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1

Does an ulnar nerve lesion influence the motion of the index finger?  

PubMed

Clawing of the ring and little fingers and "rolling" during prehension grip are well-known clinical phenomena of ulnar nerve lesions. In contrast to this the index and middle fingers seem to move normally. We compared the movement of right index fingers in healthy people with the right index fingers of people with an ulnar nerve lesion. The movement was measured using a three-dimensional real time motion analysis system based on ultrasound. The angles of the joints were plotted in a rectangular coordinate system. Statistical analysis of the numerical data showed no difference between the two groups. We trained a neural-network (Learning Vector Quantization) with the data of both groups. The network was able to distinguish between people with and without lesions of the ulnar nerve. We conclude that prehension grip of the index finger is also influenced by paralysis of the ulnar nerve. PMID:8732411

Hahn, P; Heindl, E

1996-04-01

2

Ulnar Nerve Compression at Guyon's Canal by an Arteriovenous Malformation  

PubMed Central

Guyon's canal at the wrist is not the common site of ulnar nerve compression. Ganglion, lipoma, anomalous tendon and muscles, trauma related to an occupation, arthritis, and carpal bone fracture can cause ulnar nerve compression at the wrist. However, ulnar nerve compression at Guyon's canal by vascular lesion is rare. Ulnar artery aneurysm, tortous ulnar artery, hemangioma, and thrombosis have been reported in the literature as vascular lesions. The authors experienced a case of ulnar nerve compression at Guyon's canal by an arteriovenous malformation (AVM) and the patient's symptom was improved after surgical resection. We can not easily predict vascular lesion as a cause of ulnar nerve compression at Guyon's canal. However, if there is not obvious etiology, we should consider vascular lesion as another possible etiology. PMID:19242575

Kim, Sung Soo; Kang, Hee In; Lee, Seung Jin

2009-01-01

3

Ossifying fibrolipomatous hamartoma of the ulnar nerve.  

PubMed

An ossified fibrolipomatous epineural hamartoma limited to the right ulnar nerve and some of its branches and extending from the elbow distally is described in a 5-year-old boy who complained of pain in the right hand. Such extensive involvement of the ulnar nerve is unusual; moreover, metaplastic bone is rarely present in the more common fibrolipomatous hamartoma of the median nerve. Increased awareness of this entity is necessary to avoid sacrifice of large nerves that may be included in the lesion. PMID:3137556

Drut, R

1988-01-01

4

Endoscopic ulnar nerve release and transposition.  

PubMed

The most common site of ulnar nerve compression is within the cubital tunnel. Surgery has historically involved an open cubital tunnel release with or without transposition of the nerve. A comparative study has demonstrated that endoscopic decompression is as effective as open decompression and has the advantages of being less invasive, utilizing a smaller incision, producing less local symptoms, causing less vascular insult to the nerve, and resulting in faster recovery for the patient. Ulnar nerve transposition is indicated with symptomatic ulnar nerve instability or if the ulnar nerve is located in a "hostile bed" (eg, osteophytes, scarring, ganglions, etc.). Transposition has previously been performed as an open procedure. The authors describe a technique of endoscopic ulnar nerve release and transposition. Extra portals are used to allow retractors to be inserted, the medial intermuscular septum to be excised, cautery to be used, and a tape to control the position of the nerve. In our experience this minimally invasive technique provides good early outcomes. This report details the indications, contraindications, surgical technique, and rehabilitation of the endoscopic ulnar nerve release and transposition. PMID:24296546

Morse, Levi P; McGuire, Duncan T; Bain, Gregory I

2014-03-01

5

Ulnar nerve injury and perioperative arm positioning.  

PubMed

Primum non nocere. Hippocrates included this admonition in Epidemics, Book I, Second Constitution, to do good or "to do no harm." However, even the most conscientious health care provider will encounter unexpected and serious adverse medical events. This discussion focuses on one relatively common, often perplexing, and usually unexplained perioperative complication: ulnar neuropathy. Perioperative ulnar neuropathy has received increased scientific attention because it accounts for one third of all nerve injury claims in the American Society of Anesthesiologists (ASA) Closed Claims Study database. In addition, these injuries may result in chronic pain or paresthesia, employment disability, catastrophic economic damages, and malpractice litigation. We will explore the current understanding of perioperative ulnar nerve dysfunction by summarizing the relevant scientific literature and information within the ASA closed-claims database, describing the epidemiologic features of perioperative nerve injuries, discussing relevant clinical investigations and recommendations for safe arm positioning during anesthesia, and reviewing the medico-legal issues inevitably intertwined with this topic, particularly the doctrine of res ipsa loquitur. PMID:12298308

Prielipp, Richard C; Morell, Robert C; Butterworth, John

2002-09-01

6

Isolated ulnar dorsal cutaneous nerve herpes zoster reactivation.  

PubMed

Herpes zoster is a viral disease presenting with vesicular eruptions that are usually preceded by pain and erythema. Herpes zoster can be seen in any dermatome of the body but most commonly appears in the thoracic region. Herpes zoster virus is typically transmitted from person to person through direct contact. The virus remains dormant in the dorsal ganglion of the affected individual throughout his or her lifetime. Herpes zoster reactivation commonly occurs in elderly people due to normal age-related decline in cell-mediated immunity. Postherpetic neuralgia is the most common complication and is defined as persistent pain or dysesthesia 1 month after resolution of the herpetic rash. This article describes a healthy 51-year-old woman who experienced a burning sensation and shooting pain along the ulnar dorsal cutaneous nerve. Ten days after the onset of pain, she developed cutaneous vesicular eruption and decreased light-touch sensation. Wrist and fourth and fifth finger range of motion were painful and slightly limited. Muscle strength was normal. Nerve conduction studies indicated an ulnar dorsal cutaneous nerve lesion. She was treated with anti-inflammatory and antibiotic drugs and the use of a short-arm resting splint. At 5-month follow-up, she reported no residual pain, numbness, or weakness. Herpes zoster in the upper extremity may be mistaken for entrapment neuropathies and diseases characterized by skin eruptions; ulnar nerve zoster reactivation is rarely seen. The authors report an uncommon ulnar dorsal cutaneous nerve herpes zoster reactivation. Clinicians should be aware of this virus during patients' initial evaluation. PMID:24025017

Kayipmaz, Murat; Basaran, Serdar Hakan; Ercin, Ersin; Kural, Cemal

2013-09-01

7

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 ...

8

Therapeutic Management of Hypothenar Hammer Syndrome Causing Ulnar Nerve Entrapment  

PubMed Central

Introduction. The hypothenar hammer syndrome is a rare traumatic vascular disease of the hand. Method and Materials. We report the case of a 43-years-old man with a painful tumefaction of the left hypothenar region. The ulnar artery appeared thrombosed clinically and radiologically. The patient underwent surgery to resolve the ulnar nerve compression and revascularise the artery. Results. The symptoms disappeared immediately after surgery. The arterial flow was reestablished. Postoperatively on day 20, a new thrombosis of the ulnar artery occurred. Conclusion. Hypothenar hammer syndrome is caused by repetitive trauma to the heel of the hand. The alterations of the vessel due to its chronic inflammation caused an acute compression of the ulnar nerve at the Guyon's canal and, in our case, do not allow a permanent revascularisation of the ulnar artery. PMID:22567229

Cigna, Emanuele; Spagnoli, Anna Maria; Tarallo, Mauro; De Santo, Liliana; Monacelli, Giampaolo; Scuderi, Nicolò

2010-01-01

9

Ulnar nerve palsy following rotational osteotomy of congenital radioulnar synostosis.  

PubMed

Two successive cases of ulnar nerve palsy following rotational osteotomy through a congenital radioulnar synostosis are described. Entrapment of the ulnar nerve by the fascia connecting the two heads of the flexor carpi ulnaris was documented in one patient. Recommendations to avoid this complication include shortening of the forearm at the osteotomy site and the release of unyielding soft tissue restraints. Rotational osteotomy at the distal radial metaphysis may provide a safe, alternative approach in the surgical management of this difficult problem. PMID:3793902

Hankin, F M; Smith, P A; Kling, T F; Louis, D S

1987-01-01

10

Ulnar nerve palsy-like motor and sensory loss caused by a small cortical infarct.  

PubMed

A 56-year-old man with a small infarct in the left precentral knob area induced both motor and sensory impairments that were similar to right ulnar nerve palsy. The only difference from ulnar nerve palsy was that the patient showed sensory disturbance not only on the ulnar side but also on the radial side of the right ring finger. PMID:21440458

Ueno, Tatsuya; Tomiyama, Masahiko; Haga, Rie; Nishijima, Haruo; Kon, Tomoya; Funamizu, Yukihisa; Miki, Yasuo; Arai, Akira; Suzuki, Chieko; Baba, Masayuki

2012-11-01

11

A cadaveric study comparing the three approaches for ulnar nerve block at wrist  

PubMed Central

Background: Ulnar nerve blockade as a component of wrist block is a promising technique for adequate anesthesia and analgesia for different surgeries of the hand. Due to anatomical variations in the location of ulnar nerve under the flexor carpi ulnaris (FCU) a technique with good results and minimal complications are required. Aim: The aim of the following study is to compare the three techniques (volar, transtendinous volar [TTV] and ulnar) for ulnar nerve block at the wrist in human cadaveric wrists. Materials and Methods: Our study was conducted using 40 cadaver wrists. After inserting standard hypodermic needles by three techniques for ulnar nerve blockade at the wrist, a detailed dissection of FCU was done. The mean distance from the tip of the needle to ulnar artery/nerve and number of instances in which the ulnar artery/nerve pierced were observed. Results: Inter-group statistical significance was observed in measurement of the mean distance (mm) from the tip of the needle to the ulnar artery (volar [0.92 ± 0.11], TTV [3.96 ± 0.14] and ulnar [7.14 ± 0.08] approaches) and ulnar nerve (volar/TTV/ulnar approaches were 0.71 ± 0.12/3.61 ± 0.10/6.31 ± 0.49, respectively) (P = 0.001). Inadvertent intra-arterial/intraneural injections was seen with volar approach in 14 (35%) and 16 (40%) of the cadaveric wrists respectively, statistically significant with transtendinous and ulnar techniques of ulnar nerve block. Conclusion: TTV approach could be a better technique of choice for ulnar nerve blockade at the wrist because of its ease to practice, safer profile and minimum chances of inadvertent intra-arterial/intraneural injection with adequate anesthesia/analgesia. PMID:25538516

Varshney, Rohit; Sharma, Nidhi; Malik, Shraddha; Malik, Sunny

2014-01-01

12

MR imaging of uncommon recurrence of fibrolipomatous hamartoma of the ulnar nerve.  

PubMed

We present the MR and histopathologic findings of fibrolipomatous hamartoma (FLH) of the ulnar nerve in a 54-year-old woman, a lipomatous process that rarely affects the ulnar nerve. The case illustrated is further unusual as a local soft tissue recurrent mass developed over a remarkably long course of the disease. PMID:12752006

Kakitsubata, Y; Theodorou, S J; Theodorou, D J; Shibata, M; Yuge, M; Yuki, Y; Hatakeyama, K; Yokouchi, T

2003-05-01

13

Arthroscopic ulnar nerve identification during posterior elbow arthroscopy.  

PubMed

Elbow arthroscopy has increased in popularity in the past 10 years for both diagnostic and therapeutic purposes. A major limiting factor faced by the elbow arthroscopist is the close proximity of the neurovasculature to the working field, with the risk of iatrogenic injury. Many arthroscopic procedures are less extensive than their open equivalents because of an inability to consistently and safely eliminate the risk of neural and vascular injury. Many open procedures in the posterior compartment of the elbow joint are not routinely performed arthroscopically. The primary reason for this restriction in arthroscopic practice is the locality of the posteromedially positioned ulnar nerve in the posterior compartment. Experience and practice with elbow arthroscopic techniques allows surgeons to expand the indications for arthroscopic treatment of an increasing number of elbow pathologies. A philosophy that is routine in open surgery when dealing with pathology that is adjacent to neurovasculature is to identify the neurovasculature and hence reduce the risk of injury. Our aim is to translate this philosophy to arthroscopy by helping define a safe technique for identifying the ulnar nerve in the posteromedial elbow gutter and allowing for a safer performance of procedures in the posteromedial region of the elbow. PMID:23766965

Kamineni, Srinath; Hamilton, David Anthony

2012-09-01

14

Supercharged end-to-side anterior interosseous to ulnar motor nerve transfer for intrinsic musculature reinnervation.  

PubMed

Functional motor recovery after peripheral nerve injury is predominantly determined by the time to motor end plate reinnervation and the absolute number of regenerated motor axons that reach target. Experimental models have shown that axonal regeneration occurs across a supercharged end-to-side (SETS) nerve coaptation. In patients with a recovering proximal ulnar nerve injury, a SETS nerve transfer conceptually is useful to protect and preserve distal motor end plates until the native axons fully regenerate. In addition, for nerve injuries in which incomplete regeneration is anticipated, a SETS nerve transfer may be useful to augment the regenerating nerve with additional axons and to more quickly reinnervate target muscle. We describe our technique for a SETS nerve transfer of the terminal anterior interosseous nerve (AIN) to the pronator quadratus muscle (PQ) end-to-side to the deep motor fascicle of the ulnar nerve in the distal forearm. In addition, we describe our postoperative therapy regimen for these transfers and an evaluation tool for monitoring progressive muscle reinnervation. Although the AIN-to-ulnar motor group SETS nerve transfer was specifically designed for ulnar nerve injuries, we believe that the SETS procedure might have broad clinical utility for second- and third-degree axonotmetic nerve injuries, to augment partial recovery and/or "babysit" motor end plates until the native parent axons regenerate to target. We would consider all donor nerves currently utilized in end-to-end nerve transfers for neurotmetic injuries as candidates for this SETS technique. PMID:23021177

Barbour, John; Yee, Andrew; Kahn, Lorna C; Mackinnon, Susan E

2012-10-01

15

Use of ultrasonography in ulnar nerve entrapment surgery—a prospective study  

Microsoft Academic Search

The purpose of our study is to assess the usefulness of high-resolution ultrasonography in observing the morphology and dynamics\\u000a of the ulnar nerve in the cubital tunnel and also the efficacy of ultrasonography in a more accurate diagnosis and appropriate\\u000a surgical treatment decision. Cross-sectional area of the ulnar nerves of 40 healthy volunteers in the control group were measured\\u000a bilaterally

Murat Kutlay; Ahmet Çolak; Hakan ?im?ek; Ersin Öztürk; Mehmet Güney ?enol; K?vanç Topuz; Mehmet Nusret Demircan

2009-01-01

16

Comparison of the Volar and Medial Approach in Peripheral Block of Ulnar Nerve at the Wrist – A Cadaveric Study  

PubMed Central

Context: Two standard approaches are described to block the ulnar nerve at wrist. These include a) the traditional Volar approach where the needle is inserted lateral to tendon of flexor carpi ulnaris (FCU) b) Medial approach where the needle is inserted posterior to the tendon of FCU. Caution must be exercised to avoid puncture of the ulnar artery and/or intraneural injection of the ulnar nerve in both the approaches. Aim: This study compares the volar and medial approach to the peripheral block of ulnar nerve at the wrist. The objective was two fold: a) to analyze the position of the ulnar nerve and the ulnar artery in relation to the Flexor Carpi Ulnaris tendon b) to assess the risk of injury to ulnar artery in both the volar and medial approach. Settings and Designs: Twelve cadaveric upper limbs were used and both approaches compared by an observational study. Materials and Methods: Two 18 G needles were inserted up to a depth of 7 mm using the standard volar and medial approach. The pattern of arrangement and positions of the ulnar artery and nerve in relation to FCU tendon were observed. The distance between the tip of needle and its proximity to the ulnar artery, and risk of injury were determined. Statistical analysis was done using SPSS for Windows, Version 16.0. Chicago, SPSS Inc. Results: Three patterns of arrangement and position of the ulnar nerve and artery were observed. Puncture of ulnar artery was seen in 50% of cases in the volar approach as compared to no injury at all in the medial approach. The ulnar artery is highly liable to injury during the volar approach in type I and II and safe only in type III arrangement of ulnar artery. The medial approach showed no injury to the ulnar artery or nerve at a penetration depth of 7mm. Conclusion: The medial approach is safer compared to volar approach for peripheral block of ulnar nerve at wrist.

Joy, Praisy; Satyanandan, Cephas

2014-01-01

17

Aberrant radial-ulnar nerve communication in the upper arm presenting as an unusual radial nerve palsy: a case report.  

PubMed

An unusual communication between the radial and ulnar nerves was observed during repair of a fracture of the humerus in an adult patient who presented with unusual physical exam findings. The patient had loss of radial and ulnar nerve motor function, as well as decreased sensation in both nerve distributions. Radial nerve injury following fracture of the humerus is a common condition, and anatomic variations are therefore of importance to clinicians. Communications between branches of the brachial plexus are also not uncommon findings; however there is very little mention of communication between the radial and ulnar nerves in the literature. An appreciation of unusual nerve anatomy is important in explaining unusual finding in patients. PMID:25481257

Lombardo, Daniel J; Buzas, David; Siegel, Geoffrey; Afsari, Alan

2014-12-01

18

Cortical Characterization and Inter-Dipole Distance Between Unilateral Median Versus Ulnar Nerve Stimulation of Both Hands in MEG  

Microsoft Academic Search

Summary  Contralateral somatosensory evoked fields (SEF) by whole head MEG after unilateral median and ulnar nerve stimulation of both hands were studied in 10 healthy right-handed subjects. Major parameters describing cortical activity were examined to discriminate median and ulnar nerve evoked responses. Somatic sensitivity showed high similarity in the 4 study conditions for both hand and nerve. The brain SEFs consisted

Peter J. Theuvenet; Bob W. van Dijk; Maria J. Peters; Jan M. van Ree; Fernando L. Lopes da Silva; Andrew C. N. Chen

2006-01-01

19

Anatomic Relationships and Branching Patterns of the Dorsal Cutaneous Branch of the Ulnar Nerve  

PubMed Central

Purpose To describe the variable branching patterns of the dorsal cutaneous branch of the ulnar nerve (DCBUN) relative to identifiable anatomic landmarks on the ulnar side of the wrist. Methods We dissected the ulnar nerve in 28 unmatched fresh-frozen cadavers to identify the DCBUN and its branches from its origin to the level of the metacarpophalangeal joints. The number and location of branches of the DCBUN were recorded relative to the distal ulnar articular surface. Relationships to the subcutaneous border of the ulna, the pisotriquetral joint, and the extensor carpi ulnaris tendon were defined in the pronated wrist. Results On average 2 branches of the DCBUN were present at the level of the distal ulnar articular surface (range, 1-4). On average 2.2 branches were present 2 cm distal to the ulnar articular surface (range, 1-4). At least 1 longitudinal branch crossed dorsal to the extensor carpi ulnaris tendon prior to its insertion on the fifth metacarpal in 23/28 (82%) specimens. In 27/28 (96%) specimens, all longitudinal branches of the DCBUN coursed between the dorsal-volar midpoint of the subcutaneous border of the ulna and the pisotriquetral joint. In 20/28 (71%) specimens, a transverse branch of the DCBUN to the distal radial-ulnar joint was present. Discussion During exposure of the dorsal and ulnar areas of the wrist, identification and protection of a single branch of the DCBUN is unlikely to ensure safe dissection as multiple branches are normal. The 6-U, 6-R, and ulnar midcarpal arthroscopy portals may place these branches at risk. In the pronated forearm, the area between the dorsal subcutaneous border of the ulna and the pisotriquetral joint contained all longitudinal branches of the DCBUN in 96% of specimens. Clinical Relevance During surgery involving the dorsal and ulnar areas of the wrist multiple longitudinal branches and a transverse branch of the DCBUN are normally present. PMID:23707013

Root, Cassie G.; London, Daniel A.; Strauss, Nicole L.; Calfee, Ryan P.

2014-01-01

20

The spaghetti wrist. Simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist.  

PubMed

The outcome of 15 patients who sustained simultaneous laceration of the median and ulnar nerves with flexor tendons at the wrist is described. Primary nerve repair yielded satisfactory results, the median nerve achieving a better outcome than the ulnar nerve. Most patients regained a functional range of wrist movement. Flexor tendons yielded the poorest results. A functional, albeit impaired outcome can usually be anticipated following this severe injury. PMID:8501364

Hudson, D A; de Jager, L T

1993-04-01

21

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

22

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

23

Fibrolipomatous hamartoma of sural nerve: a new site of an unusual lesion.  

PubMed

Neural fibrolipomatous hamartoma is a rare benign tumour commonly involving the median nerve. Other less frequently involved nerves include the ulnar, radial, brachial plexus, superficial peroneal nerve, inferior calcaneal nerve and median plantar nerve. Involvement of sural nerve has not been reported in the available literature so far. A three-year-old female child presented with a painless swelling over the posterolateral aspect of left leg with no associated motor or sensory deficits. Radiological investigations revealed a fat density lesion with interspersed neural element in the subcutaneous plane of the left leg. Histopathological examination of the excised specimen showed features of a fibrolipomatous hamartoma of the nerve. This report describes the occurrence of fibrolipomatous hamartoma in the sural nerve for the first time in the literature. This rare tumour should be considered in the differential diagnosis of such lesions. PMID:24763237

Parihar, Asmita; Verma, Sarika; Senger, Mamta; Agarwal, Anil; Bansal, Kalpana; Gupta, Ruchika

2014-04-01

24

An uncommon cause of tardy ulnar nerve palsy due to upper extremity prolonged malposition in a comatose child: a case report  

PubMed Central

Abstract: Background: Ulnar nerve neuropathy is one of the most common peripheral nerve dysfunctions. Elbow is the most common area affected by ulnar nerve which is mainly because of fractures or dislocations of this area. Delayed ulnar nerve palsy (Tardy Ulnar Nerve Palsy) in children due to a malpositioning of upper extremity during hospitalization is an uncommon cause of ulnar nerve injury which we have already reported it. Methods: An eight-year-old conscious patient who had weakness, paresthesia and tingling in the right 4th and 5th fingers, as well as right claw hand deformity was evaluated, he had attended once before in 4 months ago due to head trauma in coma state. The child had no clinical and radiological indications of arm or elbow fractures causing nerve compression or entrapment. Elbow malposition had caused ulnar nerve neuropathy during hospitalization. Surgery was attempted, ulnar nerve decompression and anterior transposition done. Results: After three weeks post operatively, active physical therapy was started on the right upper extremity and the hand returned to normal activity after 6 months. Conclusions: In patients with decreased level of consciousness or coma state who need prolonged hospitalization, the limbs must remain in correct position to prevent superficial nerve injuries and neuropathies. Furthermore, careful and scrutinized attention to the traumatic patients and doing on time and targeted imaging, regular follow up of patients, complete and perfect neurological examinations can prevent peripheral nerve injuries or develop on-time treatments which improve the patients' quality of life. Keywords: Ulnar nerve, Elbow malposition, Ulnar nerve decompression

Emamhadi, Mohammad Reza; Mahmoudi, Davood

2012-01-01

25

Chiropractic management of a patient with ulnar nerve compression symptoms: a case report  

PubMed Central

Objective The purpose of this case report is to describe chiropractic management of a patient with arm and hand numbness and who was suspected to have ulnar nerve compression. Clinical Features A 41-year-old woman presented with hand weakness and numbness along the medial aspect of her right forearm and the 3 most medial fingers. The onset of symptoms presented suddenly, 3 weeks prior, when she woke up in the morning and assumed she had “slept wrong.” The patient’s posture showed protracted shoulders and moderate forward head carriage. Orthopedic assessment revealed symptomatic right elevated arm stress test, grip strength asymmetry, and a Tinel sign at the right cubital tunnel. Intervention and Outcome The patient was treated using chiropractic care, which consisted of manipulative therapy, myofascial therapy, and elastic therapeutic taping. Active home care included performing postural exercises and education about workstation ergonomics. She demonstrated immediate subjective improvement of her numbness and weakness after the first treatment. Over a series of 11 treatments, her symptoms resolved completely; and she was able to perform work tasks without dysfunction. Conclusion Chiropractic treatment consisting of manipulation, soft tissue mobilizations, exercise, and education of workstation ergonomics appeared to reduce the symptoms of ulnar nerve compression symptoms for this patient. PMID:24294148

Illes, Jennifer D.; Johnson, Theodore L.

2013-01-01

26

Repair of ruptured spinal nerve roots in a brachial plexus lesion. Case report.  

PubMed

A 22-year-old woman sustained a brachial plexus injury with supraganglionic rupture of the C-8 and T-1 nerve roots as a result of a traffic accident. She was operated on approximately 1 week following the accident. After a hemilaminectomy, the intradural defects in the ruptured roots were bridged with sural nerve grafts. Within 3 years she recovered function in all muscles supplied from the lower roots in the plexus except for the intrinsic hand muscles, but she had a persisting, complete sensory loss in the ulnar nerve distribution. The possibility for functional gain after repair of spinal root lesions in brachial plexus patients is discussed. PMID:7897534

Carlstedt, T; Norén, G

1995-04-01

27

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

28

Stratification of the flexor retinaculum and the course and distribution of the ulnar, median, and palmar digital nerves: an anatomical study.  

PubMed

A gross anatomic study of 169 hands from 94 human adult cadavers was carried out to define the morphology of the flexor retinaculum and the relationship of the flexor retinaculum to the course of the median and ulnar nerves and branching of the palmar digital nerves. The following results were obtained. Three parts of the flexor retinaculum were arranged like overlapping tiles on a roof, and in all cases, the median nerve passed deep to the flexor retinaculum, whereas the ulnar nerve passed through various parts of the flexor retinaculum in 19% of cases irrespective of its proximal form and branching of the palmar digital nerves. PMID:15495165

Kawashima, Tomokazu; Sato, Kenji; Sasaki, Hiroshi

2004-11-01

29

Acute calcific tendinitis of the flexor carpi ulnaris causing acute compressive neuropathy of the ulnar nerve: a case report.  

PubMed

This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris in a 64-year-old woman. She presented with symptoms of acute ulnar nerve compression mimicking a volar compartment syndrome. Owing to rapidly progressive symptoms, emergency surgical exploration was carried out. Intra-operatively a large mass of calcium phosphate carbonate was noted in association with the flexor carpi ulnaris near its insertion at the wrist compressing the ulnar nerve and artery in Guyon's canal. Postoperatively the patient had complete resolution of symptoms. Conservative management with non-steroidal anti-inflammatory drugs, rest, splinting, and steroid therapy is recommended for acute calcific tendinitis, but this case suggests a role for surgical treatment when there is acute neural compression and severe pain. PMID:23255660

Yasen, Sam

2012-12-01

30

Establishment of a Method to Measure Length of the Ulnar Nerve and Standardize F-wave Values in Clinically Normal Beagles  

PubMed Central

We designed a new method of measuring the length of the ulnar nerve and determining standard values for F-wave parameters of the ulnar nerve in clinically normal beagles. Nerve length must be precisely measured to determine F-wave latency and conduction velocity. The length of the forelimb has served as the length of the ulnar nerve for F-wave assessments, but report indicates that F-wave latency is proportional to the length of the pathway traveled by nerve impulses. Therefore, we measured the surface distance from a stimulus point to the spinous process of the first thoracic vertebra (nerve length 1) and the anterior horn of the scapula (nerve length 2) as landmarks through the olecranon and the shoulder blade acromion. The correlation coefficients between the shortest F-wave latency and the length of nerves 1, 2 or the forelimb were 0.61, 0.7 and 0.58. Nerve length 2 generated the highest value. Furthermore, the anterior horn of the scapula was easily palpated in any dog regardless of well-fed body. We concluded that nerve length 2 was optimal for measuring the length of the ulnar nerve. PMID:25649942

HIRASAWA, Shun; SHIMIZU, Miki; MARUI, Yuumi; KISHIMOTO, Miori; OKUNO, Seiichi

2014-01-01

31

Field hockey players have different values of ulnar and tibial motor nerve conduction velocity than soccer and tennis players.  

PubMed

The aim of this study was to describe motor nerve conduction velocity in upper and lower extremities in sportsmen. Fifteen high-level field hockey players, seventeen soccer players and ten tennis players were recruited from the Polish National Field Hockey League, Polish Soccer League Clubs, and Polish Tennis Association clubs,respectively. The control group comprised of seventeen healthy, non-active young men. Nerve conduction velocities of ulnar and tibial nerve were assessed with NeuroScreen electromyograph (Toennies, Germany) equipped with standard techniques of supramaximal percutaneus stimulation with constant current and surface electrodes. No significant differences in motor nerve conduction velocities were found between dominant and non-dominant limbs in each studied group. Ulnar nerve conduction velocity measured from above elbow to below elbow was significantly lower only in the field hockey players' dominant limb. Tibial conduction velocity of the field hockey players' non-dominant lower limb was higher in comparison to the tennis players and the control group. There was no significant correlation between body mass and NCV as well as between height of subjects and NCV in both athletes or non-athletes. A slight trend towards a lower TCV values in athletes with longer duration of practicing sport was found. It was most pronounced in the non-dominant lower extremity of field hockey players. PMID:21308651

Pawlak, Matthias; Kaczmarek, Dominik

2010-12-01

32

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

33

The median nerve consistently drives flexion of the distal phalanx of the ring and little fingers: Interest in finger flexion reconstruction by nerve transfers.  

PubMed

Surgeons believe that in high ulnar nerve lesion distal interphalangeal joint (DIP) flexion of the ring and little finger is abolished. In this article, we present the results of a study on innervation of the flexor digitorum profundus of the ring and little fingers in five patients with high ulnar nerve injury and in 19 patients with a brachial plexus, posterior cord, or radial nerve injury. Patients with ulnar nerve lesion were assessed clinically and during surgery for ulnar nerve repair we confirmed complete lesion of the ulnar nerve in all cases. In the remaining 19 patients, during surgery, either the median nerve (MN) or the anterior interosseous nerve (AIN) was stimulated electrically and DIP flexion of the ring and little fingers evaluated. All patients with high ulnar nerve lesions had active DIP flexion of the ring and little fingers. Strength scored M4 in the ring and M3-M4 in the little finger. Electrical stimulation of either the MN or AIN produced DIP flexion of the ring and little fingers. Contrary to common knowledge, we identified preserved flexion of the distal phalanx of the ring and little fingers in high ulnar nerve lesions. On the basis of these observations, nerve transfers to the AIN may provide flexion of all fingers. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. PMID:25256625

Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio; Tacca, Cristiano Paulo

2014-09-25

34

An unusual branching pattern of the superficial brachial artery accompanied by an ulnar nerve with two roots  

PubMed Central

Variations in the arterial pattern of the upper limb are common and have been reported by several investigators (Fuss et al. 1985; Poteat, 1986; Tountas & Bergman, 1993; Rodriguez-Baeza et al. 1995). These variations are often associated with anomalies in the arrangement of the nerves of the brachial plexus (Miller, 1939; Lengele & Dhem, 1989). The presence of a superficial brachial artery (Schwyzer & De Garis, 1935; Skopakoff, 1959; Fuss et al. 1985) and the usual pattern of its branching in the upper arm or forearm have also been reported (McCormack et al. 1953; Keen, 1961; Karlson & Niechalev, 1982; Lippert & Pabst, 1985; Rodriguez-Baeza et al. 1995). The great variability of this arterial pattern may be attributed to the failure of regression of some paths of the embryonic arterial trunks (Tountas & Bergman, 1993; Rodriguez-Baeza et al. 1995). The aim of the present report is to describe the concomitant appearance of 3 unusual variations in the same upper limb of a male cadaver. In this arm: (1) a superficial brachial artery terminated its course by dividing into 3 branches at the cubital fossa; (2) the definitive brachial artery had an unusual origin; and (3) the ulnar nerve was abnormally formed from 2 roots. This novel variation is compared with other anatomical variations in the arterial supply of the upper limb. In a series of routine dissections of 100 embalmed human cadavers the following variations were observed in the right upper limb of a male subject. PMID:10580863

ANAGNOSTOPOULOU, S.; VENIERATOS, D.

1999-01-01

35

Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion  

PubMed Central

Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8th cranial nerve (the vestibulo-cochlear nerve) followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed. PMID:25552867

Krishnan, Shyam Sundar; Bojja, Sivaram; Vasudevan, Madabhushi Chakravarthy

2015-01-01

36

Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion.  

PubMed

Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8(th) cranial nerve (the vestibulo-cochlear nerve) followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed. PMID:25552867

Krishnan, Shyam Sundar; Bojja, Sivaram; Vasudevan, Madabhushi Chakravarthy

2015-01-01

37

The usefulness of terminal latency index of median nerve and f-wave difference between median and ulnar nerves in assessing the severity of carpal tunnel syndrome.  

PubMed

The calculated electrophysiological parameters, such as terminal latency index (TLI), residual latency, modified F ratio, and F-wave inversion, have been investigated as a diagnostic tool for detection of early stage of carpal tunnel syndrome (CTS) in the literature. However, the correlation of these calculated electrophysiological parameters with the clinical severity of CTS has not been reported. The aim of this study was to determine the correlation of the calculated electrophysiological parameters and clinical severity in patients with CTS. A retrospective study was performed with 212 hands of 106 CTS patients. The CTS hands were classified as asymptomatic, mild, moderate, and severe according to the clinical severity. The distal motor latency and distal motor conduction velocity of median nerve, minimal F-wave latency of median and ulnar nerves, and sensory nerve conduction velocity in the finger-wrist and palm-wrist segment of median nerve (SNCV f-w and SNCV p-w) were obtained in a conventional nerve conduction study. The TLI, residual latency, and modified F ratio of the median nerve and the difference of minimal F-wave latencies between the median and ulnar nerves (F-diff M-U) were calculated. The distal motor latency, residual latency, and F-diff M-U were significantly increased according to the clinical severity of CTS. The motor conduction velocity, SNCV p-w, SNCV f-w, TLI, and modified F ratio were significantly decreased according to the clinical severity of CTS. In analyses of variance and Kruskal-Wallis test, we used the Scheffe test as a post-hoc comparison analysis. The TLI, F-diff M-U, and SNCV f-w showed a significant difference among all groups of each CTS severity. The sensitivity, specificity, and cut-off value of TLI, F-diff M-U, and SNCV f-w between asymptomatic and mild, mild and moderate, and moderate and severe CTS groups were calculated by using receiver operating characteristic curve analysis. The cut-off values of TLI, F-diff M-U, and SNCV f-w between the asymptomatic and mild CTS groups were, respectively, 0.33 millisecond, 0.3 millisecond, and 40 cm/second. The cut-off values of TLI, F-diff M-U, and SNCV f-w between mild and moderate were, respectively, 0.27 millisecond, 2.3 milliseconds, and 34.8 cm/second. The cut-off values of TLI, F-diff M-U, and SNCV f-w between moderate and severe CTS groups were, respectively, 0.20 millisecond, 4.2 milliseconds, and 26.4 cm/second. We found that calculated electrophysiological parameters of conventional nerve conduction study could be a good indicator to determine the severity of CTS. PMID:24691235

Park, Kang Min; Shin, Kyong Jin; Park, Jinse; Ha, Sam Yeol; Kim, Sung Eun

2014-04-01

38

Ulnar nerve F-wave latencies recorded from the abductor digiti minimi.  

