re-establish new synaptic connections which are relevant for auditory behavior. During this process collateral sprouting occurs in the central nervous networks, too. Interestingly, after regeneration a changed neuronal network will be maintained. These paradigms are now been used to analyze molecular mechanism in neuronal plasticity on the level of single neurons and small networks. PMID:23986709

Lakes-Harlan, Reinhard

2013-01-01

344

Compressive neuropathies related to ganglions of the wrist and hand.  

PubMed

Ganglions of the wrist and hand causing compressive neuropathies are rare clinical entities. Compression of the ulnar and median nerves in their respective fibro-osseous tunnels lead to characteristic patterns of motor and/or sensory deficits, which are directly related to the location of the lesion. We present a unique case of a "dumbbell" shaped ganglion invading both Guyon's canal and the carpal tunnel causing a dual compressive neuropathy of the ulnar and median nerve. We discuss the patho-anatomy, clinical assessment, investigation and surgical treatment of this condition. PMID:24641752

Jayakumar, Prakash; Jayaram, Vijay; Nairn, David S

2014-01-01

345

Neurological complications in thyroid surgery: a surgical point of view on laryngeal nerves.  

PubMed

THE CERVICAL BRANCHES OF THE VAGUS NERVE THAT ARE PERTINENT TO ENDOCRINE SURGERY ARE THE SUPERIOR AND THE INFERIOR LARYNGEAL NERVES: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB) is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle) varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified, the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN) runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction, and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve, which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a low range. PMID:25076936

Varaldo, Emanuela; Ansaldo, Gian Luca; Mascherini, Matteo; Cafiero, Ferdinando; Minuto, Michele N

2014-01-01

346

Neurological Complications in Thyroid Surgery: A Surgical Point of View on Laryngeal Nerves  

PubMed Central

The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB) is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle) varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified, the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN) runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction, and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve, which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a low range. PMID:25076936

Varaldo, Emanuela; Ansaldo, Gian Luca; Mascherini, Matteo; Cafiero, Ferdinando; Minuto, Michele N.

2014-01-01

347

Ultrastructural Changes in Spinal Motoneurons and Locomotor Functional Study after Sciatic Nerve Repair in Conduit Tube  

PubMed Central

Objective(s) Motor deficit and neuron degeneration is seen after nerve transection. The aim of this study is to determine whether a poled polyvinelidene fluoride (PVDF) tube with other supportive strategies can protect the neuronal morphology and motor function after sciatic nerve transaction in rats. Materials and Methods After transection of the left sciatic nerve in 60 male Wistar rats (200-250 g), the epineural group was sutured end to end. In the autograft rats, a 10 mm piece of sciatic nerve was rotated 180 °C and sutured back into the nerve gap. In the nerve guidance channel (NGC) group, polarized piezoelectric PVDF tube containing NGF and collagen gel was sutured in the gap. In control group sciatic nerve was removed (10 mm) without repair. After one, four and eight weeks, the L4-L6 spinal cord segment was removed for histological study using transmission electron microscope. Functional outcome was assessed using the Basso, Bresnahan and Beattie (BBB) locomotor scale at both four and eight weeks after the lesion. Results Chromatin condensation was seen after 4 weeks in the repair groups. Cell membrane shrinkage and mitochondrial degeneration was observed after 4 and 8 weeks respectively, in the autografted and NGC rats. In the control group, chromatin condensation, cell membrane shrinkage with mitochondrial degeneration and vacuolization of perikaryon was seen after 1, 4 and 8 weeks, respectively. At 56 days, the functional recovery of the epineural rats significantly increased in comparison to the other groups (P< 0.05). Conclusion The epineural suture has more efficacies, and NGC may be used as a proper substitute for autograft in nerve injury. PMID:23492837

Delaviz, Hamdollah; Faghihi, Abolfazel; Mohamadi, Jamshid; Roozbehi, Amrollah

2012-01-01

348

'Nerves': folk idiom for anxiety and depression?  

PubMed

This study suggests that 'nerves' as presented in a primary care clinic is a lay idiom for emotional distress and documents a relationship between the folk ailment 'nerves' and anxiety and depression. One hundred and forty-nine patients at a Virginia clinic were studied, 47 with 'nerves', and 102 controls. Testing with the General Health Questionnaire (GHQ) and the Beck Depression Inventory (BDI) showed 'nerves' patients to be more anxious and depressed than controls. 'Nerves' patients had a mean GHQ score of 13.0 compared to 5.8 for controls (P less than 0.0001) and a BDI score of 7.6 compared to 2.5 for controls (P less than 0.0001). Testing with the Holmes-Rahe Social Readjustment Rating Scale showed 'nerves' patients to suffer more recent life stresses than controls: 'nerves' patients had a mean score of 187.1 compared to 119.3 for controls (P less than 0.05). 'Nerves' patients had somatic symptoms including gastrointestinal disturbances, headaches and shaking. 'Nerves' is most common among women and housewives, and is often attributed to misfortune and tragedy. The ethnomedical illness 'nerves' encompasses a rich array of cultural meanings reflecting the lifestyle and worldview of its sufferers. Despite its chronic debilitating nature, it is rarely recognized by physicians; it is, however, treated by alternative healers. Clinical implications are discussed and recommendations advanced, among them that physicians work with such healers in the recognition and treatment of 'nerves'. PMID:3206246

Nations, M K; Camino, L A; Walker, F B

1988-01-01

349

Optic Nerve Pathway Gliomas and Optic Nerve Meningiomas  

Microsoft Academic Search

\\u000a Optic pathway gliomas are intrinsic slow-growing brain tumors that are the most common primary neoplasms of the optic pathways.\\u000a Optic pathway gliomas are associated with neurofibromatosis type 1; the incidence of optic nerve glioma in patients with this\\u000a syndrome varies from 8% to 31%. Sporadic optic pathway gliomas present with visual symptoms, the most common of which is decreased\\u000a visual

Sonali Singh; Jade S. Schiffman

350

Plexiform nerve sheath tumor or vascular malformation--role of advanced MR neurography and diffusion tensor imaging.  

PubMed

The authors report a vascular malformation mimicking a plexiform peripheral nerve sheath tumor. Three Tesla magnetic resonance neurography with high-resolution anatomic and advanced functional diffusion tensor imaging was helpful in evaluating full extent of the lesion and characterizing its internal architecture. PMID:23519761

Jalali-Farahani, Sahar; Blakeley, Jaishri O; Belzberg, Allan J; Carrino, John A; Chhabra, Avneesh

2013-07-01

351

Malignant nerve sheath tumors of the head and neck: four case studies and review of the literature  

Microsoft Academic Search

Malignant peripheral nerve sheath tumors (MPNST) are very uncommon neoplasms. While the incidence of these lesions is estimated to be 0.001% in a general population, they make up 5-15% of all soft tissue sarcomas in the head and neck region. We present four cases of MPNST in the head and neck. Since certain difficulties were encountered in diagnosis, the importance

K. Hujala; P. Martikainen; H. Minn; R. Grénman

1993-01-01

352

Targeting Inflammatory Demyelinating Lesions to Sites of Wallerian Degeneration  

PubMed Central

In Theiler’s murine encephalomyelitis virus (TMEV) infection, an animal model for multiple sclerosis (MS), axonal injury precedes inflammatory demyelinating lesions, and the distribution of axonal damage present during the early phase of infection corresponds to regions where subsequent demyelination occurs during the chronic phase. We hypothesized that axonal damage recruits inflammatory cells to sites of Wallerian degeneration, leading to demyelination. Three weeks after TMEV infection, axonal degeneration was induced in the posterior funiculus of mice by injecting the toxic lectin Ricinus communis agglutinin (RCA) I into the sciatic nerve. Neuropathology was examined 1 week after lectin injection. Control mice, infected with TMEV but receiving no RCA I, had inflammatory demyelinating lesions in the anterior/lateral funiculi. Other control mice that received RCA I alone did not develop inflammatory lesions. In contrast, RCA I injection into TMEV-infected mice induced lesions in the posterior funiculus in addition to the anterior/lateral funiculi. We found no differences in lymphoproliferative responses or antibody titers against TMEV among the groups. This suggests that axonal degeneration contributes to the recruitment of inflammatory cells into the central nervous system by altering the local microenvironment. In this scenario, lesions develop from the axon (inside) to the myelin (outside) (Inside-Out model). PMID:17823280

Tsunoda, Ikuo; Tanaka, Tomoko; Saijoh, Yukio; Fujinami, Robert S.

2007-01-01

353

Surgical management of cavernous malformation of the optic nerve with canalicular extension  

PubMed Central

Background: Cavernous malformations arising in a single optic nerves paring the chiasm (intracranial prechiasmatic optic nerve) and expanding into the optic canal are extremely rare lesions. Published series or case reports regarding the surgical removal of these vascular malformations within this specific location are scarce. Case Description: We present the first case to be published, of an intracranial optic nerve cavernous malformation with a contiguous canalicular component that was totally and successfully removed through a microsurgical pterional approach with excellent clinical outcome. Conclusion: This pathology should always be considered in the differential diagnosis of optic neuropathy and visual loss. Early detection and surgical proposal are mandatory, warranting the prevention of permanent damage to visual pathways. Radical resection is challenging, but usually curative and associated with favorable visual outcomes.

Gonçalves, Vítor M.; Gonçalves, Victor

2014-01-01

354

Primary Neurolymphomatosis of the Lower Cranial Nerves Presenting as Dysphagia and Hoarseness: A Case Report  

PubMed Central

Primary neurolymphomatosis is an extremely rare tumor. We report the case of a 74-year-old patient presenting with dysphagia and hoarseness. Initial contrast-enhanced computed tomography of the head, neck, and chest did not reveal any lesions. His symptoms improved with short-term administration of prednisone but recurred and deteriorated. Magnetic resonance (MR) imaging revealed a tumor along the ninth and tenth cranial nerves across the jugular foramen. Fluorine-18 fluorodeoxyglucose positron emission tomography indicated this was a primary tumor. Repeated MR imaging after 2 months revealed considerable tumor enlargement. A left suboccipital craniotomy was performed to remove the tumor that infiltrated the ninth and tenth cranial nerves. The histopathologic diagnosis was diffuse large B-cell lymphoma. Although focal radiation therapy was administered to ensure complete eradication of the tumor, the patient died of aspiration pneumonia with systemic metastasis. To our knowledge, this is the first reported case of primary neurolymphomatosis in the lower cranial nerves. PMID:25083392

Sakai, Naoto; Ito-Yamashita, Tae; Takahashi, Goro; Baba, Satoshi; Koizumi, Shinichiro; Yamasaki, Tomohiro; Tokuyama, Tsutomu; Namba, Hiroki

2014-01-01

355

Intraneural lipomatous tumor of the median nerve: Three case reports with a review of literature  

PubMed Central

INTRODUCTION Intraneural lipoma and fibrolipomatous hamartoma of the nerve are rare soft tissue tumors that most commonly occur in the forearm and the wrist, and particularly within the median nerve. When the lesions are large enough, they may cause progressive compression neuropathy. They are distinct entities each other with different clinical and radiological findings and thereby need different surgical treatments. PRESENTATION OF CASE We report here 3 cases of intraneural lipomatous tumors of the median nerve (1 case of intraneural lipoma and 2 cases of fibrolipomatous hamartoma). DISCUSSION All patients were surgically treated successfully with complete excision for intraneural lipoma and with carpal tunnel releases for the both fibrolipomatous hamartomas. CONCLUSION A careful preoperative planning is necessary for the optimal treatment by distinguishing whether it is a resectable or non-resectable tumor based on the clinical and radiological findings, because they have characteristic findings each other. PMID:22705575

Okubo, Taketo; Saito, Tsuyoshi; Mitomi, Hiroyuki; Takagi, Tatsuya; Torigoe, Tomoaki; Suehara, Yoshiyuki; Katagiri, Hirohisa; Murata, Hideki; Takahashi, Mitsuru; Ito, Ichiro; Yao, Takashi; Kaneko, Kazuo

2012-01-01

356

Intermuscular lipoma of the gluteus muscles compressing the sciatic nerve: an inverted sciatic hernia.  