PubMed

This study was performed to create a large database of normal values for the ulnar F-wave study and to investigate the effect of various demographic factors on F-wave results. The study was designed to incorporate a standard distance measure and temperature control, which are lacking in some previous studies. One hundred ninety-three asymptomatic volunteers without risk factors for neuropathy were recruited and had ten F-waves performed on each arm. Data were collected for the shortest F-wave (Fmin), mean F-wave (Fmean), the number of F-waves present out of ten stimuli (Fpersist), and the range of latencies (Frange). An analysis of variance statistical procedure was applied, and the Fmin and Fmean were found to correlate with age, gender, and height, although the gender effect was relatively weak. For all subjects taken together, the mean Fmin was 26.5 +/- 2.5 ms. The Fmean was 27.7 +/- 2.5 ms, and the mean Frange was 2.6 +/- 1.2 ms. Ninety-seven percent of subjects had an Fpersist of five or more. Mean side-to-side difference for Fmin was 0.2 +/- 1.1 ms. PMID:10573096

Buschbacher, R M

1999-01-01

39

Tumors and tumor-like lesions of peripheral nerves.  

PubMed

The diagnosis of a peripheral nerve tumor can often be suggested on imaging. Direct continuity with a neural structure or location along a typical nerve distribution, shape, and intrinsic magnetic resonance (MR) signal characteristics represent the most important signs in this regard. Although several nonneoplastic nerve lesions can be specifically diagnosed by MR imaging, benign and malignant neoplasms of peripheral nerves can usually not be distinguished with confidence. This article reviews the MR imaging appearance, clinical and pathological features of schwannoma, localized neurofibroma, plexiform neurofibroma, intraneural perineurioma, fibrolipomatous hamartoma, nerve sheath ganglion, traumatic neuroma, malignant peripheral nerve sheath tumor, and secondary malignant neoplasms of peripheral nerves. Typical findings are illustrated on the basis of histologically confirmed cases. PMID:21072731

Woertler, Klaus

2010-11-01

40

Nerve lesions and the generation of pain  

Microsoft Academic Search

This review addresses the issue of how axotomy of periph- eral nerve fibers leads to pain and hyperalgesia. The point of axotomy (the nerve injury site), the dorsal root ganglia, and the dorsal horn of the spinal cord are candidate sites for generation of the pain signal that is likely to be critical for maintaining the neuropathic pain state. This

James N. Campbell

2001-01-01

41

Sciatic nerve tumor and tumor-like lesions - uncommon pathologies.  

PubMed

Sciatic nerve mass-like enlargement caused by peripheral nerve sheath tumors or neurocutaneous syndromes such as neurofibromatosis or schwannomatosis has been widely reported. Other causes of enlargement, such as from perineuroma, fibromatosis, neurolymphoma, amyloidosis, endometriosis, intraneural ganglion cyst, Charcot-Marie-Tooth disease, and chronic inflammatory demyelinating polyneuropathy are relatively rare. High-resolution magnetic resonance imaging (MRI) is an excellent non-invasive tool for the evaluation of such lesions. In this article, the authors discuss normal anatomy of the sciatic nerve and MRI findings of the above-mentioned lesions. PMID:22410805

Wadhwa, Vibhor; Thakkar, Rashmi S; Maragakis, Nicholas; Höke, Ahmet; Sumner, Charlotte J; Lloyd, Thomas E; Carrino, John A; Belzberg, Allan J; Chhabra, Avneesh

2012-07-01

42

Positive or Negative Ulnar Variance after Ulnar Shortening for Ulnar Impaction Syndrome: A Retrospective Study  

PubMed Central

Background The goal of this study was to compare simple radiographic findings and clinical results according to residual ulnar variance following ulnar shortening for ulnar impaction syndrome. Methods Forty-five cases of ulnar impaction syndrome, which were treated with ulnar shortening from 2005 to 2008, were studied retrospectively. Group I included 13 cases with positive residual variance after ulnar shortening and group II included 32 cases with negative variance after shortening. The presence of a lunate cystic lesion both preoperatively and at final follow-up and assessments of wrist function based on the modified Mayo wrist score, the disabilities of the arm, shoulder, and hand (DASH) score, as well as the Chun and Palmer score were evaluated. Results A cystic lesion of the lunate was present in 4 cases preoperatively and the size decreased in 2 cases at final follow-up in group I, and in 10 and 5 cases, respectively, in group II. No statistical difference was observed between the groups. The modified Mayo wrist score, DASH score, as well as the Chun and Palmer score improved significantly in both groups. No significant differences were observed between the two groups in terms of the proportion of positive cystic lesions at final follow-up or the functional scores. Conclusions After ulnar shortening, the degree of radiological change in the cystic lunate lesions and clinical improvement did not differ significantly between the groups with unintended residual positive and negative variance after shortening. PMID:22949953

Cha, Soo-Min; Kim, Kyung-Cheon

2012-01-01

43

Electrodiagnostic evaluation of ulnar neuropathy and other upper extremity mononeuropathies.  

PubMed

Upper extremity mononeuropathies are some of the common disorders seen in neurophysiology laboratories. Electrophysiologic studies rely on accurate localization based on knowledge of applicable anatomy and features of history and physical examination. Careful electrodiagnostic studies provide an accurate diagnosis, help localize the lesion site, exclude alternate diagnoses, reveal unsuspected diagnoses, determine pathophysiology of lesions, and assess severity, timeframe, and prognosis of lesions. This article discusses the electrodiagnostic approach to ulnar neuropathy, proximal median neuropathy, radial neuropathy, musculocutaneous neuropathy, axillary neuropathy, suprascapular neuropathy, and long thoracic neuropathy. Pertinent aspects of the history and physical examination, nerve conduction studies, and electromyography are presented. PMID:22361371

Dimberg, Elliot L

2012-05-01

44

Using multiple high-count electrode arrays in human median and ulnar nerves to restore sensorimotor function after previous transradial amputation of the hand.  

PubMed

Peripheral nerve interfaces that can record from and stimulate large numbers of different nerve fibers selectively and independently may help restore intuitive and effective motor and sensory function after hand amputation. To this end, and extending previous work in two subjects, two 100-electrode Utah Slanted Electrode Arrays (USEAs) were implanted for four weeks in the residual ulnar and median nerves of a 50-year-old male whose left, dominant hand had been amputated 21 years previously. Subsequent experiments involved 1) recording from USEAs for real-time control of a virtual prosthetic hand; 2) stimulation to evoke somatosensory percepts; and 3) closed-loop sensorimotor control. Overall, partial motor control and sensation were achieved using USEAs. 1) Isolated action potentials recorded from nerve motor fibers, although sparse at these distal implant sites, were activated during fictive movements of the phantom hand. Unlike in our previous two subjects, electromyographic (EMG) activity contributed to most online recordings and decodes, but was reduced in offline analyses using common average referencing. Online and offline Kalman-filter decodes of thresholded neural or EMG spikes independently controlled different digits of the virtual hand with one or two degrees of freedom. 2) Microstimulation through individual electrodes of the two USEAs evoked up to 106 different percepts, covering much of the phantom hand. The subject discriminated among five perceived stimulus locations, and between two somatosensory submodalities at a single location. 3) USEA-evoked percepts, mimicking contact with either a near or distal virtual target, were used to terminate movements of the virtual hand controlled with USEA recordings comprised wholly or mostly of EMG. These results further indicate that USEAs can help restore sensory and motor function after hand loss. PMID:25570369

Clark, Gregory A; Wendelken, Suzanne; Page, David M; Davis, Tyler; Wark, Heather A C; Normann, Richard A; Warren, David J; Hutchinson, Douglas T

2014-08-01

45

[Open knee joint injuries (including vascular and nerve lesions)].  

PubMed

Immediate definitive reconstruction of all damaged structures leads to better results than delayed operations. If direct closure of the joint is not possible, local rotational flaps, muscle flaps or free skin-fat tissue flaps (i.e. a scapular flap) may be used. In injuries of the popliteal artery, the interposition of a saphenic vein graft is preferable to local reconstruction of the artery. Nerve injuries are the only exception to comprehensive primary repair. Reconstruction in these lesions is usually done later when all wounds are healed. The postoperative treatment includes the use of continuous passive motion whenever possible. PMID:2577577

Glinz, W; Meyer, V E

1989-01-01

46

[Nerve conduction studies of suprascapular nerve for site-of-lesion diagnosis].  

PubMed

Shoulder pain is a common symptom, resulting not only from bone and shoulder joint diseases, but also from neurogenic lesions. Entrapment neuropathy of the suprascapular nerve also causes shoulder symptoms. Conduction of the suprascapular nerve was studied in 12 healthy control subjects and 25 patients suffering from shoulder pain and/or dysfunction. Surface stimulation was performed at Erb's point, and compound muscle action potentials(M waves) were recorded from the supraspinatus and the infraspinatus muscles with concentric needle electrodes. To determine the optimal site for recording M waves from the infraspinatus muscle, simultaneous multi-channel recordings of M waves using pairs of surface electrodes were obtained from different sites over the infraspinatus muscle. In two patients, latency of the M waves to the infraspinatus muscle was prolonged, whereas that to the supraspinatus muscle was normal. These findings indicate entrapment neuropathy at the spinoglenoid notch. In three patients, the latency to the infraspinatus and supraspinatus muscles was prolonged. These findings are compatible with entrapment neuropathy at the suprascapular notch. The latency to the supraspinatus and infraspinatus muscles was prolonged in patients with brachial plexus injury and in those with suprascapular nerve injury. In patients with myopathy, those with neuralgic amyotrophy and those with cervical radiculopathy, the latency was normal. Thus, conduction studies of the suprascapular nerve using multiple-channel recordings are useful, especially for the diagnosis of entrapment neuropathy of the suprascapular nerve. PMID:12166080

Ito, Junko

2002-06-01

47

[Paralytic shoulder secondary to post-traumatic peripheral nerve lesions in the adult].  

PubMed

A critical review is presented of the indications for nerve repair or transfer and for palliative operations in the management of paralytic shoulder following traumatic neurological injuries in the adult. Different situations are considered: paralytic shoulder following supraclavicular lesions of the brachial plexus, following retro- and infraclavicular lesions and following lesions to the terminal branches of the plexus (axillary, suprascapular and musculocutaneous nerves) and finally problems related to lesions of the accessory nerve and the long thoracic nerve. I. Supraclavicular lesions of the brachial plexus. In complete (C5 to T1) lesions, the possibilities for nerve repair or transfer are at best limited, and the aim is to restore active flexion of the elbow. Palliative operations may be associated in order to stabilize the shoulder. In case of a complete C5 to T1 root avulsion, amputation at the distal humerus may be considered but is rarely performed combined with shoulder arthrodesis if the trapezius and serratus anterior muscles are functioning. The shoulder may also be stabilized by a ligament plasty using the coracoacromial ligament. In cases where the supraspinatus and long head of the biceps have recovered, but where active external rotation is absent, function may be improved by derotation osteotomy of the humerus. In partial C5,6 or C5,6,7 lesions, the indications for nerve repair and transfer are wider, as well as the indications for muscle transfers. In C5,6 lesions, a neurotization from the accessory nerve to the suprascapular nerve gives 60% satisfactory results; this is also true following treatment of C5,6,7 lesions, whereas restoration of active elbow flexion is obtained in 100% of cases in C5,6 lesions but only in 86% in C5,6,7 lesions. In cases where shoulder function has not been restored, palliative operations may be considered: arthrodesis or, more often, derotation osteotomy of the humerus which can be combined with transfer of the teres major and latissimus dorsi. II. Retro- and infraclavicular lesions of the brachial plexus. Twenty-five percent of the lesions of the brachial plexus occur in the retro- or infraclavicular region and involve the secondary trunks, most commonly the posterior trunk. Nerve repair should be performed early. The shoulder may be affected owing to involvement of the axillary nerve in cases of lesions of the posterior trunk, often associated with a lesion of the suprascapular nerve. Regarding the terminal branches (axillary, suprascapular and musculocutaneous nerves), spontaneous recovery may be expected in a significant proportion of cases but is often delayed (6-9 months), and the problem is to avoid unnecessary operations while not unduly delaying surgical repair in cases where it is indicated. MRI may be useful to delineate those cases where surgery is indicated: repair is usually performed around 6 months following trauma. Isolated lesions of the axillary nerve may be repaired with good results using a nerve graft. The lesion may occur in combination with a lesion of the suprascapular nerve; the latter may be interrupted at several levels. Proximal repair may be performed using a nerve graft; distal lesions are more difficult to repair and may require intramuscular neurotization. Lesions of the musculocutaneous nerve may be repaired with good results using a nerve graft. Lesions of the axillary nerve may be seen associated with lesions of the rotator cuff. The treatment varies according to the age and condition of the patient and according to the condition of the cuff muscles and tendons: in a young patient with avulsion of the tendons from bone, cuff reinsertion is indicated; in an older patient, the cuff must be evaluated by MRI or arthroscan, and repair is indicated unless the cuff tear is not amenable to surgery or there is fatty degeneration of the muscles. Palliative surgery may be indicated in cases seen late or after failed attempts at nerve repair. (ABSTRACT PMID:10216997

Alnot, J Y

1999-03-01

48

Nerves of the hand beyond the carpal tunnel.  

PubMed

Imaging studies including ultrasound (US) and magnetic resonance imaging may be required to evaluate the median nerve in patients with suspected carpal tunnel syndrome. However, the radial and ulnar nerves contribute to sensory and motor innervations to the hand as well. Compressive, traumatic, and iatrogenic events may damage the small terminal branches of these nerves. In the hand, US is able to identify injuries of the median, ulnar, radial nerve, and terminal branches. This article presents the role of imaging to evaluate the nerves of the hand with an emphasis on US. Due to its high-resolution capabilities, US is useful to determine the location, extent, and type of nerve lesion. Moreover, US is useful for a postsurgical assessment. The anterior interosseous nerve, Guyon's tunnel syndrome, and Wartenberg's syndrome are also described. PMID:22648428

Tagliafico, Alberto; Cadoni, Angela; Fisci, Erica; Gennaro, Sergio; Molfetta, Luigi; Perez, Maribel Miguel; Klauser, Andrea S; Martinoli, Carlo

2012-04-01

49

The association of middle ear effusion with trigeminal nerve mass lesions in dogs.  

PubMed

The trigeminal nerve is involved in the opening of the pharyngeal orifice of the Eustachian tube by operating the tensor veli palatini muscle. The hypothesis was investigated that middle ear effusion occurs in a more severe disease phenotype of canine trigeminal nerve mass lesions compared with dogs without middle ear effusion. Three observers reviewed canine MRIs with an MRI-diagnosis of trigeminal nerve mass lesion from three institutions. Various parameters describing the musculature innervated by the trigeminal nerve were scored and compared between dogs with and without middle ear effusion. Nineteen dogs met the inclusion criteria. Ipsilateral middle ear effusion was observed in 63 per cent (95% CI 48.4 per cent to 77.6 per cent) of the dogs. The size of the trigeminal nerve mass lesions was positively correlated with the severity of masticatory muscle mass loss (Spearman r=0.5, P=0.03). Dogs with middle ear effusion had a significantly increased generalised masticatory muscle mass loss (P=0.02) or tensor veli palatini muscle loss score (P=0.03) compared with those without. Larger trigeminal nerve mass lesions were associated with a greater degree of masticatory muscle mass loss. Masticatory muscle mass and, importantly, tensor veli palatini muscle mass was more severely affected in dogs with middle ear effusion suggesting an associated Eustachian tube dysfunction. PMID:24097818

Wessmann, A; Hennessey, A; Goncalves, R; Benigni, L; Hammond, G; Volk, H A

2013-11-01

50

Axonal regeneration in an articular branch following rat sciatic nerve lesions.  

PubMed

This study examines the outcome of axonal regeneration in the posterior articular nerve of the adult rat knee joint (PAN), after sciatic nerve lesions. Some animals had previously been subjected to chemical sympathectomy with guanethidine. In crushed cases the number of myelinated PAN axons was 50% above control level. The occurrence of C-fibers was doubled, mainly due to an increased number of sympathetic efferents. In neurotomy/suture cases the number of myelinated fibers was clearly elevated, but the number of C-fibers was close to normal. Most C-fibers were sensory. Similar, but less marked, post-regeneration abnormalities were seen in the nerve to the lateral gastrocnemius muscle. The sural nerve exhibited moderately increased numbers of myelinated and unmyelinated fibers in crushed cases. In neurotomy cases, the myelinated axons had increased and the C-fibers had decreased in number. The size distribution of myelinated PAN axons was less abnormal in crushed cases than after neurotomy, like in the other nerves. These results show that the outcome of axon regeneration in an articular branch of the lesioned rat sciatic nerve differs from that in non-articular branches, and suggest that joints may become hyperinnervated by C-fibers after nerve crush lesions. PMID:8138804

Povlsen, B; Hildebrand, C

1993-12-15

51

Peripheral contributions to the mechanical hyperalgesia following a lumbar 5 spinal nerve lesion in rats  

Microsoft Academic Search

Using lumbar 5 (L5) dorsal root rhizotomy-bearing rats, we examined the extent to which L5 spinal nerve lesion (SNL)-induced mechanical hyperalgesia was governed by two peripheral components, that is Wallerian degeneration (WD) and peripherally-propagating injury discharge (PID). The contribution of WD to SNL-induced hyperalgesia was studied by excluding PID with lidocaine treatment that blocked nerve conduction temporarily, but completely at

J. H. Jang; B. H. Lee; T. S. Nam; J. W. Kim; D. W. Kim; J. W. Leem

2010-01-01

52

Bilateral Suprascapular Nerve Entrapment by Ganglion Cyst Associated with Superior Labral Lesion  

PubMed Central

Suprascapular nerve compression is a rare cause of shoulder pain. We report the clinical features, radiological findings, arthroscopic management and outcome of three patients with suprascapular nerve compression caused by labral ganglion cyst associated with SLAP lesion. We performed simultaneous suture anchor SLAP repair and cyst decompression with a blunt probe. Upon a two-year follow-up, patients recovered full shoulder function without pain or limitations in activities of daily living. PMID:23730376

Rizzello, Giacomo; Longo, Umile Giuseppe; Trovato, Ugo; Fumo, Caterina; Khan, Wasim Sardar; Maffulli, Nicola; Denaro, Vincenzo

2013-01-01

53

Iatrogenic suprascapular nerve injury after repair of type II SLAP lesion.  

PubMed

Suprascapular neuropathy after an arthroscopic repair of a SLAP lesion is theoretically possible, but it has been rarely reported. We present a case of suprascapular nerve injury at the spinoglenoid notch as a complication of an improperly inserted suture anchor after repair of a type II SLAP lesion. The diagnosis was confirmed by the magnetic resonance imaging findings and an electrodiagnostic study, and direct compression of the nerve was visualized under repeat arthroscopy. An anatomic study of the superior glenoid shows that the available bone stock of the superior glenoid rim for the anchor insertion is found to decrease posteriorly. During the repair of a SLAP lesion, surgeons should consider the possibility of an iatrogenic injury to the suprascapular nerve by an improperly inserted suture anchor. PMID:20620802

Kim, Sung-Hun; Koh, Yong-Gon; Sung, Chang-Hun; Moon, Hong-Kyo; Park, Young-Sik

2010-07-01

54

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

55

Spasmodic torticollis following unilateral VIII nerve lesions: neck EMG modulation in response to vestibular stimuli  

Microsoft Academic Search

Three patients with spasmodic torticollis following VIII nerve lesions (VIII-ST) underwent quantitative assessment of their sternomastoid EMG during vestibular (otolith and semicircular canal) stimulation. The results were compared with a normal control group and with six patients with idiopathic spasmodic torticollis (ST). Backwards tilt of the VIII-ST patients resulted in a marked increase in the EMG, especially in the more

A M Bronstein; P Rudge; A H Beechey

1987-01-01

56

Traumatic distal ulnar artery thrombosis.  

PubMed

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. PMID:25276455

Karaarslan, Ahmet A; Karaka?l?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, Senol

2014-01-01

57

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. PMID:25276455

Karaarslan, Ahmet A.; Karaka?l?, Ahmet; Mayda, Aslan; Karc?, Tolga; Aycan, Hakan; Kobak, ?enol

2014-01-01

58

The variable clinical manifestations of ulnar neuropathies at the elbow.  

PubMed Central

In twenty-five cases of ulnar neuropathy at the elbow, the involvement of the fibres from three sensory and to four motor branches were examined clinically and, where possible, electrophysiologically. Of the sensory fibres, those from the terminal digital nerves were most commonly involved. The fibres to the hand muscles were much more frequently involved than those to the forearm muscles. These findings suggest that in ulnar neuropathies at the elbow there is variable damage to the fascicles within the nerve. PMID:3031220

Stewart, J D

1987-01-01

59

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

60

ATP and NO Dually Control Migration of Microglia to Nerve Lesions  

PubMed Central

Microglia migrate rapidly to lesions in the central nervous system (CNS), presumably in response to chemoattractants including ATP released directly or indirectly by the injury. Previous work on the leech has shown that nitric oxide (NO), generated at the lesion, is both a stop signal for microglia at the lesion and crucial for their directed migration from hundreds of micrometers away within the nerve cord, perhaps mediated by a soluble guanylate cyclase (sGC). In the present study, application of 100 ?M ATP caused maximal movement of microglia in leech nerve cords. The nucleotides ADP, UTP, and the non-hydrolyzable ATP analog AMP-PNP (adenyl-5?-yl imidodiphosphate) also caused movement, whereas AMP, cAMP and adenosine were without effect. Both movement in ATP and migration after injury were slowed by 50 ?M reactive blue 2 (RB2), an antagonist of purinergic receptors, without influencing the direction of movement. This contrasted with the effect of the NO scavenger cPTIO (2-(4-carboxyphenyl)-4,4,5,5-teramethylimidazoline-oxyl-3-oxide), which misdirected movement when applied at 1 mM. The cPTIO reduced cGMP immunoreactivity without changing immunoreactivity of eNOS (endothelial nitric oxide synthase), which accompanies increased NOS activity after nerve cord injury, consistent with involvement of sGC. Moreover, the sGC-specific inhibitor LY83583 applied at 50 ?M had a similar effect, in agreement with previous results with methylene blue. Taken together, the experiments support the hypothesis that ATP released directly or indirectly by injury activates microglia to move, while NO which activates sGC directs migration of microglia to CNS lesions. PMID:19025930

Duan, Yuanli; Sahley, Christie L.; Muller, Kenneth J.

2009-01-01

61

ATP and NO dually control migration of microglia to nerve lesions.  

PubMed

Microglia migrate rapidly to lesions in the central nervous system (CNS), presumably in response to chemoattractants including ATP released directly or indirectly by the injury. Previous work on the leech has shown that nitric oxide (NO), generated at the lesion, is both a stop signal for microglia at the lesion and crucial for their directed migration from hundreds of micrometers away within the nerve cord, perhaps mediated by a soluble guanylate cyclase (sGC). In this study, application of 100 microM ATP caused maximal movement of microglia in leech nerve cords. The nucleotides ADP, UTP, and the nonhydrolyzable ATP analog AMP-PNP (adenyl-5'-yl imidodiphosphate) also caused movement, whereas AMP, cAMP, and adenosine were without effect. Both movement in ATP and migration after injury were slowed by 50 microM reactive blue 2 (RB2), an antagonist of purinergic receptors, without influencing the direction of movement. This contrasted with the effect of the NO scavenger cPTIO (2-(4-carboxyphenyl)-4,4,5,5-teramethylimidazoline-oxyl-3-oxide), which misdirected movement when applied at 1 mM. The cPTIO reduced cGMP immunoreactivity without changing the immunoreactivity of eNOS (endothelial nitric oxide synthase), which accompanies increased NOS activity after nerve cord injury, consistent with involvement of sGC. Moreover, the sGC-specific inhibitor LY83583 applied at 50 microM had a similar effect, in agreement with previous results with methylene blue. Taken together, the experiments support the hypothesis that ATP released directly or indirectly by injury activates microglia to move, whereas NO that activates sGC directs migration of microglia to CNS lesions. PMID:19025930

Duan, Yuanli; Sahley, Christie L; Muller, Kenneth J

2009-01-01

62

Necrotizing skin lesion and radial nerve palsy in a patient treated with glatiramer acetate.  

PubMed

Glatiramer acetate (GA) is an approved and well tolerated drug for the treatment of relapsing-remitting multiple sclerosis. We report a case of a 52 year-old man with psoriasis and relapsing-remitting multiple sclerosis who developed, after 21 months of GA treatment, an injection-site cutaneous necrosis that involved both subcutaneous and muscular tissue with massive edema, followed, 3 days later, by radial nerve palsy. After few days another similar lesion appeared in another injection-site. We hypothesize that cutaneous necrosis could be due to a local dis-immune reaction and, probably, psoriasis could have played an important role in its pathogenesis. PMID:23778027

Carotenuto, Antonio; Iodice, Rosa; Barbato, Francesco; Orefice, Nicola Salvatore; Orefice, Giuseppe

2013-08-15

63

Kinematics of ulnar head arthroplasty.  

PubMed

This in vitro study evaluated the performance of an ulnar head replacement. A joint simulator was employed that produced active forearm rotation in cadaveric specimens, with motion measured using an electromagnetic tracking system. The kinematics of the intact forearm were compared with a partial ulnar head replacement and a full replacement (with and without soft-tissue reconstruction) and a full excision of the ulnar head. There were no differences between intact kinematics and those following prosthetic reconstruction. However, ulnar head excision produced distal radioulnar joint instability in the form of radioulnar convergence and increased anteroposterior translations. PMID:14599827

Gordon, K D; Dunning, C E; Johnson, J A; King, G J W

2003-12-01

64

Muscle Ciliary Neurotrophic Factor Receptor ? Promotes Axonal Regeneration and Functional Recovery Following Peripheral Nerve Lesion  

PubMed Central

Ciliary neurotrophic factor (CNTF) administration maintains, protects, and promotes the regeneration of both motor neurons (MNs) and skeletal muscle in a wide variety of models. Expression of CNTF receptor ? (CNTFR?), an essential CNTF receptor component, is greatly increased in skeletal muscle following neuromuscular insult. Together the data suggest that muscle CNTFR? may contribute to neuromuscular maintenance, protection, and/or regeneration in vivo. To directly address the role of muscle CNTFR?, we selectively-depleted it in vivo by using a “floxed” CNTFR? mouse line and a gene construct (mlc1f-Cre) that drives the expression of Cre specifically in skeletal muscle. The resulting mice were challenged with sciatic nerve crush. Counting of nerve axons and retrograde tracing of MNs indicated that muscle CNTFR? contributes to MN axonal regeneration across the lesion site. Walking track analysis indicated that muscle CNTFR? is also required for normal recovery of motor function. However, the same muscle CNTFR? depletion unexpectedly had no detected effect on the maintenance or regeneration of the muscle itself, even though exogenous CNTF has been shown to affect these functions. Similarly, MN survival and lesion-induced terminal sprouting were unaffected. Therefore, muscle CNTFR? is an interesting new example of a muscle growth factor receptor that, in vivo under physiological conditions, contributes much more to neuronal regeneration than to the maintenance or regeneration of the muscle itself. This novel form of muscle–neuron interaction also has implications in the therapeutic targeting of the neuromuscular system in MN disorders and following nerve injury. PMID:23504871

Lee, Nancy; Spearry, Rachel P.; Leahy, Kendra M.; Robitz, Rachel; Trinh, Dennis S.; Mason, Carter O.; Zurbrugg, Rebekah J.; Batt, Myra K.; Paul, Richard J.; Maclennan, A. John

2014-01-01

65

Fibrolipomatous hamartoma of nerve. A clinicopathologic analysis of 26 cases.  

PubMed

Nineteen cases of fibrolipomatous hamartoma of nerve without macrodactyly and seven cases with macrodactyly are discussed. Twenty-five involved the hand, wrist, palm, and finger, and one case involved the foot. Nineteen patients had isolated fibrofatty enlargement of nerve, while seven had macrodactyly in addition to the peripheral nerve changes. Involved nerves included the median nerve, ulnar nerve, an unidentified nerve near the elbow, and a nerve on the dorsum of the foot. Four of nine patients with neurologic symptoms of pain or paresthesias had physical findings compatible with compression neuropathy, and two others were described as having carpal tunnel syndrome. Most patients had been aware of a mass for several years. Microscopically, the lesion was characterized by fibrofatty enlargement of nerve with massive epineural and perineural fibrosis. In two of the cases with macrodactyly, the fibrofatty enlargement of the nerve was associated with overgrowth of bone and the surrounding subcutaneous tissues. In one case, the perineural fibrosis was associated with metaplastic bone. The histogenesis of fibrofatty overgrowth of nerve has been disputed. Mature fat cells have been described within the normal nerve sheath, and it is thought that proliferation of these cells leads to the fatty enlargement of the nerve and its coverings. The relationship of these neural changes to the development of macrodactyly remains controversial. Follow-up in 18 patients (69%) reveals a benign course following biopsy, limited excision, or division of the flexor retinaculum in the wrist. PMID:3970300

Silverman, T A; Enzinger, F M

1985-01-01

66

Asymptomatic spinal cord lesions in clinically isolated optic nerve, brain stem, and spinal cord syndromes suggestive of demyelination  

Microsoft Academic Search

OBJECTIVESConventional T2 weighted MRI studies have highlighted the fact that the presence of clinically silent brain lesions increases the risk of developing clinically definite multiple sclerosis after an isolated syndrome of the optic nerve, brain stem, or spinal cord. The objectives of the present study are: (1) to show whether or not these patients also have asymptomatic abnormalities of the

J I O’Riordan; N A Losseff; C Phatouros; A J Thompson; I F Moseley; D G MacManus; W I McDonald; D H Miller

1998-01-01

67

Evidence from Auditory Nerve and Brainstem Evoked Responses for an Organic Brain Lesion in Children with Autistic Traits  

ERIC Educational Resources Information Center

In an attempt to resolve the question as to whether children with autistic traits have an organic nervous system lesion, auditory nerve and brainstem evoked responses were recorded in a group of 15 children (4 to 12 years old) with autistic traits. (Author)

Student, M.; Sohmer, H.

1978-01-01

68

Case of fibrolipomatous hamartoma of the digital nerve without macrodactyly.  

PubMed

Fibrolipomatous hamartoma of nerves without macrodactyly is a rare lesion characterized by fibrofatty proliferation causing epineural and perineural fibrosis with fatty infiltration around the nerve bundles. We report an unusual case of fibromatous hamartoma of the ulnar digital nerve of the thumb in a 43-year-old woman. Magnetic resonance imaging revealed a large fusiform mass along the nerve. The findings were unusual and pathognomonic and included a coaxial cable-like appearance on axial sections and a spaghettilike appearance on coronal sections on both T1- and T2-weighted images; these findings were useful for the diagnosis and preoperative evaluation of this lesion. Surgical exploration revealed a yellow, cordlike mass of the digital nerve enlarged by fat. Gross excision could not be done without extensive damage to the nerve. Therefore, a limited excision with biopsy of the fibrolipomatous tissue around the nerve bundles was performed. The histological appearance was consistent with fibrolipomatous hamartoma. There was no recurrence of the mass and no neurological deficit 3 years after surgery. Some authors have suggested that invasive excision can cause catastrophic sensory or motor deficits because of the extensive fatty infiltration of the nerve fascicles. In conclusion, the recommended treatment for this lesion is limited excision with only biopsy to confirm the diagnosis. PMID:22197873

Nanno, Mitsuhiko; Sawaizumi, Takuya; Takai, Shinro

2011-01-01

69

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

70

Nerve injuries sustained during warfare: part I--Epidemiology.  

PubMed

We describe 261 peripheral nerve injuries sustained in war by 100 consecutive service men and women injured in Iraq and Afghanistan. Their mean age was 26.5 years (18.1 to 42.6), the median interval between injury and first review was 4.2 months (mean 8.4 months (0.36 to 48.49)) and median follow-up was 28.4 months (mean 20.5 months (1.3 to 64.2)). The nerve lesions were predominantly focal prolonged conduction block/neurapraxia in 116 (45%), axonotmesis in 92 (35%) and neurotmesis in 53 (20%) and were evenly distributed between the upper and the lower limbs. Explosions accounted for 164 (63%): 213 (82%) nerve injuries were associated with open wounds. Two or more main nerves were injured in 70 patients. The ulnar, common peroneal and tibial nerves were most commonly injured. In 69 patients there was a vascular injury, fracture, or both at the level of the nerve lesion. Major tissue loss was present in 50 patients: amputation of at least one limb was needed in 18. A total of 36 patients continued in severe neuropathic pain. This paper outlines the methods used in the assessment of these injuries and provides information about the depth and distribution of the nerve lesions, their associated injuries and neuropathic pain syndromes. PMID:22434470

Birch, R; Misra, P; Stewart, M P M; Eardley, W G P; Ramasamy, A; Brown, K; Shenoy, R; Anand, P; Clasper, J; Dunn, R; Etherington, J

2012-04-01

71

Quantitative Analysis of the Medial Ulnar Collateral Ligament Ulnar Footprint and Its Relationship to the Ulnar Sublime Tubercle  

Microsoft Academic Search

Background: The medial ulnar collateral ligament is the major soft tissue restraint to valgus displacement of the elbow. Currently, little has been published regarding the medial ulnar collateral ligament’s ulnar footprint.Hypothesis: The medial ulnar collateral ligament has a long attachment onto the ulna and the anatomy of the footprint is consistent.Study Design: Descriptive laboratory study.Methods: The authors studied the morphologic

Lutul D. Farrow; Andrew J. Mahoney; John J. Stefancin; Mihra S. Taljanovic; Joseph E. Sheppard; Mark S. Schickendantz

2011-01-01

72

Spinal nerve root injuries in brachial plexus lesions: basic science and clinical application of new surgical strategies. A review.  