PubMed

The authors report the case of a 50-year-old woman with a benign intermuscular lipoma of the gluteus compressing the sciatic nerve in its course through the sciatic notch. This benign soft-tissue tumor extended into the pelvis, displacing the rectum laterally. Resection was necessary to alleviate symptoms and prevent irreversible damage of the nerve. Wide exposure of the piriformis muscle and sciatic nerve via a transgluteal approach allowed safe lesion removal, and thus avoiding a laparotomy to resect the intrapelvic extension of the tumor. This report features a curious case of soft-tissue tumor growth across the sciatic foramen forming an inverted sciatic hernia. The authors' proposed approach was simple and safe and avoided a laparotomy. PMID:22900844

López-Tomassetti Fernández, Eudaldo M; Hernández, Juan Ramón Hernández; Esparragon, Jose Ceballos; García, Angel Turegano; Jorge, Valentin Nuńez

2012-10-01

357

Lost in the jungle: new hurdles for optic nerve axon regeneration.  

PubMed

The poor regenerative capacity of injured central nervous system (CNS) axons leads to permanent neurological deficits after brain, spinal cord, or optic nerve lesions. In the optic nerve, recent studies showed that stimulation of the cytokine or mammalian target of rapamycin (mTOR) signaling pathways potently enhances sprouting and regeneration of injured retinal ganglion cell axons in adult mice, but does not allow the majority of axons to reach their main cerebral targets. New analyses have revealed axon navigation defects in the optic nerve and at the optic chiasm under conditions of strong growth stimulation. We propose that a balanced growth stimulatory treatment will have to be combined with guidance factors and suppression of local growth inhibitory factors to obtain the full regeneration of long CNS axonal tracts. PMID:24874558

Pernet, Vincent; Schwab, Martin E

2014-07-01

358

Gram stain of skin lesion  

MedlinePLUS

Skin lesion gram stain ... a glass slide. A series of different colored stains is applied to the sample. A laboratory team ... test. For information on risks related to the removal of a skin sample, see skin lesion biopsy .

359

Combination of Acellular Nerve Graft and Schwann Cells-Like Cells for Rat Sciatic Nerve Regeneration  

PubMed Central

Objective. To investigate the effect of tissue engineering nerve on repair of rat sciatic nerve defect. Methods. Forty-five rats with defective sciatic nerve were randomly divided into three groups. Rats in group A were repaired by acellular nerve grafts only. Rats in group B were repaired by tissue engineering nerve. In group C, rats were repaired by autogenous nerve grafts. After six and twelve weeks, sciatic nerve functional index (SFI), neural electrophysiology (NEP), histological and transmission electron microscope observation, recovery ratio of wet weight of gastrocnemius muscle, regenerated myelinated nerve fibers number, nerve fiber diameter, and thickness of the myelin sheath were measured to assess the effect. Results. After six and twelve weeks, the recovery ratio of SFI and wet weight of gastrocnemius muscle, NEP, and the result of regenerated myelinated nerve fibers in groups B and C were superior to that of group A (P < 0.05), and the difference between groups B and C was not statistically significant (P > 0.05). Conclusion. The tissue engineering nerve composed of acellular allogenic nerve scaffold and Schwann cells-like cells can effectively repair the nerve defect in rats and its effect was similar to that of the autogenous nerve grafts. PMID:25114806

Gao, Songtao; Zheng, Yan; Cai, Qiqing; Deng, Zhansheng; Yao, Weitao; Wang, Jiaqiang; Wang, Xin; Zhang, Peng

2014-01-01

360

Electrospun micro- and nanofiber tubes for functional nervous regeneration in sciatic nerve transections  

PubMed Central

Background Although many nerve prostheses have been proposed in recent years, in the case of consistent loss of nervous tissue peripheral nerve injury is still a traumatic pathology that may impair patient's movements by interrupting his motor-sensory pathways. In the last few decades tissue engineering has opened the door to new approaches;: however most of them make use of rigid channel guides that may cause cell loss due to the lack of physiological local stresses exerted over the nervous tissue during patient's movement. Electrospinning technique makes it possible to spin microfiber and nanofiber flexible tubular scaffolds composed of a number of natural and synthetic components, showing high porosity and remarkable surface/volume ratio. Results In this study we used electrospun tubes made of biodegradable polymers (a blend of PLGA/PCL) to regenerate a 10-mm nerve gap in a rat sciatic nerve in vivo. Experimental groups comprise lesioned animals (control group) and lesioned animals subjected to guide conduits implantated at the severed nerve stumps, where the tubular scaffolds are filled with saline solution. Four months after surgery, sciatic nerves failed to reconnect the two stumps of transected nerves in the control animal group. In most of the treated animals the electrospun tubes induced nervous regeneration and functional reconnection of the two severed sciatic nerve tracts. Myelination and collagen IV deposition have been detected in concurrence with regenerated fibers. No significant inflammatory response has been found. Neural tracers revealed the re-establishment of functional neuronal connections and evoked potential results showed the reinnervation of the target muscles in the majority of the treated animals. Conclusion Corroborating previous works, this study indicates that electrospun tubes, with no additional biological coating or drug loading treatment, are promising scaffolds for functional nervous regeneration. They can be knitted in meshes and various frames depending on the cytoarchitecture of the tissue to be regenerated. The versatility of this technique gives room for further scaffold improvements, like tuning the mechanical properties of the tubular structure or providing biomimetic functionalization. Moreover, these guidance conduits can be loaded with various fillers like collagen, fibrin, or self-assembling peptide gels or loaded with neurotrophic factors and seeded with cells. Electrospun scaffolds can also be synthesized in different micro-architectures to regenerate lesions in other tissues like skin and bone. PMID:18405347

Panseri, Silvia; Cunha, Carla; Lowery, Joseph; Del Carro, Ubaldo; Taraballi, Francesca; Amadio, Stefano; Vescovi, Angelo; Gelain, Fabrizio

2008-01-01

361

A critical role for macrophages near axotomized neuronal cell bodies in stimulating nerve regeneration.  

PubMed

Macrophages have been implicated in peripheral nerve regeneration for some time, supposedly through their involvement in Wallerian degeneration, the process by which the distal nerve degenerates after axotomy and is cleared by phagocytosis. Thus, in several studies in which macrophage accumulation in the distal nerve was reduced and Wallerian degeneration inhibited, regeneration was delayed. However, this interpretation ignores the more recent findings that macrophages also accumulate around axotomized cell bodies. The function of macrophage action at this second site has not been clear. In two mutant strains of mice, the slow Wallerian degeneration (Wld(s)) mouse and the chemokine receptor CCR2 knock-out mouse, we report that macrophage accumulation after axotomy was abolished in both the dorsal root ganglion (DRG) and the distal sciatic nerve. To measure neurite outgrowth, DRG neurons were given a conditioning lesion, and outgrowth was measured in vitro 7 d later in the absence of the distal nerve segment. The increased growth normally seen after a conditioning lesion did not occur or was reduced in Wld(s) or CCR2(-/-) mice. In the superior cervical ganglion (SCG), particularly in Wld(s) mice, macrophage accumulation was reduced but not abolished after axotomy. In SCG neurons from Wld(s) mice, the conditioning lesion response was unchanged; however, in CCR2(-/-) mice in which the effect on macrophage accumulation was greater, SCG neurite outgrowth was significantly reduced. These results indicate that macrophages affect neurite outgrowth by acting at the level of peripheral ganglia in addition to any effects they might produce by facilitation of Wallerian degeneration. PMID:24107955

Niemi, Jon P; DeFrancesco-Lisowitz, Alicia; Roldán-Hernández, Lilinete; Lindborg, Jane A; Mandell, Daniel; Zigmond, Richard E

2013-10-01

362

Local Anesthesia and Nerve Blocks  

Microsoft Academic Search

\\u000a Many inguino-scrotal procedures in urology can be performed under local anesthesia. Sometimes local anesthetics are used to\\u000a supplement post-operative pain relief in patients who had general anesthesia. The common nerve blocks are an inguinal block\\u000a for hernia repairs and inguinal orchidectomies, a cord block for vasectomies, and a penile block for circumcision and frenuloplasty.\\u000a The testis and scrotum are innervated

Hashim Hashim

363

[Traumatic cord and nerve root injuries: imaging features at the acute and chronic phases].  

PubMed

Cord injuries are frequent and severe lesions resulting in significant disability, most frequently in younger subjects. The area of cord injured results in clinical syndromes (Brown-Sequard, motor and/or sensory deficit...). Cord and rootlet injuries are best depicted on MRI. Diffusion tensor imaging with tractography enables depiction of the most severe cord lesions and some prediction of tissue viability which may provide an idea of the potential functional prognosis and patient recovery. MRI is optimal to demonstrate areas of cord hemorrhage or compression, partial or complete cord transsection, nerve root avulsion... PMID:20814392

Ducreux, D; Lacour, Mc; Cazejust, J; Benoudiba, F; Sarrazin, Jl

2010-09-01

364

Peripheral seventh nerve palsy due to transorbital intracranial penetrating pontine injury.  