PubMed

This paper reviews studies aimed at developing novel surgical means to correct functional deficits after spinal nerve root injuries in brachial plexus lesions. In a long series of animal experiments it has been possible to demonstrate re-established connectivity between severed roots and the damaged spinal cord segment. This encouraging functional recovery by a new surgical strategy of managing ventral root avulsion injuries prompted clinical application, with restoration of activity. PMID:7658961

Carlstedt, T P

1995-01-01

73

Ulnar-Sided Wrist Pain in the Athlete.  

PubMed

The athlete's wrist, especially those using bats, sticks, racquets, or clubs, is subjected to extremely high torque loads during athletic activities. These loads stress the stabilizing elements of the ulnocarpal and distal radioulnar complexes. Lesions of these regions can lead to painful dysfunction and instabilities that negatively impact athletic performance. This article reviews some of the common ulnar-sided maladies focusing on anatomy, biomechanics, diagnosis, and treatment. PMID:25455400

Crosby, Nicholas E; Greenberg, Jeffrey A

2015-01-01

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

Effects of Distal Nerve Injuries on Dorsal-Horn Neurons and Glia: Relationships Between Lesion Size and Mechanical Hyperalgesia  

PubMed Central

Penetrating limb injuries are common and usually heal without long-lasting effects, even when nerves are cut. However, rare nerve-injury patients develop prolonged and disabling chronic pain (neuralgia). When pain severity is disproportionate to severity of the inciting injury, physicians and insurers may suspect exaggeration and limit care or benefits, although the nature of the relationship between lesion-size and the development and persistence of neuralgia remains largely unknown. We compared cellular changes in the spinal dorsal-horn (the initial CNS pain-processing area) after partial or total tibial-nerve axotomies in male Sprague–Dawley rats to determine if these changes are proportional to the numbers of peripheral axons cut. Unoperated rats provided controls. Plantar hind-paw responses to touch, pin, and cold were quantitated bilaterally to identify hyperalgesic rats. We also compared data from nerve-injured rats with or without hyperalgesic responses to mechanical hind-paw stimulation to evaluate concordance between pain behaviors and dorsal-horn cellular changes. Hyperalgesia was no less prevalent or severe after partial than after total axotomy. L5 spinal-cord sections from rats killed 7 days postoperatively were labeled for markers of primary afferents (substance P calcitonin gene-related peptide isolectin B4, gamma aminobutyric acid, and glial fibrillary acidic protein), then labeled cells were stereologically quantitated in somatotopically defined dorsal-horn regions. Total axotomy reduced markers of primary afferents more than partial axotomy. In contrast, GABA-immunoreactive profiles were similarly reduced after both lesions, and in rats with sensory loss versus hyperalgesia. Numbers of GFAP-immunoreactive astrocytes increased independently of lesion size and pain status. Small nerve injuries can thus have magnified and disproportionate effects on dorsal-horn neurons and glia, perhaps providing a biological correlate for the disproportionate pain of post-traumatic neuralgias (including complex regional pain syndrome-I) that follow seemingly minor nerve injuries. However, the presence of similar dorsal-horn changes in rats without pain behaviors suggests that not all transcellular responses to axotomy are pain-specific. PMID:18992304

Lee, J. W.; Siegel, S. M.; Oaklander, A. L.

2008-01-01

76

Ulnar artery thrombosis: a 6-year experience.  

PubMed

Thrombosis of the ulnar artery can be a cause of significant morbidity. Most often a consequence of blunt trauma to the hypothenar eminence of the hand, it may be attributable to one traumatic event or to repetitive insults. Surgery is often required. We reviewed the presentation and diagnosis of ulnar artery thrombosis and evaluated the effectiveness of treatment by ulnar artery excision with interposition vein grafting. Retrospective chart analysis from 1989 to 1995 at the Medical Center of Central Georgia showed that nine patients (eight male, one female) were treated for ulnar artery thrombosis. Three had associated ulnar artery aneurysms. Eight of the nine were treated with artery excision and interposition vein grafting. Four also received stellate ganglion blocks before surgery. One was treated with stellate ganglion blocks alone. All patients had symptomatic relief and resolution of physical findings. We conclude that ulnar artery thrombosis can be managed with ulnar artery excision and interposition vein grafting when conservative measures fail. PMID:12132826

Troum, S J; Floyd, W E; Sapp, J

2001-01-01

77

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

78

Occupational lesion of the suprascapular nerve leading to marked atrophy of the supra- and infraspinatus muscles.  

PubMed

Suprascapular neuropathy is a relatively uncommon cause of shoulder pain and it is usually related to nerve entrapment. Marked atrophy of the supra- and infraspinatus muscles is not often observed, because the pain and limitation of movements could require medical attention at early stages of the disease. We report on a case of suprascapular neuropathy in a young male resulting from occupational compression of the nerve. A picture of the patient is included. PMID:19078749

Araujo, Mauro Gomes; Fragoso, Yara Dadalti

2004-09-01

79

Use of ultrasound and fluoroscopy guidance in percutaneous radiofrequency lesioning of the sensory branches of the femoral and obturator nerves.  

PubMed

Hip pain is a common condition that is often seen in patients with multiple comorbidities. Often surgery is not an option due to these comorbidities. Percutaneous radiofrequency lesioning of the articular branches of the obturator and femoral nerves is an alternative treatment for hip pain. Traditionally, fluoroscopy is used to guide needle placement. We report a case where a novel approach was used with ultrasound guidance to visualize vascular and soft tissue structures in real time. The use of ultrasound might help to guide the needle to avoid vascular complications due to anatomical variation between patients. PMID:23656575

Chaiban, Gassan; Paradis, Tyler; Atallah, Joseph

2014-04-01

80

Purpurin expression in the zebrafish retina during early development and after optic nerve lesion in adults.  

PubMed

Purpurin, a retina-specific protein, is known to play a role in cell adhesion during development of the chicken retina. Although purpurin has been significantly detected in adult chicken retina, its function in the matured retina is not well understood. Therefore, to determine the expression pattern of purpurin in the retina, we simultaneously investigated expression patterns of purpurin in the zebrafish retina during development in larvae and optic nerve regeneration after nerve transection in adults. In early development, levels of purpurin suddenly increased in the zebrafish retina 3 to 5 days after fertilization, and purpurin-positive immunoreactivity was diffusely located in all retinal layers. In contrast, levels of purpurin mRNA rapidly increased in the adult retina 1-3 days after optic nerve transection, and rapidly declined by 10 days after injury. Signal for purpurin mRNA was seen only in photoreceptors. Immunohistochemistry showed that levels of purpurin protein were also increased in the retina 1-3 days after nerve injury, but positive staining was located in photoreceptors and ganglion cells, and the staining in ganglion cells was stronger than that in photoreceptors. Thus, the transient expression of purpurin protein was greatly different during development and optic nerve regeneration. In the former, purpurin may be required in all retinal layers, whereas in the latter, purpurin may be required for injured ganglion cells. PMID:17466280

Tanaka, Masayuki; Murayama, Daisuke; Nagashima, Mikiko; Higashi, Tomomi; Mawatari, Kazuhiro; Matsukawa, Toru; Kato, Satoru

2007-06-11

81

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

82

Effects of histidine and n-acetylcysteine on experimental lesions induced by doxorubicin in sciatic nerve of rats.  

PubMed

Abstract In this study, the effect of separate and combined intraperitoneal (i.p.) injections of histidine and n-acetylcysteine were investigated on experimental damage induced by doxorubicin (DOX) in sciatic nerve of rats. DOX was i.p. injected at a dose of 4?mg/kg once weekly for four weeks. Histidine and n-acetylcysteine were i.p. injected at a same dose of 20?mg/kg. Cold and mechanical allodynia were recorded using acetone spray and von Frey filaments tests, respectively. The sciatic nerve damage was evaluated by light microscopy. Plasma levels of malondialdehyde (MDA) and total antioxidant capacity (TAC) were measured. Histidine and especially n-acetylcysteine at a same dose of 20?mg/kg suppressed cold and mechanical allodynia, improved sciatic nerve lesions and reversed MDA and TAC levels in DOX-treated groups. Combination treatment with histidine and n-acetylcysteine showed better responses when compared with them used alone. The results of the present study showed peripheral neuroprotective effects for histidine and n-acetylcysteine. Reduction of free radical-induced toxic effects may have a role in neuroprotective properties of histidine and n-acetylcysteine. PMID:25427688

Farshid, Amir Abbas; Tamaddonfard, Esmaeal; Najafi, Sima

2014-11-27

83

Cardiovascular responses to sciatic nerve stimulation are blocked by paratrigeminal nucleus lesion  

Microsoft Academic Search

The paratrigeminal nucleus (Pa5) receives primary sensory inputs from the vagus, glossopharyngeal, and trigeminal nerves and has efferent projections to the nucleus of the solitary tract (NTS), rostroventrolateral reticular nucleus (RVL), as well as to the nucleus ambiguus (Amb), lateral reticular (LRt), parabrachial (PB) and ventral posteromedial thalamic (VPM) nuclei, suggesting that it may play a significant role in cardiovascular

Yun-Guo Yu; Cristofer A Caous; Antonio C Balan; Giles A Rae; Charles J Lindsey

2002-01-01

84

Ulnar artery aneurysm of the hand.  

PubMed

A case of traumatic ulnar artery aneurysm is presented in this study, and the relationship between the various forms of ulnar artery aneurysm and the different methods of treatment, as well as the arterial implications are discussed. The individual palmar arch anatomy may indicate and influence the choice of management technique, in each case. PMID:6662632

Bayle, E; Tran, K; Benslamia, H; Dufilho, A; Drouard, F

1983-01-01

85

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, Êmyle; Teixeira Goes, Bruno; Zugaib Cavalcanti, João; Vannier-Santos, Marcos André; Martinez, Ana Maria Blanco; Baptista, Abrahão Fontes

2014-01-01

86

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

87

Novel surgical strategies to correct neural deficits following experimental spinal nerve root lesions.  

PubMed

In attempts to correct neural deficits following avulsion trauma, novel experimental strategies were developed. In rats, spinal roots were replanted superficially in the dorsal horn following dorsal root avulsion and concomitant denervation by ganglionectomy. Outgrowth from cord neurons in the dorsal horn into the implanted dorsal root was demonstrated by means of retrograde HRP labeling. Double labeling experiments showed that some of these neurons had retained their central projections while extending new processes into the implanted root. After dorsal root avulsion, sensory pathways might be reconstructed by substituting the lost input from damaged primary sensory neurons with induced peripheral outgrowths from secondary neurons. In primates, intraspinal replantation of avulsed ventral nerve roots was investigated as a surgical treatment for motor deficits that develop after severe brachial plexus injury. Two to 3 months after surgery there were EMG signs of reinnervation in previously denervated muscles, which were shortly followed by evidence of clinical recovery. A gradual improvement in the function of the affected arm occurred and motor behavior became normalized, although the EMG activity in the reinnervated muscles at maximal contraction was still reduced. The outcome of these experimental studies indicates that reconstructive surgery applied to the brachial plexus might be of value to restore functional deficits induced by traumatic spinal nerve root avulsions also in man. PMID:8457894

Carlstedt, T; Aldskogius, H; Hallin, R G; Nilsson-Remahl, I

1993-01-01

88

Injury to ulnar collateral ligament of thumb.  

PubMed

Injury of the ulnar collateral ligament (UCL) of thumb can be incapacitating if untreated or not treated properly. This injury is notorious for frequently being missed by inexperienced health care personnel in emergency departments. It has frequently been described in skiers, but also occurs in other sports such as rugby, soccer, handball, basketball, volleyball and even after a handshake. The UCL of the thumb acts as a primary restraint to valgus stress and is injured if hyperabduction and hyperextension forces are applied to the first metacarpophalangeal joint. The diagnosis is best established clinically, though MRI is the imaging modality of choice. Many treatment options exist, surgical treatment being offered depending on various factors, including timing of presentation (acute or chronic), grade (severity of injury), displacement (Stener lesion), location of tear (mid-substance or peripheral), associated or concomitant surrounding tissue injury (bone, volar plate, etc.), and patient-related factors (occupational demands, etc.). This review aims to identify the optimal diagnostic techniques and management options for UCL injury available thus far. PMID:24590986

Madan, Simerjit Singh; Pai, Dinker R; Kaur, Avneet; Dixit, Ruchita

2014-02-01

89

Granulocyte macrophage colony stimulating factor produced in lesioned peripheral nerves induces the up-regulation of cell surface expression of MAC-2 by macrophages and Schwann cells  

PubMed Central

Peripheral nerve injury is followed by Wallerian degeneration which is characterized by cellular and molecular events that turn the degenerating nerve into a tissue that supports nerve regeneration. One of these is the removal, by phagocytosis, of myelin that contains molecules which inhibit regeneration. We have recently documented that the scavenger macrophage and Schwann cells express the galactose- specific lectin MAC-2 which is significant to myelin phagocytosis. In the present study we provide evidence for a mechanism leading to the augmented expression of cell surface MAC-2. Nerve lesion causes noneuronal cells, primarily fibroblasts, to produce the cytokine granulocyte macrophage-colony stimulating factor (GM-CSF). In turn, GM- CSF induces Schwann cells and macrophages to up-regulate surface expression of MAC-2. The proposed mechanism is based on the following novel observations. GM-CSF mRNA was detected by PCR in in vitro and in vivo degenerating nerves, but not in intact nerves. The GM-CSF molecule was detected by ELISA in medium conditioned by in vitro and in vivo degenerating peripheral nerves as of the 4th h after injury. GM-CSF activity was demonstrated by two independent bioassays, and repressed by activity blocking antibodies. Significant levels of GM-CSF were produced by nerve derived fibroblasts, but neither by Schwann cells nor by nerve derived macrophages. Mouse rGM-CSF enhanced MAC-2 production in nerve explants, and up-regulated cell surface expression of MAC-2 by Schwann cells and macrophages. Interleukin-1 beta up-regulated GM-CSF production thus suggesting that injury induced GM-CSF production may be mediated by interleukin-1 beta. Our findings highlight the fact that fibroblasts, by producing GM-CSF and thereby affecting macrophage and Schwann function, play a significant role in the cascade of molecular events and cellular interactions of Wallerian degeneration. PMID:8601605

1996-01-01

90

Effect of change in macular birefringence imaging protocol on retinal nerve fiber layer thickness parameters using GDx VCC in eyes with macular lesions.  

PubMed

This study evaluates the effect of two macular birefringence protocols (bow-tie retardation and irregular macular scan) using GDx VCC on the retinal nerve fiber layer (RNFL) thickness parameters in normal eyes and eyes with macular lesions. In eyes with macular lesions, the standard protocol led to significant overestimation of RNFL thickness which was normalized using the irregular macular pattern protocol. In eyes with normal macula, absolute RNFL thickness values were higher in irregular macular pattern protocols with the difference being statistically significant for all parameters except for inferior average thickness. This has implications for monitoring glaucoma patients who develop macular lesions during the course of their follow-up. PMID:24469116

Dada, Tanuj; Tinwala, Sana I; Dave, Vivek; Agarwal, Anand; Sharma, Reetika; Wadhwani, Meenakshi

2014-08-01

91

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

92

Peripheral nerve ultrasound in ALS phenotypes.  

PubMed

Introduction. We sought to determine the cross sectional area (CSA) of peripheral nerves in patients with distinct subtypes of amyotrophic lateral sclerosis (ALS). Methods. Ulnar and median nerve ultrasound was performed in 78 ALS patients [classic, n=21, upper motor neuron dominant (UMND), n=14, lower motor neuron dominant (LMND), n=20, bulbar, n=15, primary lateral sclerosis (PLS) n=8] and 18 matched healthy controls. Results. Compared to controls ALS patients had significant, distally pronounced reductions of ulnar CSA (forearm/wrist level) across all disease groups except for PLS. Median nerve CSA (forearm/wrist level) did not differ between controls and ALS. Conclusion. Ulnar nerve ultrasound in ALS subgroups revealed significant differences in distal CSA values, which suggests it has value as a marker of LMN involvement. Its potential was particularly evident in UMND and PLS groups, which can be hard to separate clinically, yet their accurate separation has important prognostic implications. © 2014 Wiley Periodicals, Inc. PMID:25155020

Schreiber, Stefanie; Abdulla, Susanne; Debska-Vielhaber, Grazyna; Machts, Judith; Dannhardt-Stieger, Verena; Feistner, Helmut; Oldag, Andreas; Goertler, Michael; Petri, Susanne; Kollewe, Katja; Kropf, Siegfried; Schreiber, Frank; Heinze, Hans-Jochen; Dengler, Reinhard; Nestor, Peter J; Vielhaber, Stefan

2014-08-25

93

Lesion-induced increase in nerve growth factor mRNA is mediated by c-fos  

SciTech Connect

Lesion of the sciatic nerve caused a rapid increase in c-fos and c-jun mRNA that was followed about 2 hr later by an increase in nerve growth factor (NGF) mRNA. To evaluate whether the initial increase in c-fos mRNA is casually related to the subsequent increase in NGF mRNA, the authors performed experiments with fibroblasts of transgenic mice carrying an exogenous c-fos gene under the control of a metallothionein promoter. In primary cultures of these fibroblasts, CdCl{sub 2} evoked a rapid increase in exogenous c-fos mRNA, followed immediately by an increase in endogenous c-jun mRNA and with a slight delay by an increase in NGF mRNA. In fibroblasts of C3H control mice, CdCl{sub 2} had no effect on the mRNA levels of the protooncogenes c-fos and c-jun or of NGF. Additional evidence for a casual relationship between c-fos induction and the subsequent increase in NGF mRNA was obtained in cotransfection experiments. DNase I footprint experiments demonstrated that a binding site for transcription factor AP-1 in the first intron of the NGF gene was protected following c-fos induction. That this protected AP-1 site indeed was functional in the regulation of NGF expression was verified by deletion experiments and by a point mutation in the corresponding AP-1 binding region in the NGF promoter-chloramphenicol acetyltransferase reporter construct.

Hengerer, B.; Lindholm, D.; Heumann, R.; Thoenen, H. (Max Planck Institute for Psychiatry, Munich (West Germany)); Ruether, U. (European Molecular Biology Laboratory, Heidelberg (West Germany)); Wagner, E.F. (Research Institute of Molecular Pathology, Vienna (Austria))

1990-05-01

94

Bilateral fibrolipomatous hamartoma of the median nerve with macrocheiria and late-onset nerve entrapment syndrome.  

PubMed

The case of a 46-year-old man is reported who presented with an extraordinary constellation of fibrolipomatous hamartomas of the right ulnar and both median nerves, with a right-sided giant hand ("macrocheiria") due to enlarged bones and subcutaneous tissue, and unusual late manifestation of nerve entrapment at the right wrist. Magnetic resonance imaging of the hypertrophied nerves disclosed large nerve fascicles surrounded by fibrous tissue, which allowed preoperative diagnosis. PMID:9572249

Meyer, B U; Röricht, S; Schmitt, R

1998-05-01

95

Percutaneous radiofrequency lesioning of the suprascapular nerve for the management of chronic shoulder pain: a case series  

PubMed Central

Purpose The objective of this study was to retrospectively evaluate the analgesic effects of continuous radiofrequency lesioning of the suprascapular nerve (SSN) for chronic shoulder pain. The authors sought to obtain insight into the time-sensitive analgesic success and complications of this therapy. Patients and methods This study was a retrospective case series involving patients with unremitting shoulder pain that had lasted for at least 12 months. Patients were selected if they showed a reduction of at least 50% in pain intensity during the anesthetic phase after SSN block, no additional motor weakness of the shoulder, and pain relief lasting for less than 2 months after separate treatments of the SSN with depot corticosteroids and pulsed radiofrequency. Nine patients were referred to the Arnold Pain Management Center. Of these nine patients, six patients who had significant chronic shoulder pain unresponsive to oral medications and intra-articular injections and who were not considered surgical candidates were selected. These patients were treated with a single radiofrequency lesion of the SSN at 80°C for 60 seconds. The primary outcome was a reduction in pain intensity by 50%, as determined by the numeric rating scale, and duration of this effect. The secondary outcome was improvement in either the passive or the active range of motion (ROM). Patients were also monitored for adverse effects such as weakness or increased pain. Results The pooled mean numeric rating scale score before the procedure was 7.2 ± 1.2; this fell to 3.0 ± 0.9 at 5–7 weeks post procedure. The duration of pain relief ranged from 3 to 18 months, and all patients underwent at least one additional treatment. The change in baseline ROM improved from an average of 60° ± 28° (flexion) and 58° ± 28° (abduction) to 99° ± 46° (flexion) and 107° ± 39° (abduction). No adverse side effects were observed. Conclusion Continuous radiofrequency lesioning of the SSN seems to be an effective treatment for chronic shoulder pain. There can be improved ROM of the shoulder following this treatment. More formal, controlled studies are required to confirm these observations. PMID:22570561

Simopoulos, Thomas T; Nagda, Jyotsna; Aner, Musa M

2012-01-01

96

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

97

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

98

A rare case of peripheral nerve hemangioblastoma-case report and literature review.  

PubMed

Hemangioblastoma is a rare benign tumor that consists of neoplastic vacuolated stromal cells and highly developed capillary blood vessels. These tumors are almost exclusively found in the central nervous system, but in extremely rare cases, it can arise in peripheral nerves. In the majority of cases, it occurs sporadically (60 to 75 %), but in about 25 % of cases, it is associated with von Hippel-Lindau disease. We present the first case of ulnar nerve hemangioblastoma in a 70-year-old male. The patient presented with a slow-growing palpable mass on the front side of the right upper arm. Macroscopically, the tumor was round shaped, encapsulated, reddish-orange in color, very well vascularized, and about 3 cm in diameter; one nerve fascicle was entering the tumor tissue, so it was resected with the tumor. The rest of the nerve fascicles were intact. Postoperative course was uneventful. Histopathological analysis with immunohistochemical analysis confirmed that the tumor was a peripheral nerve hemangioblastoma WHO grade I. Physical treatment was conducted, and there was no motor neurological deficit on follow-up after 3 months, only hypoesthesia of the fourth and fifth finger. These lesions are so rarely found arising from peripheral nerves that only four published cases exist in literature today. There is very little data about these tumors in world literature, so we consider our paper a valuable contribution to global knowledge on these tumors. PMID:25323100

Rasulic, Lukas; Samardzic, Miroslav; Bascarevic, Vladimir; Micovic, Mirko; Cvrkota, Irena; Zivkovic, Bojana

2015-01-01

99

Nerve conduction in Frogs and Humans  

NSDL National Science Digital Library

These exercises are taken from a vertebrate physiology course, and use either a human subject or a dissected frog, thus providing relatively simply alternatives that may suit your needs. Nerve conduction velocity can be measured in the frog sciatic nerve with recordings of the biphasic action potential on the outside of the nerve trunk. Absolute and relative refractory periods can also be determined. Conduction velocity in the human can be obtained from electromyograms taken from the fourth and fifth fingers following stimulation of the ulnar nerve.

Elizabeth Vizsolyi (Univ. of British Columbia; )

1988-06-13

100

Palmar cutaneous nerve conduction in patients with carpal tunnel syndrome.  

PubMed

Objective: This study aimed to assess palmar cutaneous branch of the median nerve (PCBm) conduction in patients with clinically diagnosed carpal tunnel syndrome (CTS), to compare PCBm conduction with that of the median and ulnar nerves, and to determine the PCBm conduction abnormality rate in patients with CTS. Materials and Methods: The study included 99 hands of 60 patients with clinical CTS and 38 hands of 38 healthy controls. Sensory nerve conduction study (NCS) was performed on the median nerve, ulnar nerve, and PCBm, and onset latency, conduction velocity and amplitude were recorded. Additionally, differences in latency and velocity between the median nerve and PCBm, and the difference in latency between the median and ulnar nerves were calculated. Results: In all, 56% of the patients with CTS had abnormal PCBm conduction. Additionally, in 7 of 8 hands with abnormal sensation -both in the thenar eminence and abnormal sensory distribution along the main branch -NCS of the PCBm was also abnormal. Conclusions: The PCBm is not ideal as a comparator nerve for the neurophysiological diagnosis of CTS. The frequency of PCBm abnormality in CTS patients may be related to the concomitant damage in both of these nerves. Additionally, the present findings may help explain, at least in part, why patients with CTS often exhibit sensory involvement beyond the classical median nerve sensory borders. PMID:25271802

Uluc, Kayihan; Aktas, Ilknur; Sunter, Gulin; Kahraman Koytak, Pinar; Akyuz, Gulseren; Isak, Baris; Tanridag, Tulin; Us, Onder

2014-11-01

101

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

102

Fibrolipomatous hamartoma of median nerve.  

PubMed

Fibrolipomaous hamartoma is a benign neoplasm of nerves, resulting from anomalous growth of fibroadipose tissue of the nerve sheath. The median nerve is the most commonly involved nerve. Magnetic resonance imaging (MRI) features are pathognomonic, showing a coaxial cable-like appearance on axial images and spaghetti-like appearance on coronal images. Preferred management of the lesion is conservative. PMID:17875173

Jain, T P; Srivastava, D N; Mittal, R; Gamanagatti, S

2007-10-01

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

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

2014-01-01

104

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

105

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

106

Sympathetic skin response and regeneration of sudomotor fibers after complete division of peripheral nerves  

Microsoft Academic Search

Sympathetic skin responses (SSRs) were studied in hands of patients during regeneration of their median or ulnar nerves following complete severance and suture. The SSRs were elicited with electrical stimuli presented to the forearm of the normal side and recorded between the dorsum of the hand and three sites in the innervation area of the two nerves. The amplitude and

Uroš Ah?an; Jerneja Kolbl; Martin Janko

1996-01-01

107

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

PubMed

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

108

Fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve).  

PubMed

Fibrolipomatous hamartoma (FLH) is a rare, benign lesion of the peripheral nerves most frequently involving the median nerve and its digital branches (80 %). Pathognomonic MR features of FLH such as coaxial-cable-like appearance on axial planes and a spaghetti-like appearance on coronal planes have been described by Marom and Helms, obviating the need for diagnostic biopsy. We present a case of fibrolipomatous hamartoma of the inferior calcaneal nerve (Baxter nerve) with associated subcutaneous fat proliferation. PMID:22526881

Zeng, Rong; Frederick-Dyer, Katherine; Ferguson, N Lynn; Lewis, James; Fu, Yitong

2012-09-01

109

Nerve conduction studies in early tuberculoid leprosy  

PubMed Central

Context: Hansen's disease is a chronic illness; besides involving skin and peripheral nerves, it affects multiple organs. Nerve involvement is always present in leprosy, and it may be present much before the patient manifests clinically. Aims: To assess nerve conduction parameters in thickened and contralateral non-thickened nerves in early tuberculoid leprosy Materials and Methods: Fifty new untreated male patients with tuberculoid and borderline tuberculoid leprosy in the age group of 15-50 years with thickened peripheral nerves on one side were included in the study. Nerve conduction studies consisting of sensory and motor velocity (NCV), distal latencies, and amplitude were carried out on thickened ulnar, common peroneal, and posterior tibial nerves and contralateral normal nerves. Statistical Analysis Used: Mean values along with coefficient of variation were obtained for various parameters. These were compared with normal values of the control population. P value was used to verify statistical significance. Results: Nerve conduction parameters were deranged in most of the thickened nerves. Sensory parameters were affected early in the disease process. Conclusion: Additional parameters are required to assess nerve damage in early cases, where it is more in slow conducting fibers (average velocity fibers). Change in conduction velocity may not be marked; this calls for the measurement of fast fibers separately because potentials recorded are mainly from myelinated fibers. PMID:25593812

Vashisht, Deepak; Das, Arjun Lal; Vaishampayan, Sanjeev S; Vashisht, Surbhi; Joshi, Rajneesh

2014-01-01

110

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. PMID:25317163

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

2014-01-01

111

Effects of Acute Organophosphorus Poisoning on Function of Peripheral Nerves: A Cohort Study  

PubMed Central

Background Following acute organophosphorus (OP) poisoning patients complain of numbness without objective sensory abnormalities or other features of OP induced delayed polyneuropathy. The aim of this study was to measure peripheral nerve function after acute exposure to OP. Methods A cohort study was conducted with age, gender and occupation matched controls. Motor nerve conduction velocity (MNCV), amplitude and area of compound muscle action potential (CMAP), sensory nerve conduction velocity (SNCV), F- waves and electromyography (EMG) on the deltoid and the first dorsal interosseous muscles on the dominant side were performed, following acute OP poisoning. All neurophysiological assessments except EMG were performed on the controls. Assessments were performed on the day of discharge from the hospital (the first assessment) and six weeks (the second assessment) after the exposure. The controls were assessed only once. Results There were 70 patients (50 males) and 70 controls. Fifty-three patients attended for the second assessment. In the first assessment MNCV of all the motor nerves examined, CMAP amplitude and SNCV of ulnar nerve, median and ulnar F-wave occurrence in the patients were significantly reduced compared to the controls. In the second assessment significant reduction was found in SNCV of both sensory nerves examined, MNCV of ulnar nerve, CMAP amplitude of common peroneal nerve, F-wave occurrence of median and ulnar nerves. No abnormalities were detected in the patients when compared to the standard cut-off values of nerve conduction studies except F-wave occurrence. EMG studies did not show any abnormality. Conclusion There was no strong evidence of irreversible peripheral nerve damage following acute OP poisoning, however further studies are required. PMID:23185328

Jayasinghe, Sudheera S.; Pathirana, Kithsiri D.; Buckley, Nick A.

2012-01-01

112

Nerve conduction velocity study of the upper limb in Raynaud's phenomenon.  

PubMed

A prospective study of upper limb nerve conduction velocity was performed in 39 subjects (9 males, 30 females, mean age 46.8 years) with idiopathic Raynaud's phenomenon (RP) and 18 patients (3 males, 15 females, mean age 49.9 years) with RP secondary to systemic sclerosis (SS). Five subjects with idiopathic RP (13%) showed slowing of sensory conduction velocity (SCV) of the distal median nerve, associated with delayed distal motor latency (DML) of the same nerve in three patients, without clinical signs or symptoms of carpal tunnel syndrome (CTS). Three patients with secondary RP (17%) had reduction of SCV of the distal median nerve, associated with increased DML of the same nerve in one and with clinically silent slowing of SCV of the ulnar nerve in two (11%). Mean distal SCVs of the median nerve were significantly lower and mean DMLs were significantly higher in both groups with respect to a control group. Mean distal conduction of the ulnar nerve was significantly slower only in the group with secondary RP. No slowing was observed in the proximal part of any nerve. It seems likely that patients with idiopathic RP have slowing of conduction in the distal part of the median nerve, along the carpal tunnel. Since slowing does not occur in all parts of the nerves of the hand, it cannot be related to acral vasomotor disturbances, but to local or systemic factors. In contrast, patients with secondary RP had slowing of median and ulnar nerve conduction velocity, presumably related to subclinical distal peripheral neuropathy. A nerve conduction study of the hand could be useful in cases of suspected secondary origin of RP. In idiopathic RP, slowing of conduction may only affect the median nerve, whereas in secondary RP it may affect other nerves of the hand. PMID:10984133

Mondelli, M; Romano, C; De Stefano, R; Cioni, R

2000-01-01

113

Corrective osteotomy for malunion of the distal radius: the effect of concomitant ulnar shortening osteotomy.  

PubMed

Positive ulnar variance due to inadequate correction of radial length is a common disorder after radial corrective osteotomy. To avoid this complication we performed a combination of ulnar-shortening osteotomy and radial corrective osteotomy in 6 of 22 radial corrections. The indication for the combined procedure was a relative ulnar length of minimally 6 mm. The functional outcome was fair in 1 and good in 5 cases with combined osteotomy. Overall, the functional results were good in 17 cases, and pain in the distal radioulnar joint was observed in 3 of 22 patients. Positive ulnar variance was the reason for pain in only 1 patient. Eventually, 2 hemiresections of the ulnar head (Bower's arthroplasty) were performed. It appears that a combination of ulnar shortening and radial osteotomy is a reliable technique, which can reduce symptoms and need for secondary operations on the ulnar side of the wrist. PMID:8861595

Oskam, J; Bongers, K M; Karthaus, A J; Frima, A J; Klasen, H J

1996-01-01

114

Axo-glial dysjunction. A novel structural lesion that accounts for poorly reversible slowing of nerve conduction in the spontaneously diabetic bio-breeding rat.  