PubMed

The case of a child injured by a knitting needle penetrating transorbitally and intracranially, resulting in carotid cavernous fistula and pontine injury, is reported. After receiving medical and endovascular treatment, the only remaining abnormal neurological manifestation was right peripheral facial nerve palsy. The clinical sequences of events and the demonstration of a pontine lesion leading to peripheral facial palsy are presented. Facial nuclear injury with a penetrating trauma is an extremely rare condition. It is important to identify the anatomical regions injured in penetrating traumas. The lesions must be identified by computerized tomography, magnetic resonance imaging, clinical and laboratory investigation. PMID:16283198

Cosan, T Erhan; Adapinar, Baki; Cakli, Hamdi; Gurbuz, M Kezban

2006-04-01

365

Changes in crossed spinal reflexes after peripheral nerve injury and repair.  

PubMed

We investigated the changes induced in crossed extensor reflex responses after peripheral nerve injury and repair in the rat. Adults rats were submitted to non repaired sciatic nerve crush (CRH, n = 9), section repaired by either aligned epineurial suture (CS, n = 11) or silicone tube (SIL4, n = 13), and 8 mm resection repaired by tubulization (SIL8, n = 12). To assess reinnervation, the sciatic nerve was stimulated proximal to the injury site, and the evoked compound muscle action potential (M and H waves) from tibialis anterior and plantar muscles and nerve action potential (CNAP) from the tibial nerve and the 4th digital nerve were recorded at monthly intervals for 3 mo postoperation. Nociceptive reinnervation to the hindpaw was also assessed by plantar algesimetry. Crossed extensor reflexes were evoked by stimulation of the tibial nerve at the ankle and recorded from the contralateral tibialis anterior muscle. Reinnervation of the hindpaw increased progressively with time during the 3 mo after lesion. The degree of muscle and sensory target reinnervation was dependent on the severity of the injury and the nerve gap created. The crossed extensor reflex consisted of three bursts of activity (C1, C2, and C3) of gradually longer latency, lower amplitude, and higher threshold in control rats. During follow-up after sciatic nerve injury, all animals in the operated groups showed recovery of components C1 and C2 and of the reflex H wave, whereas component C3 was detected in a significantly lower proportion of animals in groups with tube repair. The maximal amplitude of components C1 and C2 recovered to values higher than preoperative values, reaching final levels between 150 and 245% at the end of the follow-up in groups CRH, CS, and SIL4. When reflex amplitude was normalized by the CNAP amplitude of the regenerated tibial nerve, components C1 (300-400%) and C2 (150-350%) showed highly increased responses, while C3 was similar to baseline levels. In conclusion, reflexes mediated by myelinated sensory afferents showed, after nerve injuries, a higher degree of facilitation than those mediated by unmyelinated fibers. These changes tended to decline toward baseline values with progressive reinnervation but still remained significant 3 mo after injury. PMID:11929897

Valero-Cabré, Antoni; Navarro, Xavier

2002-04-01

366

Nerve transfer in brachial plexus traction injuries.  

PubMed

Brachial plexus palsy due to traction injury, especially spinal nerve-root avulsion, represents a severe handicap for the patient. Despite recent progress in diagnosis and microsurgical repair, the prognosis in such cases remains unfavorable. Nerve transfer is the only possibility for repair in cases of spinal nerve-root avulsion. This technique was analyzed in 37 patients with 64 reinnervation procedures of the musculocutaneous and/or axillary nerve using upper intercostal, spinal accessory, and regional nerves as donors. The most favorable results, with an 83.8% overall rate of useful functional recovery, were obtained in patients with upper brachial plexus palsy in which regional donor nerves, such as the medial pectoral, thoracodorsal, long thoracic, and subscapular nerves, had been used. The overall rates of recovery for the spinal accessory and upper intercostal nerves were 64.3% and 55.5%, respectively, which are significantly lower. The authors evaluate the results of nerve transfer and analyze different donor nerves as factors influencing the prognosis of surgical repair. PMID:1730947

Samardzic, M; Grujicic, D; Antunovic, V

1992-02-01

367

Inferior alveolar nerve block: Alternative technique  

PubMed Central

Background: Inferior alveolar nerve block (IANB) is a technique of dental anesthesia, used to produce anesthesia of the mandibular teeth, gingivae of the mandible and lower lip. The conventional IANB is the most commonly used the nerve block technique for achieving local anesthesia for mandibular surgical procedures. In certain cases, however, this nerve block fails, even when performed by the most experienced clinician. Therefore, it would be advantageous to find an alternative simple technique. Aim and Objective: The objective of this study is to find an alternative inferior alveolar nerve block that has a higher success rate than other routine techniques. To this purpose, a simple painless inferior alveolar nerve block was designed to anesthetize the inferior alveolar nerve. Materials and Methods: This study was conducted in Oral surgery department of Vinayaka Mission's dental college Salem from May 2009 to May 2011. Five hundred patients between the age of 20 years and 65 years who required extraction of teeth in mandible were included in the study. Out of 500 patients 270 were males and 230 were females. The effectiveness of the IANB was evaluated by using a sharp dental explorer in the regions innervated by the inferior alveolar, lingual, and buccal nerves after 3, 5, and 7 min, respectively. Conclusion: This study concludes that inferior alveolar nerve block is an appropriate alternative nerve block to anesthetize inferior alveolar nerve due to its several advantages.

Thangavelu, K.; Kannan, R.; Kumar, N. Senthil

2012-01-01

368

Iatrogenic injury to oral branches of the trigeminal nerve: records of 449 cases  

Microsoft Academic Search

The aims of this study were threefold: (1) to describe iatrogenic lesions to oral branches of the trigeminal nerve, signs\\u000a and symptoms, and functional status, (2) to report on a simple neurosensory examination method, and (3) to discuss means of\\u000a prevention of iatrogenic injury. The etiology and functional status of 449 injuries to oral branches collected over 18 years\\u000a were retrospectively

Sřren Hillerup

2007-01-01

369

Malignant peripheral nerve sheath tumor of the thyroid: A clinicopathological and ultrastructural study of one case  

Microsoft Academic Search

Thyroid malignant peripheral nerve sheath tumors (TMPNST) are very uncommon neoplasms that can be confused with anaplastic\\u000a carcinoma, Riedel’s thyroiditis, or other soft tissue tumors that may occur in the thyroid region. An example of TMPNST is\\u000a presented in this report. The tumor occurred in a 56-yr-old woman. Fine needle aspiration did not provide adequate material.\\u000a After thyroidectomy, the lesion

Judit Pallares; Luis Perez-Ruiz; Susana Ros; Ma Jose Panades; Javier Pardo-Mindan; Josep Lloreta; Xavier Matias-Guiu

2004-01-01

370

Adrenal spindle-cell sarcoma with features of malignant peripheral nerve sheath tumor  

Microsoft Academic Search

An unusual malignant spindle-cell tumor of the adrenal medulla originally diagnosed as leiomyosarcoma is illustrated. On the\\u000a evidence of histological and immunohistochemical findings, the neoplasm was rediagnosed as a spindle-cell sarcoma with features\\u000a of malignant peripheral nerve sheath tumor. Unlike ordinary pheochromocytoma, which may also show a spindling cell pattern,\\u000a such lesions are malignant and its recognition may have implications

H. R. Harach; P. Laidler

1993-01-01

371

Malignant Peripheral Nerve Sheath Tumor of Bone in Children and Adolescents  

Microsoft Academic Search

Malignant peripheral nerve sheath tumor (MPNST) of bone is a rare entity. We have examined three lesions that fit standard\\u000a histopathologic criteria for MPNST of soft tissues but that arose in the skeleton of three children aged 6 to 13 years. None\\u000a was affected by neurofibromatosis 1 (NF1). Histologic features typical of MPNST included spindle cells with comma-shaped nuclei,\\u000a tactoid

W. Allen Wesche; Vivek Khare; Bhaskar N. Rao; Laura C. Bowman; David M. Parham

1999-01-01

372

Klatskin-Like Lesions  

PubMed Central

Hilar cholangiocarcinoma, also known as Klatskin tumour, is the commonest type of cholangiocarcinoma. It poses unique problems in the diagnosis and management because of its anatomical location. Curative surgery in the form of major hepatic resection entails significant morbidity. About 5–15% of specimens resected for presumed Klatskin tumour prove not to be cholangiocarcinomas. There are a number of inflammatory, infective, vascular, and other pathologies, which have overlapping clinical and radiological features with a Klatskin tumour, leading to misinterpretation. This paper aims to summarise the features of such Klatskin-like lesions that have been reported in surgical literature. PMID:22811587

Senthil Kumar, M. P.; Marudanayagam, R.

2012-01-01

373

Nanofibrous nerve conduits for repair of 30-mm-long sciatic nerve defects  

PubMed Central

It has been confirmed that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit can promote peripheral nerve regeneration in rats. However, its efficiency in repair of over 30-mm-long sciatic nerve defects needs to be assessed. In this study, we used a nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit to bridge a 30-mm-long gap in the rat sciatic nerve. At 4 months after nerve conduit implantation, regenerated nerves were cally observed and histologically assessed. In the nanofibrous graft, the rat sciatic nerve trunk had been reconstructed by restoration of nerve continuity and formation of myelinated nerve fiber. There were Schwann cells and glial cells in the regenerated nerves. Masson's trichrome staining showed that there were no pathological changes in the size and structure of gastrocnemius muscle cells on the operated side of rats. These findings suggest that nanofibrous poly(3-hydroxybutyrate-co-3-hydroxyvalerate) nerve conduit is suitable for repair of long-segment sciatic nerve defects.

Biazar, Esmaeil; Keshel, Saeed Heidari; Pouya, Majid; Rad, Hadi; Nava, Melody Omrani; Azarbakhsh, Mohammad; Hooshmand, Shirin

2013-01-01

374

Neural fibrolipoma of the superficial peroneal nerve in the ankle: a case report with immunohistochemical analysis.  

PubMed

This report presents a case of neural fibrolipoma arising from the superficial peroneal nerve in the ankle. A 28-year-old woman was referred with a soft tissue mass in the anterior aspect of the right ankle, which had been gradually enlarging for the past 10 years. Magnetic resonance imaging showed a mass lesion, measuring approximately 8 x 3 x 2 cm, with high to partially low signal intensity on both T1- and T2-weighted images. A band of low signal intensity within the lesion, which is indicative of coexistence with the tumor and the superficial peroneal nerve, could be detected on both T1- and T2-weighted images. The patient underwent an excisional biopsy. The specimen microscopically consisted of nerve bundles and fibro-fatty proliferation with abundant collagen fibers. Immunoreactivity for CD34 antigen antibody was detected in fibrous spindle cells. This is the first report to present an immunohistochemical profile of neural fibrolipoma. Neural fibrolipoma should be considered as a differential diagnosis when a lipomatous lesion is encountered in the foot or ankle as well as in the upper extremities. PMID:12685550

Akisue, Toshihiro; Matsumoto, Keiji; Yamamoto, Tetsuji; Kizaki, Tomohiko; Fujita, Ikuo; Yoshiya, Shinichi; Kurosaka, Masahiro

2002-11-01

375

Intercostal nerve conduction study in man.  