PubMed Central

Biochemical abnormalities in peripheral nerve are thought to precede and condition the development of diabetic neuropathy, but metabolic intervention in chronic diabetic neuropathy produces only limited acute clinical response. The residual, metabolically unresponsive neurological deficits have never been rigorously defined in terms of either persistent metabolic derangements or irreversible structural defects because human nerve tissue is rarely accessible for anatomical and biochemical study and experimentally diabetic animals do not develop the structural hallmarks of human diabetic neuropathy. Detailed neuroanatomical-functional-biochemical correlation was therefore undertaken in long-term spontaneously diabetic BB-Wistar rats that functionally and structurally model human diabetic neuropathy. Vigorous insulin replacement in chronically diabetic BB rats essentially normalized both the sural nerve fiber caliber spectrum and the decreased sciatic nerve myo-inositol and (Na,K)-ATPase levels generally associated with conduction slowing in diabetic animals; yet, nerve conduction was only partially restored toward normal. Morphometric analysis revealed a striking disappearance of paranodal axo-glial junctional complexes that was not corrected by insulin replacement. Loss of these strategic junctional complexes, which are thought to limit lateral migration of axolemmal Na channels away from nodes of Ranvier, correlates with and can account for the diminished nodal Na permeability and resultant nodal conduction delay characteristic of chronic diabetic neuropathy in this animal model. Images PMID:3003160

Sima, A A; Lattimer, S A; Yagihashi, S; Greene, D A

1986-01-01

115

Conduction velocity in the proximal segments of a motor nerve in the Guillain-Barré syndrome  

Microsoft Academic Search

Conduction velocity from spinal cord to axilla (estimated using the F wave) has been compared with conduction velocity from axilla to wrist (measured in the conventional manner) in the motor fibres of the ulnar nerve in 17 controls subjects and in 11 patients with the Guillain-Barré syndrome (GBS). In the patients with GBS the conduction velocity was, in general reduced

D King; P Ashby

1976-01-01

116

A Comparison of Ulnar Shortening Osteotomy Alone Versus Combined Arthroscopic Triangular Fibrocartilage Complex Debridement and Ulnar Shortening Osteotomy for Ulnar Impaction Syndrome  

PubMed Central

Background This study compared the results of patients treated for ulnar impaction syndrome using an ulnar shortening osteotomy (USO) alone with those treated with combined arthroscopic debridement and USO. Methods The results of 27 wrists were reviewed retrospectively. They were divided into three groups: group A (USO alone, 10 cases), group B (combined arthroscopic debridement and USO, 9 cases), and group C (arthroscopic triangular fibrocartilage complex [TFCC] debridement alone, 8 cases). The wrist function was evaluated using the modified Mayo wrist score, disabilities of the arm, shoulder and hand (DASH) score and Chun and Palmer grading system. Results The modified Mayo wrist score in groups A, B, and C was 74.5 ± 8.9, 73.9 ± 11.6, and 61.3 ± 10.2, respectively (p < 0.05). The DASH score in groups A, B, and C was 15.6 ± 11.8, 19.3 ± 11.9, and 33.2 ± 8.5, respectively (p < 0.05). The average Chun and Palmer grading score in groups A and B was 85.7 ± 8.9 and 84.7 ± 6.7, respectively. The difference in the Mayo wrist score, DASH score and Chun and Palmer grading score between group A and B was not significant (p > 0.05). Conclusions Both USO alone and combined arthroscopic TFCC debridement with USO improved the wrist function and reduced the level of pain in the patients treated for ulnar impaction syndrome. USO alone may be the preferred method of treatment in patients if the torn flap of TFCC is not unstable. PMID:21909465

Song, Hyun Seok

2011-01-01

117

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

Microsoft Academic Search

Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex\\u000a anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US),\\u000a computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to\\u000a differential diagnosis. Clinical imaging findings are reviewed

Atsuya Watanabe; Felipe Souza; Peter S. Vezeridis; Philip Blazar; Hiroshi Yoshioka

2010-01-01

118

Ulnar variance and the role of joint levelling procedure for Kienböck's disease  

Microsoft Academic Search

Forty patients with Kienböck's disease were reviewed to determine the relationship between ulnar variance and the development of Kienböck's disease in a Japanese cohort. The joint levelling procedures designed to correct ulnar variance were evaluated in 11 patients after a mean of 9.7 years following surgery. The mean ulnar variance was 0.50±1.67 in patients with Kienböck's disease and 0.56±1.76 in

Keiichi Muramatsu; Koichiro Ihara; Shinya Kawai; Kazuteru Doi

2003-01-01

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

A rare variant of the ulnar artery with important clinical implications: a case report  

PubMed Central

Background Variations in the major arteries of the upper limb are estimated to be present in up to one fifth of people, and may have significant clinical implications. Case presentation During routine cadaveric dissection of a 69-year-old fresh female cadaver, a superficial brachioulnar artery with an aberrant path was found bilaterally. The superficial brachioulnar artery originated at midarm level from the brachial artery, pierced the brachial fascia immediately proximal to the elbow, crossed superficial to the muscles that originated from the medial epicondyle, and ran over the pronator teres muscle in a doubling of the antebrachial fascia. It then dipped into the forearm fascia, in the gap between the flexor carpi radialis and the palmaris longus. Subsequently, it ran deep to the palmaris longus muscle belly, and superficially to the flexor digitorum superficialis muscle, reaching the gap between the latter and the flexor carpi ulnaris muscle, where it assumed is usual position lateral to the ulnar nerve. Conclusion As far as the authors could determine, this variant of the superficial brachioulnar artery has only been described twice before in the literature. The existence of such a variant is of particular clinical significance, as these arteries are more susceptible to trauma, and can be easily confused with superficial veins during medical and surgical procedures, potentially leading to iatrogenic distal limb ischemia. PMID:23194303

2012-01-01

121

Isolated cranial nerve palsies in multiple sclerosis  

PubMed Central

During a 10 year period 24 patients with definite multiple sclerosis with isolated cranial nerve palsies were studied (third and fourth nerve: one patient each, sixth nerve: 12 patients, seventh nerve: three patients, eighth nerve: seven patients), in whom cranial nerve palsies were the presenting sign in 14 and the only clinical sign of an exacerbation in 10 patients. MRI was carried out in 20 patients and substantiated corresponding brainstem lesions in seven patients (third nerve: one patient, sixth nerve: four patients, eighth nerve: two patients). Additional abnormal findings of electro-oculography, or masseter reflex, or blink reflex, or combinations of these were found in 20 patients and interpreted in favour of a brainstem lesion at the level of the respective cranial nerve. In 11 of 14 patients with isolated cranial nerve palsies as the presenting sign of multiple sclerosis, dissemination in space was documented by MRI, and in the remaining three by evoked potentials. In patients with multiple sclerosis with isolated cranial nerve palsies, MRI is the most sensitive method of documenting dissemination in space and electrophysiological testing the most sensitive at disclosing brainstem lesions.?? PMID:9408116

Thomke, F.; Lensch, E.; Ringel, K.; Hopf, H. C.

1997-01-01

122

Peripheral nerve injuries in sports-related surgery: presentation, evaluation, and management: AAOS exhibit selection.  

PubMed

Peripheral nerve injuries during sports-related operative interventions are rare complications, but the associated morbidity can be substantial. Early diagnosis, efficient and effective evaluation, and appropriate management are crucial to maximizing the prognosis, and a clear and structured algorithm is therefore required. We describe the surgical conditions and interventions that are commonly associated with intraoperative peripheral nerve injuries. In addition, we review the common postoperative presentations of patients with these injuries as well as the anatomic structures that are directly injured or associated with these injuries during the operation. Some examples of peripheral nerve injuries incurred during sports-related surgery include ulnar nerve injury during ulnar collateral ligament reconstruction of the elbow and elbow arthroscopy, median nerve injury during ulnar collateral ligament reconstruction of the elbow, axillary nerve injury during Bankart repair and the Bristow transfer, and peroneal nerve injury during posterolateral corner reconstruction of the knee and arthroscopic lateral meniscal repair. We also detail the clinical and radiographic evaluation of these patients, including the utility and timing of radiographs, magnetic resonance imaging (MRI), ultrasonography, electromyography (EMG), and nonoperative or operative management. The diagnosis, evaluation, and management of peripheral nerve injuries incurred during sports-related surgical interventions are critical to minimizing patient morbidity and maximizing postoperative function. Although these injuries occur during a variety of procedures, common themes exist regarding evaluation techniques and treatment algorithms. Nonoperative treatment includes physical therapy and medical management. Operative treatments include neurolysis, transposition, neurorrhaphy, nerve transfer, and tendon transfer. This article provides orthopaedic surgeons with a simplified, literature-based algorithm for evaluation and management of peripheral nerve injuries associated with sports-related operative procedures. PMID:22992827

Maak, Travis G; Osei, Daniel; Delos, Demetris; Taylor, Samuel; Warren, Russell F; Weiland, Andrew J

2012-08-15

123

Rotatory palmar subluxation of the lunate in post-traumatic ulnar carpal translocation  

Microsoft Academic Search

Post-traumatic ulnar carpal translocation is a rare, severe ligamentous injury to the wrist. Radiologic findings include widening of the radiocarpal joint space at the radial styloid process and ulnar displacement of the carpus. Less than 50% of the lunate articulates with the radius in the neutral position; the lunate is tilted dorsally with palmar subluxation due to a ruptured radioscapholunate

Axel Stäbler; Richard G. H. Baumeister; Ulrike Szeimies; Ulrich Fink; Hermann Berger

1994-01-01

124

The practical uses of ultrasound in a clinical setting to diagnose thrombosis of the ulnar artery.  

PubMed

A 43-year-old professional skateboarder presented to the sports medicine clinic with complaints of left wrist pain to the ulnar aspect. Two weeks prior to presentation, his wrist became suddenly painful with no specific trauma. He reported a history of falls over the years while skateboarding but none directly correlated to his onset of wrist pain. Radiographic results were negative for wrist or hand fracture. Physical examination yielded tenderness and mild swelling to the ulnar aspect of the wrist. Musculoskeletal ultrasound was used to assess tendon and ligament integrity, all of which was intact. Both radial and ulnar arteries were visualized, and ulnar artery thrombosis was incidentally diagnosed. He was advised to immediately proceed to the hospital, where an open arthrectomy was performed to the ulnar artery the following day. The patient was released from the hospital 2 days later and subsequently made a full recovery. PMID:24459558

Serafine, Matthew S; Peterson, Charles S

2013-07-01

125

Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations  

PubMed Central

Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns.

Woitzik, Erin; deGraauw, Chris; Easter, Brock

2014-01-01

126

Ulnar Impaction Syndrome: A case series investigating the appropriate diagnosis, management, and post-operative considerations.  

PubMed

Ulnar sided wrist pain is a common site for upper extremity disability. Ulnar impaction syndrome results in a spectrum of triangular fibrocartilage complex (TFCC) injuries and associated lunate, triquetrum, and ligamentous damage. Patients commonly present with insidious ulnar sided wrist pain and clicking, and a history of trauma or repetitive axial loading and rotation. In this case series, three patients presented to a sports chiropractor for evaluation and were subsequently diagnosed with ulnar impaction syndrome. Treatment strategies consist of conservative management, arthroscopic debridement or repair, arthroscopic wafer procedure, or ulnar shortening osteotomy. For the athlete, intervention should be individualized and sport-specific, considering athletic priorities, healing potential, return to play, and long-term health concerns. PMID:25550665

Woitzik, Erin; deGraauw, Chris; Easter, Brock

2014-12-01

127

Traumatic ulnar translocation of the carpus: early recognition and treatment.  

PubMed

This study evaluated the clinical outcomes and radiographic features of surgically treated traumatic ulnocarpal translocation in nine patients (ten cases). All ligament and fracture repairs were completed within 2 months of injury. Seven cases were examined at a mean of 6.5 years, and information in three cases was obtained from medical records at a mean of 13 months after injury. At final evaluation, the mean disabilities of the arm, shoulder, and hand score was 6 (range, 0-16), and the mean Mayo modified wrist score was 76 (range, 40-100). Ulnocarpal translocation was evident in nine of the injured wrists, six of which showed arthritis, and in four of the uninjured wrists. Ulnar variance measured negative in nine cases and neutral in one case. Pre-existing medial alignment of the carpus and ulnar minus variance may predispose to traumatic ulnocarpal translocation. Early injury repair does not assure restoration of radiocarpal alignment or prevent joint deterioration; however, these changes do not always portend a suboptimal result. PMID:22357328

Berschback, J C; Kalainov, D M; Husain, S N; Wiedrich, T A; Cohen, M S; Nagle, D J

2012-10-01

128

Analysis of somatosensory evoked potentials in peroneal nerve palsy.  

PubMed

The peroneal nerve SEPs over the CZ' of the scalp were studied in patients with peroneal nerve palsy. The initial positive peak latencies of P27 (to popliteal fossa stimulation), P30 (to fibular neck stimulation) and P37 (to dorsum of the foot stimulation) were measured. The latency difference P30-P27 was prolonged in all patients with the fibular head lesions. In patients with the superficial peroneal nerve lesions at the foreleg, P37-P27 was prolonged whereas P30-P27 was normal. Clinical application of peroneal nerve SEPs was useful in deciding the site of the lesion causing the peroneal nerve palsy. PMID:2820182

Ito, J; Yamao, S; Kameyama, M

1987-06-01

129

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. PMID:25422648

Chen, Jun; Wu, Shan; Ren, Jun

2014-01-01

130

Lipomatosis of the sciatic nerve: typical and atypical MRI features.  

PubMed

Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously described in the literature for other nerves, but also contain atypical features not previously highlighted, relating to the variability in distribution and extent of the fatty deposition. Recognition of the MRI appearance of this entity is important in order to avoid unnecessary attempts at surgical resection of this lesion. PMID:16283177

Wong, Bernadette Zhi Ying; Amrami, Kimberly K; Wenger, Doris E; Dyck, P James B; Scheithauer, Bernd W; Spinner, Robert J

2006-03-01

131

Endoscopic sural nerve harvest in the pediatric patient.  

PubMed

A technique of endoscopic sural nerve harvest was devised to minimize the donor-site scarring in pediatric patients requiring peripheral nerve-grafting procedures. The harvests were performed under tourniquet control using two 2-cm incisions for access at the lateral malleolus and the midcalf. Endoscopic visualization and blunt dissection of the nerve were achieved with a 4-mm Hopkins telescope with 30-degree angled lens (Karl Storz GmbH, Tuttlingen, Germany) stabilized in an Emory retractor and attached to a video camera. The medial sural nerve was divided in the popliteal fossa proximally under endoscopic visualization. The lateral sural nerve was identified and harvested when present. Between June of 1994 and March of 1995, 18 patients underwent 27 sural nerve harvests using the endoscopic technique. Mean patient age was 3.3 years (range 4 to 197 months). Indications for surgery included obstetrical brachial plexus palsy (12), facial palsy (5), and ulnar nerve neuroma (1). Nerve-graft length harvested ranged from 13 to 41 cm. Mean tourniquet time per limb was 92 minutes. No nerve graft injury was noted on examination under the operating microscope. Postoperative pain, swelling, and ecchymosis were minimal. Donorsite scarring has been aesthetically satisfactory to date. PMID:8823033

Capek, L; Clarke, H M; Zuker, R M

1996-10-01

132

Nerve conduction studies of upper extremities in tennis players  

PubMed Central

Objectives: The influence of regular and intense practice of an asymmetric sport such as tennis on nerves in the elbow region was examined. Methods: The study included 21 male elite tennis players with a mean (SD) age of 27.5 (1.7) years and 21 male non-active controls aged 26.4 (1.9) years. Anthropometric measurements (height, weight, limb length, and perimeters of arm and forearm) were determined for each subject, and range of motion assessment and radiographic examination carried out. Standard nerve conduction techniques using constant measured distances were applied to evaluate the median, ulnar, and radial nerves in the dominant and non-dominant limb of each individual. Results: The sensory and motor conduction velocities of the radial nerve and the sensory conduction velocity of the ulnar nerve were significantly delayed in the dominant arms of tennis players compared with their non-dominant arms and normal subjects. There were no statistical differences in the latencies, conduction velocities, or amplitudes of the median motor and sensory nerves between controls and tennis players in either the dominant or non-dominant arms. However, the range of motion of the upper extremity was significantly increased in tennis players when compared with control subjects. Tennis players were taller and heavier than control subjects and their dominant upper limb lengths were longer, and arm and forearm circumferences greater, than those of the control subjects. Conclusions: Many of the asymptomatic tennis players with abnormal nerve conduction tests in the present study may have presymptomatic or asymptomatic neuropathy similar to subclinical entrapment nerve neuropathy. PMID:15388554

Colak, T; Bamac, B; Ozbek, A; Budak, F; Bamac, Y

2004-01-01

133

Lipomatosis of the sciatic nerve: typical and atypical MRI features  

Microsoft Academic Search

Lipomatosis of nerve, also known as fibrolipomatous hamartoma, is a rare condition of nerve, usually affecting the median\\u000a nerve. The MRI appearance is characteristic. We describe two cases of lipomatosis of nerve involving the sciatic nerve, an\\u000a extremely unusual location for this lesion, in patients with sciatic neuropathy. These cases share the typical features previously\\u000a described in the literature for

Bernadette Zhi Ying Wong; Kimberly K. Amrami; Doris E. Wenger; P. James B. Dyck; Bernd W. Scheithauer; Robert J. Spinner

2006-01-01

134

Adreno-leukodystrophy (sex-linked Schilder's disease). A pathogenetic hypothesis based on ultrastructural lesions in adrenal cortex, peripheral nerve and testis.  

PubMed

Striated adrenal cells in the zona reticularis and inner fasciculata apparently constitute the initial adrenolytic lesion in patients with adreno-leukodystrophy (ALD). Cytoplasmic ballooning and macrovacuolization develop after the striations, and probably represent exaggerated responses to adrenocorticotropin (ACTH). Intracytoplasmic lamellae and lamellar-lipid profiles, containing a free 3beta-hydroxysterol, are the ultrastructural correlates of the striations seen with the light microscope. The ultrastructural demonstration of intracytoplasmic lamellae and lamellar-lipid profiles in adrenal striated cells, testicular interstitial cells, Schwann cells and brain macrophages from patients with ALD provides further morphologic evidence for a systemic metabolic defect common to the nervous and endocrine systems. In our experience, adrenal biopsy has proven to be the most effective procedure for the diagnosis of adreno-leukodystrophy. An hypothesis proposing a membrane abnormality affecting its stability and turnover might explain the concomitant destruction of adrenal cortex and brain in these patients. PMID:4212914

Powers, J M; Schaumburg, H H

1974-09-01

135

Nerve fibre composition of the palmar cutaneous branch of the median nerve and clinical implications.  

PubMed

Fifteen fresh human cadaver hands were dissected, using x2.8 loupe magnification, to study the subcutaneous innervation at the site of the incision (in the line with the radial border of the ring finger) for standard open carpal tunnel decompression. Subcutaneous nerve branches were detected and traced proximally to determine their origin. Morphometric analysis of nerve cross sections from the site of the incision and from the main nerve trunk proximal to cutaneous arborisation was performed using light and transmission electron microscopy and a computer-based image analysis system. At the site of the incision, the ulnar sub-branch (US) of the palmar cutaneous branch of the median nerve (PCBMN), which innervates the skin over the hypothenar eminence, was found in 10 of 15 cases. Branches from the ulnar side were not detected. The main trunk of PCBMN consisted on average of 1000 (SD 229) myelinated axons arranged in 1-4 fascicles. In the US of the PCBMN there were on average 620 (SD 220) myelinated axons, 80% of them smaller than 40 microm(2) i.e. thin myelinated axons, and on average 2037 (SD 1106) unmyelinated axons, arranged in 1-3 fascicles. The ratio of the number of myelinated axons in the US and the main trunk of the PCBMN was on average 63% (SD 19%). Frequency distribution of cross-sectional areas of myelinated axons shows no significant difference between the US and the main nerve trunk of the PCBMN. The importance of incision trauma to subcutaneous innervation of palmar triangle is emphasised and possible mechanisms of scar discomfort are discussed. PMID:14615254

Ahcan, U; Arnez, Z M; Bajrovi?, F F; Hvala, A; Zorman, P

2003-12-01

136

Acute Ulnar Shortening for Delayed Presentation of Distal Radius Growth Arrest in an Adolescent  

PubMed Central

Distal radius physeal fractures are common in children and adolescents. However, posttraumatic growth arrest is uncommon. The management of posttraumatic growth arrest is dependent on the severity of the deformity and the remaining growth potential of the patient. Various treatment options exist. We present a 17-year-old male with distal radius growth arrest who presented four years after the initial injury. He had a symptomatic 15?mm positive ulnar variance managed with an ulnar shortening osteotomy with the use of the AO mini distractor intraoperatively. To the best of our knowledge, an acute ulnar shortening of 15?mm is the largest reported. PMID:23227397

Ellanti, Prasad; Harrington, Paul

2012-01-01

137

Peripheral nerve conduits: technology update  

PubMed Central

Peripheral nerve injury is a worldwide clinical problem which could lead to loss of neuronal communication along sensory and motor nerves between the central nervous system (CNS) and the peripheral organs and impairs the quality of life of a patient. The primary requirement for the treatment of complete lesions is a tension-free, end-to-end repair. When end-to-end repair is not possible, peripheral nerve grafts or nerve conduits are used. The limited availability of autografts, and drawbacks of the allografts and xenografts like immunological reactions, forced the researchers to investigate and develop alternative approaches, mainly nerve conduits. In this review, recent information on the various types of conduit materials (made of biological and synthetic polymers) and designs (tubular, fibrous, and matrix type) are being presented. PMID:25489251

Arslantunali, D; Dursun, T; Yucel, D; Hasirci, N; Hasirci, V

2014-01-01

138

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

139

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

140

Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy)  

Microsoft Academic Search

BackgroundAlthough ulnar neuropathy at the elbow (UNE) is the second most frequent focal peripheral neuropathy of the upper limb after carpal tunnel syndrome (CTS), no figures on its prevalence or incidence in the general population have been reported.

Mauro Mondelli; Fabio Giannini; Michele Ballerini; Federica Ginanneschi; Elena Martorelli

2005-01-01

141

Myoclonus following a Peripheral Nerve Block  

PubMed Central

Myoclonus is an extremely rare perioperative complication following neuraxial anesthesia. It has also been reported to occur due to peripheral nerve lesions. We report a case of self-limiting myoclonus following a routine peripheral nerve block in an otherwise healthy patient. PMID:23936682

Hudson, Arlene J.; Guthmiller, Kevin B.; Hyatt, Marian N.

2013-01-01

142

Ulnar translation, a commonly overlooked, unrecognized deformity of distal radius fractures: techniques to correct the malalignment.  

PubMed

Distal radius fracture is one of the most common fractures, accounting for up to 15% of all bone injuries. Radial shortening, loss of palmar inclination, and/or radial tilt are commonly recognized and addressed components of radius fracture deformity. However, a common but typically overlooked and unrecognized component of distal radius fracture deformity is ulnar translation of the proximal radius metaphyseal/shaft. Several techniques to address ulnar translation deformity are presented. PMID:18776778

Rapley, Jay H; Kearny, J Patrick; Schrayer, A; Viegas, Steven F

2008-09-01

143

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. PMID:25426362

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

2014-01-01

144

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

145

Ulnar variance in children — standard measurements for evaluation of ulnar shortening in juvenile rheumatoid arthritis, hereditary multiple exostosis and other bone or joint disorders in childhood  

Microsoft Academic Search

Measurements for radioulnar variance in adults cannot be used in children because the epiphyses are not fully ossified. We describe a method of determining ulnar variance in children by using the distance from the distal metaphysis of the radius to the distal metaphysis of the ulna. Standards for this measurement are presented for ages 1.5 to 15.5 years in boys

Renate Hafner; Andrew K. Poznanski; J. Mark Donovan

1989-01-01

146

Retardation of rat sciatic nerve regeneration after local application of minute doses of vincristine  

Microsoft Academic Search

The effect of vincristine on regeneration of rat sural and tibial nerves following a crush lesion of the sciatic nerve was studied in the pinch test. Vincristine locally applied through an osmotic minipump at the site of the lesion dose-dependently retarded regeneration of the tibial and sural nerve at a threshold dose of 5 ng\\/day, whereas regeneration was blocked at

Gé S. F. Ruigt; Maria H. C. Brok

1995-01-01

147

New sonographic measures of peripheral nerves: a tool for the diagnosis of peripheral nerve involvement in leprosy.  

PubMed

To evaluate ultrasonographic (US) cross-sectional areas (CSAs) of peripheral nerves, indexes of the differences between CSAs at the same point (?CSAs) and between tunnel (T) and pre-tunnel (PT) ulnar CSAs (?TPTs) in leprosy patients (LPs) and healthy volunteers (HVs). Seventy-seven LPs and 49 HVs underwent bilateral US at PT and T ulnar points, as well as along the median (M) and common fibular (CF) nerves, to calculate the CSAs, ?CSAs and ?TPTs. The CSA values in HVs were lower than those in LPs (p < 0.0001) at the PT (5.67/9.78 mm2) and T (6.50/10.94 mm2) points, as well as at the M (5.85/8.48 mm2) and CF (8.17/14.14 mm2) nerves. The optimum CSA- receiver operating characteristic (ROC) points and sensitivities/specificities were, respectively, 6.85 mm2 and 68-85% for the PT point, 7.35 mm2 and 71-78% for the T point, 6.75 mm2 and 62-75% for the M nerve and 9.55 mm2 and 81-72% for the CF nerve. The ?CSAs of the LPs were greater than those of the HVs at the PT point (4.02/0.85; p = 0.007), T point (3.71/0.98; p = 0.0005) and CF nerve (2.93/1.14; p = 0.015), with no difference found for the M nerve (1.41/0.95; p = 0.17). The optimum ?CSA-ROC points, sensitivities, specificities and p-values were, respectively, 1.35, 49%, 80% and 0.003 at the PT point, 1.55, 55-85% and 0.0006 at the T point, 0.70, 58-50% and 0.73 for the M nerve and 1.25, 54-67% and 0.022 for the CF nerve. The ?TPT in the LPs was greater than that in the HVs (4.43/1.44; p <0.0001). The optimum ?TPT-ROC point was 2.65 (90% sensitivity/41% specificity, p < 0.0001). The ROC analysis of CSAs showed the highest specificity and sensitivity at the PT point and CF nerve, respectively. The PT and T ?CSAs had high specificities (> 80%) and ?TPT had the highest specificity (> 90%). New sonographic peripheral nerve measurements (?CSAs and ?TPT) provide an important methodological improvement in the detection of leprosy neuropathy. PMID:23778664

Frade, Marco Andrey Cipriani; Nogueira-Barbosa, Marcello Henrique; Lugão, Helena Barbosa; Furini, Renata Bazan; Marques Júnior, Wilson; Foss, Norma Tiraboschi

2013-05-01

148

Monteggia lesion in an Asian small-clawed otter (Aonyx cinerea).  

PubMed

A 10-yr-old female Asian small-clawed otter (Aonyx cinerea) presented with a history of right forelimb lameness. Antebrachial radiographs revealed a Monteggia lesion, classified by cranial radial head luxation and distal diaphyseal ulnar fracture. Open reduction with placement of an ulnar-radial positional screw was performed. The lateral collateral ligament was reconstructed using suture anchored by a condylar screw and bone tunnel in the radius. Reduction and proper implant placement was confirmed on postoperative radiographs. The ulnar-radial positional screw was removed 6 wk postoperatively to allow proper supination and pronation. Limb function was greatly improved at this time; however, a mild lameness was still observed. At 7 mo postoperatively, the otter was ambulating lameness-free. Radiographs documented proper joint reduction and stable condylar screw. At 32 mo postoperatively, the otter continued to exhibit normal ambulation. PMID:24450070

Peters, Holly J; Hettlich, Bianca F; Barrie, Michael T

2013-12-01

149

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

150

A simple model of radial nerve injury in the rhesus monkey to evaluate peripheral nerve repair  

PubMed Central

Current research on bone marrow stem cell transplantation and autologous or xenogenic nerve transplantation for peripheral nerve regeneration has mainly focused on the repair of peripheral nerve defects in rodents. In this study, we established a standardized experimental model of radial nerve defects in primates and evaluated the effect of repair on peripheral nerve injury. We repaired 2.5-cm lesions in the radial nerve of rhesus monkeys by transplantation of autografts, acellular allografts, or acellular allografts seeded with autologous bone marrow stem cells. Five months after surgery, regenerated nerve tissue was assessed for function, electrophysiology, and histomorphometry. Postoperative functional recovery was evaluated by the wrist-extension test. Compared with the simple autografts, the acellular allografts and allografts seeded with bone marrow stem cells facilitated remarkable recovery of the wrist-extension functions in the rhesus monkeys. This functional improvement was coupled with radial nerve distal axon growth, a higher percentage of neuron survival, increased nerve fiber density and diameter, increased myelin sheath thickness, and increased nerve conduction velocities and peak amplitudes of compound motor action potentials. Furthermore, the quality of nerve regeneration in the bone marrow stem cells-laden allografts group was comparable to that achieved with autografts. The wrist-extension test is a simple behavioral method for objective quantification of peripheral nerve regeneration. PMID:25206757

Wang, Dong; Huang, Xijun; Fu, Guo; Gu, Liqiang; Liu, Xiaolin; Wang, Honggang; Hu, Jun; Yi, Jianhua; Niu, Xiaofeng; Zhu, Qingtang

2014-01-01

151

Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries  

PubMed Central

OBJECTIVE: To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries. DATA SOURCES: The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011. STUDY SELECTION: The following types of article were selected: (1) clinical trials describing the repair of median, ulnar, radial, and digital nerve injuries published in English; and (2) studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to investigate the patient and intervention factors associated with outcomes. MAIN OUTCOME MEASURES: Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3+ or S4. RESULTS: Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were independent predictors of outcome after the repair of nerve injuries (P < 0.05), and that the nerve injured was the main factor affecting the rate of good to excellent recovery. CONCLUSION: Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up. PMID:25206870

He, Bo; Zhu, Zhaowei; Zhu, Qingtang; Zhou, Xiang; Zheng, Canbin; Li, Pengliang; Zhu, Shuang; Liu, Xiaolin; Zhu, Jiakai

2014-01-01

152

Exploring the anatomy of dorsal radiocarpal ligament of the wrist and its ulnar part: a cadaveric study.  

PubMed

The current study aimed to explore the anatomy of the dorsal radio-carpal ligament (DRC ligament) and to investigate the presence and histological structure of ulnar part of the DRC ligament. Twenty cadaveric wrist joints were dissected and attachments of the DRC ligament and the newly described ulnar part of the DRC ligament were identified and noted. Samples of both ligaments were sent for histological examination. The DRC ligament was identified in all 20 specimens with type I Mizuseki arrangement of fibres seen in 60% of wrists. The ulnar part of the DRC ligament was successfully identified in 18 of the 20 wrists. The histological observation of the ulnar part of the DRC ligament showed the highly uniform arrangement of collagen bundles typical of ligaments. This study explores the anatomy of the DRC ligament and confirms the presence of the ulnar part of DRC ligament through histological analysis not undertaken in previous studies. PMID:23061937

Jariwala, A; Khurjekar, K; Whiton, S; Wigderowitz, C A

2012-01-01

153

The radial hyperaemic response: a new and objective assessment of ulnar collateral supply to the hand.  

PubMed

The assessment of adequate ulnar collateral supply to the hand is mandatory prior to the harvest of the radial artery as a conduit for coronary artery bypass grafting. However, there is currently no one test which is widely used in all centres. We report a new and objective method of assessing ulnar collateral supply to the hand prior to harvest of the radial artery. This technique involves assessing the presence of a hyperaemic flow response to occlusion of the radial artery using an intraoperative transit time flowmeter. We found this technique to be objective and reliable, and would advocate its use in patients with a positive Allen's test. PMID:11888782

Roberts, N; Ghosh, S; Boehm, M; Galiñanes, M

2002-03-01

154

A rare variant of the superficial ulnar artery, and its clinical implications: a case report  

PubMed Central

The superficial ulnar artery is a rare variation of the upper limb arterial system that arises from the brachial or axillary artery and runs superficial to the muscles arising from the medial epicondyle [1-3]. The incidence is about 0.7 to 7% [1,4,5]. In our routine dissections we found a superficial ulnar artery, which crossed the cubital fossa superficial to the bicipital aponeurosis making it highly vulnerable to intra-arterial injection. This is a rare variation that every medical and nursing staff member should know about. PMID:17988391

Senanayake, Kithsiri J; Salgado, Sujatha; Rathnayake, Manjula J; Fernando, Ranil; Somarathne, Kosala

2007-01-01

155

Effects of melatonin on peripheral nerve regeneration.  

PubMed

In the available literature, there are thousands of studies on peripheral nerve regeneration using many nerves of several animals at different ages with various types of lesions and different methods of evaluation at certain time of follow-up. Despite many experimental data and clinical observations, there is still no ideal treatment method enhancing peripheral nerve regeneration. In clinical practice, various types of surgical nerve repair techniques do not frequently result in complete recovery due to neuroma formation, lipid peroxidative damage, ischemia and other factors. Recently, a number of neuroscientists demonstrated that pineal neurohormone melatonin (MLT) has an effect on the morphologic features of the nerve tissue, suggesting its neuroprotective, free radical scavenging, antioxidative, and analgesic effects in degenerative diseases of peripheral nerves. At present, it is widely accepted that MLT has a useful effect on axon length and sprouting after traumatic events to peripheral nerves. Our studies using various experimental injury models clearly suggest positive effects of MLT on the number of axons, thickness of myelin sheath by inhibition of collagen accumulation and neuroma formation following traumatic events to peripheral nerves, myelination of developing peripheral nerve after intrauterine ethanol exposure. Nevertheless, further experimental and randomized controlled clinical studies are vital to identify the clinical use of MLT hormone. This is an overview of recent patents and current literature in terms of the effects of MLT on peripheral nerve regeneration based on a critical analysis of electrophysiological, biochemical and light and electron microscopic findings, in addition to functional observations. PMID:22074585

Turgut, Mehmet; Kaplan, Süleyman

2011-05-01

156

Parapharyngeal branchial cleft cyst presenting with cranial nerve palsies.  

PubMed

The authors report a case of branchial cleft cyst for which the location and presentation of the lesion were unusual. This abnormality should be considered in the differential diagnosis of cystic lesions of the parapharyngeal space. The presence of multiple cranial nerve palsies in association with a mass in this region does not necessarily indicate a neoplastic lesion. PMID:8149269

Durrant, T J; Sevick, R J; Lauryssen, C; MacRae, M E

1994-04-01

157

The Proximal Medial Sural Nerve Biopsy Model: A Standardised and Reproducible Baseline Clinical Model for the Translational Evaluation of Bioengineered Nerve Guides  

PubMed Central

Autologous nerve transplantation (ANT) is the clinical gold standard for the reconstruction of peripheral nerve defects. A large number of bioengineered nerve guides have been tested under laboratory conditions as an alternative to the ANT. The step from experimental studies to the implementation of the device in the clinical setting is often substantial and the outcome is unpredictable. This is mainly linked to the heterogeneity of clinical peripheral nerve injuries, which is very different from standardized animal studies. In search of a reproducible human model for the implantation of bioengineered nerve guides, we propose the reconstruction of sural nerve defects after routine nerve biopsy as a first or baseline study. Our concept uses the medial sural nerve of patients undergoing diagnostic nerve biopsy (?2?cm). The biopsy-induced nerve gap was immediately reconstructed by implantation of the novel microstructured nerve guide, Neuromaix, as part of an ongoing first-in-human study. Here we present (i) a detailed list of inclusion and exclusion criteria, (ii) a detailed description of the surgical procedure, and (iii) a follow-up concept with multimodal sensory evaluation techniques. The proximal medial sural nerve biopsy model can serve as a preliminarynature of the injuries or baseline nerve lesion model. In a subsequent step, newly developed nerve guides could be tested in more unpredictable and challenging clinical peripheral nerve lesions (e.g., following trauma) which have reduced comparability due to the different nature of the injuries (e.g., site of injury and length of nerve gap). PMID:25006574

van Neerven, Sabien G. A.; Claeys, Kristl G.; O'Dey, Dan mon; Brook, Gary A.; Sellhaus, Bernd; Schulz, Jörg B.; Weis, Joachim; Pallua, Norbert

2014-01-01

158

Compartment syndrome resulting from undetected ulnar artery injury in the absence of a forearm fracture.  

PubMed

A 6-year-old boy presented following a transient crush injury to his forearm. He displayed mild abrasions but no laceration or associated fractures. The injury resulted in traumatic rupture of the ulnar artery, which caused a large forearm haematoma and an acute forearm compartment syndrome. Prompt clinical diagnosis and operative intervention were required to prevent disastrous consequences. PMID:25538213

Chadha, Priyanka; Lloyd-Hughes, Hawys; Halsey, Timothy

2014-01-01

159

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

E-print Network

of the right and left radius and b Vetalar, Parke-Davis, Norris Plains, NJ c Rompun, Haver, Shawnee, KS ulna through small incisions. The screws were placed in the ulna through a 4 cm incision between the ulnaris lateralis muscle and ulnar head of the deep...

Smith, Barbara Lynn

2012-06-07

160

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 Duràn-Mckinster; Luz Orozco-Covarrubias; Marimar Saez-De-Ocariz; Ramòn Ruiz-Maldonado

161

New treatment alternatives in the ulnar neuropathy at the elbow: ultrasound and low-level laser therapy.  

PubMed

Ulnar nerve entrapment at the elbow (UNE) is the second most common entrapment neuropathy of the arm. Conservative treatment is the treatment of choice in mild to moderate cases. Elbow splints and avoiding flexion of the involved elbow constitute majority of the conservative treatment; indeed, there is no other non-invasive treatment modality. The aim of this study was to investigate the efficacy of ultrasound (US) and low-level laser therapy (LLLT) in the treatment of UNE to provide an alternative conservative treatment method. A randomized single-blind study was carried out in 32 patients diagnosed with UNE. Short-segment conduction study (SSCS) was performed for the localization of the entrapment site. Patients were randomized into US treatment (frequency of 1 MHz, intensity of 1.5 W/cm(2), continuous mode) and LLLT (0.8 J/cm(2) with 905 nm wavelength), both applied five times a week for 2 weeks. Assessments were performed at baseline, at the end of the treatment, and at the first and third months by visual analog scale, hand grip strength, semmes weinstein monofilament test, latency change at SSCS, and patient satisfaction scale. Both treatment groups had significant improvements on clinical and electrophysiological parameters (p < 0.05) at first month with no statistically significant difference between them. Improvements in all parameters were sustained at the third month for the US group, while only changes in grip strength and latency were significant for the LLLT group at third month. The present study demonstrated that both US and LLLT provided improvements in clinical and electrophysiological parameters and have a satisfying short-term effectiveness in the treatment of UNE. PMID:25319131

Ozkan, Feyza Unlu; Sayg?, Evrim Karada?; Senol, Selcen; Kapc?, Serap; Aydeniz, Banu; Akta?, Ilknur; Gozke, Eren

2014-10-16

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

Ulnar metaphyseal osteochondrosis in seven captive bred cheetahs (Acinonyx jubatus).  

PubMed

Distal ulna metaphyseal osteochondrosis was identified in seven captive bred cheetahs raised in Australia between 1984 and 2005. The disorder was characterized by bilateral carpal valgus conformation. In the metaphyseal region of the distal ulnae, an osteolucent defect that appeared as a proximal extension of the lucent physis was identified radiographically between 6 and 10 months of age. Ulna ostectomy was done to correct the angular limb deformity. Histologically, changes were identified in the osteolucent lesion that resembled osteochondrosis. We propose that the condition is probably familial and/or dietary in origin. PMID:19051644

Allan, Graeme; Portas, Timothy; Bryant, Benn; Howlett, Rolfe; Blyde, David

2008-01-01

164

The Influence of Non-union of the Ulnar Styloid on Pain, Wrist Function and Instability after Distal Radius Fracture  

Microsoft Academic Search

The influence of non-union on the outcome of distal radius fractures is debated. We tested the null hypothesis that there\\u000a is no difference in pain, wrist function, or instability between patients with union or non-union of an ulnar styloid base\\u000a fracture after operative treatment of a fracture of the distal radius. Eighteen adults with an ulnar styloid base non-union\\u000a were

Mathieu Wijffels; David Ring

2011-01-01

165

Nerve Impulses in Plants  

ERIC Educational Resources Information Center

Summarizes research done on the resting and action potential of nerve impulses, electrical excitation of nerve cells, electrical properties of Nitella, and temperature effects on action potential. (GS)

Blatt, F. J.

1974-01-01

166

Large-Scale Functional Reorganization in Adult Monkey Cortex after Peripheral Nerve Injury  

NASA Astrophysics Data System (ADS)

In adult monkeys, peripheral nerve injuries induce dramatic examples of neural plasticity in somatosensory cortex. It has been suggested that a cortical distance limit exists and that the amount of plasticity that is possible after injury is constrained by this limit. We have investigated this possibility by depriving a relatively large expanse of cortex by transecting and ligating both the median and the ulnar nerves to the hand. Electrophysiological recording in cortical areas 3b and 1 in three adult squirrel monkeys no less than 2 months after nerve transection has revealed that cutaneous responsiveness is regained throughout the deprived cortex and that a roughly normal topographic order is reestablished for the reorganized cortex.

Garraghty, Preston E.; Kaas, Jon H.

1991-08-01

167

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

168

Stress in the human elbow joint. II. Proximal radio-ulnar joint.  

PubMed

The proximal radio-ulnar joint has two different types of articular surfaces. The contact area between the articulating surfaces is at its greatest when the joint is in a middle position. The highest density of osseous material is found on the ulnar side of the head of the radius. The subchondral bone beneath the radial notch of the ulna has a higher density at the edges than in the middle. In photoelastic experiments the intensity and configuration of isochromatics correspond to the material density of the osseous tissue of ulna and radius. The analysis of spongiosa near the joint shows bands of compressive cancellous trabeculae radiating axially into the subchondral cortex, crossed at right angles by bands of tensile cancellous trabeculae. These findings are in agreement with the course of the trajectories found in photoelastic experiments. The composition of the annular ligament is variable. The palmar and dorsal parts are made up of firm connective tissue; opposite the radial notch of the ulna, however, cartilage cells are embedded in the ligament. The histological composition of the annular ligament and the cancellous architecture in the radius and the ulna are in agreement with Pauwels' (1963) hypothesis that part of the compressive force in the elbow joint is transferred to the proximal radio-ulnar joint via the annular ligament. The distribution of the material in the subchondral bony tissue indicates that there is only partial contact between the radial head circumference and the radial notch of the ulna in all positions of the joint. PMID:6476404

Bartz, B; Tillmann, B; Schleicher, A

1984-01-01

169

Changes in the expression of P2X1 and P2X2 purinergic receptors in facial motoneurons after nerve lesions in rodents and correlation with motoneuron degeneration.  

PubMed

Involvement of P2X1 and P2X2 purinergic receptors in motoneuron response to injury was investigated with Western blotting and immunohistochemistry and correlated with motoneuron loss, Bcl-2 expression, nitric oxide synthase induction and glial activation. P2X1 was highly induced in rat facial motoneurons after nerve resection, which causes slowly occurring neurodegeneration. P2X1 induction was lower and less persistent after nerve crush, permissive for fiber regeneration. P2X2 expression was found in nuclei of rat facial motoneurons, with nuclear export in the cytoplasm after nerve resection. P2X1 induction in axotomized facial motoneurons was impaired in superoxide dismutase (SOD)1-G93A-mutant mice, a model of motoneuron disease. The data in rats point to a correlation of P2X1 induction with motoneuron degeneration, which also involves P2X2 intracellular changes, rather than with axon regeneration effort. The data in mice show that the SOD1 mutation interferes with injury-elicited P2X1 induction, suggesting alterations of ATP release from mutant motoneurons after damage. PMID:17055278

Kassa, Roman M; Bentivoglio, Marina; Mariotti, Raffaella

2007-01-01

170

Fibrolipomatous hamartoma of nerve.  

PubMed

Fibrolipomatous hamartomas of nerve are rare, benign, fibrofatty malformations of peripheral nerves, most commonly affecting the median nerve. Lower extremity cases are extremely rare. The authors present a very rare case of a fibrolipomatous hamartoma involving the superficial peroneal nerve, and review the literature regarding its clinical presentation and surgical management. PMID:8161996

Bibbo, C; Warren, A M

1994-01-01

171

Amplitude of sensory nerve action potential in early stage diabetic peripheral neuropathy: an analysis of 500 cases  

PubMed Central

Early diagnosis of diabetic peripheral neuropathy is important for the successful treatment of diabetes mellitus. In the present study, we recruited 500 diabetic patients from the Fourth Affiliated Hospital of Kunming Medical University in China from June 2008 to September 2013: 221 cases showed symptoms of peripheral neuropathy (symptomatic group) and 279 cases had no symptoms of peripheral impairment (asymptomatic group). One hundred healthy control subjects were also recruited. Nerve conduction studies revealed that distal motor latency was longer, sensory nerve conduction velocity was slower, and sensory nerve action potential and amplitude of compound muscle action potential were significantly lower in the median, ulnar, posterior tibial and common peroneal nerve in the diabetic groups compared with control subjects. Moreover, the alterations were more obvious in patients with symptoms of peripheral neuropathy. Of the 500 diabetic patients, neural conduction abnormalities were detected in 358 cases (71.6%), among which impairment of the common peroneal nerve was most prominent. Sensory nerve abnormality was more obvious than motor nerve abnormality in the diabetic groups. The amplitude of sensory nerve action potential was the most sensitive measure of peripheral neuropathy. Our results reveal that varying degrees of nerve conduction changes are present in the early, asymptomatic stage of diabetic peripheral neuropathy. PMID:25221597

Zhang, Yunqian; Li, Jintao; Wang, Tingjuan; Wang, Jianlin

2014-01-01

172

The nerves around the shoulder.  

PubMed

Neuropathies of the shoulder are considered to be entrapment syndromes. They are relatively common, accounting for about 2% of cases of sport-related shoulder pain. Many instances involve suprascapular neuropathy, but the clinical diagnosis is often delayed because of nonspecific symptoms. Classically, EMG is the gold standard investigation but MRI currently reveals muscular abnormality in 50% of cases. Muscle edema, the most characteristic symptom, is nonspecific. In general, the topography of edema, the presence of a lesion compressing the nerve and clinical history contribute to the diagnosis. Although atrophy and fatty degeneration may persist after the disappearance of edema, they are rarely symptomatic. The main differential diagnosis is Parsonage-Turner syndrome. Evidence of a cyst pressing on a nerve may prompt puncture-infiltration guided by ultrasonography or CT-scan. PMID:21546184

Blum, Alain; Lecocq, Sophie; Louis, Matthias; Wassel, Johnny; Moisei, Andreea; Teixeira, Pedro

2013-01-01

173

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

174

Cervicothoracic lesions in infants and children.  

PubMed

Cervicothoracic lesions are not uncommon in children. All cervicothoracic lesions except superficial lesions extend from the neck to the thorax through the thoracic inlet. Evaluation of this area involves multiple imaging modalities: plain radiography, ultrasonography, nuclear medicine, computed tomography, and magnetic resonance (MR) imaging. However, MR imaging is the method of choice for assessing the full extents of cervicothoracic lesions and their relationships to neurovascular structures. Cervicothoracic lesions can be classified as congenital lesions, inflammatory lesions, benign tumors, malignant tumors, and traumatic lesions. Lymphangioma is the most common cervicothoracic mass in children; other congenital lesions include hemangioma, thymic cyst, and vascular anomalies. Inflammatory adenopathy reactive to tuberculosis, mononucleosis, tularemia, cat-scratch fever, infection with human immunodeficiency virus, or other upper respiratory tract infections can manifest as cervicothoracic lesions; tuberculous abscesses and abscesses of other origins can also be seen. Lipoma, lipoblastoma, aggressive fibromatosis, and nerve sheath tumors (either isolated lesions or those associated with neurofibromatosis) can also occur as cervicothoracic masses. Malignant cervicothoracic tumors include lymphoma, thyroid carcinoma, neuroblastoma, and chest wall tumors (rhabdomyosarcoma, Ewing sarcoma, and neuroectodermal tumor). Traumatic cervicothoracic lesions include pneumomediastinum of traumatic origin, traumatic pharyngeal pseudodiverticulum, esophageal foreign-body granuloma, and cervicothoracic hematoma. PMID:10336190

Castellote, A; Vázquez, E; Vera, J; Piqueras, J; Lucaya, J; Garcia-Peña, P; Jiménez, J A

1999-01-01

175

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

2014-01-01

176

Ulnar head implant arthroplasty: an intermediate term review of 1 surgeon's experience.  

PubMed

Ulnar head arthroplasty has been an emerging alternative for salvage of resection arthroplasty at the distal radioulnar joint (DRUJ) since the early 1990s. Recently, it has been offered for initially treating painful arthrosis or instability of the DRUJ. This follow-up study reports a surgeon's experience treating DRUJ disorders with ulnar head arthroplasty. Twenty-two wrists in 20 patients (11 females, 9 males), 6 with no prior wrist procedures were treated between 1995 and 2006 for painful DRUJ disorders with either Herbert-Martin (Martin Medizin-Technik, Tuttingen, Germany) or Avanta (Small Bone Innovations, New York, NY) head prosthesis. Follow-up averaged 54.3 months. A standardized telephone survey determined preoperative /postoperative verbal analog pain scores and a modified Mayo Wrist Score (delineating poor, fair, good, or excellent outcomes). Data suggest that ulnar head implant arthroplasty is a reasonable treatment option for DRUJ-related pain, loss of function, or salvage of failed distal ulna resection procedures. The analog pain score statistically significant decreased by 1.68 points when comparing preoperative to postoperative scores. Average Modified Mayo Wrist Scores were good, independent of whether the procedure was primary or salvaged. No significant difference was seen between the primary or salvage group modified Mayo Wrist Scores. Whereas averaged modified Mayo scores for both the primary and salvage groups were in the good category, prostheses used as primary procedures may be associated with fewer poor or fair outcomes. Two good and 1 excellent outcome of 3 wrists requiring revision procedures suggest that even with revision of the implant arthroplasty, satisfactory results may be expected. PMID:19730047

Yen Shipley, Nancy; Dion, Greg R; Bowers, William H

2009-09-01

177

Is there a safe zone to avoid superficial radial nerve injury with Kirschner wire fixation in the treatment of distal radius? A cadaveric study  

PubMed Central

Aim of the study To determine the relation of the superficial radial nerve to bony land-marks and to identify a safe zone for K-wire pinning in the distal radius. Method The superficial radial nerve was dissected in sixteen upper extremities of preserved cadavers. Results We found that the superficial radial nerve emerged from under brachioradialis at a mean distance of 8.45 (±1.22) cm proximal to the radial styloid. The mean distance from the first major branching point of the superficial radial nerve to the radial styloid were 4.8 ± 0.4 cm. All branches of the superficial radial nerve were found to lie in the radial half of an isosceles triangle formed by the radial styloid, Lister's tubercle and the exit point of the superficial radial nerve. There is an elliptical area just proximal to the Lister's tubercle. This area is not crossed by any tendons or nerve. It is bounded by the extensor carpiradialis brevis, extensor pollicis longus. Conclusion Pinning through the radial styloid is unsafe as the branches of the superficial radial nerve passé close to it. The ulnar half of the isosceles triangle is safe regarding the nerve. The elliptical zone just proximal to the Lister's tubercle is safe regarding the tendons and nerve.

Ali, Ayman M.; El-Alfy, Barakat; Attia, Hamdino

2014-01-01

178

Rare isolated trigeminal nerve sarcoidosis mimicking schwannoma.  

PubMed

Sarcoidosis is a granulomatous disorder of unknown etiology involving multiple organ systems. Isolated neurosarcoidosis is exceedingly rare. This case report presents isolated trigeminal nerve sarcoidosis mimicking schwannoma in a patient presenting with symptoms of trigeminal neuralgia. Neuroimaging revealed a mass associated with trigeminal nerve which prospectively thought to represent schwannoma. However, surgical pathology was consistent with sarcoidosis. Given great overlap in imaging characteristic of tumors in the Meckel's cave intraoperative frozen section biopsy may be considered to rule out an inflammatory lesion. PMID:25457541

Bangiyev, Lev; Kornacki, Susan; Mikolaenko, Irina

2015-01-01

179

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

180

Rupture of the ulnar collateral ligament of the thumb – a review  

PubMed Central

Skier’s thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. It is an often-encountered injury and can lead to chronic pain and instability when diagnosed incorrectly. Knowledge of the anatomy and accurate physical examination are essential in the evaluation of a patient with skier’s thumb. This article provides a review of the relevant anatomy, the correct method of physical examination and the options for additional imaging and treatment with attention to possible pitfalls. PMID:23938194

2013-01-01

181

Rupture of the ulnar collateral ligament of the thumb - a review.  

PubMed

Skier's thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. It is an often-encountered injury and can lead to chronic pain and instability when diagnosed incorrectly. Knowledge of the anatomy and accurate physical examination are essential in the evaluation of a patient with skier's thumb. This article provides a review of the relevant anatomy, the correct method of physical examination and the options for additional imaging and treatment with attention to possible pitfalls. PMID:23938194

Mahajan, Mandhkani; Rhemrev, Steven J

2013-01-01

182

LYMPHOID LESIONS IN POLIOMYELITIS  

PubMed Central

Examination of 50 autopsied cases of human poliomyelitis showed prominent hyperplastic and inflammatory changes in the lymphoid tissues of 41, the most frequent and severe lesions observed save those in the central nervous system. Histologically the germinal centers showed prominent degenerative and regenerative alterations, fluid transudation, giant cell formation, and rare inclusion bodies, all consistent with virus effects. Treatment of mice with x-rays, aminopterin, and adrenocorticotropic hormone increased poliomyelitis infections following intraperitoneal injection of MEF strain virus, potentiated by intracerebrally injected corn starch. This was ascribed to the damage to lymphoid tissues produced by these agents. On the basis of combined morphologic and virus studies, the presence of gastrointestinal, lymphoid, nervous tissue, and nerve cell defense barriers to poliomyelitis virus is suggested. Use of irradiated mice might prove useful in primary isolation of virus from human poliomyelitis. PMID:14832397

Sommers, Sheldon C.; Wilson, Joan C.; Hartman, Frank W.

1951-01-01

183

Nerve conduction velocity  

MedlinePLUS

... to determine the speed of the nerve signals. Electromyography (recording from needles placed into the muscles) is ... Often, the nerve conduction test is followed by electromyography (EMG). In this test, needles are placed into ...

184

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

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. PMID:25236378

2014-01-01

186

Laser or razor? A novel experimental peripheral nerve repair technique.  

PubMed

An operative repair technique for crushed sciatic nerve in the rat was used to examine whether removal of the damaged tissue could be better achieved with a low wattage CO2 laser or a blade. This approach was compared to results in rats undergoing conventional end-to-end nerve anastomosis using a microsurgical approach. Crushed sciatic nerves were exposed bilaterally 24 hours after injury and treated as follows. A longitudinally split polyethylene catheter was placed under the nerve, which was fixed to the catheter with 9-0 stitches placed away from lesion area; the nerve was bathed in ice-cold polyvinyl alcohol/chlorpromazine (PVA/CPZ) solution. After the nerve was crushed, the lesioned tissue was removed using laser pulses or a thin blade. A collagen matrix was used to fill the gap, and the preparation was covered and allowed to recover for 6 weeks. End-to-end anastomosis was done following same parameters, but with omission of the nerve catheter, PVA/CPZ solution, and collagen matrix; these nerves were reunited using epineurial stitches. High performance liquid chromotography (HPLC) analysis of each group showed that the laser approach reduced the levels of norepinephrine distal to the lesion, least, suggesting better regeneration of proximal axonal growth. Morphological and neuroelectric findings, although suggestive, showed no significant differences between laser and blade repair, a finding that reinforces the idea that such endpoints are not as sensitive as chemical assays of tissue transmitter levels such as HPLC. Laser or blade repair using nerve-catheter fixation and collagen bridge matrix was superior to end-to-end nerve anastomosis when morphological, neuroelectric, and HPLC values were compared in this model.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3362320

de la Torre, J C; Karaca, M; Merali, Z; Fortin, T; Richard, M

1988-03-01

187

[Regeneration of the facial nerve in comparison to other peripheral nerves : from bench to bedside].  

PubMed

Despite increasing knowledge of cellular and molecular mechanisms determining the success or failure of peripheral nerve regeneration, no effective treatments for peripheral nerve injury exist. Newly developed and validated approaches for precise numerical assessment of motor deficits have recently allowed testing of novel strategies in experimental animals. One of these approaches is the daily manual stimulation of the denervated musculature. This treatment is effective in cases of cranial nerve lesions with preservation of the sensory input (facial or hypoglossal nerve) and has the potential of direct translation in clinical settings. However, manual stimulation appears to be ineffective for the treatment of mixed peripheral nerve injuries. Generally, no long-term improvement of functional recovery is achieved by electrical stimulation in rodents. While short-term post-traumatic stimulation of the proximal nerve stump has no negative effects, direct electrical stimulation of the muscle during the period of de- and reinnervation appears to hinder muscle fibre reinnervation. Finally, experimental evidence suggests that application of peptides known as glycomimetics, which mimic functional properties of carbohydrate molecules, may provide significant benefits after injuries of mixed peripheral nerves. PMID:20454881

Irintchev, A; Angelov, D N; Guntinas-Lichius, O

2010-05-01

188

Stress-induced gastric lesions in spontaneously hypertensive rats  

Microsoft Academic Search

Studies were conducted to determine the roles of the parasympathetic and the sympathetic nerves in the induction of gastric hemorrhagic lesions induced by cold-plus-restraint stress in spontaneously hypertensive rats (SHR). After bilateral vagotomy or reserpine treatment, partial reduction in the incidence and severity (per stomach) of gastric lesions was observed. Pretreatment with vagotomy plus reserpine, levodopa, or levodopa plus reserpine

Marvin M. Goldenberg

1974-01-01

189

Capecitabine and sixth cranial nerve palsy.  

PubMed

Capecitabine is an oral chemotherapeutic agent converted to 5 fluorouracil (5-FU). Neurotoxicity associated with the medication encompasses both central and peripheral nervous systems. We describe a 60 year old man with colonic carcinoma who developed diplopia due to a sixth nerve palsy following the use of capecitabine which is an orally administered prodrug of 5-FU. An MRI of brain did not reveal a space occupying lesion or vascular insult to account for his cranial nerve palsy. The sixth nerve palsy resolved spontaneously once capecitabine was withdrawn. Physicians in all walks of life are increasingly likely to come across such patients and should familiarize themselves with toxicities consequent to chemotherapy. Further research is needed to elucidate the cause of capecitabine associated neurotoxicity. PMID:20479552

Dasgupta, Sonali; Adilieje, Chineme; Bhattacharya, Amlan; Smith, Bruce; Sheikh, Moeen ul Haq

2010-01-01

190

[Suprascapular nerve entrapment in a basketball player].  

PubMed

A basketball player was shown to have a suprascapular nerve lesion without any history of shoulder girdle trauma. This acute neuropathy, never previously described in basketball players, is a result of repeated micro-trauma, due to nerve traction over the coracoid notch during violent movement ("dunking" most probably). Clinically, he was unable to abduct his arm and had some difficulty in external rotation. He developed atrophy in both the supra- and the infraspinatus muscles. Nerve conduction latency to the supraspinatus muscle was 8.0 ms, and to the infraspinatus, 8.5 ms. The compound muscle action potential registered in the supraspinatus was 1.224 mV, and in the infraspinatus, 1.237 mV. After 3 weeks of inactivity, recovery was spontaneous and practically complete. PMID:9461687

Tsur, A; Shahin, R

1997-09-01

191

Optic nerve hypoplasia, encephalopathy, and neurodevelopmental handicap.  

PubMed Central

Abnormalities of the central nervous system are frequently described in optic nerve hypoplasia. In a longitudinal study of 46 consecutive children (32 term, 14 preterm) with bilateral optic nerve hypoplasia 32 (69.5%) had associated neurodevelopmental handicap. Of these, 90% had structural central nervous system abnormalities on computed tomographic brain scans. Neurodevelopmental handicap occurred in 62.5% of the term and 86% of the preterm infants respectively. Term infants had a greater incidence of ventral developmental midline defects and proportionately fewer maternal and/or neonatal complications throughout pregnancy, while encephaloclastic lesions were commoner among the premature infants. An association of optic nerve hypoplasia with the twin transfusion syndrome and prenatal vascular encephalopathies is described. PMID:2021594

Burke, J P; O'Keefe, M; Bowell, R

1991-01-01

192

Lipofibromatous hamartoma of the median nerve  

PubMed Central

Lipofibromatous hamartoma is a rare tumour of peripheral nerves which is characterised by an excessive infiltration of the epineurium and perineurium by fibroadipose tissue. To the best of our knowledge, only approximately 88 cases are reported in the literature. We report a rare case of lipofibromatous hamartoma of the median nerve causing secondary carpal tunnel syndrome in a 25 year old patient. This patient was treated conservatively with decompression and biopsy and experienced a complete resolution of symptoms post-operatively. Magnetic resonance imaging may be used to diagnose this lesion as it has very distinctive characteristics. Multiple conditions have been associated with this lesion and a greater understanding of these associations may clarify the pathogenesis. The architecture of the tumour makes excision very challenging and the surgical management remains controversial. A review of the literature regarding the etiology, pathogenesis and surgical management of lipofibromatous hamartoma is included. PMID:20920178

2010-01-01

193

The Sauve-Kapandji procedure for post-traumatic disorders of the distal radio-ulnar joint  

Microsoft Academic Search

e present the results of a retrospective series of 41 Sauve-Kapandji procedures carried out for complications of fractures of the distal radius. All the operations were undertaken by one surgeon with a mean follow-up of 32 months. A total of 37 patients was available for clinical review. The indications for surgery were pain on the ulnar side of the wrist

P. B. Carter; P. R. Stuart

2000-01-01

194

A superficial ulnar artery anastomosing with a larger anterior interosseous artery to supply the wrist and hand  

PubMed Central

The term superficial ulnar artery (SUA) is applied to an artery which arises from the axillary, brachial or superficial brachial arteries and courses over the origins of the superficial forearm muscles to join at the midlevel of the forearm with the ulnar artery, sometimes replacing it (Wankoff, 1962; Lippert & Pabst, 1985; Nakatani et al. 1996, 1997). Its incidence ranges from 0.7% (Adachi, 1928) to 3.3% (Müller, 1903). The SUA has been reported with different terminologies; arteria antebrachialis superficialis ulnaris (Gruber, 1867; Müller, 1903; Adachi, 1928), high origin of the ulnar artery (Rodriguez-Baeza et al. 1995; Aharinejad et al. 1997) and SUA with a high origin (Fuss, 1988). The present observation adds several aspects to the anatomical variations of the superficial ulnar arteries already described, most notably its anastomosis with the anterior interosseous artery. This anastomosis has previously been reported twice (Quain, 1844; Gruber, 1867) but without explanation as to the course taken by the anastomotic branch. The SUA was found in the right arm of a 66-y-old male during routine dissections in the Unit of Anatomy and Embryology at the Autonomous University of Barcelona. PMID:9688511

SAÑUDO, J. R.; MIRAPEIX, R. M.; GARCIA, R.; RODRIGUEZ-NIDENFÜNR, M.

1998-01-01

195

Fibrolipomatous hamartoma of nerve arising in the brachial plexus.  

PubMed

Fibrolipomatous hamartoma of nerve is a rare benign infiltrating condition of peripheral nerves leading to progressive functional loss. Previous descriptions have virtually all been confined to the distal part of the upper limb, with the median nerve being the commonest reported site. Most cases occur in the first 3 decades of life and a third are associated with macrodactyly. A case is described in a 63-year-old woman, involving the whole of the brachial plexus, a previously unreported site for this particular lesion. PMID:7759925

Price, A J; Compson, J P; Calonje, E

1995-02-01

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. PMID:25180190

Buskbjerg Jager, Sara

2014-01-01

197

Conservative management of ulnar tunnel syndrome: secondary to excessive healing tissue; a rare complication after flexor tendon injury--a case report.  

PubMed

The ulnar tunnel syndrome occurs usually from ganglions, lipoma, cysts, chronic repetitive trauma, bicycling, and the activities that require either prolonged wrist hyper extension or continued pressure on the hypothenar eminence. The ulnar tunnel syndrome after flexor tendon repair is a rare complication. We report on a 24-year-old man with ulnar tunnel syndrome after a flexor tendon repair secondary to girder cut injury. The patient was managed conservatively for his hypertrophic scar for 9 weeks. After 9 weeks, the patient presented with no clawing and complete closure of the hand. PMID:22627928

Sudhagar, G; Le blanc, Monique

2012-06-01

198

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

199

The furcal nerve revisited.  

PubMed

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. PMID:25317309

Harshavardhana, Nanjundappa S; Dabke, Harshad V

2014-08-01

200

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

201

Bilateral superficial ulnar artery with high origin from the axillary artery: its anatomy and clinical significance.  

PubMed

The superficial ulnar artery (SUA) is a rare anatomical variant that usually arises either in the axilla or the arm and runs a superficial course in the forearm, enters the hand, and participates in the formation of superficial palmar arch. During the routine dissection of cadavers in the department of anatomy, whilst preparing the specimen for medical students, an unusual bilateral branch of the axillary artery was found in one of the cadavers: a rare variant of the artery known as SUA, which originates from the 2nd part of the axillary arteries of both sides. The SUA is a known anatomical variant, but the bilateral high origin from the 2nd part of the axillary artery is extremely unusual. Its occurrence is of great clinical importance to the surgical and radiological departments. PMID:22532186

Gupta, G; Singh, K; Chhabra, S; Gupta, V; Kayalvizhi, I

2012-02-01

202

Brachial, radial, and ulnar arteries in the endovascular era: choice of intervention.  

PubMed

To say that endovascular techniques have revolutionized treatment of aortic aneurysms is an understatement. These same techniques and principles are now being applied to peripheral aneurysms. Because of the small diameter of the arteries in the arm, the relative scarcity of true aneurysms of these arteries, and the fact that these arteries are readily accessible, open surgery remains the mainstay of therapy. On the other hand, nonsurgical approaches are playing an important role in the treatment of peripheral pseudoaneurysms and aneurysmal changes associated with arterial and venous access. This article reviews the natural history, treatment, and outcomes of aneurysms of the radial, brachial, and ulnar arteries. We will also focus on interventional treatment of pseudoaneurysms. PMID:16360575

Buda, Steven J; Johanning, Jason M

2005-12-01

203

Treadmill Exercise Induced Functional Recovery after Peripheral Nerve Repair Is Associated with Increased Levels of Neurotrophic Factors  

PubMed Central

Benefits of exercise on nerve regeneration and functional recovery have been reported in both central and peripheral nervous system disease models. However, underlying molecular mechanisms of enhanced regeneration and improved functional outcomes are less understood. We used a peripheral nerve regeneration model that has a good correlation between functional outcomes and number of motor axons that regenerate to evaluate the impact of treadmill exercise. In this model, the median nerve was transected and repaired while the ulnar nerve was transected and prevented from regeneration. Daily treadmill exercise resulted in faster recovery of the forelimb grip function as evaluated by grip power and inverted holding test. Daily exercise also resulted in better regeneration as evaluated by recovery of compound motor action potentials, higher number of axons in the median nerve and larger myofiber size in target muscles. Furthermore, these observations correlated with higher levels of neurotrophic factors, glial derived neurotrophic factor (GDNF), brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1), in serum, nerve and muscle suggesting that increase in muscle derived neurotrophic factors may be responsible for improved regeneration. PMID:24618564

Park, Jae-Sung; Höke, Ahmet

2014-01-01

204

Central bilateral sixth nerve palsy associated with a unilateral preganglionic Horner's syndrome.  

PubMed

Unilateral peripheral sixth nerve palsy associated with an ipsilateral postganglionic Horner's syndrome has previously been described. Isolated bilateral sixth nerve palsy due to a pontine hemorrhagic lesion, however, is a rare occurrence. We describe such a case whose only other neurological finding was a unilateral preganglionic Horner's syndrome. PMID:2971682

Kellen, R I; Burde, R M; Hodges, F J; Roper-Hall, G

1988-09-01

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

[Nerve sheath tumours].  

PubMed

Peripheral nerve sheath tumors are common neoplasms in daily practice. Diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer; but on occasion, they are diagnostically challenging (especially with locally aggressive and malignant tumors). This article aims to provide an update of the data (clinical, histological, immunohistochemistry and genomic) of benign, intermediate and malignant peripheral nerve sheath tumors, thanks to the latest WHO "Classification of Tumors of Soft Tissue and Bone", published in 2013, which includes a new chapter on "Nerve Sheath Tumors". Advances in molecular biology have provided new insights into the nature of the various peripheral nerve sheath tumors, and have begun to suggest novel targeted therapeutic approaches. PMID:25541115

Le Guellec, Sophie

2015-01-01

207

Immunohistochemical Demonstration of EMA\\/Glut1Positive Perineurial Cells and CD34Positive Fibroblastic Cells in Peripheral Nerve Sheath Tumors  

Microsoft Academic Search

To clarify the cellular composition of various peripheral nerve tumorous lesions (traumatic neuroma, 5 cases; schwannoma, 10 cases; neurofibroma, 14 cases; perineurioma, 3 cases; conventional malignant peripheral nerve sheath tumor (MPNST), 7 cases; perineurial MPNST, 4 cases), expression of several markers specific to nerve sheath cells, including glucose transporter protein 1 (Glut1) and CD34, were immunohistochemically investigated with highly sensitive

Takanori Hirose; Takayuki Tani; Tetsuya Shimada; Keisuke Ishizawa; Shio Shimada; Toshiaki Sano

2003-01-01

208

Spontaneous nerve torsion: unusual cause of radial nerve palsy.  