PubMed Central

A new surface technique for the conduction study of the lower intercostal nerves has been developed and applied to 30 normal subjects. The problem of the short available nerve segment of the intercostal nerves and the bizzare compound motor action potential (CMAP) of inconsistent latency while recording over the intercostal muscles, is overcome by applying recording electrodes over the rectus abdominis muscle and stimulating the nerves at two points at a fair distance away. With the use of multiple recording sites over the rectus abdominis, the motor points for different intercostal nerves were delineated. CMAP of reproducible latencies and waveforms with sharp take-off points were obtained. Conduction velocity of the intercostal nerves could be determined. PMID:2526200

Pradhan, S; Taly, A

1989-01-01

376

Intercostal nerve conduction study in man.  

PubMed

A new surface technique for the conduction study of the lower intercostal nerves has been developed and applied to 30 normal subjects. The problem of the short available nerve segment of the intercostal nerves and the bizzare compound motor action potential (CMAP) of inconsistent latency while recording over the intercostal muscles, is overcome by applying recording electrodes over the rectus abdominis muscle and stimulating the nerves at two points at a fair distance away. With the use of multiple recording sites over the rectus abdominis, the motor points for different intercostal nerves were delineated. CMAP of reproducible latencies and waveforms with sharp take-off points were obtained. Conduction velocity of the intercostal nerves could be determined. PMID:2526200

Pradhan, S; Taly, A

1989-06-01

377

Saphenous nerve innervation of the medial ankle  

PubMed Central

Background The distal saphenous nerve is commonly known to provide cutaneous innervation of the medial side of the ankle and distally to the base of the great toe. We hypothesize that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule. Methods Five fresh limbs were dissected and the saphenous nerve was traced distally with magnification. The medial malleolus, talus, and soft tissue were fixed in formaldehyde, decalcified, and embedded in paraffin and sectioned. Histologic slides were then prepared using S100 antibody nerve stains. Results Histologic slides were examined and myelinated nerves could be observed within the medial capsule and periosteum in all the specimens. Conclusion We have demonstrated that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule. PMID:23630434

Clendenen, Steven R; Whalen, Joseph L

2013-01-01

378

Diencephalic regions contributing to sympathetic nerve discharge in anesthetized cats.  

PubMed

We reported that the forebrain is responsible for a significant component (38%) of inferior cardiac postganglionic sympathetic nerve discharge (SND) in baroreceptor-denervated cats anesthetized with alpha-chloralose [Huang et al., Am. J. Physiol. 252 (Regulatory Integrative Comp. Physiol. 21): R645-R652, 1987]. The current study was initiated to assess the contribution of various diencephalic regions to the forebrain-dependent component of SND in this preparation. For this purpose, the reductions in inferior cardiac SND and blood pressure produced acutely by midbrain transection at stereotaxic plane A3 in nonlesioned control cats were compared with those in cats in which diencephalic lesions were made with radio-frequency current. Lesions of the anterior medial hypothalamus including the paraventricular nucleus failed to attenuate the decreases in SND and blood pressure produced by midbrain transection. In contrast, the effects of midbrain transection were significantly attenuated by lesions of the lateral hypothalamus (including medial forebrain bundle), posterior medial hypothalamus, or the medial thalamus. We conclude that both the hypothalamus and medial thalamus contribute to SND in anesthetized cats. PMID:3344835

Huang, Z S; Varner, K J; Barman, S M; Gebber, G L

1988-02-01

379

Chronic electrical stimulation of transected peripheral nerves preserves anatomy and function in the primary somatosensory cortex.  

PubMed

The structure and function of the central nervous system strongly depend on the organization and efficacy of the incoming sensory input. A disruption of somesthetic input severely alters the metabolic activity, electrophysiological properties and even gross anatomical features of the primary somatosensory cortex. Here we examined, in the rat somatosensory cortex, the neuroprotective and therapeutic effects of artificial sensory stimulation after irreversible unilateral transection of a peripheral sensory nerve (the infraorbital branch of the trigeminal nerve). The proximal stump of the nerve was inserted into a silicon tube with stimulating electrodes, through which continuous electrical stimulation was applied for 12 h/day (square pulses of 100 ?s, 3.0 V, at 20 Hz) for 4 weeks. Deafferented animals showed significant decreases in cortical evoked potentials, cytochrome oxidase staining intensity (layers II-IV), cortical volume (layer IV) and number of parvalbumin-expressing (layers II-IV) and calbindin-D28k-expressing (layers II/III) interneurons. These deafferentation-dependent effects were largely absent in the nerve-stimulated animals. Together, these results provide evidence that chronic electrical stimulation has a neuroprotective and preservative effect on the sensory cortex, and raise the possibility that, by controlling the physical parameters of an artificial sensory input to a sectioned peripheral nerve, chronically deafferented brain regions could be maintained at near-'normal' conditions. Our findings could be important for the design of sensory neuroprostheses and for therapeutic purposes in brain lesions or neural degenerative processes. PMID:23006217

Herrera-Rincon, Celia; Torets, Carlos; Sanchez-Jimenez, Abel; Avendańo, Carlos; Panetsos, Fivos

2012-12-01

380

Transsartorial approach for saphenous nerve block  

Microsoft Academic Search

Blockade of conduction in the saphenous nerve is important in providing surgical anaesthesia in the lower leg. Unfortunately,\\u000a previously described techniques have lacked clinical effectiveness in practice. We developed a transsartorial approach for\\u000a conduction block of the saphenous nerve. We first confirmed its potential clinical utility in 12 cadaveric specimens by demonstrating\\u000a that the saphenous nerve was consistently stained by

Michael van der Wal; Scott A. Lang; Ray W. Yip

1993-01-01

381

MR neurography of sciatic nerve injection injury  

Microsoft Academic Search

We report on magnetic resonance neurography (MRN) as a supplementary diagnostic tool in sciatic nerve injection injury. The\\u000a object of the study was to test if T2-weighted (w) contrast within the sciatic nerve serves as an objective criterion for\\u000a sciatic injection injury. Three patients presented with acute sensory and\\/or motor complaints in the distribution of the sciatic\\u000a nerve after dorsogluteal

Mirko Pham; Carsten Wessig; Jörg Brinkhoff; Karlheinz Reiners; Guido Stoll; Martin Bendszus

2011-01-01

382

Mandibular nerve entrapment in the infratemporal fossa  

Microsoft Academic Search

The posterior trunk of the mandibular nerve (V3) comprises of three main branches. Various anatomic structures may entrap and potentially compress the mandibular nerve branches.\\u000a A usual position of mandibular nerve (MN) compression is the infratemporal fossa (ITF) which is one of the most difficult\\u000a regions of the skull base to access surgically. The anatomical positions of compression are: the

Maria N. PiagkouT; T. Demesticha; G. Piagkos; G. Androutsos; P. Skandalakis

2011-01-01

383

Tissue engineering and peripheral nerve regeneration (III)  

Microsoft Academic Search

The biodegradation rate and biocompatibility of poly (d, \\/ -lactide) (PDLLA)in vivo were evaluated. The aim of this study was to establish a nerve guide constructed by the PDLLA with 3-D microenvironment and\\u000a to repair a 10 mm of sciatic nerve gap in rats. The process of the nerve regeneration was investigated by histological assessment,\\u000a electrophysiological examination, and determination of

Shenguo Wang; Jianwei Hou; Jianzhong Bei; Yongqiang Zhao

2001-01-01

384

Evaluation of recurrent laryngeal nerve monitoring in thyroid surgery  

Microsoft Academic Search

AimThyroidectomy creates a potential risk for all parathyroid glands and nerves. Nerve identification has decreased the rates of nerve injury during thyroidectomy. Intraoperative nerve monitoring (IONM) has been used as an adjunct to the visual identification of the nerve. The aim of this clinical trial is to evaluate the effect of the identification time of RLN during thyroidectomy using IONM.

Serkan Sar?; Ye?im Erbil; Aziz Sümer; Orhan Agcaoglu; Adem Bayraktar; Halim Issever; Selcuk Ozarmagan

2010-01-01

385

Use new PLGL-RGD-NGF nerve conduits for promoting peripheral nerve regeneration  

PubMed Central

Background Nerve conduits provide a promising strategy for peripheral nerve injury repair. However, the efficiency of nerve conduits to enhance nerve regeneration and functional recovery is often inferior to that of autografts. Nerve conduits require additional factors such as cell adhesion molecules and neurotrophic factors to provide a more conducive microenvironment for nerve regeneration. Methods In the present study, poly{(lactic acid)-co-[(glycolic acid)-alt-(L-lysine)]} (PLGL) was modified by grafting Gly-Arg-Gly-Asp-Gly (RGD peptide) and nerve growth factor (NGF) for fabricating new PLGL-RGD-NGF nerve conduits to promote nerve regeneration and functional recovery. PLGL-RGD-NGF nerve conduits were tested in the rat sciatic nerve transection model. Rat sciatic nerves were cut off to form a 10 mm defect and repaired with the nerve conduits. All of the 32 Wistar rats were randomly divided into 4 groups: group PLGL-RGD-NGF, group PLGL-RGD, group PLGL and group autograft. At 3 months after surgery, the regenerated rat sciatic nerve was evaluated by footprint analysis, electrophysiology, and histologic assessment. Experimental data were processed using the statistical software SPSS 10.0. Results The sciatic function index value of groups PLGL-RGD-NGF and autograft was significantly higher than those of groups PLGL-RGD and PLGL. The nerve conduction velocities of groups PLGL-RGD-NGF and autograft were significantly faster than those of groups PLGL-RGD and PLGL. The regenerated nerves of groups PLGL-RGD-NGF and autograft were more mature than those of groups PLGL-RGD and PLGL. There was no significant difference between groups PLGL-RGD-NGF and autograft. Conclusions PLGL-RGD-NGF nerve conduits are more effective in regenerating nerves than both PLGL-RGD nerve conduits and PLGL nerve conduits. The effect is as good as that of an autograft. This work established the platform for further development of the use of PLGL-RGD-NGF nerve conduits for clinical nerve repair. PMID:22776032

2012-01-01

386

Enhancement of median nerve regeneration by mesenchymal stem cells engraftment in an absorbable conduit: improvement of peripheral nerve morphology with enlargement of somatosensory cortical representation  

PubMed Central

We studied the morphology and the cortical representation of the median nerve (MN), 10 weeks after a transection immediately followed by treatment with tubulization using a polycaprolactone (PCL) conduit with or without bone marrow-derived mesenchymal stem cell (MSC) transplant. In order to characterize the cutaneous representation of MN inputs in primary somatosensory cortex (S1), electrophysiological cortical mapping of the somatosensory representation of the forepaw and adjacent body parts was performed after acute lesion of all brachial plexus nerves, except for the MN. This was performed in ten adult male Wistar rats randomly assigned in three groups: MN Intact (n = 4), PCL-Only (n = 3), and PCL+MSC (n = 3). Ten weeks before mapping procedures in animals from PCL-Only and PCL+MSC groups, animal were subjected to MN transection with removal of a 4-mm-long segment, immediately followed by suturing a PCL conduit to the nerve stumps with (PCL+MSC group) or without (PCL-Only group) injection of MSC into the conduit. After mapping the representation of the MN in S1, animals had a segment of the regenerated nerve processed for light and transmission electron microscopy. For histomorphometric analysis of the nerve segment, sample size was increased to five animals per experimental group. The PCL+MSC group presented a higher number of myelinated fibers and a larger cortical representation of MN inputs in S1 (3,383 ± 390 fibers; 2.3 mm2, respectively) than the PCL-Only group (2,226 ± 575 fibers; 1.6 mm2). In conclusion, MSC-based therapy associated with PCL conduits can improve MN regeneration. This treatment seems to rescue the nerve representation in S1, thus minimizing the stabilization of new representations of adjacent body parts in regions previously responsive to the MN. PMID:25360086

Oliveira, Julia T.; Bittencourt-Navarrete, Ruben Ernesto; de Almeida, Fernanda M.; Tonda-Turo, Chiara; Martinez, Ana Maria B.; Franca, Joao G.

2014-01-01

387

Effect of pulsed infrared lasers on neural conduction and axoplasmic transport in sensory nerves  

NASA Astrophysics Data System (ADS)

Over the past ten years there has been an increasing interest in the use of lasers for neurosurgical and neurological procedures. Novel recent applications range from neurosurgical procedures such as dorsal root entry zone lesions made with argon and carbon dioxide microsurgical lasers to pain relief by low power laser irradiation of the appropriate painful nerve or affected region1 '2 However, despite the widespread clinical applications of laser light, very little is known about the photobiological interactions between laser light and nervous tissue. The present studies were designed to evaluate the effects of pulsed Nd:YAG laser light on neural impulse conduction and axoplasmic transport in sensory nerves in rats and cats. Our data indicate that Q-switched Nd:YAG laser irradiation can induce a preferential impairment of (1) the synaptic effects of small afferent fibers on dorsal horn cells in the spinal cord and of (2) small slow conducting sensory nerve fibers in dorsal roots and peripheral nerves. These results imply that laser light might have selective effects on impulse conduction in slow conducting sensory nerve fibers. In agreement with our elecirophysiological observations recent histological data from our laboratory show, that axonal transport of the enzyme horseradish peroxidase is selectively impaired in small sensory nerve fibers. In summary these data indicate, that Q-switched Nd:YAG laser irradiation can selectively impair neural conduction and axoplasmic transport in small sensory nerve fibers as compared to fast conducting fibers. A selective influence of laser irradiation on slow conducting fibers could have important clinical applications, especially for the treatment of chronic pain.

Wesselmann, Ursula; Rymer, William Z.; Lin, Shien-Fong

1990-06-01

388

Dural ectasia of the optic nerve sheath  

PubMed Central

Optic nerve dural ectasia is a rare cause of optic nerve sheath enlargement due to the accumulation of CSF around the optic nerve with no associated pathology. It diagnosed by MRI studies and can follow benign or sometimes an unfavorable course. We describe the case of a 24-day-old female referred for a visual blurring, which we diagnosed as a dural ectasia of the optic nerve sheath by MRI and confirmed in surgical intervention. We present this case report to illustrate the classic imaging features of the disease. PMID:25374645

Kacem, Hanane Hadj; Hammani, Lehcen; Ajana, Ali; Nassar, Itimad

2014-01-01

389

Raman microspectroscopy for visualization of peripheral nerves  

NASA Astrophysics Data System (ADS)

The peripheral nervous system plays an important role in motility, sensory, and autonomic functions of the human body. Preservation of peripheral nerves in surgery is essential for improving quality of life of patients. To preserve peripheral nerves, detection of ne peripheral nerves that cannot be identi ed by human eye or under white light imaging is necessary. In this study, we sought to provide a proof-of-principle demonstration of a label-free detection technique of peripheral nerve tissues against adjacent tissues that employs spontaneous Raman microspectroscopy. A line-illumination confocal Raman microscope was used for the experiment. A laser operating at the wavelength of 532 nm was used as an excitation laser light. We obtained Raman spectra of peripheral nerve, brous connective tissue, skeletal muscle, blood vessel, and adipose tissue of Wistar rats, and extracted speci c spectral features of peripheral nerves and adjacent tissues. By applying multivariate image analysis, peripheral nerves were clearly detected against adjacent tissues without any preprocessing neither xation nor staining. These results suggest the potential of the Raman spectroscopic observation for noninvasive and label-free nerve detection, and we expect this method could be a key technique for nerve-sparing surgery.

Minamikawa, Takeo; Harada, Yoshinori; Koizumi, Noriaki; Takamatsu, Tetsuro

2013-02-01

390

Study on Variant Anatomy of Sciatic Nerve  

PubMed Central

Introduction: Sciatic Nerve (SN) is the nerve of the posterior compartment of thigh formed in the pelvis from the ventral rami of the L4 to S3 spinal nerves. It leaves the pelvis via the greater sciatic foramen below piriformis and divides into Common Peroneal Nerve (CPN) and Tibial Nerve (TN) at the level of the upper angle of the popliteal fossa. Higher division of the sciatic nerve is the most common variation where the TN and CPN may leave the pelvis through different routes. Such variation may lead to compression of the nerve and lead to Non-discogenic sciatica. Materials and Methods: Fifty lower limbs were used for the study from Department of Anatomy, J.J.M.M.C Davangere, Karnataka, India. Observation and Results: In our study on 25 cadavers (50 lower limbs), we have observed 4 (8 %) lower limbs high division of sciatic nerve was noted. High division of sciatic nerve in the back of thigh was noted in one specimen (2%), while high division within the pelvis was noted in 3 specimens (6%), while in 46 (92%) it occurred outside the pelvis. Conclusion: Knowledge regarding such variation and differences in the course of SN is important for the surgeons to plan for various surgical interventions pertaining to the gluteal region. The variant anatomy of SN may cause piriformis syndrome and failure of SN block. Hence present study is undertaken to know the level of division, exit, course, relationship to piriformis and variations in the branching pattern of SN.

V, Sangeetha

2014-01-01

391

Tissue engineered constructs for peripheral nerve surgery  

PubMed Central

Summary Background Tissue engineering has been defined as “an interdisciplinary field that applies the principles of engineering and life sciences toward the development of biological substitutes that restore, maintain, or improve tissue function or a whole organ”. Traumatic peripheral nerve injury resulting in significant tissue loss at the zone of injury necessitates the need for a bridge or scaffold for regenerating axons from the proximal stump to reach the distal stump. Methods A review of the literature was used to provide information on the components necessary for the development of a tissue engineered peripheral nerve substitute. Then, a comprehensive review of the literature is presented composed of the studies devoted to this goal. Results Extensive research has been directed toward the development of a tissue engineered peripheral nerve substitute to act as a bridge for regenerating axons from the proximal nerve stump seeking the distal nerve. Ideally this nerve substitute would consist of a scaffold component that mimics the extracellular matrix of the peripheral nerve and a cellular component that serves to stimulate and support regenerating peripheral nerve axons. Conclusions The field of tissue engineering should consider its challenge to not only meet the autograft “gold standard” but also to understand what drives and inhibits nerve regeneration in order to surpass the results of an autograft. PMID:24385980

Johnson, P. J.; Wood, M. D.; Moore, A. M.; Mackinnon, S. E.

2013-01-01

392

Heparin-Binding-Affinity-Based Delivery Systems Releasing Nerve Growth Factor Enhance Sciatic Nerve Regeneration  

Microsoft Academic Search

The controlled delivery of nerve growth factor (NGF) to the peripheral nervous system has been shown to enhance nerve regeneration following injury, although the effect of release rate has not been previously studied with an affinity-based delivery system (DS). The goal of this research was to determine if the binding site affinity of the DS affected nerve regeneration in vivo

Matthew D. Wood; Daniel Hunter; Susan E. Mackinnon; Shelly E. Sakiyama-Elbert

2010-01-01

393

[Serious jaw osteolytic lesions].  

PubMed

Among oral and maxillofacial diseases, the maxillary osteolytic lesions constitute a rich and investigated field to define the more appropriate diagnosis and treatment. In the maxillary region, the same tumors of the other bones (osteogenic sarcoma, chondroma, etc.) cause found together with tumors and dysembryoplasias connected with the teeth development (ameloblastoma, odontoma, odontogenic myxoma, etc.). Moreover in the medullary spaces of the bones, there are reticular and hematopoietic cells that are connected with different diseases (leucemia, myeloma, lymphoma, etc.). What's more, due to the possible presence of pseudotumors (fibrous dysplasia, giant cell tumor, etc.) and metastases of tumors of other regions (breast, lung, prostate gland, etc.), the diagnosis of this disease could be difficult. In this paper the more important pictures of this disease, that due to its recurrence or malignity needs an accurate diagnosis by imaging like CT, CT-3D, MR, etc, are analyzed. The more suitable surgical approach is presented, according to the forms of the disease. PMID:12686916

Junquera, L; Corbacelli, A; Ascani, G; Iacomino, E

2003-01-01

394

Neuropathology and craniofacial lesions of osteopetrotic Red Angus calves.  

PubMed

Inherited osteopetrosis was identified in cattle herds in Wyoming, Nebraska, and Missouri in 2008 to 2010. Ten affected Red Angus calves were examined to characterize lesions in brain, teeth, and skull. Six affected aborted or stillborn calves were homozygous for the recently characterized deletion mutation in SLC4A2. Four affected calves were heterozygous for the SLC4A2 mutation and survived 1 to 7 days after birth. Gross lesions were similar in all 10 calves. Brains were rectangular and dorsoventrally compressed, with concave depressions in the parietal cortex owing to thickened parietal bone. Cerebellar hemispheres were compressed with herniation of the cerebellar vermis into the foramen magnum. Moderate bilateral chromatolysis affected multiple cranial nerve nuclei and, in some calves, the red nucleus. There was loss of retinal ganglion cells with severe atrophy of optic nerves. Periventricular corpora amylacea were in the thalamus, caudate nucleus, and midbrain. Vessels and neuropil in the dorsomedial aspect of the thalamus were mineralized. Dysplastic change in premolar and molar teeth comprised intra-alveolar intermingling of dentin, enamel, cementum, and bone, contributing to dental ankylosis. Changes in the heads of osteopetrotic calves are similar to those in children with malignant forms of homozygous recessive osteopetrosis. PMID:21768604

O'Toole, D; Swist, S; Steadman, L; Johnson, G C

2012-09-01

395

Brain involvement by leprosy presenting as a frontal cystic lesion.  