PubMed

Spontaneous nerve torsion is a rare cause of nerve palsy. We describe a case of nerve torsion affecting the radial nerve in order to inform radiologists of the existence of this condition and subtle features on cross-sectional imaging that can suggest the diagnosis preoperatively. PMID:25244923

Endo, Yoshimi; Miller, Theodore T; Carlson, Erik; Wolfe, Scott W

2015-03-01

209

Bone regeneration using an injectable calcium phosphate\\/autologous iliac crest bone composites for segmental ulnar defects in rabbits  

Microsoft Academic Search

Background Treatment of segmental bone loss remains a challenge in skeletal repair. A major therapeutic goal is the development of implantable\\u000a materials that will promote bone regeneration. Objective We evaluate bone regeneration in grafts containing different concentrations autologous iliac crest bone (ACB) particles,\\u000a carried in a new injectable calcium phosphate cement (CPC), in ulnar bone defects in rabbits. Methods Large

Yao Weitao; Kong Kangmei; Wang Xinjia; Qi Weili

2008-01-01

210

Size of distal radial and distal ulnar arteries in adults of southern Rajasthan and their implications for percutaneous coronary interventions  

PubMed Central

Aims and objectives Transradial interventions are gaining popularity in recent years. However the radial artery being small, there is a limitation in using interventional devices through this route. We have measured radial and ulnar arteries size in adult patients at our tertiary care cardiology center in southern Rajasthan. Method Adult patients >30 years, who came for Echocardiography at a tertiary care center were included. Radial and ulnar arteries inner diameters were measured 2–3 cm above the Styloid process in both forearms with the Ultrasonography. Patient information about weight, height, diabetes and hypertension were collected. Body mass index and Body surface area were calculated. Results We studied 204 patients, which includes 60.8% males. Mean diameter was 2.325 ± 0.4 mm mm for radial arteries and 2.358 ± 0.39 mm for ulnar arteries (p = 0.24). Hypertensive and male patients had larger mean radial artery diameter than non hypertensive (2.383 mm v/s 2.272 mm, p = 0.006) and female patients (2.37 mm v/s 2.26 mm, p = 0.008) respectively. Diabetic patients (2.305 mm) had nonsignificantly smaller radial arteries diameters than nondiabetics (2.329 mm, p = 0.6). We calculated correlations between radial arteries diameters and Body surface area, Body mass index, height and weight of patients, none of these correlations were statistically significant (r = 0.30, r = 0.28, r = 0.07, r = 0.031 respectively). Conclusion Mean radial artery diameter (2.325 ± 0.4 mm) in the study was slightly smaller than ulnar artery (2.358 ± 0.39 mm). Males and hypertensives had a larger mean radial artery diameter than females and non hypertensives. Radial artery inner diameter measurement by Ultrasonography may be more helpful than Allen's test for ideal selection of cases. PMID:25443603

Beniwal, Sunil; Bhargava, Kapil; Kausik, Satish K.

2014-01-01

211

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

212

Changes in nerve microcirculation following peripheral nerve compression?  

PubMed Central

Following peripheral nerve compression, peripheral nerve microcirculation plays important roles in regulating the nerve microenvironment and neurotrophic substances, supplying blood and oxygen and maintaining neural conduction and axonal transport. This paper has retrospectively analyzed the articles published in the past 10 years that addressed the relationship between peripheral nerve compression and changes in intraneural microcirculation. In addition, we describe changes in different peripheral nerves, with the aim of providing help for further studies in peripheral nerve microcirculation and understanding its protective mechanism, and exploring new clinical methods for treating peripheral nerve compression from the perspective of neural microcirculation. PMID:25206398

Gao, Yueming; Weng, Changshui; Wang, Xinglin

2013-01-01

213

[Transplantation of nerve tissue].  

PubMed

The results of transplantation of various parts of the central and peripheral nervous system are considered. Transplantation of nerve trunks is used clinically, and heterogenous regeneration of the nerves results in reinnervation of tissues and organs. The spinal ganglion transplantation is successfully used in experiments with both embryonic and mature differentiated neurons. Transplantation of different parts of the cortex, some subcortical structures, hyppocampus, hypothalamus, cerebellum and the spinal cord is made using immature neurons. Some attempts have been made to transplant the nerve tissue grown in vitro into a host. PMID:6998434

Chumasov, E I; Chalisova, N I

1980-01-01

214

Suprascapular nerve entrapment.  

PubMed

It is important to be aware of neuropathy involving the suprascapular nerve. While direct trauma to the suprascapular nerve is the usual cause (direct blow to the base of the neck or posterior shoulder, shoulder dislocation or fracture), the problem may result from overuse injuries (such as repetitive tennis serving or spiking of a volley ball), excessive horizontal adduction, weight lifting, backpacking or no apparent reason. These last three years we have operated 8 cases of suprascapular nerve neurolysis at the level of suprascapular incision, and section of the transverse scapular ligament through the back supraspinal approach. PMID:15830964

Corò, L; Azuelos, A; Alexandre, A

2005-01-01

215

Cyclic AMP Signaling: A Molecular Determinant of Peripheral Nerve Regeneration  

PubMed Central

Disruption of axonal integrity during injury to the peripheral nerve system (PNS) sets into motion a cascade of responses that includes inflammation, Schwann cell mobilization, and the degeneration of the nerve fibers distal to the injury site. Yet, the injured PNS differentiates itself from the injured central nervous system (CNS) in its remarkable capacity for self-recovery, which, depending upon the length and type of nerve injury, involves a series of molecular events in both the injured neuron and associated Schwann cells that leads to axon regeneration, remyelination repair, and functional restitution. Herein we discuss the essential function of the second messenger, cyclic adenosine monophosphate (cyclic AMP), in the PNS repair process, highlighting the important role the conditioning lesion paradigm has played in understanding the mechanism(s) by which cyclic AMP exerts its proregenerative action. Furthermore, we review the studies that have therapeutically targeted cyclic AMP to enhance endogenous nerve repair. PMID:25177696

Knott, Eric P.; Assi, Mazen; Pearse, Damien D.

2014-01-01

216

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

217

Peripheral nerve injuries in baseball players.  

PubMed

Baseball players place significant stress across their shoulders and elbows during the throwing motion, causing unique patterns of injuries in the overhead throwing athlete. Specific nerve injuries include suprascapular neuropathy, quadrilateral space syndrome, and cubital tunnel syndrome. Nonoperative treatment includes cessation of throwing and symptom management. As symptoms improve, athletes should start rehabilitation, focusing on restoring shoulder and trunk flexibility and strength. The final rehabilitation phase involves an interval throwing program with attention directed at proper mechanics, with the goal of returning the athlete to competitive throwing. Surgery may assist in a positive outcome in particular patients who fail to improve with nonoperative treatment. Additional indications for surgery may include more profound neuropathy and nerve compression by a mass lesion. PMID:19084770

Cummins, Craig A; Schneider, David S

2009-02-01

218

Peripheral nerve injuries in baseball players.  

PubMed

Baseball players place significant stress across their shoulders and elbows during the throwing motion, causing unique patterns of injuries in the overhead throwing athlete. Specific nerve injuries include suprascapular neuropathy, quadrilateral space syndrome, and cubital tunnel syndrome. Nonoperative treatment includes cessation of throwing and symptom management. As symptoms improve, athletes should start rehabilitation, focusing on restoring shoulder and trunk flexibility and strength. The final rehabilitation phase involves an interval throwing program with attention directed at proper mechanics, with the goal of returning the athlete to competitive throwing. Surgery may assist in a positive outcome in particular patients who fail to improve with nonoperative treatment. Additional indications for surgery may include more profound neuropathy and nerve compression by a mass lesion. PMID:18295091

Cummins, Craig A; Schneider, David S

2008-02-01

219

Cervical Radiculopathy (Pinched Nerve)  

MedlinePLUS

... nerve. The medical term for this condition is cervical radiculopathy. Understanding your spine and how it works can help you better understand cervical radiculopathy. Learn more about your spine online at Spine Basics: http://orthoinfo. org/topic. ...

220

Diabetic Nerve Problems  

MedlinePLUS

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

221

Bilateral ptosis due to mesencephalic lesions with relative preservation of ocular motility.  

PubMed

Three cases of bilateral ptosis with relatively normal ocular motility are presented. In two of the patients, neuroimaging demonstrated lesions in the region of the third cranial nerve subnuclei. These unusual clinical presentations are due to isolated involvement of the central caudal nucleus supplying the bilateral levator muscles, with, virtually complete sparing of other third cranial nerve structures. PMID:8956161

Martin, T J; Corbett, J J; Babikian, P V; Crawford, S C; Currier, R D

1996-12-01

222

Clinical analysis of a large kindred with the pallister ulnar-mammary syndrome  

SciTech Connect

The ulnar-mammary syndrome (UMS) is an autosomal dominant disorder characterized by posterior limb deficiencies or duplications, apocrine/mammary gland hypoplasia and/or dysfunction, abnormal dentition, delayed puberty in males, and genital anomalies. We present the clinical descriptions of 33 members of a six generation kindred with UMS. The number of affected individuals in this family is more than the sum of all previously reported cases of UMS. The clinical expression of UMS is highly variable. While most patients have limb deficiencies, the range of abnormalities extends from hypoplasia of the terminal phalanx of the 5th digit to complete absence of the ulna and 3rd, 4th, and 5th digits. Moreover, affected individuals may have posterior digital duplications with or without contralateral limb deficiencies. Apocrine gland abnormalities range from diminished axillary perspiration with normal breast development and lactation, to complete absence of the breasts and no axillary perspiration. Dental abnormalities include misplaced or absent teeth. Affected males consistently undergo delayed puberty, and both sexes have diminished to absent axillary hair. Imperforate hymen were seen in some affected women. A gene for UMS was mapped to chromosome area 12q23-q24.1. A mutation in the gene causing UMS can interfere with limb patterning in the proximal/distal, anterior/posterior, and dorsal/ventral axes. This mutation disturbs development of the posterior elements of forearm, wrist, and hand while growth and development of the anterior elements remain normal. 24 refs., 4 figs., 1 tab.

Bamshad, M.; Root, S.; Carey, J.C. [Univ. of Utah Health Sciences Center, Salt Lake City, UT (United States)] [Univ. of Utah Health Sciences Center, Salt Lake City, UT (United States)

1996-11-11

223

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

224

In-vivo measurement of distal radio-ulnar joint translation.  

PubMed

Distal radio-ulnar joint (DRUJ) instability is increasingly recognised and assessment can be subjective and difficult. Previous research has used cadaveric models or in-vivo with CT, with variable results. A test device was designed to establish normal values of in-vivo DRUJ dorso-palmar translation. Twenty volunteers were recruited. Those with previous wrist/forearm injuries were excluded. The device held the elbow at 90° flexion and neutral forearm rotation, with the distal ulna secured. A dorso-palmar shear force was applied to the distal radius and displacement measured three times on each wrist alternately by the same operator. The mean translation of the DRUJ is 5.5 mm. Same-sided mean measurements for two subjects taken days apart varied by 1 mm. The intra-class correlation coefficient was 0.93. The device is reliable, reproducible and appears to be a simple valid test. Contralateral sides were comparable. It will primarily be a research device to guide clinical practice in DRUJ instability. PMID:23413844

Nagata, H; Hosny, S; Giddins, G E B

2013-01-01

225

Fibrolipomatous Hamartoma of the Nerve Arising in the Neck: A Case Report With Review of the Literature and Differential Diagnosis.  

PubMed

: We report an unusual case of a fibrolipomatous hamartoma that arose in a nuchal nerve. Typically, fibrolipomatous hamartoma, otherwise known as a neural fibrolipoma or lipomatosis of nerve, arises in the median nerve, brachial plexus, cranial nerves, or plantar nerves. The differential diagnosis is broad and includes benign and malignant spindle cell lesions, such as spindle cell lipoma, perineurioma, and myxoid liposarcoma. We were able to identify the lesion based on the typical histology, including triphasic composition with spindle cell, neural, and adipocytic components and whorled architecture. Because of the atypical location in the neck, detailed immunohistochemical staining was performed. The lesional spindle cells were negative for SMA, CD10, CD68, EMA, S100, PGP9.5, CD34, CD56, and beta-catenin. Colloidal iron stain highlighted marked intralesional mucin deposition. This detailed immunohistochemical profile is a useful diagnostic aid and to our knowledge has not been previously described. PMID:25033011

Philp, Lauren; Naert, Karen A; Ghazarian, Danny

2014-07-15

226

GLIAL RESPONSES AFTER CHORDA TYMPANI NERVE INJURY  

PubMed Central

The chorda tympani (CT) nerve innervates lingual taste buds and is susceptible to damage during dental and inner ear procedures. Interruption of the CT results in a disappearance of taste buds, which can be accompanied by taste disturbances. Because the CT usually regenerates to reinnervate taste buds successfully in a few weeks, a persistence of taste disturbances may indicate alterations in central nervous function. Peripheral injury to other sensory nerves leads to glial responses at central terminals, which actively contribute to abnormal sensations arising from nerve damage. Therefore, the current study examined microglial and astrocytic responses in the first central gustatory relay -the nucleus of the solitary tract (nTS)- after transection of the CT. Damage to the CT resulted in significant microglial responses in terms of morphological reactivity and an increased density of microglial cells from 2-20 days after injury. This increased microglial population primarily resulted from microglial proliferation from 1.5-3 days, which was supplemented by microglial migration within sub-divisions of the nTS between days 2-3. Unlike other nerve injuries, CT injury did not result in recruitment of bone marrow-derived precursors. Astrocytes also reacted in the nTS with increased levels of GFAP by 3 days, although none showed evidence of cell division. GFAP levels remained increased at 30 days by which time microglial responses had resolved. These results show that nerve damage to the CT results in central glial responses, which may participate in long lasting taste alterations following CT lesion. PMID:22315167

Bartel, Dianna L.

2013-01-01

227

The Effect of Unilateral SLN Lesion on Swallowing Threshold Volume  

PubMed Central

Objectives/Hypotheses The Superior Laryngeal Nerve (SLN) is the major sensory nerve for the upper larynx. Damage to this nerve impacts on successful swallowing. The first aim of the study was to assess the effect of unilateral SLN lesion on the threshold volume sufficient to elicit swallowing in an intact pig model; this volume was defined radiographically as the maximum bolus area visible in lateral view. The second aim was to determine if a difference existed between ipsi-lateral and contra-lateral function as a result of unilateral sensory loss, measured as the radiologic density of fluid seen in the valleculae. Finally, we determined if there was a relationship between the threshold volume and the occurrence of aspiration after a unilateral SLN lesion. Study Design Repeated measures animal study. Methods Four female infant pigs underwent unilateral SLN lesion surgery. The maximum vallecular bolus area in lateral view and the relative vallecular density on each side in the dorsoventral view were obtained from videofluoroscopic recordings in both the pre-lesion control and post lesion experimental states. Results In lateral view, the lesioned group had a bigger maximum bolus area than the control group (p<0.001). Although occasional left-right asymmetry in the dorsoventral view was observed,, the vallecular densities were, on average, equal on both the left (intact) and right (lesioned) sides (p>0.05). A bigger maximum bolus area did not predict aspiration in the lesioned group (p>0.05). Conclusion Unilateral SLN lesions increased the swallowing threshold volume symmetrically in right and left valleculae but the increased threshold may not be the main mechanism for the occurrence of aspiration. The Effect of Unilateral SLN Lesion on Swallowing Threshold Volume PMID:23670486

Ding, Peng; Campbell-Malone, Regina; Holman, Shaina D.; Lukasik, Stacey L.; Thexton, Allan J.; German, Rebecca Z.

2015-01-01

228

Histopathology of idiopathic lesions in the eyes of Homarus americanus from Long Island Sound.  

PubMed

In 1999, American lobsters, Homarus americanus, from western Long Island Sound (WLIS) experienced a significant mortality. In 2001 and 2004, the eyes and eyestalks of lobsters from WLIS and central LIS were examined for histopathological changes. Idiopathic lesions were identified in the ommatidia and optic nerve fibers proximal to the ommatidia in 29 (56%) of the lobsters from LIS. Lesions were categorized as either moderate or severe. Moderate lesions had altered rhabdoms, clumped pigment, and altered optic nerve fibers. Severe lesions were marked by absent rhabdoms, clumped pigment in both the ommatidial region and in the optic nerve region; and optic nerve fibers that had been completely destroyed and were replaced by vascular tissue. Idiopathic lesions occurred primarily in the central and ventral regions of the eye, and with much less frequency in the dorsal region. In addition, damage to the dorsal area tended to occur only when the severity of lesions was high, indicating a spatially progressive pattern to the lesion development. The lesions occurred in both western and central Long Island Sound, with no significant differences in severity between locations. The prevalence of lesions did not vary between years, but in 2004, several eyes had less severe pathology than those from 2001. These data indicate that the etiological agent is present throughout a large portion of the Sound, and that lobsters are probably continually exposed to it. PMID:16376928

Maniscalco, Andrea M; Shields, Jeffrey D

2006-02-01

229

Repair of sciatic nerve defects using tissue engineered nerves  

PubMed Central

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

2013-01-01

230

Brachial plexus lesions after backpack carriage in young adults.  

PubMed

Carrying a heavy backpack exerts compression on shoulders, with the potential to cause brachial plexopathy. We evaluated the incidence and predisposing factors of compression plexopathy of the shoulder region in 152,095 military conscripts, hypothesizing that a low body mass index and poor physical fitness predispose to the plexus lesion. Reports of conscripts with neural lesions of the upper arm associated with load carriage were reviewed retrospectively for details associated with the condition onset, symptoms, signs, nerve conduction studies, and electromyographic examinations. Height, weight, and physical fitness scores were obtained from their military training data. The incidence of neural compression after shoulder load carriage in Finnish soldiers was 53.7 (95% confidence interval, 39.5-67.8) per 100,000 conscripts per year. The long thoracic nerve was affected in 19, the axillary nerve in 13, the suprascapular nerve in seven, and the musculocutaneous nerve in six patients. Four patients (7%) had hereditary neuropathy with susceptibility to pressure palsies (HNPP). Symptoms were induced by lighter loads in patients with HNPP. Vulnerability to brachial plexopathy was not predictable from body structure or physical fitness level. To prevent these lesions, awareness of the condition and its symptoms should be increased and backpack designs should be improved. PMID:16906084

Mäkelä, Jyrki P; Ramstad, Raimo; Mattila, Ville; Pihlajamäki, Harri

2006-11-01

231

Stretch-induced nerve injury: a proposed technique for the study of nerve regeneration and evaluation of the influence of gabapentin on this model  

PubMed Central

The rat models currently employed for studies of nerve regeneration present distinct disadvantages. We propose a new technique of stretch-induced nerve injury, used here to evaluate the influence of gabapentin (GBP) on nerve regeneration. Male Wistar rats (300 g; n=36) underwent surgery and exposure of the median nerve in the right forelimbs, either with or without nerve injury. The technique was performed using distal and proximal clamps separated by a distance of 2 cm and a sliding distance of 3 mm. The nerve was compressed and stretched for 5 s until the bands of Fontana disappeared. The animals were evaluated in relation to functional, biochemical and histological parameters. Stretching of the median nerve led to complete loss of motor function up to 12 days after the lesion (P<0.001), compared to non-injured nerves, as assessed in the grasping test. Grasping force in the nerve-injured animals did not return to control values up to 30 days after surgery (P<0.05). Nerve injury also caused an increase in the time of sensory recovery, as well as in the electrical and mechanical stimulation tests. Treatment of the animals with GBP promoted an improvement in the morphometric analysis of median nerve cross-sections compared with the operated vehicle group, as observed in the area of myelinated fibers or connective tissue (P<0.001), in the density of myelinated fibers/mm2 (P<0.05) and in the degeneration fragments (P<0.01). Stretch-induced nerve injury seems to be a simple and relevant model for evaluating nerve regeneration. PMID:24270909

Machado, J.A.; Ghizoni, M.F.; Bertelli, J.; Teske, Gabriel C.; Teske, Guilherme C.; Martins, D.F.; Mazzardo-Martins, L.; Cargnin-Ferreira, E.; Santos, A.R.S.; Piovezan, A.P.

2013-01-01

232

Stretch-induced nerve injury: a proposed technique for the study of nerve regeneration and evaluation of the influence of gabapentin on this model.  

PubMed

The rat models currently employed for studies of nerve regeneration present distinct disadvantages. We propose a new technique of stretch-induced nerve injury, used here to evaluate the influence of gabapentin (GBP) on nerve regeneration. Male Wistar rats (300 g; n=36) underwent surgery and exposure of the median nerve in the right forelimbs, either with or without nerve injury. The technique was performed using distal and proximal clamps separated by a distance of 2 cm and a sliding distance of 3 mm. The nerve was compressed and stretched for 5 s until the bands of Fontana disappeared. The animals were evaluated in relation to functional, biochemical and histological parameters. Stretching of the median nerve led to complete loss of motor function up to 12 days after the lesion (P<0.001), compared to non-injured nerves, as assessed in the grasping test. Grasping force in the nerve-injured animals did not return to control values up to 30 days after surgery (P<0.05). Nerve injury also caused an increase in the time of sensory recovery, as well as in the electrical and mechanical stimulation tests. Treatment of the animals with GBP promoted an improvement in the morphometric analysis of median nerve cross-sections compared with the operated vehicle group, as observed in the area of myelinated fibers or connective tissue (P<0.001), in the density of myelinated fibers/mm2 (P<0.05) and in the degeneration fragments (P<0.01). Stretch-induced nerve injury seems to be a simple and relevant model for evaluating nerve regeneration. PMID:24270909

Machado, J A; Ghizoni, M F; Bertelli, J; Teske, Gabriel C; Teske, Guilherme C; Martins, D F; Mazzardo-Martins, L; Cargnin-Ferreira, E; Santos, A R S; Piovezan, A P

2013-11-01

233

Pulsed radiofrequency lesioning for treatment of chronic breast neuropathic pain after breast reduction -A case report-  

PubMed Central

Breast surgery is a common procedure performed in women. Many women who undergo breast surgery suffer from ill-defined pain syndromes. A nerve block is used in the treatment of the acute and chronic pain, but the effectiveness of the treatment has been limited because of its short duration. Recently, the advent of pulsed radiofrequency lesioning (PRF) has proved a successful treatment for chronic refractory pain involving the peripheral nerves. We experienced a case of a 52-year-old female patient complaining of chronic breast neuropathic pain after breast reduction, which was relieved after PRF lesioning of the 4th thoracic spinal nerve and its root. PMID:21286450

Kim, Hyung Tae; Kim, Kwang Yong; Kim, Yeon Dong

2010-01-01

234

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

235

Sympathetic skin response and regeneration of sudomotor fibers after complete division of peripheral nerves.  

PubMed

Sympathetic skin responses (SSRs) were studied in hands of patients during regeneration of their median or ulnar nerves following complete severance and suture. The SSRs were elicited with electrical stimuli presented to the forearm of the normal side and recorded between the dorsum of the hand and three sites in the innervation area of the two nerves. The amplitude and area of the SSRs were compared to those obtained at the identical points on the uninjured hand. The responses were followed up for 16 months at 1-1.5-month intervals in a group of 6 adults and for 14 months at monthly intervals in 7 children. After an initial absence, the SSRs appeared after about 4 months postoperatively at the most proximal site in the adults and 2-3 months in the children. It progressed subsequently over a 14- or 16-month observation period to less than 50% of the normal side in the adults and to close to 100% in children, fastest and most complete for the proximal recording site, considerably earlier in the children. End-stage recovery studied in another group of 14 adults and 7 children 2-7 years postoperatively reached an average of 80-100% at the most proximal recording site in most adults and children. The intermediate and the distal sites showed less complete return of the SSR. The method of recording SSRs is considered suitable to follow regeneration of the sudomotor fibers in the cut and sutured nerves of the hand. PMID:8740662

Ahcan, U; Kolbl, J; Janko, M

1996-04-20

236

Lipofibromatous Hamartoma of the Median Nerve in Association with or without Macrodactyly.  

PubMed

Lipofibromatous hamartoma is a rare tumour-like condition involving the peripheral nerves, particularly the median nerve. It commonly affects the volar aspect of the hands, wrists and forearms of young adults. Most patients present either early with macrodactyly or later with a forearm mass lesion or symptoms consistent with compressive neuropathy of the involved nerve. The clinical and histomorphological findings of five patients with lipofibromatous hamartoma of the median nerve are analysed. The presentation, pathological features and differential diagnosis of neural lipofibromas are discussed along with a brief review of the literature. Of the five cases of lipofibromatous hamartoma, all were seen to involve the median nerve, occurring in four women and one man. Three of these cases had associated macrodactyly which was congenital in two and was seen from childhood in one. Microscopic examination showed fibrofatty tissue surrounding and infiltrating along the epineurium and perineurium. The nerve bundles were splayed apart by the infiltrating adipose tissue. Neural fibrolipomatous hamartoma is a benign condition. Most respond to conservative management with surgical exploration, biopsy and carpal tunnel release to decompress the nerve. Correct diagnosis of this uncommon lesion is important as surgical excision of the lesion may lead to loss of neurological function. PMID:25371022

Kini, Jyoti R; Kini, Hema; Rau, Aarathi; Kamath, Jagannath; Kini, Anand

2014-11-01

237

SIDELINE ASSESSMENT AND RETURN?TO?PLAY DECISION?MAKING FOR AN ACUTE ELBOW ULNAR COLLATERAL LIGAMENT SPRAIN  

PubMed Central

Throwing athletes are at high risk for elbow injuries. The ulnar collateral ligament (UCL) of the elbow, in particular, must resist large valgus forces during the throwing motion. An acute UCL sprain requires the sports medicine professional on the sidelines to thoroughly assess the injury and reach a return?to?play decision in a timely manner. A sports medicine professional who makes an accurate diagnosis, reaches a correct return?to?play decision, and initiates early treatment gives the athlete the best chance for a rapid, successful return to their sport. Level of Evidence: 5 PMID:23593559

Smith, Danny

2013-01-01

238

Optic nerve hypoplasia in children.  

PubMed Central

Optic nerve hypoplasia (ONH) is characterised by a diminished number of optic nerve fibres in the optic nerve(s) and until recently was thought to be rare. It may be associated with a wide range of other congenital abnormalities. Its pathology, clinical features, and the conditions associated with it are reviewed. Neuroendocrine disorders should be actively sought in any infant or child with bilateral ONH. Early recognition of the disorder may in some cases be life saving. Images PMID:2191713

Zeki, S. M.; Dutton, G. N.

1990-01-01

239

Neuropathic pain: are there distinct subtypes depending on the aetiology or anatomical lesion?  

E-print Network

1 Neuropathic pain: are there distinct subtypes depending on the aetiology or anatomical lesion-1Jul2008 Author manuscript, published in "N/P" DOI : 10.1016/j.pain.2008.01.006 #12; 2 ABSTRACT Neuropathic pain can be caused by a variety of nerve lesions and it is unsettled whether it should

Paris-Sud XI, Université de

240

Peroneal nerve entrapment in runners  

Microsoft Academic Search

In a practice involving large groups of athletes, seven runners and one soccer player with peroneal nerve compression neuropathy secondary to exercise have been found. Running incited pain, numbness and tin gling to varying degrees in all patients, and examination after running revealed muscle weakness and a positive percussion test as the nerve winds around the fibular neck. Nerve conduction

Robert E. Leach; Michael B. Purnell; Akiyoshi Saito

1989-01-01

241

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; Sofiène Baccar; Anissa Miaaoui; Monia Ben Messaoud; Imène Turki; Ilhem Cheour; Emna Menif

2007-01-01

242

Vagus Nerve Stimulation  

Microsoft Academic Search

Vagus nerve stimulation (VNS) is a safe and reliable treatment adjunct for patients with medically intractable epilepsy. It is both a preventive and an abortive form of therapy, potentially effective against both partial and generalized seizures in adults and children. VNS also has a number of serendipitous effects on mood, memory, and attention and has been approved for the treatment

Arun Paul Amar; Michael L. Levy; Charles Y. Liu; Michael L. J. Apuzzo

2008-01-01

243

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.

244

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

245

Sensory nerve conduction of the plantar nerve compared with other nerve conduction tests in rats  

Microsoft Academic Search

ObjectiveIn rats the available techniques for evaluation of sensory nerve conduction are limited. We report a new method of sensory nerve conduction of the plantar nerve using needle electrodes as the recording electrodes behind the medial malleolus and ring electrodes as the stimulating electrodes around the three middle toes.

Katsumi Kurokawa; Diogo F de Almeida; Yun Zhang; Charles D Hébert; John G Page; Karen M Schweikart; Shin J Oh

2004-01-01

246

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; Ghi??, RA; Pârvan, AA; Japie, E; Gavriliu, ?; Georgescu, I; El Nayef, T; ?iripa, I; Hamei, ?

2013-01-01

247

[Pathology of wrist ligaments. 32 lesions of the carpal triangular fibrocartilage complex (TFCC). Prognostic significance of associated luno-triquetral lesions].  

PubMed

Trauma of the wrist is often responsible for multiple ligament injuries. We wanted to know if the association of a luno-triquetral ligament lesion and a triangular fibrocartilage disc lesion has a poor prognosis. We reviewed 32 patients with a traumatic injury of the triangular ligament, with a mean age of 35 years, and 32 months of follow up. The functional scores used were the Modified Mayo Wrist score, the Quick DASH score, and the Herzberg score. Patients were classified according to the severity of luno-triquetral lesions, in conformity with the Geissler's classification. Ten patients had a healthy ligament, 11 a stable lesion stage 1 and 11 an unstable lesion stage 2, 3 or 4. The joint mobility averages were 59.5° in flexion, 64.2° in extension, a pronation of 71.3°, a supination of 74.1°, an ulnar inclination of 33.8° and a radial inclination of 16.8°. The Modified Mayo Wrist score average was 75/100, the Herzberg score average was 81.5/100 and the average of the Quick DASH 8/100. The patients were all very satisfied or satisfied with their intervention. There was no statistically significant difference between the three groups studied regarding mobility and functional scores. In this study, an associated luno-triquetral ligament injury does not seem to worsen the functional outcome after surgery, provided appropriate treatment had been performed. However, a larger patient sample is needed to verify these findings. PMID:23182183

Gaumet, G; Fontes, D; Wavreille, G; Limousin, M

2012-12-01

248

Atypical presentation of leprosy in HIV.  

PubMed

Atypical presentations can be expected when leprosy, a mycobacterial disease is associated with HIV. We report a case of a 28 year old male driver with a high risk behavior, who came for evaluation of hypoaesthetic, scaly erythematous plaques over face, trunk, upper extremity; verrucous lesions over elbows and necrotic lesions over the neck and lower extremities since 6 months. No other systemic complaints were present. Nerve examination showed grossly thickened left greater auricular nerve and cord like thickening of bilateral ulnar and lateral popliteal nerves. His investigations revealed anemia, a reactive ELISA for HIV-1 and CD4 of 400 cell/cmm. Ultrasonography of the thickened nerves revealed an abscess in the left ulnar nerve whereas the left greater auricular nerve showed neuritis. Histopathology from an erythematous plaque was suggestive of borderline tuberculoid leprosy in reaction. Final diagnosis was borderline tuberculoid leprosy in type 1 reaction with atypical and varied morphology in an immunocompromised male with neuritis of the left greater auricular nerve, a silent left ulnar nerve abscess with early left ulnar nerve palsy. Our case highlights the atypical morphology of leprosy lesions and the unexpected protective cellular response as suggested by formation of nerve abscess in a HIV positive patient. PMID:21434511

Manjare, A K; Tambe, S A; Phiske, M M; Jerajani, H R

2010-01-01

249

Collagen (NeuraGen®) nerve conduits and stem cells for peripheral nerve gap repair.  

PubMed

Collagen nerve guides are used clinically for peripheral nerve defects, but their use is generally limited to lesions up to 3 cm. In this study we combined collagen conduits with cells as an alternative strategy to support nerve regeneration over longer gaps. In vitro cell adherence to collagen conduits (NeuraGen(®) nerve guides) was assessed by scanning electron microscopy. For in vivo experiments, conduits were seeded with either Schwann cells (SC), SC-like differentiated bone marrow-derived mesenchymal stem cells (dMSC), SC-like differentiated adipose-derived stem cells (dASC) or left empty (control group), conduits were used to bridge a 1cm gap in the rat sciatic nerve and after 2-weeks immunohistochemical analysis was performed to assess axonal regeneration and SC infiltration. The regenerative cells showed good adherence to the collagen walls. Primary SC showed significant improvement in distal stump sprouting. No significant differences in proximal regeneration distances were noticed among experimental groups. dMSC and dASC-loaded conduits showed a diffuse sprouting pattern, while SC-loaded showed an enhanced cone pattern and a typical sprouting along the conduits walls, suggesting an increased affinity for the collagen type I fibrillar structure. NeuraGen(®) guides showed high affinity of regenerative cells and could be used as efficient vehicle for cell delivery. However, surface modifications (e.g. with extracellular matrix molecule peptides) of NeuraGen(®) guides could be used in future tissue-engineering applications to better exploit the cell potential. PMID:24792394

di Summa, Pietro G; Kingham, Paul J; Campisi, Corrado C; Raffoul, Wassim; Kalbermatten, Daniel F

2014-06-20

250

Intraneural ganglion cyst on the external popliteal nerve.  