PubMed

Leprosy has a predilection for peripheral nerves and is not considered to involve the CNS. The idea that the CNS is exempt from Mycobacterium leprae bacilli has been suspected from a clinical perspective or CSF study in leprosy patients. However, there has been no direct evidence for CNS involvement by leprosy in a living patient. To the best of the authors' knowledge, the present case is the first report providing histopathological and molecular evidence for CNS involvement by leprosy in a living patient. Brain MRI revealed a 2-cm cystic lesion in the right frontal lobe of the patient. The medical history revealed that the patient had been receiving multidrug therapy for borderline lepromatous leprosy. Neuronavigation-guided craniotomy and lesion removal were performed due to a presumptive diagnosis of low-grade glioma. The brain specimen demonstrated variably thickened blood vessels and densely scattered foamy macrophages in the perivascular spaces and parenchymal stroma. Fite acid-fast stain displayed red granular inclusions that were suggestive for fragmented M. leprae. M. leprae-specific nested polymerase chain reaction amplification showed positive bands, and DNA sequencing also demonstrated homology with the M. leprae genome. This case supports the notion that M. leprae can involve the cerebral cortex regardless of cranial nerve engagement. PMID:24527821

Lee, Kyung-Hwa; Moon, Kyung-Sub; Yun, Sook Jung; Won, Young Ho; Lee, Jae-Hyuk; Lee, Min-Cheol; Jung, Shin

2014-07-01

396

Nerve fiber layer (NFL) degeneration associated with acute q-switched laser exposure in the nonhuman primate  

NASA Astrophysics Data System (ADS)

We have evaluated acute laser retinal exposure in non-human primates using a Rodenstock scanning laser ophthalmoscope (SLO) equipped with spectral imaging laser sources at 488, 514, 633, and 780 nm. Confocal spectral imaging at each laser wavelength allowed evaluation of the image plane from deep within the retinal vascular layer to the more superficial nerve fiber layer in the presence and absence of the short wavelength absorption of the macular pigment. SLO angiography included both fluorescein and indocyanine green procedures to assess the extent of damage to the sensory retina, the retinal pigment epithelium (RPE), and the choroidal vasculature. All laser exposures in this experiment were from a Q-switched Neodymium laser source at an exposure level sufficient to produce vitreous hemorrhage. Confocal imaging of the nerve fiber layer revealed discrete optic nerve sector defects between the lesion site and the macula (retrograde degeneration) as well as between the lesion site and the optic disk (Wallerian degeneration). In multiple hemorrhagic exposures, lesions placed progressively distant from the macula or overlapping the macula formed bridging scars visible at deep retinal levels. Angiography revealed blood flow disturbance at the retina as well as at the choroidal vascular level. These data suggest that acute parafoveal laser retinal injury can involve both direct full thickness damage to the sensory and non-sensory retina and remote nerve fiber degeneration. Such injury has serious functional implications for both central and peripheral visual function.

Zwick, Harry; Zuclich, Joseph A.; Stuck, Bruce E.; Gagliano, Donald A.; Lund, David J.; Glickman, Randolph D.

1995-01-01

397

Detergent-free Decellularized Nerve Grafts for Long-gap Peripheral Nerve Reconstruction  

PubMed Central

Background: Long-gap peripheral nerve defects arising from tumor, trauma, or birth-related injuries requiring nerve reconstruction are currently treated using nerve autografts and nerve allografts. Autografts are associated with limited supply and donor-site morbidity. Allografts require administration of transient immunosuppressants, which has substantial associated risks. To overcome these limitations, we investigated the use of detergent-free decellularized nerve grafts to reconstruct long-gap nerve defects in a rodent model and compared it with existing detergent processing techniques. Methods: Nerve grafts were harvested from the sciatic nerves of 9 donor rats. Twenty-four recipient rats were divided into 4 groups (6 animals per group): (1) nerve grafts (NG, positive control), (2) detergent-free decellularized (DFD) grafts, (3) detergent decellularized grafts, and (4) silicone tube conduits (negative control). Each recipient rat had a 3.5-cm graft or conduit sutured across a sciatic nerve transection injury. All animals were harvested at 12 weeks postimplantation for functional muscle analysis and nerve histomorphometry. Results: Histomorphometry results indicated maximum growth in NG when compared with other groups. DFD and detergent decellularized groups showed comparable regeneration at 12 weeks. Silicone tube group showed no regeneration as expected. Muscle force data indicated functional recovery in NG and DFD groups only. Conclusions: This study describes a detergent-free nerve decellularization technique for reconstruction of long-gap nerve injuries. We compared DFD grafts with an established detergent processing technique and found that DFD nerve grafts are successful in promoting regeneration across long-gap peripheral nerve defects as an alternative to existing strategies.

Vasudevan, Srikanth; Huang, Jiying; Botterman, Barry; Matloub, Hani S.; Keefer, Edward

2014-01-01

398

Palsies of Cranial Nerves That Control Eye Movement  

MedlinePLUS

... Disorders 4 Palsies of Cranial Nerves That Control Eye Movement These disorders involve paralysis of one of the cranial nerves that control eye movement (the 3rd, 4th, or 6th nerve), impairing the ...

399

Mechanical Loading for Peripheral Nerve Stabilization and Regeneration.  

National Technical Information Service (NTIS)

Peripheral nerve damage is one consequence of injury to the extremities of soldiers by improvised explosive devices (IEDs). The degree of functional recovery from peripheral nerve damage is often poor, particularly for severed nerves. The result can be im...

R. Wilson, S. B. Shah, T. Chuang

2013-01-01

400

Mechanical Loading for Peripheral Nerve Stabilization and Regeneration.  

National Technical Information Service (NTIS)

Peripheral nerve damage is one consequence of injury to the extremities of soldiers by improvised explosive devices (IEDs). The degree of functional recovery from peripheral nerve damage is often poor, particularly for severed nerves. The result can be im...

R. E. Wilson, S. B. Shah, T. Chuang

2012-01-01

401

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2013 CFR

...false Electrical peripheral nerve stimulator. 868.2775 ...2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator (neuromuscular...effect of anesthetic drugs and gases. (b)...

2013-04-01

402

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

...false Electrical peripheral nerve stimulator. 868.2775 ...2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator (neuromuscular...effect of anesthetic drugs and gases. (b)...

2014-04-01

403

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

...2014-04-01 false Nerve conduction velocity measurement device. 882.1550... § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is a...

2014-04-01

404

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Nerve conduction velocity measurement device. 882.1550... § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is a...

2011-04-01

405

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Nerve conduction velocity measurement device. 882.1550... § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is a...

2012-04-01

406

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Nerve conduction velocity measurement device. 882.1550... § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is a...

2010-04-01

407

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Nerve conduction velocity measurement device. 882.1550... § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is a...

2013-04-01

408

[Localization of peripheral nerves. Success and safety with electrical nerve stimulation].  

PubMed

Peripheral electrical nerve stimulation is one of the standard applications in peripheral regional anesthesia in addition to the ultrasound technique. Among other findings, the visualization of needle and nerve during ultrasound-guided blockade caused a change in clinical practice of peripheral nerve stimulation in the last decade. In the present article old and new aspects of principles and clinical practice of the nerve stimulation technique are presented and summarized in a total clinical concept in order to achieve safe and successful peripheral regional anesthesia using electrical peripheral nerve stimulation. PMID:24715260

Neuburger, M; Schwemmer, U; Volk, T; Gogarten, W; Kessler, P; Steinfeldt, T

2014-05-01

409

Cat diencephalic neurons with sympathetic nerve-related activity.  

PubMed

In a companion paper, we demonstrated that hypothalamic or medial thalamic lesions attenuate the reduction in inferior cardiac postganglionic sympathetic nerve discharge (SND) produced by decerebration in the anesthetized cat [Huang et al., Am. J. Physiol. 254 (Regulatory Integrative Comp. Physiol. 23): R249-R256, 1988]. This raised the possibility that these diencephalic regions contain the cell bodies of neurons that contribute to SND. The current study tested this possibility in cats anesthetized with alpha-chloralose. Spike-triggered averaging of inferior cardiac SND revealed the existence of two types of hypothalamic and medial thalamic neurons with sympathetic nerve-related activity. Recordings were made from the soma-dendritic region of these neurons, since an inflection often appeared on the rising phase of the unit action potential. The activity of type 1 neurons was synchronized to an aperiodic spikelike event in SND, whereas that of type 2 neurons was synchronized to a 2- to 6-Hz rhythmic component. Some of the type 2 neurons but none of the type 1 neurons had cardiac-related activity. Microstimulation at type 1 and type 2 unit recording sites increased SND. Our results are consistent with the possibility that hypothalamic and medial thalamic neurons contribute to the rhythmic and aperiodic components of SND in the anesthetized cat. PMID:3344836

Varner, K J; Barman, S M; Gebber, G L

1988-02-01

410

A Safe Lab on Nerve Gases.  

ERIC Educational Resources Information Center

Describes an experiment involving pineapples and gelatin that allows students to investigate the conditions that typically render an enzyme functionless, similar to the effect of nerve gasses. Discusses the materials, procedures, and results, drawing analogies to the effects of a nerve gas. (CW)

Tucker, David C.

1988-01-01

411

Flexible signal generator for facial nerve detection  

Microsoft Academic Search

During surgical intervention on patient face, the facial nerve must be protected. To avoid the risk of its damage, we propose an electronic device that could detect the presence of this nerve. Thanks to its excitability, it was possible therefore to record a noticeable muscular electric reaction on the face. An active stimulating electrode would be placed on the patient

Habib ELKHORCHANI; Hamadi GHARIANI; A. Benhamida; M. Ghorbel

2004-01-01

412

Compression neuropathies of the median nerve  

Microsoft Academic Search

Specific compression syndromes of the median nerve are known in the proximal forearm and at the wrist. Carpal tunnel syndrome is the best known and most common, but pronator teres syndrome and anterior interosseous nerve syndrome also are clinically significant. In this discussion, we review the history, relevant anatomy, diagnosis, and treatment modalities for these compression syndromes.

Jason T. Koo; Robert M. Szabo

2004-01-01

413

Ephaptic Coupling of Myelinated Nerve S. Binczaka  

E-print Network

of this paper, clarifying the nature of conduction on a real nerve and setting the stage for an exploration and discrete limits, clarifying the nature of the conduction process on an isolated nerve axon. Since) interactions between impulses on parallel fibers, which may play a functional role in neural pro- cessing. 1

Eilbeck, Chris

414

Heptadecapeptide Gastrin in the Vagal Nerve  

Microsoft Academic Search

Immunoreactive gastrin was present in vagal nerves from cats, dogs, and human beings. The abdominal portion of the vagus contained gastrin in amounts ranging from 16 to 273 pmol\\/g of nerve tissue (wet weight). The thoracic and cervical portion of the vagi contained only minute amounts of gastrin. Gel chromatography of extracts of human, canine, and feline abdominal vagi monitored

K. Uvnas-Wallensten; J. F. Rehfeld; L.-I. Larsson; B. Uvnas

1977-01-01

415

Nerve growth factor: from neurotrophin to neurokine  

Microsoft Academic Search

Nerve growth factor (NGF) is largely known as a target-derived factor responsible for the survival and maintenance of the phenotype of specific subsets of peripheral neurones and basal forebrain cholinergic nuclei during development and maturation. However, NGF also exerts a modulatory role on sensory, nociceptive nerve physiology during adulthood that appears to correlate with hyperalgesic phenomena occurring in tissue inflammation.

Rita Levi-Montalcini; Stephen D. Skaper; Roberto Dal Toso; Lucia Petrelli; Alberta Leon

1996-01-01

416

Biochemical engineering nerve conduits using peptide amphiphiles.  

PubMed

Peripheral nerve injury is a debilitating condition. The gold standard for treatment is surgery, requiring an autologous nerve graft. Grafts are harvested from another part of the body (a secondary site) to treat the affected primary area. However, autologous nerve graft harvesting is not without risks, with associated problems including injury to the secondary site. Research into biomaterials has engendered the use of bioartificial nerve conduits as an alternative to autologous nerve grafts. These include synthetic and artificial materials, which can be manufactured into nerve conduits using techniques inspired by nanotechnology. Recent evidence indicates that peptide amphiphiles (PAs) are promising candidates for use as materials for bioengineering nerve conduits. PAs are biocompatible and biodegradable protein-based nanomaterials, capable of self-assembly in aqueous solutions. Their self-assembly system, coupled with their intrinsic capacity for carrying bioactive epitopes for tissue regeneration, form particularly novel attributes for biochemically-engineered materials. Furthermore, PAs can function as biomimetic materials and advanced drug delivery platforms for sustained and controlled release of a plethora of therapeutic agents. Here we review the realm of nerve conduit tissue engineering and the potential for PAs as viable materials in this exciting and rapidly advancing field. PMID:22910143

Tan, Aaron; Rajadas, Jayakumar; Seifalian, Alexander M

2012-11-10

417

Malignant peripheral nerve sheath tumors in childhood  

Microsoft Academic Search

Malignant peripheral nerve sheath tumor (MPNST) is an uncommon sarcoma in the pediatric population; however, its presence should be considered in a child with an enlarging or painful soft-tissue mass. Diagnosis of this neoplasm depends on either the demonstration of its origin within a peripheral nerve or the association with a contiguous neurofibroma. We have identified 16 cases of MPNST

Barbara S Ducatman; Bernd W Scheithauer; David G Piepgras; Herbert M Reiman

1984-01-01

418

Contribution of the distal nerve sheath to nerve and muscle preservation following denervation and sensory protection.  

PubMed

The goal of this study was to determine the contribution of the distal nerve sheath to sensory protection. Following tibial nerve transection, rats were assigned to one of the following groups: (1) saphenous-to-tibial nerve neurorrhaphy; (2) saphenous-to-gastrocnemius neurotization; (3) unprotected controls (tibial nerve transection); or (4) immediate common peroneal-to-tibial nerve neurorrhaphy. After a 6-month denervation period and motor reinnervation, ultrastructural, histologic, and morphometric analyses were performed on the distal tibial nerve and gastrocnemius muscle cross-sections. Sensory axons neurotized to muscle maintain existing muscle integrity, as demonstrated by less fibrosis, collagenization, and fat deposition, more than unprotected muscle, and preserve the distribution pattern of fast twitch fibers. However, neurorrhaphy of the sensory nerve to the distal tibial nerve (involving the distal nerve sheath) improves existing endoneurial sheath structure, demonstrated by reduced collagen, and enhances regeneration, shown by improved axon-to-Schwann cell coupling and increased axon area. The authors conclude that sensory protection of muscle does not require the distal nerve sheath, but that preservation of the distal sheath may contribute to enhanced nerve regeneration. PMID:15672322

Veltri, Karen; Kwiecien, Jacek M; Minet, Wyatt; Fahnestock, Margaret; Bain, James R

2005-01-01

419

Sensory recovery following decellularized nerve allograft transplantation for digital nerve repair.  

PubMed

This study reported preliminary clinical experience of using decelluarised nerve allograft material for repair of digital nerve defect in five hand injury patients. From October 2009 to July 2010, five patients with traumatic nerve defect were treated with nerve repair using AxoGen® nerve allograft (AxoGen Inc, Alachua, FL) in California Hospital Medical Center. All patients were followed at least for 12 months, and sensory recovery and signs of infection or rejection were documented by a hand therapist. Average two-point discrimination was 6 mm, and average Semmes-Weinstein Monofilaments test was 4.31. No wound infections or signs of rejections were observed at wound site. All patients reported sensory improvement during the follow-up period after operation. It is believed that decellularised nerve allografts may provide a readily available option for repair of segmental nerve defect. PMID:23848418

Guo, Yang; Chen, Gary; Tian, Guanglei; Tapia, Carla

2013-12-01

420

Exposure of the sciatic nerve in the gluteal region without sectioning the gluteus maximus: Analysis of a series of 18 cases  

PubMed Central

Background: Dissecting through the gluteus maximus muscle by splitting its fibers, instead of complete sectioning of the muscle, is faster, involves less damage to tissues, and diminishes recovery time. The objective of the current paper is to present a clinical series of sciatic nerve lesions where the nerve was sufficiently exposed via the transgluteal approach. Methods: We retrospectively selected 18 traumatic sciatic nerve lesions within the buttock, operated upon from January 2005 to December 2009, with a minimum follow-up of 2 years. In all patients, a transgluteal approach was employed to explore and reconstruct the nerve. Results: Ten males and eight females, with a mean age of 39.7 years, were studied. The etiology of the nerve lesion was previous hip surgery (n = 7), stab wound (n = 4), gunshot wound (n = 3), injection (n = 3), and hip dislocation (n = 1). In 15 (83.3%) cases, a motor deficit was present; in 12 (66.6%) cases neuropathic pain and in 12 (66.6%) cases sensory alterations were present. In all cases, the transgluteal approach was adequate to expose the injury and treat it by neurolysis alone (10 cases), neurolysis and neurorrhaphy (4 cases), and reconstruction with grafts (4 cases; three of these paired with neurolysis). The mean pre- and postoperative grades for the tibial nerve (LSUHSC scale) were 1.6 and 3.6, respectively; meanwhile, for the peroneal division, preoperative grade was 1.2 and postoperative grade was 2.4. Conclusions: The transgluteal approach adequately exposes sciatic nerve injuries of traumatic origin in the buttock and allows for adequate nerve reconstruction without sectioning the gluteus maximus muscle. PMID:22439106

Socolovsky, Mariano; Masi, Gilda Di

2012-01-01

421

[Clinicopathological study of acute esophageal mucosal lesion].  

PubMed

Acute esophageal mucosal lesion (AEML) is a comprehensive disease that includes necrotizing esophagitis and acute erosive esophagitis, which result in upper gastrointestinal bleeding. However, little is known about AEML. We examined the clinicopathological features of 57 AEML cases. AEML presented as acute diffuse esophagitis showing an endoscopically erosive mucosa. The disease did not include corrosive injury, radiation-induced damage, infectious esophagitis, or acute exacerbation of chronic gastroesophageal reflux disease. AEML predominantly affected elderly men, and upper gastrointestinal bleeding was the frequent presenting symptom. Severe underlying diseases such as cranial nerve disease or pneumonia were observed in 98% of the patients. Esophageal sliding hernia and gastroduodenal ulcers were endoscopically observed in 67% and 63% of the patients, respectively. Deaths due to exacerbation of the underlying diseases accounted for 16%. Most cases rapidly improved with conservative management using a proton pump inhibitor or an H2 blocker. Therefore, AEML should be considered a disease having characteristics different from those of common gastroesophageal reflux disease. PMID:23831655

Kawauchi, Hirohito; Ohta, Tomoyuki; Matsubara, Yu; Yoshizaki, Koji; Sakamoto, Jun; Amitsuka, Hisato; Kimura, Keisuke; Maemoto, Atsuo; Orii, Fumika; Ashida, Toshifumi

2013-07-01

422

Peripheral Nerve Damage Facilitates Functional Innervation of Brain Grafts in Adult Sensory Cortex  

NASA Astrophysics Data System (ADS)

The neuralb pathways that relay information from cutaneous receptors to the cortex provide the somatic sensory information needed for cortical function. The last sensory relay neurons in this pathway have cell bodies in the thalamus and axons that synapse on neurons in the somatosensory cortex. After cortical lesions that damage mature thalamocortical fibers in the somatosensory cortex, we have attempted to reestablish somatosensory cortical function by grafting embryonic neocortical cells into the lesioned area. Such grafts survive in adult host animals but are not innervated by thalamic neurons, and consequently the grafted neurons show little if any spontaneous activity and no responses to cutaneous stimuli. We have reported that transection of peripheral sensory nerves prior to grafting ``conditions'' or ``primes'' the thalamic neurons in the ventrobasal complex so that they extend axons into grafts subsequently placed in the cortical domain of the cut nerve. In this report we present evidence that the ingrowth of ventrobasal fibers leads to graft neurons that become functionally integrated into the sensory circuitry of the host brain. Specifically, the conditioning lesions made prior to grafting produce graft neurons that are spontaneously active and can be driven by natural activation of cutaneous receptors or electrical stimulation of the transected nerve after it regenerates. Furthermore, oxidative metabolism in these grafts reaches levels that are comparable to normal cortex, whereas without prior nerve cut, oxidative metabolism is abnormally low in neocortical grafts. We conclude that damage to the sensory periphery transsynaptically stimulates reorganization of sensory pathways through mechanisms that include axonal elongation and functional synaptogenesis.

Ebner, Ford F.; Erzurumlu, Reha S.; Lee, Stefan M.