PubMed

There are many causes for the paralysis of the external sciatic popliteal nerve , such as the intraneural ganglion cyst. In this case, we evaluate a 52-year-old woman with no relevant personal record, who was admitted with paresis of the right foot of 4?months of evolution associated with alterations in the sensitivity that rose up to the posterolateral region of the leg. The diagnosis was based on MR and cyst decompression and disconnection of the articular branch. Given the low incidence of these lesions, their origin is still subject to controversy. The most widely accepted theory is the unifying articular theory described by Spinner in the year 2003. Intraneural ganglion cysts must be included in the differential diagnosis of progressive paralysis of the sciatic nerve, lesions of the nerve root at L5 and nerve sheath tumours that start at the lateral compartment of the knee. The treatment of a fibular intraneural ganglion cyst must be surgical and the operation must be performed as soon as possible. PMID:24891476

Rendon, Diego; Pescador, David; Cano, Carlos; Blanco, Juan

2014-01-01

251

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

252

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

253

[Mucoid pseudo-cysts of the sheath of the external popliteal sciatic nerve. Apropos of 2 cases].  

PubMed

Two cases of paralysis of the etxernal popliteal sciatic nerve are described. They are secondary to the development of a pseudo-cyst containing mucoid matter within the connective tissue sheath of the nerve itself. The authors describe the pathological anatomy of these lesions and discuss their aetiology, favouring the theory of mucoid degeneration of the connective tissues of the nerve sheath. They give brief indication of the clinical symptoms and emphasize the need for early but simplified surgery, ruling out any nerve resection. PMID:1241153

Faivre, J; Chatel, M; Le Beguec, P; Sabouraud, O; Jan, M; Ramée, M P

1975-10-01

254

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

255

Example based lesion segmentation  

NASA Astrophysics Data System (ADS)

Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

2014-03-01

256

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

257

Resolution of Isolated Unilateral Hypoglossal Nerve Palsy Following Microvascular Decompression of the Intracranial Vertebral Artery  

PubMed Central

Isolated hypoglossal nerve paresis due to mechanical compression from a vascular lesion is very rare. We present a case of a 32-year-old man who presented with spontaneous abrupt-onset dysarthria, swallowing difficulty and left-sided tongue atrophy. Brain computed tomographic angiography and magnetic resonance imaging of the brainstem demonstrated an abnormal course of the left vertebral artery compressing the medulla oblongata at the exit zone of the hypoglossal rootlets that was relieved by microvascular decompression of the offending intracranial vertebral artery. This case supports the hypothesis that hypoglossal nerve palsy can be due to nerve stretching and compression by a pulsating normal vertebral artery. Microvascular decompression of the intracranial nerve and careful evaluation of the imaging studies can resolve unexpected isolated hypoglossal nerve palsy. PMID:21556237

Cheong, Jin Hwan; Yang, Moon Sul; Kim, Choong Hyun

2011-01-01

258

Accessory Branch of Median Nerve Supplying the Brachialis Muscle: A Case Report and Clinical Significance  

PubMed Central

A very rare case of an accessory branch of the median nerve taking its origin in the region of the right arm was observed to supply the infero-medial portion of the brachialis muscle in a male cadaver. Simultaneously, the ipsilateral musculocutaneous nerve was innervating the muscles of the anterior compartment of the arm. Such an aberrant muscular branch of the median nerve for the brachialis muscle is very rarely reported in the literature. Lesion of the median nerve proximal to the branch’s origin site could induce weak flexion of the elbow, whereas injury of the musculocutaneous nerve could lead to misinterpretation of symptoms. We discuss the patterns of brachialis muscle innervation as well as the clinical applications of such a variant. PMID:25653932

Anastasopoulos, Nikolaos; Nitsa, Zoi; Kitsoulis, Panagiotis; Spyridakis, Ioannis

2014-01-01

259

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

260

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

PubMed Central

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

2014-01-01

261

Acute carpal tunnel syndrome due to a hemangioma of the median nerve  

PubMed Central

Hemangioma of the median nerve presenting as acute carpal tunnel syndrome is unusual A-18- year old male presented with severe incapacitating pain of sudden onset of left forearm and hand after manual field work. There was swelling on volar aspect of forearm, with hyperalgesia in the median nerve distribution. The fingers and wrist were inmarked flexion and the patient did not allow wrist and finger extension. X-rays were within normal limits. An emergency volar carpal ligament release revealed, haematoma about 100 ml with numerous vessels encircling the median nerve. Histopathology of lesion turned out to be a cavernous hemangioma. Post operatively patient had full recovery. PMID:21124689

Meena, DS; Sharma, Mrinal; Sharma, CS; Patni, Purnima

2007-01-01

262

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

263

Congenital lung lesions.  

PubMed

Confusion, controversy, and uncertainty are all terms applicable to the diagnosis and management of congenital lung lesions both prenatally and postnatally. This review examines the current status of fetal diagnosis and treatment of these lesions; reviews the various classifications, including congenital cystic adenomatoid malformation/congenital pulmonary airway malformation, sequestrations, variants and hybrid lesions; discusses the risk of malignant transformation or misdiagnosis with pleuropulmonary blastoma; presents the arguments in favor and against resection of asymptomatic lesions, the timing of such resection, and the long-term pulmonary function after resection; and reviews the experience with thoracoscopic resection of congenital lung lesions. PMID:22682383

Puligandla, Pramod S; Laberge, Jean-Martin

2012-06-01

264

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

265

Effects of laser therapy in peripheral nerve regeneration  

PubMed Central

OBJECTIVE: The influence of dose of low power lasertherapy (AsGaAl, 830 nm) on the regeneration of the fibular nerve of rats after a crush injury was evaluated by means of the functional gait analysis and histomorphometric parameters. METHODS: Controlled crush injury of the right common fibular nerve, immediately followed by increasing doses (G1: no irradiation; G2: simulated; G3: 5 J/cm2; G4: 10 J/cm2; G5: 20 J/cm2) laser irradiation directly on the lesion site for 21 consecutive days. Functional gait analysis was carried out at weekly intervals by measuring the peroneal/fibular functional index (PFI). The animals were killed on the 21st postoperative day for removal of the fibular nerve, which was prepared for the histomorphometric analysis. RESULTS: The PFI progressively increased during the observation period in all groups, without significant differences between them (p>0.05). The transverse nerve area was significantly wider in group 2 than in groups 3 and 4, while fiber density was significantly greater in group 4 than in all remaining groups. CONCLUSION: The low power AsGaAl laser irradiation did not accelerate nerve recovery with any of the doses used. Level of Evidence I, Therapeutic Studies Investigating the Results of Treatment. PMID:24453680

Sene, Giovana Almeida Leitão; Sousa, Fausto Fernandes de Almeida; Fazan, Valéria Sassoli; Barbieri, Cláudio Henrique

2013-01-01

266

Chest wall lesions.  

PubMed

Chest wall lesions in childhood include a wide range of pathologies. Benign lesions include lipoma, neurofibroma, lymphangioma, haemangioma and mesenchymal hamartoma. Malignant lesions include neuroblastoma, rhabdomyosarcoma, Ewings sarcoma, Askin tumour and primitive neuroectodermal tumours. Manifestations of systemic diseases such as leukaemia, lymphoma, Langerhans cell histocytosis and infections such as tuberculosis and actinomycosis may also cause chest wall lesions. The imaging characteristics of the above are reviewed but only a minority of lesions show diagnostic imaging characteristics. Most lesions require biopsy and histopathological examination for definitive diagnosis. The role of different imaging modalities is discussed, with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread, with computed tomography and nuclear medicine being used mainly to assess remote disease. PMID:12457604

Watt, Andrew J B

2002-12-01

267

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, Sofiène; Miaaoui, Anissa; Ben Messaoud, Monia; Turki, Imène; Cheour, Ilhem; Menif, Emna

2007-01-01

268

Peripheral nerve repair with nerve growth factor and fibrin matrix  

Microsoft Academic Search

A fibrin sealant matrix (FS) with or without a nerve growth factor (NGF) has been used to improve the recovery of severed peripheral nerves, and these have been compared with the results of using only the standard epineural suture (SUT). Regeneration in the early phase (up to 6 days) was measured by the pinch test. The functional recovery process (up

L. Zeng; A. Worseg; H. Redl; G. Schlag

1994-01-01

269

Nerve-pulse interactions  

SciTech Connect

Some recent experimental and theoretical results on mechanisms through which individual nerve pulses can interact are reviewed. Three modes of interactions are considered: (1) interaction of pulses as they travel along a single fiber which leads to velocity dispersion; (2) propagation of pairs of pulses through a branching region leading to quantum pulse code transformations; and (3) interaction of pulses on parallel fibers through which they may form a pulse assembly. This notion is analogous to Hebb's concept of a cell assembly, but on a lower level of the neural hierarchy.

Scott, A.C.

1982-01-01

270

Managing Chemotherapy Side Effects: Nerve Changes  

MedlinePLUS

... institutes of health Managing Chemotherapy Side Effects Nerve Changes “My fingers and toes felt numb and tingly. ... getting cuts, I always wore shoes.” About nerve changes Some chemotherapy can cause nerve problems. You may ...

271

Effects of nerve growth factor on nerve regeneration after corneal nerve damage  

PubMed Central

The study aims to determine the relation between the effects of mouse nerve growth factor (mNGF) and nerve regeneration after corneal surgery nerve damage. Mechanical nerve injury animal model was established by LASIK (the excimer laser keratomileusis) surgery in 12 Belgian rabbits. mNGF and the balanced salt solution (BBS) were alternatively administered in the left and right eye two times every day for 8 weeks. The morphous and growth of the sub-basal nerve plexus and superficial stroma were observed by in vivo confocal microscopy at the end of weeks 1, 2, 4 and 8 after the surgery. The animal model is successfully established. The morphology and density of corneal nerve have been observed and demonstrated by confocal microscopy. A systematic administration of mNGF can significantly promote the nerve regeneration at the end of weeks 1, 2, 4 and 8, which comparing to the administration of balanced salt solution (P < 0.05). mNGF has effect on sub-basal nerve plexus and superficial stroma after corneal nerve damage which is caused by LASIK. The experimental results suggested that the mNGF may solve the problem of dry eye after LASIK. PMID:25550989

Ma, Ke; Yan, Naihong; Huang, Yongzhi; Cao, Guiqun; Deng, Jie; Deng, Yingping

2014-01-01

272

Role of the ventrolateral region of the nucleus of the tractus solitarius in processing respiratory afferent input from vagus and superior laryngeal nerves  

Microsoft Academic Search

The role of respiratory neurons located within and adjacent to the region of the ventrolateral nucleus of the tractus solitarius (vlNTS) in processing respiratory related afferent input from the vagus and superior laryngeal nerves was examined. Responses in phrenic neural discharge to electrical stimulation of the cervical vagus or superior laryngeal nerve afferents were determined before and after lesioning the

D. R. McCrimmon; D. F. Speck; J. L. Feldman

1987-01-01

273

The anatomical relationship of the superficial radial nerve and the lateral antebrachial cutaneous nerve: A possible factor in persistent neuropathic pain.  

PubMed

The superficial branch of the radial nerve (SBRN) is known for developing neuropathic pain syndromes after trauma. These pain syndromes can be hard to treat due to the involvement of other nerves in the forearm. When a nerve is cut, the Schwann cells, and also other cells in the distal segment of the transected nerve, produce the nerve growth factor (NGF) in the entire distal segment. If two nerves overlap anatomically, similar to the lateral antebrachial cutaneous nerve (LACN) and SBRN, the increase in secretion of NGF, which is mediated by the injured nerve, results in binding to the high-affinity NGF receptor, tyrosine kinase A (TrkA). This in turn leads to possible sprouting and morphological changes of uninjured fibers, which ultimately causes neuropathic pain. The aim of this study was to map the level of overlap between the SBRN and LACN. Twenty arms (five left and 15 right) were thoroughly dissected. Using a new analysis tool called CASAM (Computer Assisted Surgical Anatomy Mapping), the course of the SBRN and LACN could be compared visually. The distance between both nerves was measured at 5-mm increments, and the number of times they intersected was documented. In 81% of measurements, the distance between the nerves was >10 mm, and in 49% the distance was even <5 mm. In 95% of the dissected arms, the SBRN and LACN intersected. On average, they intersected 2.25 times. The close (anatomical) relationship between the LACN and the SBRN can be seen as a factor in the explanation of persistent neuropathic pain in patients with traumatic or iatrogenic lesion of the SBRN or the LACN. PMID:25455286

Poublon, A R; Walbeehm, E T; Duraku, L S; Eilers, P H C; Kerver, A L A; Kleinrensink, G J; Coert, J H

2014-10-16

274

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

275

[A new method of anastomosing severed nerves].  

PubMed

Nerve anastomoses glued with "Fribrinkleber" can be protected from tissue plasminogen-activators both by natural and synthetic inhibitors of fibrinolysis whether administered locally or systemically. The glued nerve-anastomoses do not attain the bond strength of sutured nerves, but show less foreign body reaction. Gluing nerves with Fibrinkleber" combined with inhibition of fibrinolysis would seem to be a good method for reuniting severed nerves. It may be especially useful in nerve transplantation if tension is avoided. PMID:376235

Duspiva, W; Blümel, G; Haas-Denk, S; Wriedt-Lübbe, I

1977-04-01

276

Neurotrophin3 enhances sprouting of corticospinal tract during development and after adult spinal cord lesion  

Microsoft Academic Search

THE number of neurotrophic factors found in the central nervous system is rapidly growing, but their functions in vivo are largely unknown. In the peripheral nervous system they promote the survival of developing and lesioned neurons and enhance nerve fibre growth and regeneration1-6. Here we study the effects of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3)

Lisa Schnell; Regula Schneider; Roland Kolbeck; Yves-Alain Barde; Martin E. Schwab

1994-01-01

277

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.; Chévez-Barrios, Patricia; Baskin, David S.

2014-01-01

278

Intractable hiccup caused by spinal cord lesions in demyelination disease  

PubMed Central

Objective This study aimed to summarize the clinical features of patients who presented intractable hiccup (IH) without brain and medulla oblongata (MO) lesions. Method This study included six patients who were diagnosed with inflammatory demyelinating myelitis, categorized as neuromyelitis optica (NMO), multiple sclerosis (MS), and myelitis. Patients who presented IH with cervical lesions but without MO lesions were also included. Clinical profiles, laboratory data, and magnetic resonance imaging findings were analyzed. Results Three out of six patients were diagnosed with NMO, whereas the remaining three were diagnosed with acute myelitis, recurrent myelities, and MS, respectively. The duration of hiccup was from 2 to 23 days (average = 9.33 ± 8.64 days). Five patients (83.33%, patients 1–5) had long segmental lesions and one had a patchy lesion. None of these patients had any MO lesions. Half of them were successfully treated with high-dose methylprednisolone combined with gamma-aminobutyric acid (GABA) inhibitor. Conclusion IH occurred in patients without MO lesion. However, the mechanism remained unclear. Immune factors of demyelinating neuropathy stimulated the hiccup reflex arch. Cervical cord lesions may activate the hiccup center. In general, IH can be controlled by IVMP combined with GABA inhibitor. Unilateral phrenic nerve block may elicit no effect. PMID:24090474

Hao, Xiao-ting; Wang, Lu; Yan, Bo; Zhou, Hong-yu

2013-01-01

279

Reciprocal inhibition following lesions of the spinal cord in man.  

PubMed Central

1. Reciprocal inhibition was studied in normal subjects and patients with spinal cord lesions by stimulating the posterior tibial nerve below the threshold of the soleus alpha-motoneurone axons and recording the changes in firing probability of single tibialis anterior motor units activated by voluntary contraction. A short-latency (about 35 ms) period of decreased firing probability was assumed to represent reciprocal inhibition. 2. For a given stimulus intensity this inhibition was greater in patients with spinal lesions than in normal subjects. 3. The stimulus intensities at which soleus motoneurones and the Ia inhibitory interneurones were brought to threshold provided an estimate of the relative excitability of these two neural populations. In the patients with spinal lesions the Ia inhibitory interneurones were more excitable than soleus motoneurones, whereas in normal subjects the excitabilities were approximately equal. 4. Stimulation of the posterior tibial nerve below the threshold of alpha-motoneurone axons also resulted in a second period of inhibition with a latency of approximately 50 ms. This was less prominent in the patients with spinal cord lesions. 5. It is concluded that transmission through the pathways mediating reciprocal inhibition of flexor muscles during their voluntary contraction is enhanced following a spinal cord lesion in man but that a later inhibitory process is depressed. PMID:2607428

Ashby, P; Wiens, M

1989-01-01

280

Axonal regeneration and remyelination evaluation of chitosan/gelatin-based nerve guide combined with transforming growth factor-?1 and Schwann cells.  

PubMed

Despite efforts in peripheral nerve injury and regeneration, it is difficult to achieve a functional recovery following extended peripheral nerve lesions. Even if artificial nerve conduit, cell components and growth factors can enhance nerve regeneration, integration in peripheral nerve repair and regeneration remains yet to be explored. For this study, we used chitosan/gelatin nerve graft constructed with collagenous matrices as a vehicle for Schwann cells and transforming growth factor-?1 to bridge a 10-mm gap of the sciatic nerve and explored the feasibility of improving regeneration and reinnervation in rats. The nerve regeneration was assessed with functional recovery, electrophysiological test, retrograde labeling, and immunohistochemistry analysis during the post-operative period of 16 weeks. The results showed that the internal sides of the conduits were compact enough to prevent the connective tissues from ingrowth. Nerve conduction velocity, average regenerated myelin area, and myelinated axon count were similar to those treated with autograft (p > 0.05) but significantly higher than those bridged with chitosan/gelatin nerve graft alone (p < 0.05). Evidences from retrograde labeling and immunohistochemistry analysis are further provided in support of improving axonal regeneration and remyelination. A designed graft incorporating all of the tissue-engineering strategies for peripheral nerve regeneration may provide great progress in tissue engineering for nerve repair. PMID:23740553

Nie, Xin; Deng, Manjing; Yang, Maojin; Liu, Luchuan; Zhang, Yongjie; Wen, Xiujie

2014-01-01

281

Occipital nerve stimulation.  

PubMed

Occipital nerve stimulation (ONS) is a form of neuromodulation therapy aimed at treating intractable headache and craniofacial pain. The therapy utilizes neurostimulating electrodes placed subcutaneously in the occipital region and connected to a permanently implanted programmable pulse generator identical to those used for dorsal column/spinal cord stimulation. The presumed mechanisms of action involve modulation of the trigeminocervical complex, as well as closure of the physiologic pain gate. ONS is a reversible, nondestructive therapy, which can be tailored to a patient's individual needs. Typically, candidates for successful ONS include those patients with migraines, Chiari malformation, or occipital neuralgia. However, recent MRSA infections, unrealistic expectations, and psychiatric comorbidities are generally contraindications. As with any invasive procedure, complications may occur including lead migration, infection, wound erosion, device failure, muscle spasms, and pain. The success of this therapy is dependent on careful patient selection, a preimplantation trial, meticulous implantation technique, programming strategies, and complication avoidance. PMID:25411143

Mammis, Antonios; Agarwal, Nitin; Mogilner, Alon Y

2015-01-01

282

Peripheral nerve fibromyxoid sarcoma.  

PubMed

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue neoplasm with metastatic potential and needs to be recognized as such, because it can be mistaken for other types of sarcoma due to its unremarkable appearance. This 49-year-old man presented with an approximately 5-cm mass on the anteromedial aspect of his left thigh that slowly increased over 10 years. Clinical symptoms were limited to local discomfort and intermittent distal numbness. Due to the location, imaging findings, and lack of serious symptoms, the initial differential diagnosis favored a schwannoma. An initial biopsy revealed histopathological findings consistent with a perineurioma, although with atypical features. The patient elected to have the mass excised, and the tumor, which arose from a branch of the saphenous nerve, could be separated well from the surrounding soft tissue. Histopathological investigation of the mass displayed characteristic features of a fibromyxoid sarcoma, which was confirmed by subsequent fluorescence in situ hybridization analysis. Due to concerns about infiltration beyond the margins, radical reexcision was advocated and performed, resulting in definite clear surgical margins. At follow-up, the patient had regained full strength with no residual neurological symptoms or any new deficits. He has since been healthy and disease free for a total of 4 years in follow-up. This case documents, to the authors' knowledge, the first observation of an LGFMS associated with a peripheral nerve. It also supports the use of fluorescence in situ hybridization analysis as an essential diagnostic method in establishing the diagnosis of LGFMS. PMID:24766104

Alter, Raanan Y; Wamsley, Christina C; Mullen, John T; Haile, Winta Z; Goldsmith, Jeffrey D; Kasper, Ekkehard M

2014-09-01

283

Peripheral nerve injury of various types, for example complete nerve transection or loose nerve constrictions (Bennett model), results in  

E-print Network

Summary Peripheral nerve injury of various types, for example complete nerve transection or loose-protein-coupled receptors, ion channels, enzymes, and other types of molecules. Peripheral nerve injuries are often transmission. It has been postulated that nerve injury causes sprouting of large-diameter primary afferents

Sandini, Giulio

284

Malignant peripheral nerve sheath tumor of the distal phalanx of the fifth toe: a case report  

PubMed Central

Malignant peripheral nerve sheath tumor (MPNST) involving bone is rare. We report a case of MPNST of the fifth toe. The lesion was located in the distal phalanx of the right fifth toe and extended into surrounding subcutaneous tissues. Findings on magnetic resonance imaging and histological features of the case are described and the literature is briefly reviewed. PMID:24778799

Kunisada, Makoto; Goto, Hajimu; Ohno, Yoshiharu; Yamashita, Junji; Funasaka, Yoko; Nishigori, Chikako; Fujii, Masahiko

2014-01-01

285

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

286

[The superior laryngeal nerve: an anatomical structure at risk during thyroid surgery].  

PubMed

The effects of injury to the external branch of the superior laryngeal nerve (ESLN) during thyroid surgery are well known, while the frequency and consequences of ESLN lesions aren't today well known. The Authors report their own experience of the incidence of ESLN injuries in thyroid surgery. PMID:1886684

Cannizzaro, M A; Fiocco, S; Piazza, L; De Maria, A; Liardo, G; Troiano, L; Terminella, A

1991-05-15

287

Predicting recovery of facial nerve function following injury from a basilar skull fracture.  

PubMed

Twenty-five patients with posttraumatic facial nerve palsy were studied. Partial recovery of function had occurred in 95% of these patients by 18 months after injury. At 5 months posttrauma, there was some recovery in 92.5% of those with a partial lesion compared with 10% of those with a complete lesion. This difference attains statistical significance. Complete recovery of nerve function had occurred by 10.5 months in 53.5% of the patients; in 62% of patients with a partial lesion, complete recovery had occurred by 4 months compared with 0% in those with a complete lesion. This difference also attains statistical significance. There was no statistically significant difference in recovery of function between patients with an immediate as opposed to a delayed onset of facial nerve palsy. It was determined that the degree of palsy had a statistically significant influence on recovery of facial nerve function, whereas the time of onset did not. The data presented support a conservative approach to these injuries and it is recommended that the possibility of surgical treatment should be entertained in patients with complete facial palsy persisting for 12 to 18 months after injury. PMID:1919699

Adegbite, A B; Khan, M I; Tan, L

1991-11-01

288

Horner's syndrome with abducens nerve palsy.  

PubMed

A 68-year-old male patient presented with a week of sudden diplopia. He had been diagnosed with nasopharyngeal cancer 8 months prior and had undergone chemotherapy with radiotherapy. Eight-prism diopter right esotropia in the primary position and a remarkable limitation in abduction in his right eye were observed. Other pupillary disorders and lid drooping were not found. After three weeks, the marginal reflex distance 1 was 3 mm in the right eye and 5 mm in the left eye. The pupil diameter was 2.5 mm in the right eye, and 3 mm in the left eye under room illumination. Under darkened conditions, the pupil diameter was 3.5 mm in the right eye, and 5 mm in the left eye. After topical application of 0.5% apraclonidine, improvement in the right ptosis and reversal pupillary dilatation were observed. On brain magnetic resonance imaging, enhanced lesions on the right cavernous sinus, both sphenoidal sinuses, and skull base suggested the invasion of nasopharyngeal cancer. Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's syndrome. PMID:22131787

Kang, Na Hee; Lim, Key Hwan; Sung, Sun Hee

2011-12-01

289

Horner's Syndrome with Abducens Nerve Palsy  

PubMed Central

A 68-year-old male patient presented with a week of sudden diplopia. He had been diagnosed with nasopharyngeal cancer 8 months prior and had undergone chemotherapy with radiotherapy. Eight-prism diopter right esotropia in the primary position and a remarkable limitation in abduction in his right eye were observed. Other pupillary disorders and lid drooping were not found. After three weeks, the marginal reflex distance 1 was 3 mm in the right eye and 5 mm in the left eye. The pupil diameter was 2.5 mm in the right eye, and 3 mm in the left eye under room illumination. Under darkened conditions, the pupil diameter was 3.5 mm in the right eye, and 5 mm in the left eye. After topical application of 0.5% apraclonidine, improvement in the right ptosis and reversal pupillary dilatation were observed. On brain magnetic resonance imaging, enhanced lesions on the right cavernous sinus, both sphenoidal sinuses, and skull base suggested the invasion of nasopharyngeal cancer. Lesions on the cavernous sinus need to be considered in cases of abducens nerve palsy and ipsilateral Horner's syndrome. PMID:22131787

Kang, Na Hee; Sung, Sun Hee

2011-01-01

290

Schwannoma of the suprascapular nerve presenting with atypical neuralgia: case report and review of the literature.  

PubMed

Compressive lesions of the suprascapular nerve produce weakness and atrophy of the supra- and infraspinatus muscles and a poorly defined aching pain along the posterior aspect of the shoulder joint and the adjacent scapula. Entrapment neuropathy of the suprascapular nerve is fairly common whereas tumorous lesions are rare; among the latter ganglion cysts are frequently seen. An isolated solitary schwannoma of the suprascapular nerve presenting with atypical neuralgic pain is exceptional. The location of a schwannoma under the firm deep cervical fascia in the posterior triangle of the neck is implicated in the genesis of neuralgic pains mimicking the suprascapular entrapment syndrome. One such case is reported with discussion of the relevant clinical features. PMID:11148084

Sharma, R R; Pawar, S J; Netalkar, A S

2001-01-01

291

Interest of telemicrosurgery in peripheral nerve tumors: about a series of seven cases.  

PubMed

Surgery of the chronic peripheral nerve lesion should not only limit recurrence after excision, but it should also limit the sensory and motor sequelae. The aim of this work was to study the interest of telemicrosurgery to improve this result. Our series included 7 patients with peripheral nerve neuroma and tumors including two cases of hereditary neurofibromatosis. A Da Vinci S(®) robot equipped with microsurgical instruments was used for intraneural dissection. One case was performed with minimally invasive approach. At last follow-up, the pain decreased from 6/10 preoperatively to 3/10 postoperatively. The sensory deficit was stable except for two patients, whose sensory function was improved. No recurrence was noted. Telemicrosurgery seems to have two interests in the treatment of chronic peripheral nerve lesions: it reduces the size of incisions and increases the accuracy of surgery. These preliminary results suggest that surgical robots could play an essential role in microsurgery. PMID:24290701

Tigan, L; Miyamoto, H; Hendriks, S; Facca, S; Liverneaux, P

2014-02-01

292

MRI diagnosis of fibrolipomatous hamartoma of the median nerve and associated macrodystrophia lipomatosa.  

PubMed

Fibrolipomatous hamartoma is an uncommon congenital disorder, which is characterized by disproportionate hyperplasia of adipose tissue infiltrating along the perineurium, the epineurium and the affected nerve trajectory. We present a case of combined fibrolipomatous hamartoma and macrodystrophia lipomatosa of the median nerve. The involved sites included the left palm, wrist and forearm. Part of the patient's middle finger had been amputated due to previous macrodystrophia lipomatosa; however, the lesion continued to enlarge and was accompanied by numbness. Magnetic resonance imaging demonstrated a typical fibrolipomatous hamartoma with high signal intensity of fat on both T1-weighted and T2-weighted images, characteristic coaxial cable appearance on axial images, and spaghetti appearance on sagittal images. A similar skipped lesion at the median nerve of the middle forearm was also noted. To the best of our knowledge, this has not been reported in the English literature. PMID:20875626

Chiang, Chia-Ling; Tsai, Meng-Yuan; Chen, Clement Kuen-Huang

2010-09-01

293

The Sciatic Nerve Cuffing Model of Neuropathic Pain in Mice  

PubMed Central

Neuropathic pain arises as a consequence of a lesion or a disease affecting the somatosensory system. This syndrome results from maladaptive changes in injured sensory neurons and along the entire nociceptive pathway within the central nervous system. It is usually chronic and challenging to treat. In order to study neuropathic pain and its treatments, different models have been developed in rodents. These models derive from known etiologies, thus reproducing peripheral nerve injuries, central injuries, and metabolic-, infectious- or chemotherapy-related neuropathies. Murine models of peripheral nerve injury often target the sciatic nerve which is easy to access and allows nociceptive tests on the hind paw. These models rely on a compression and/or a section. Here, the detailed surgery procedure for the "cuff model" of neuropathic pain in mice is described. In this model, a cuff of PE-20 polyethylene tubing of standardized length (2 mm) is unilaterally implanted around the main branch of the sciatic nerve. It induces a long-lasting mechanical allodynia, i.e., a nociceptive response to a normally non-nociceptive stimulus that can be evaluated by using von Frey filaments. Besides the detailed surgery and testing procedures, the interest of this model for the study of neuropathic pain mechanism, for the study of neuropathic pain sensory and anxiodepressive aspects, and for the study of neuropathic pain treatments are also discussed. PMID:25078668

Yalcin, Ipek; Megat, Salim; Barthas, Florent; Waltisperger, Elisabeth; Kremer, Mélanie; Salvat, Eric; Barrot, Michel

2014-01-01

294

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

295

Development of mature microcystic lesions in the cochlear nuclei of the Mongolian gerbil, Meriones unguiculatus.  

PubMed

Microcystic lesions are a persistent final stage in a neurodegenerative disorder characteristic of the cochlear nuclei of gerbils. When gerbils of various ages raised under known acoustic conditions were examined, the volume density and number of lesions increased with age, however, the affected region was restricted to the posteroventral cochlear nucleus and adjacent portions of the dorsal cochlear nucleus, interstitial nucleus, and posterior anteroventral cochlear nucleus. Lesions were also noted in a separate locus in the auditory nerve trunk associated with the acoustic nerve nucleus. The fusiform and molecular layers of the dorsal cochlear nucleus were spared at all ages observed. The spherical cell region of the arteroventral cochlear nucleus was also largely spared. A good correlation was observed between the cumulative input from the auditory nerve fibers caused by the ambient acoustic environment acting over the life of the animal and the number of lesions in tonotopic subdivisions of the cochlear nuclei. The earliest microcysts formed in regions receiving auditory nerve fibers most strongly stimulated by the ambient noise. Thereafter, short exposures to higher levels of input or long exposures to lower levels of input were quantitatively equivalent in producing microcystic lesions. PMID:2076978

Statler, K D; Chamberlain, S C; Slepecky, N B; Smith, R L

1990-12-01

296

Dieulafoy's lesion of esophagus.  

PubMed

Dieulafoy's lesion is a rare arterial malformation that can cause massive gastrointestinal hemorrhage. The lesion occurs most commonly in the proximal stomach. The esophagus is not a common location for this lesion. We present the case of a 25-year-old woman who was admitted to our emergency unit with the findings of hematemesis and melena. Early upper gastrointestinal endoscopic examination revealed a Dieulafoy's lesion, which was located in the distal esophagus. Endoscopic band ligation stopped the bleeding successfully. The patient was discharged 3 days after the band ligation without any complications. Dieulafoy's lesion may cause severe, life-threatening bleeding. Endoscopic diagnosis can be difficult because of the small size and obscure location of the lesion. An abnormally dilated artery that penetrates through the mucosa constitutes the etiology. Endoscopy plays an important role in the diagnosis and treatment of this pathology. Despite widespread awareness of this entity, it may present a real challenge for the endoscopist due to the small size and hidden location of the lesion. The endoscopic approach to occult gastrointestinal bleeding for the diagnosis of vascular malformations is accepted as a quick and safe diagnostic method. PMID:11961659

Ertekin, C; Barbaros, U; Taviloglu, K; Guloglu, R; Kasoglu, A

2002-01-01

297

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

298

Multiple schwannomas of the sciatic nerve  

Microsoft Academic Search

Schwannomas are rare benign tumours of nerve sheath cells of neural crest origin. Often these tumours are solitary and encapsulated. Multiple schwannomas can arise from the peripheral nervous system including cranial nerves, spinal roots, the brachial and lumbar–sacral plexus or major peripheral nerves. We report an extremely rare case of schwannomatosis of the sciatic nerve in a young female and

J. Huang; R. Mobbs; C. Teo

2003-01-01

299

Regeneration of perivascular adrenergic innervation in rat tibial nerve after nerve crush  

Microsoft Academic Search

Adrenergic innervation of blood vessels in the rat tibial nerve during degeneration and regeneration was studied using the formaldehyde-induced fluorescence method. The left sciatic nerve was crushed with suture threads to produce a 4-mm length of crushed nerve. At 1, 3, 7, 14, 28, 56 and 84 days after nerve crush, degenerative and regenerative changes in the nerve were verified

J. Koistinaho; K. C. Wadhwani; A. Balbo; S. I. Rapoport

1991-01-01

300

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

E-print Network

Video-Gait Analysis of Functional Recovery of Nerve Repaired with Chitosan Nerve Guides MINAL PATEL assessment of functional sciatic nerve recovery treated with chitosan nerve guides. We used video to functional nerve recovery. The chitosan group showed increased functional improvement compared to the control

VandeVord, Pamela

301

Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study  

SciTech Connect

Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent larynegeal branch. It is rarely caused by intralargngeal lesions. Four teen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained.

Agha, F.P.

1983-07-01

302

Spectrum of optic nerve hypoplasia.  

PubMed Central

Optic nerve hypoplasia is a non-progressive condition characterised by subnormal vision and a subnormal number of optic nerve axons. It may be unilateral or bilateral, isolated or combined with other defects. Analysis of fundus photographs from a series of 7 patients with a stationary abnormality of different degrees showed that the functional defects could be closely correlated with defects in the retinal nerve fibre layer. Our observations show that the condition has a wide range of both functional and anatomical defects and that a subnormal diameter of the optic disc is not a requisite for the diagnosis. Presumably, there is also a wide variety of causes, not only a primary failure of development of retinal ganglion cells. We suggest that optic nerve hypoplasia can be viewed as a non-specific manifestation of damage to the visual system, sustained any time before its full development. Images PMID:629914

Frisén, L.; Holmegaard, L.