1989-01-01

423

Histological assessment in peripheral nerve tissue engineering  

PubMed Central

The histological analysis of peripheral nerve regeneration is one of the most used methods to demonstrate the success of the regeneration through nerve conduits. Nowadays, it is possible to evaluate different parameters of nerve regeneration by using histological, histochemical, immunohistochemical and ultrastructural techniques. The histochemical methods are very sensible and are useful tools to evaluate the extracellular matrix remodeling and the myelin sheath, but they are poorly specific. In contrast, the immunohistochemical methods are highly specific and are frequently used for the identification of the regenerated axons, Schwann cells and proteins associated to nerve regeneration or neural linage. The ultrastructural techniques offer the possibility to perform a high resolution morphological and quantitative analysis of the nerve regeneration. However, the use of a single histological method may not be enough to assess the degree of regeneration, and the combination of different histological techniques could be necessary. PMID:25374585

Carriel, Víctor; Garzón, Ingrid; Alaminos, Miguel; Cornelissen, Maria

2014-01-01

424

Update on nerve repair by biological tubulization  

PubMed Central

Many surgical techniques are available for bridging peripheral nerve defects. Autologous nerve grafts are the current gold standard for most clinical conditions. In selected cases, alternative types of conduits can be used. Although most efforts are today directed towards the development of artificial synthetic nerve guides, the use of non-nervous autologous tissue-based conduits (biological tubulization) can still be considered a valuable alternative to nerve autografts. In this paper we will overview the advancements in biological tubulization of nerve defects, with either mono-component or multiple-component autotransplants, with a special focus on the use of a vein segment filled with skeletal muscle fibers, a technique that has been widely investigated in our laboratory and that has already been successfully introduced in the clinical practice. PMID:24606921

2014-01-01

425

Facial nerve outcome after acoustic neuroma surgery: a study from the era of cranial nerve monitoring.  

PubMed

The introduction of intraoperative cranial nerve monitoring in posterior fossa surgery has greatly aided the surgeon in identification and anatomic preservation of cranial nerves. As a result, the long-term function of the facial nerve continues to improve after removal of acoustic neuroma. Herein, we report our long-term (1 year or greater) facial nerve outcome in 129 patients who underwent surgical removal of their acoustic neuromas with the aid of intraoperative neurophysiologic monitoring between 1986 and 1990. The facial nerve was anatomically preserved in 99.2% of the patients, and 90% of all the patients had grade 1 or 2 facial nerve function 1 year after surgery. Long-term facial function was inversely correlated with the size of tumor (chi-squared, p < 0.02) and was not related to the side of tumor, the age and sex of the patient, or the surgical approach. In a comparison among tumor groups matched for size, no statistically significant difference in facial nerve outcome between the translabyrinthine and retrosigmoid approaches was detected. The proximal facial nerve stimulation threshold at the end of surgical removal was predictive of long-term facial nerve function (analysis of variance, p < 0.02). At 1 year, 98% (87 of 89) of the patients with electrical thresholds of 0.2 V or less had grade 1 or 2 facial nerve function compared with only 50% (8 of 16) of those with thresholds between 0.21 and 0.6 V. In the era of cranial nerve monitoring, patients can be better advised about long-term facial nerve outcome after surgical intervention. Preoperatively, the size of the tumor is the most critical factor in predicting long-term facial function. Postoperatively, the proximal seventh nerve stimulation threshold at the end of the surgical procedure can be used as one prognostic measure of long-term facial nerve function. PMID:7970793

Lalwani, A K; Butt, F Y; Jackler, R K; Pitts, L H; Yingling, C D

1994-11-01

426

Multifunctional Silk Nerve Guides for Axon Outgrowth  

NASA Astrophysics Data System (ADS)

Peripheral nerve regeneration is a critical issue as 2.8% of trauma patients present with this type of injury, estimating a total of 200,000 nerve repair procedures yearly in the United States. While the peripheral nervous system exhibits slow regeneration, at a rate of 0.5 mm -- 9 mm/day following trauma, this regenerative ability is only possible under certain conditions. Clinical repairs have changed slightly in the last 30 years and standard methods of treatment include suturing damaged nerve ends, allografting, and autografting, with the autograft the gold standard of these approaches. Unfortunately, the use of autografts requires a second surgery and there is a shortage of nerves available for grafting. Allografts are a second option however allografts have lower success rates and are accompanied by the need of immunosuppressant drugs. Recently there has been a focus on developing nerve guides as an "off the shelf" approach. Although some natural and synthetic guidance channels have been approved by the FDA, these nerve guides are unfunctionalized and repair only short gaps, less than 3 cm in length. The goal of this project was to identify strategies for functionalizing peripheral nerve conduits for the outgrowth of neuron axons in vitro . To accomplish this, two strategies (bioelectrical and biophysical) were indentified for increasing axon outgrowth and promoting axon guidance. Bioelectrical strategies exploited electrical stimulation for increasing neurite outgrowth. Biophysical strategies tested a range of surface topographies for axon guidance. Novel methods were developed for integrating electrical and biophysical strategies into silk films in 2D. Finally, a functionalized nerve conduit system was developed that integrated all strategies for the purpose of attaching, elongating, and guiding nervous tissue in vitro. Future directions of this work include silk conduit translation into a rat sciatic nerve model in vivo for the purpose of repairing long (> 3 cm) peripheral nerve gaps.

Tupaj, Marie C.

427

Endoneurial pathology of the needlestick-nerve-injury model of Complex Regional Pain Syndrome, including rats with and without pain behaviors  

PubMed Central

Current rodent models of neuropathic pain produce pain hypersensitivity in almost all lesioned animals and not all identified experimental effects are pain specific. 18G needlestick-nerve-injury (NNI) to one tibial nerve of outbred Sprague-Dawley rats models the phenotype of Complex Regional Pain Syndrome (CRPS), a post-traumatic neuropathic pain syndrome, leaving roughly half of NNI rats with hyperalgesia. We compared endoneurial data from these divergent endophenotypes searching for pathological changes specifically associated with pain-behaviors. Tibial, sural, and common sciatic nerves from 12 NNI rats plus 10 nerves from sham-operated controls were removed 14 days post-surgery for morphometric analysis. PGP9.5+ unmyelinated-fibers were quantitated in plantar hindpaw skin. Distal tibial nerves of NNI rats had endoneurial edema, 30% fewer axons, twice as many mast cells, and thicker blood-vessel walls than uninjured tibial nerves. However the only significant difference between nerves from hyperalgesic versus non-hyperalgesic NNI rats was greater endoneurial edema in hyperalgesic rats (p < 0.01). We also discovered significant axonal losses in uninjured ipsilateral sural nerves of NNI rats, demonstrating spread of neuropathy to nearby nerves formerly thought spared. Tibial and sural nerves contralateral to NNI had significant changes in endoneurial bloodvessels. Similar pathological changes have been identified in CRPS-I patients. The current findings suggest that severity of endoneurial vasculopathy and inflammation may correlate better with neuropathic pain behaviors than degree of axonal loss. Spread of pathological changes to nearby ipsilateral and contralesional nerves might potentially contribute to extraterritorial pain in CRPS. PMID:21676634

Klein, Max M.; Lee, Jeung Woon; Siegel, Sandra M.; Downs, Heather M.; Oaklander, Anne Louise

2011-01-01

428

[A case report. Moisture lesions].  

PubMed

Differentiating between pressure ulcers and moisture related lesions is of clinical importance since prevention and treatment strategies differ greatly and the consequences of the outcome for the patient are important. In this article, we describe a case involving a 65 years old woman who had moisture lesions. Wound related characteristics (location, causes, shape, edges, depth, colour and necrosis), along with patient related characteristics, are helpful to differentiate between a pressure ulcer and a moisture lesion. Clinically, separate identification of moisture lesions makes sense, because they do not follow the same pattern as pressure ulcers. For example, these lesions are not found over a bony prominence (occurring in areas of low pressure), with blanchable erythema, and there is no necrosis. For these reasons we believe that these wounds are more likely to be moisture lesions. A nursing care plan was then developed, which includes objectives and nursing intervention implementation. The effects of moisture on the skin should be taken into consideration as these can lead in a higher risk of lesions. Therefore, it is vital that healthcare professionals have an up to date knowledge of both moisture lesions and pressure ulcers, and are able to use the appropriate assessment tools and skin care regimes in order to prevent a bad situation from becoming worse. PMID:19616986

Zapata Sampedro, Marco Antonio; Castro Varela, Laura

2009-01-01

429

Differences in peripheral nerve degeneration/regeneration between wild-type and neuronal nitric oxide synthase knockout mice.  

PubMed

Nitric oxide (NO), a unique biological messenger molecule, is synthesized by three isoforms of the enzyme NO synthase (NOS) and diffuses from the site of production across cellular membranes. A postulated role for NO in degeneration and regeneration of peripheral nerves has been explored in a sciatic nerve model comparing wild-type mice and mice lacking neuronal NOS after transection and microsurgical repair. In NOS knockout mice, regenerative delay was observed, preceded by a decelerated Wallerian degeneration (WD). In the regenerated nerve, pruning of uncontrolled sprouts was disturbed, leading to an enhanced number of axons, whereas remyelination seemed to be less affected. Delayed regeneration was associated with a delayed recovery of sensor and motor function. In such a context, possible NO targets are neurofilaments and myelin sheaths of the interrupted axon, filopodia of the growth cone, newly formed neuromuscular endplates, and Schwann cells in the distal nerve stump. The results presented suggest that 1) local release of NO following peripheral nerve injury is a crucial factor in degeneration/regeneration, 2) success of fiber regeneration in the peripheral nervous system depends on a regular WD, and 3) manipulation of NO supply may offer interesting therapeutic options for treatment of peripheral nerve lesions. PMID:11992469

Keilhoff, Gerburg; Fansa, Hisham; Wolf, Gerald

2002-05-15

430

Three-dimensional interactive atlas of cranial nerve-related disorders.  

PubMed

Anatomical knowledge of the cranial nerves (CN) is fundamental in education, research and clinical practice. Moreover, understanding CN-related pathology with underlying neuroanatomy and the resulting neurological deficits is of vital importance. To facilitate CN knowledge anatomy and pathology understanding, we created an atlas of CN-related disorders, which is a three-dimensional (3D) interactive tool correlating CN pathology with the underlying surface and sectional neuroanatomy as well as the resulting neurological deficits. A computer platform was developed with: 1) anatomy browser along with the normal brain atlas (built earlier); 2) simulator of CN lesions; 3) tools to label CN-related pathology; and 4) CN pathology database with lesions and disorders, and the resulting signs, symptoms and/or syndromes. The normal neuroanatomy comprises about 2,300 3D components subdivided into modules. Cranial nerves contain more than 600 components: all 12 pairs of cranial nerves (CN I - CN XII) and the brainstem CN nuclei. The CN pathology database was populated with 36 lesions compiled from clinical textbooks. The initial view of each disorder was preset in terms of lesion location and size, surrounding surface and sectional neuroanatomy, and disorder and neuroanatomy labeling. Moreover, path selection from a CN nucleus to a targeted organ further enhances pathology-anatomy relationships. This atlas of CN-related disorders is potentially useful to a wide variety of users ranging from medical students and residents to general practitioners, neuroradiologists and neurologists, as it contains both normal brain anatomy and CN-related pathology correlated with neurological disorders presented in a visual and interactive way. PMID:23859281

Nowinski, W L; Chua, B C

2013-06-01