1978-01-01

303

Ion Channels in Nerve Membranes  

ERIC Educational Resources Information Center

Discusses research that indicates that nerve membranes, which play a key role in the conduction of impulses, are traversed by protein channels with ion pathways opened and closed by the membrane electric field. (Author/MLH)

Ehrenstein, Gerald

1976-01-01

304

Overview of Optic Nerve Disorders  

MedlinePLUS

... Resources for Help and Information The One-Page Merck Manual of Health Medical Terms Conversion Tables Manuals ... Papilledema Optic Neuritis Ischemic Optic Neuropathy Toxic Amblyopia Merck Manual > Patients & Caregivers > Eye Disorders > Optic Nerve Disorders ...

305

Ultrasound of the nerves of the knee region: Technique of examination and normal US appearance  

PubMed Central

The diagnosis of disorders of the peripheral nerves (PN) has traditionally been based on clinical and electrophysiological data since nerve tissue cannot be visualized on standard radiographs. More recently, however, nerve structures have been evaluated with magnetic resonance imaging (MRI) and ultrasound (US). The former modality is expensive and not available in all institutions. There are also some contraindications to its use, and the assessment of long nerves can be time-consuming since different coils must be used. Thanks to recent advances in sonographic software and hardware, US can now be used for in-depth assessment of the PN of the upper and lower limbs. Most knee disorders involve lesions to the cruciate ligaments and/or the menisci, which are difficult to evaluate with US. However, similar symptoms may be caused by compression of one or more nerves in the knee region or intrinsic disorders involving these structures. Because of their superficial positions, the nerves around the knee can be clearly visualized with US. A thorough knowledge of the normal anatomy of this region and a careful scanning technique are essential for a successful diagnostic US examination. In this article, we will review the normal gross and microscopic anatomy of the nerves in the knee region, the US technique used for their examination, and their normal US appearance. PMID:23396637

Bianchi, S.; Martinoli, C.; Demondion, X.

2007-01-01

306

Neuromuscular hamartoma of the sciatic nerve: Case report and review of the literature  

PubMed Central

Background: Neuromuscular hamartomas are rare benign tumors with mature skeletal elements mixed with mature neural elements. They present typically as solitary lesions in childhood and have been reported to be associated with cranial nerves or large peripheral nerves such as the brachial plexus, median nerve, and sciatic nerve. To date, eight cases of sciatic nerve neuromuscular hamartomas have been reported. We present a case along with an outline for the natural history of the disease with a review of the literature of the reported cases dating back to 1895. Case Description: An 11-year-old boy presented with progressive right lower extremity pain and atrophy. Magnetic resonance imaging revealed a large right sciatic nerve mass, and electromyography demonstrated evidence of ongoing denervation and reinnervation. Initial computed tomography-guided biopsy was unrevealing and subsequent open biopsy was consistent with neuromuscular choristoma. Conclusion: Neuromuscular choristomas represent a rare disease. Symptoms of foot deformity, leg size discrepancy, and pain merit a complete work-up including spinal and peripheral nerve etiologies. PMID:23493803

Lam, Sandi; Grandhi, Ramesh; Wong, Ricky; Hamilton, Ronald; Greene, Stephanie

2013-01-01

307

A schwannoma of the S1 dural sleeve was resected while the intact nerve fibers were preserved using a microscope. Report of a case with early MRI findings.  

PubMed

In this report, we describe a small schwannoma of the dural sleeve and mention that it is often difficult to differentiate this tumor from lumbar disc herniation, especially a sequestered hernia, or a discal cyst. Gadolinium-enhanced MR images were a useful preoperative examination modality for differentiating this lesion from other diseases. Microscopically, the intradural tumor was successfully removed. The dura mater of the S1 nerve root was opened microsurgically, allowing the nerve fibers involved in the tumor to be identified. The involved fibers were cut around the tumor, and the lesion was resected while the intact nerve fibers were preserved. Based on histological examination of the resected specimen, the tumor was diagnosed as a schwannoma with multilocular cystic degeneration. Microsurgery allowed the tumor to be removed with minimal impairment from cutting of nerve fibers in the nerve root. PMID:17674301

Kobayashi, S; Uchida, K; Kokubo, Y; Yayama, T; Nakajima, H; Inukai, T; Nomura, E; Baba, H

2007-04-01

308

Tooth Abfraction Lesions  

MedlinePLUS

... Choices include a composite material or glass ionomer cement . A tooth with abfraction lesions may be more ... need treatment. For others, filling the areas with cement or composite solves the problem. Additional Info American ...

309

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

310

Microscopic lesions suggestive of Marek's disease in a Black Francolin (Francolinus f. francolinus).  

PubMed

Microscopic lesions suggestive of Marek's disease were found in tissues from the exotic game bird Black Francolin (Francolinus f. francolinus). These lesions consisted of a solitary spherical mass near the syrinx, histologically composed of sheets of small pleomorphic lymphocytes and a few plasma cells. Lymphocytic cell infiltrates were also seen microscopically in cuffs around vessels of the brain, in the sciatic nerve, and in several visceral organs. PMID:938389

Pettit, J R; Taylor, P A; Gough, A W

1976-01-01

311

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

312

Nerve conduction during Wallerian degeneration in the baboon  

Microsoft Academic Search

Conduction in the lateral popliteal nerve of the baboon was studied during the course of Wallerian degeneration. Six nerves were examined. In each case the muscle response to nerve stimulation and the ascending nerve action potential were recorded daily until the nerve became inexcitable. The muscle response to nerve stimulation disappeared after four to five days, but ascending nerve action

R. W. Gilliatt; R. J. Hjorth

1972-01-01

313

Optic Nerve Monitoring  

PubMed Central

Orbital and anterior skull base surgery is generally performed close to the prechiasmatic visual pathway, and clear strategies for detecting and handling visual pathway damage are essential. To overcome the common problem of a missed clinical examination because of an uncooperative or unresponsive patient, flash visual evoked potentials and electroretinograms should be used. These electrophysiologic examination techniques can provide evidence of intact, pathologic, or absent conductivity of the visual pathway when clinical assessment is not feasible. Visual evoked potentials and electroretinograms are thus essential diagnostic procedures not only for primary diagnosis but also for intraoperative evaluation. A decision for or against treatment of a visual pathway injury has to be made as fast as possible due to the enormous importance of the time elapsed with such injuries; this can be achieved additionally using multislice spiral computed tomography. The first-line conservative treatment of choice for such injuries is megadose methylprednisolone therapy. Surgery is used to decompress the orbital compartment by exposure of the intracanalicular part of the optic nerve in the case of optic canal compression. Modern craniomaxillofacial surgery requires detailed consideration of the diagnosis and treatment of traumatic visual pathway damage with the ultimate goal of preserving visual acuity. PMID:24436741

Schumann, Paul; Kokemüller, Horst; Tavassol, Frank; Lindhorst, Daniel; Lemound, Juliana; Essig, Harald; Rücker, Martin; Gellrich, Nils-Claudius

2013-01-01

314

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

315

The efficacy of end-to-end and end-to-side nerve repair (neurorrhaphy) in the rat brachial plexus  

PubMed Central

Proximal nerve injury often requires nerve transfer to restore function. Here we evaluated the efficacy of end-to-end and end-to-side neurorrhaphy of rat musculocutaneous nerve, the recipient, to ulnar nerve, the donor. The donor was transected for end-to-end, while an epineurial window was exposed for end-to-side neurorrhaphy. Retrograde tracing showed that 70% donor motor and sensory neurons grew into the recipient 3 months following end-to-end neurorrhaphy compared to 40–50% at 6 months following end-to-side neurorrhaphy. In end-to-end neurorrhaphy, regenerating axons appeared as thick fibers which regained diameters comparable to those of controls in 3–4 months. However, end-to-side neurorrhaphy induced slow sprouting fibers of mostly thin collaterals that barely approached control diameters by 6 months. The motor end plates regained their control density at 4 months following end-to-end but remained low 6 months following end-to-side neurorrhaphy. The short-latency compound muscle action potential, typical of that of control, was readily restored following end-to-end neurorrhaphy. End-to-side neurorrhaphy had low amplitude and wide-ranging latency at 4 months and failed to regain control sizes by 6 months. Grooming test recovered successfully at 3 and 6 months following end-to-end and end-to-side neurorrhaphy, respectively, suggesting that powerful muscle was not required. In short, both neurorrhaphies resulted in functional recovery but end-to-end neurorrhaphy was quicker and better, albeit at the expense of donor function. End-to-side neurorrhaphy supplemented with factors to overcome the slow collateral sprouting and weak motor recovery may warrant further exploration. PMID:19682138

Liao, Wen-Chieh; Chen, Jeng-Rung; Wang, Yueh-Jan; Tseng, Guo-Fang

2009-01-01

316

Consequences and adaptation in daily life – patients’ experiences three decades after a nerve injury sustained in adolescence  

PubMed Central

Background To explore the patients’ experiences during the three decades following repair of a nerve injury in the forearm and its consequences for daily life. Strategies that were used to facilitate adaptation were also investigated. Methods Fifteen participants with a complete median and/or ulnar nerve injury repaired in the ages from 13–20 years were interviewed using a semi-structured interview guide. The median follow-up time was 31 years (range 23–40). The participants were asked to describe the past and present symptoms of the injured hand, the consequences of the injury for daily life, personal qualities and support from others. In addition, they were asked to describe strategies used to facilitate adaptation. The interviews were subjected to content analysis. Results The nerve injury lead to sensory and motor deficits in the injured hand, as well as sensitivity to cold and secondary back problems. Emotional reactions to trauma and symptoms related to post-traumatic stress disorder were described, as well as how they managed to cope with such reactions. There was a noticeable impact on education, leisure, professional or domestic life for some, while others could continue by changing e.g. their performance pattern. The participants’ life roles and relations were also affected. Both emotion- and problem-based strategies were used to manage challenges in daily life. Conclusions The present qualitative study can help us to provide the patient with honest and realistic information about what to expect after a nerve injury at forearm level, without eliminating hope. Emotional reactions to trauma should be identified and dealt with. In addition, health-care professionals can promote a variety of coping mechanisms to facilitate daily living for the injured patients. PMID:23968274

2013-01-01

317

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

318

Antineutrophil cytoplasmic antibody-associated vasculitis with oculomotor nerve palsy.  

PubMed

We report a patient with antineutrophil cytoplasmic antibody-associated vasculitis with oculomotor nerve palsy. The patient presented with a high fever, diplopia, blepharoptosis and impairment of ocular movement of the left eye except for lateral gaze. Multiple erythematous and livedoid lesions were observed on the forehead, both cheeks and both legs. Laboratory examination showed positive results for myeloperoxidase antineutrophil cytoplasmic antibodies. Skin biopsy revealed leucocytoclastic vasculitis of the small arteries in the lower dermis. The patient was successfully treated with systemic corticosteroids. PMID:19187297

Seishima, M; Mizutani, Y; Shibuya, Y; Arakawa, C

2009-03-01

319

THE PRODUCTION OF CARBON DIOXIDE BY NERVE  

PubMed Central

1. A modified Osterhout respiratory apparatus for the detection of CO2 from nerve is described. 2. The lateral-line nerve from the dogfish discharges CO2 at first with a gush for half an hour or so and then steadily at a lower rate for several hours. 3. Simple handling of the nerve does not increase the output of CO2; cutting it revives gush. 4. The CO2 produced by nerve is not escaping simply from a reservoir but is a true nervous metabolite. 5. The rate of discharge of CO2 from a quiescent nerve varied from 0.0071 to 0.0128 mg. per gram of nerve per minute and averaged 0.0095 mg. 6. Stimulated nerve showed an increased rate of CO2 production of 15.8 percent over that of quiescent nerve. 7. The results of these studies indicate that chemical change is a factor in nerve transmission. PMID:19872167

Parker, G. H.

1925-01-01

320

Chapter 24: Electrical stimulation for improving nerve regeneration: where do we stand?  

PubMed

While injured neurons regenerate their axons in the peripheral nervous system, it is well recognized that functional recovery is frequently poor. Animal experiments in which injured motoneurons remain without peripheral targets (chronic axotomy) and Schwann cells in distal nerve stumps remain without innervation (chronic denervation) revealed that it is the duration of chronic axotomy and Schwann cell denervation that accounts for this poor functional recovery and not irreversible muscle atrophy that has been so commonly thought to be the reason. More recently, we demonstrated that axon outgrowth across lesion sites is a major contributing factor to the long delays incurred between the injury and the reinnervation of denervated targets. In the rat, a period of 1 month transpires before all motoneurons regenerate their axons across a lesion site. We have developed a technique of 1 h low-frequency electrical stimulation (ES) of the proximal nerve stump just after surgical repair of a transected peripheral nerve that greatly accelerates axon outgrowth. This technique has been applied in patients after carpal tunnel release surgery where the ES promoted the regeneration of all median nerves to reinnervate thenar muscles within 6-8 months, which contrasted with failure of any injured nerves to reinnervate muscles in the same time frame without ES. These findings are very promising such that the ES method could become a clinically viable tool for accelerating axon regeneration and muscle reinnervation. PMID:19682653

Gordon, Tessa; Sulaiman, Olewale A R; Ladak, Adil

2009-01-01

321

Neural mechanisms of pupillary abnormality following thalamic lesions: experimental lesion and stimulation studies in cats, and consideration of pupillary findings in thalamic vascular lesions.  

PubMed

Neural mechanisms of the pupillary abnormality in thalamic lesions were experimentally studied in cats. Moderate to considerable anisocoria appeared after kainic acid lesions involving the medial thalamus. The pupil on the side of the lesion was larger than its partner. Only subtle or no pupillary inequality was produced by lateral thalamic lesions. Electrical stimulation of the midline and medial thalamus evoked dilation bilaterally in sympathectomized pupils. Thus, pupillary dilation produced by stimulation of the thalamus was shown to be mediated in part by the oculomotor parasympathetic nerve (OPN). There was no threshold difference between ipsilateral (ipsi) and contralateral (contra) pupils. However, amplitude of dilation was significantly larger in the contra pupil than in the ipsi, when stimulus was given to the pupillo-dilatory medial thalamic nuclei. In these, the mediodorsal, parataenial, central dorsal, paracentral (Pc), and parafascicular nuclei and the medial division of the medial pulvinar nucleus were included. Pupillary dilation mediated by the ocular sympathetic nerve (OSN) was investigated by stimulating Pc and comparing the ipsi-contra difference in the amplitude of dilation between sympathectomized and non-sympathectomized pairs of pupils. In contrast to the results in sympathectomized pairs, there was no ipsi-contra difference in the amplitude of dilation or it was larger in the ipsi pupil in non-sympathectomized pairs. From these, it was inferred that stimulation of Pc activated OSN ipsilaterally or bilaterally with ipsi dominance. It was concluded that the medial and midline thalamus exerts pupillo-dilatory effects through a set of neural mechanisms; 1) ipsi-dominant bilateral OPN inhibition, and 2) ipsi or ipsi-dominant bilateral OSN activation. Neural mechanisms of the pupillary abnormality in thalamic vascular lesions were also considered. PMID:1479196

Kimura, S; Shoumura, K; Ichinohe, N; Yun, S

1992-01-01

322

Axonal and vascular changes following injury to the rat's optic nerve.  

PubMed Central

The optic nerve of the rat has been examined by light and electron microscopy, and also for vascular permeability to fluorescently labelled albumin, 2 days to 34 weeks after crushing in the orbit. The operation was usually followed by loss of 20-70% of the retinal ganglion cells. Axons could be followed from the retina into the optic nerve at all postoperative times, but they always ended anterior to the lesion. Evidence of feeble regenerative growth of optic axons was seen in the first few postoperative weeks: bifurcating fibres and fibres that turned back towards the eye were present within the optic nerve anterior to the lesion. At the site of crushing, the optic nerve eventually became a thin cord of astroglia, surrounded and partly infiltrated by collagenous connective tissue. Long argyrophilic fibres were conspicuous in the intracranial part of the crushed optic nerve from the seventh to the fourteenth postoperative week. These were shown by electron microscopy to be degenerating myelinated axons that had not been phagocytosed. It was conceivable that axons from the contralateral retina could have sprouted at the chiasma and grown into the degenerated optic nerve. This possibility was excluded by tracing anterograde axonal transport of horseradish peroxidase injected into the contralateral eye. Intravenously injected fluorescent protein entered the connective tissue of the orbit and the connective tissue trabeculae of the optic nerve, but it did not permeate into the central nervous tissue except at the lamina cribrosa, where the optic axons pierce the sclera. Permeability at this site was the same on the operated and unoperated sides. Abnormal permeability of the vasculature was seen at the site of crushing the optic nerve. Fluorescence there was strongest in the first two postoperative weeks and was not seen after the third week. A much less conspicuous defect of barrier function occurred in the intracranial portion of the crushed optic nerve, from the seventh to the fourteenth postoperative week. The responses of the optic nerve of the rat to axotomy contrast markedly with those of the goldfish, in which the blood vessels become permeable to protein throughout the optic pathway and the axons regenerate successfully. Various attempts were made to increase or prolong the opening of the blood-optic nerve barrier in the rat, in the hope of enhancing axonal regeneration, but these endeavours were all unsuccessful. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 PMID:4077712

Kiernan, J A

1985-01-01

323

Hypovitaminosis D in widespread pain: its effect on pain perception, quality of life and nerve conduction studies.  

PubMed

The aim of the study was to investigate the effects of hypovitaminosis D on pain, quality of life (QoL) and nerve conduction studies (NCSs) in patients with chronic widespread pain (CWP). We randomly selected 83 female patients with CWP according to their vitamin D levels in this cross-sectional study. Patients were divided into two groups as sufficient vitamin D level (above 20 ng/ml) and deficient vitamin D level (below 20 ng/ml, hypovitaminosis D). Various pain scales and Nottingham Health Profile (NHP) were used. NCSs were also done. In patients with hypovitaminosis D, there were significantly higher pain scores for all scales (p value range 0.002-0.027). The subscale and total NHP scores were significantly higher in hypovitaminosis D group (p = 0.048-0.001) except social isolation subscale (p = 0.553). Vitamin D levels were in negative correlation with right and left median and/or ulnar motor nerve amplitudes, left tibial motor amplitude. This study confirm that hypovitaminosis D is related with higher pain intensity and lower QoL scores in patients with CWP when compared with control group. Additionally, we identified for the first time that there were negative correlations between vitamin D levels and some findings of NCSs. PMID:25085713

Kuru, Pinar; Akyuz, Gulseren; Yagci, Ilker; Giray, Esra

2015-02-01

324

The platelet storage lesion.  

PubMed

The gradual loss of quality in stored platelets as measured collectively with various metabolic, functional, and morphologic in vitro assays is known as the platelet storage lesion. With the advent of pathogen reduction technologies and improved testing that can greatly reduce the risk for bacterial contamination, the platelet storage lesion is emerging as the main challenge to increasing the shelf life of platelet concentrates. This article discusses the contribution of platelet production methods to the storage lesion, long-established and newly developed methods used to determine platelet quality, and the significance for clinical transfusion outcome. Highlighted are the novel technologies applied to platelet storage including platelet additive solutions and pathogen inactivation. PMID:20513565

Devine, Dana V; Serrano, Katherine

2010-06-01

325

Lumbosacral plexus lesions  

Microsoft Academic Search

\\u000a \\u000a Background  Aim of the present study was to analyse the main causes of lumbosacral plexus lesions together with the best diagnostic and\\u000a therapeutic options for better patient outcome.\\u000a \\u000a \\u000a \\u000a Methods  We report our surgical experience with eight patients in whom lesion mechanisms consisted of high-energy trauma (4 pts), firearm\\u000a injuries (2 pts), spontaneous retroperitoneal haematoma in anticoagulant therapy (1 pt) and schwannoma (1

G. Stevanato; L. Vazzana; S. Daramaras; G. Trincia; G. C. Saggioro; G. Squintani

326

Pure neuritic leprosy with nerve abscess presenting as a cystic, soft tissue mass: report of a case diagnosed by fine needle aspiration cytology.  

PubMed

Pure neuritic leprosy (PNL) with nerve abscess manifesting as a huge, cystic, soft tissue mass is highly uncommon. Fine needle aspiration cytology can serve as an important initial diagnostic modality in such an instance. We report a case of 28-year-old male, who presented with a huge swelling in the lower, medial aspect of the right upper arm. The clinical diagnosis was schwannoma. Fine needle aspiration (FNA) yielded 80 ml of sticky, turbid, pale brown fluid. Cytologic examination revealed abundant, caseous, necrotic material and many degenerated neutrophils in a thin proteinaceous background. Stain for acid fast bacilli (AFB) was negative. Based on an AFB negative, caseous, necrotic material obtained from the soft tissue mass located in the ulnar nerve region, a cytodiagnosis of tuberculoid PNL with nerve abscess was given, and this was confirmed by the subsequent histopathologic examination. Our case emphasizes the major role of minimally traumatic, FNA technique in the diagnosis of rare cases of clinically unsuspected neuritic leprosies. PMID:19217052

Siddaraju, Neelaiah; Sistla, Sarath Chandra; Singh, Neha; Muniraj, Femela; Chahwala, Qutubuddin; Basu, Debdatta; Kumar, Surendra

2009-05-01

327

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

328

Isolated Bilateral Fourth Cranial Nerve Palsies as the Presenting Sign of Hydrocephalus  

PubMed Central

Midbrain lesions leading to bilateral fourth nerve palsies are typically accompanied by other brainstem symptomatology. Here we report a case of a 29-year-old man with hydrocephalus and significant third ventricle dilation applying pressure on the dorsal midbrain and having as only manifestation isolated, bilateral fourth cranial nerve palsies. This finding, reported now for the first time, could be attributed to a partially working ventriculoperitoneal shunt previously placed to this patient, which was able to sporadically relieve the increases of the intraventricular pressure on the midbrain that would normally lead to other manifestations. PMID:21829403

Mantopoulos, Dimosthenis; Hunter, David G.; Cestari, Dean M.

2011-01-01

329

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

330

Fibrolipomatous hamartoma of the median nerve in the elbow: a case report.  

PubMed

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

331

Neuromodulation of the suprascapular nerve.  

PubMed

The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. The painful limitation of shoulder motion affects hand and arm motion as well; therefore, it significantly influences work performance and everyday activities as well as the quality of life. Therefore, the treatment of patients with chronic shoulder pain has major social and health economic implications. In this article we present a patient with a complex history of shoulder pathology including 7 surgeries that left the patient with chronic debilitating shoulder pain. She was suffering from chronic pain and limited mobility of the shoulder joint due to adhesive shoulder capsulitis. She was treated with a multimodality approach with the goals of increasing shoulder range of motion and decreasing her pain. This did not provide significant improvement. The suprascapular nerve supplies motor and sensory innervation to the shoulder, and can be easily accessible in the supraspinatus fossa. A suprascapular nerve block dramatically decreased her pain. This clinical observation along with confirmatory nerve block play an important role during the decision-making process for a trial period of electrical neuromodulation. She was followed for 3 months after the permanent implantation of a suprascapular nerve stimulator. Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge. PMID:25415792

Elahi, Foad; Reddy, Chandan G

2014-12-01

332

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

333

Perioral lesions and dermatoses.  

PubMed

The purpose of this article is to review the common neoplasms, infections, and inflammatory dermatoses that may present around or near the mouth. Dental professionals are well positioned to evaluate perioral skin conditions, further contributing to patients' general health. This article includes a review of seborrheic keratosis, warts, actinic keratoses, actinic cheilitis, and squamous cell carcinoma, among several other perioral cutaneous lesions. PMID:24655530

Lim, Geoffrey F S; Cusack, Carrie Ann R; Kist, Joseph M

2014-04-01

334

Take Charge of Your Diabetes (Nerve Damage)  

MedlinePLUS

... gov . Diabetes Public Health Resource Share Compartir Take Charge of Your Diabetes Some Signs of Diabetic Nerve ... There’s a lot you can do to take charge and prevent nerve damage. A recent study shows ...

335

Nerve blocks in the treatment of headache.  

PubMed

Nerve blocks and neurostimulation are reasonable therapeutic options in patients with head and neck neuralgias. In addition, these peripheral nerve procedures can also be effective in primary headache disorders, such as migraine and cluster headaches. Nerve blocks for headaches are generally accomplished by using small subcutaneous injections of amide-type local anesthetics, such as lidocaine and bupivicaine. Targets include the greater occipital nerve, lesser occipital nerve, auriculotemporal nerve, supratrochlear and supraorbital nerves, sphenopalatine ganglion, cervical spinal roots, and facet joints of the upper cervical spine. Although definitive studies examining the usefulness of nerve blocks are lacking, reports suggest that this area deserves further attention in the hope of acquiring evidence of effectiveness. PMID:20430319

Levin, Morris

2010-04-01

336

Distal capitate shortening with capitometacarpal fusion for management of the early stages of Kienböck¿s disease with neutral ulnar variance: case series.  

PubMed

BackgroundThe aim of surgical management of Kienböck¿s disease has been proposed to slow the progressive osteonecrosis and secondary carpal damage. The aim of this case series was to evaluate the results of a new technique, combining distal capitate shortening with capitometacarpal fusion for the treatment of Kienböck¿s disease (Lichtman stage II or stage IIIA) in neutral ulnar variance patients.MethodsFrom 2009 to 2012, 12 patients (mean age: 25¿±¿7.6 years) were enrolled in this series. Radiological and clinical evaluations using the modified Mayo wrist scoring system were performed both pre-operatively and 12 months post-operatively. In addition, values of the scapho-capitate angle were evaluated both pre-operatively and 12 months post-operatively. The mean follow-up was 20.7¿±¿11.2 months. Statistical analysis was performed for comparisons between pre-operative and post-operative findings with the use of paired sample T test, Pearson¿s correlation, independent sample T test, and Spearman¿s rho correlation. Statistical significance was determined to be present at p <0.05.ResultsAll patients achieved bony union at the fusion site within a mean period of 11.5¿±¿2.4 weeks. Regarding wrist pain, grip strength, total wrist arc of motion, practicing daily activities in a normal pattern, and the total modified Mayo wrist score, there were statistically significant differences between the pre-operative and post-operative results. For the differential arc of motion, the only non-significant results were at the ulnar/radial deviation range (p¿=¿0.262). The mean pre-operative scapho-capitate angle was 29.75¿±¿3.44 while the mean post-operative value was 33.67¿±¿4.77 (p¿<¿0.001). Both pre-operative and post-operative scapho-capitate angle values were positively correlated to post-operative pain, ulnar/radial deviation, and final score (p¿=¿0.001, 0.027, 0.021 and p¿=¿0.001, 0.004, 0.002, respectively). Other parameters had no correlation to this angle.Post-operative MRI (at 12 months follow-up) demonstrated better lunate revascularization in four patients; one of them was diagnosed as having Lichtman stage IIIA Kienböck¿s disease. There were no patient-reported complications at the end of follow-up.ConclusionsDistal capitate shortening combined with capitometacarpal fusion represents a new reliable method in the treatment of early stages of Kienböck¿s disease with neutral ulnar variance. PMID:25304759

Fouly, Ezzat H; Sadek, Ahmed F; Amin, Mohammed F

2014-10-11

337

Depiction of the triangular fibro-cartilage in patients with ulnar-sided wrist pain: comparison of direct multi-slice CT arthrography and direct MR arthrography  

Microsoft Academic Search

To compare direct multi-slice CT arthrography (MSCT-AG) and direct MR arthrography (MR-AG) of the wrist with regard to the\\u000a depiction of the triangular fibro-cartilage (TFC). Fifteen consecutive patients with ulnar-sided wrist pain suspicious for\\u000a TFC tear underwent both MSCT-AG and MR-AG of the wrist. Images obtained were evaluated by two radiologists in a blinded fashion\\u000a for the depiction of six

Georg Omlor; Martin Jung; Thomas Grieser; Karl Ludwig

2009-01-01

338

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

339

Multiple schwannomas of the sciatic nerve.  

PubMed

Schwannomas are rare benign tumours of nerve sheath cells of neural crest origin. Often these tumours are solitary and encapsulated. Multiple schwannomas can arise from the peripheral nervous system including cranial nerves, spinal roots, the brachial and lumbar-sacral plexus or major peripheral nerves. We report an extremely rare case of schwannomatosis of the sciatic nerve in a young female and include a comprehensive literature review. Treatment options are discussed. PMID:12763357

Huang, J; Mobbs, R; Teo, C

2003-05-01

340

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

341

[Traumatic lesions of the proximal tibial epiphysis].  

PubMed

36 fractures of the tibia involving the proximal tibial epiphyseal cartilage were treated in 35 patients at the Accident Hospital Lorenz Böhler, Vienna over a ten-year period from 1980 to 1989. The average age at injury was 13.2 years. Most common concomitant injuries were ruptures of the ACL and/or MCL associated with meniscal lesions in type III- and IV-fractures and fractures of the fibula in type II injuries. We saw two associated aggravating problems as defined by a compartment-syndrome of the lower leg with one immediate peroneal-nerve palsy, but lesion or disruption of the popliteal artery was not observed. 26 patients were treated conservatively and nine patients had to be operated on. Long-term follow-up (means 6.4 years) was available in 28 cases. Premature epiphyseal closure was seen in three cases and one of them developed an axis angulation in the sense of genu recurvatum but operative correction was not necessary. Unsatisfactory results were stated in four cases due to their knee instability or posttraumatic painful arthrosis. There was no case of growth disturbance with axis deformation or angulation requiring surgical revision. PMID:1636220

Rappold, G

1992-06-01

342

Metastatic malignant peripheral nerve sheath tumor of the cauda equina.  

PubMed

Malignant peripheral nerve sheath tumor (MPNST) of the cauda equina is rare, with only four reported patients in the literature. We present a 70-year-old woman with a history of left sciatic nerve MPNST that had been treated by left hemipelvectomy 4 years prior. She then presented with disabling right leg weakness that progressed over 7months. Spine imaging revealed an intradural extramedullary lesion from L5 to S1 with compression of the cauda equina. She underwent an L3-S1 laminectomy with subtotal resection of the lesion, which was diagnosed as a metastatic MPNST. At the 3-month postoperative visit, her lower extremity strength had returned to baseline. The only notable postoperative complication was a superficial wound infection that resolved with antibiotic treatment and wet-to-dry dressing changes. Thus, although uncommon, the spinal canal and cauda equina should be considered as possible locations for metastatic MPNST in the appropriate clinical scenario. To our knowledge, this is the first report of a patient with a metastatic MPNST to the cauda equina. PMID:21450470

Than, Khoi D; Ghori, Ahmer K; Wang, Anthony C; Pandey, Aditya S

2011-06-01

343

Modern concepts in facial nerve reconstruction  

PubMed Central

Background Reconstructive surgery of the facial nerve is not daily routine for most head and neck surgeons. The published experience on strategies to ensure optimal functional results for the patients are based on small case series with a large variety of surgical techniques. On this background it is worthwhile to develop a standardized approach for diagnosis and treatment of patients asking for facial rehabilitation. Conclusion A standardized approach is feasible: Patients with chronic facial palsy first need an exact classification of the palsy's aetiology. A step-by-step clinical examination, if necessary MRI imaging and electromyographic examination allow a classification of the palsy's aetiology as well as the determination of the severity of the palsy and the functional deficits. Considering the patient's desire, age and life expectancy, an individual surgical concept is applicable using three main approaches: a) early extratemporal reconstruction, b) early reconstruction of proximal lesions if extratemporal reconstruction is not possible, c) late reconstruction or in cases of congenital palsy. Twelve to 24 months after the last step of surgical reconstruction a standardized evaluation of the therapeutic results is recommended to evaluate the necessity for adjuvant surgical procedures or other adjuvant procedures, e.g. botulinum toxin application. Up to now controlled trials on the value of physiotherapy and other adjuvant measures are missing to give recommendation for optimal application of adjuvant therapies. PMID:21040532

2010-01-01

344

Electrical Conduction through Nerve and DNA  

Microsoft Academic Search

The aim of the present study was to analyse electric resistivity at different ambient temperatures between 300 to 20K in the frog sciatic nerve and salmon sperm DNA. When the electrical contacts were leaned just into the sciatic nerve, an increase of the sciatic nerve resistivity was observed for 240 K < T < 300 K and a rise of

H. Abdelmelek; A. El-May; Ben Hamouda; M. Ben Salem; J. M. Pequignot; M. Sakly

2003-01-01

345

Peripheral nerve complications following burn injury  

SciTech Connect

The involvement of peripheral nerves in burn injury is not common, but when nerves are involved, prompt therapeutic intervention is necessary to avoid increased morbidity. Aside from the direct effects of the trauma, the burn team must anticipate dangerously excessive edema from circumferential burns, and avoid secondary nerve damage from inappropriate splinting, exercises or traction.

Salisbury, R.E.; Dingeldein, G.P.

1982-03-01

346

Nucleus caudalis lesioning: Case report of chronic traumatic headache relief  

PubMed Central

Background: The nucleus caudalis dorsal root entry zone (DREZ) surgery is used to treat intractable central craniofacial pain. This is the first journal publication of DREZ lesioning used for the long-term relief of an intractable chronic traumatic headache. Case Description: A 40-year-old female experienced new-onset bi-temporal headaches following a traumatic head injury. Despite medical treatment, her pain was severe on over 20 days per month, 3 years after the injury. The patient underwent trigeminal nucleus caudalis DREZ lesioning. Bilateral single-row lesions were made at 1-mm interval between the level of the obex and the C2 dorsal nerve roots, using angled radiofrequency electrodes, brought to 80°C for 15 seconds each, along a path 1 to 1.2 mm posterior to the accessory nerve rootlets. The headache improved, but gradually returned. Five years later, her headaches were severe on over 24 days per month. The DREZ surgery was then repeated. Her headaches improved and the relief has continued for 5 additional years. She has remained functional, with no limitation in instrumental activities of daily living. Conclusions: The nucleus caudalis DREZ surgery brought long-term relief to a patient suffering from chronic traumatic headache. PMID:22059123

Sandwell, Stephen E.; El-Naggar, Amr O.

2011-01-01

347

The Optical Stretcher Nerve Regeneration  

E-print Network

!"# $ %& ' "!((! )# The Optical Stretcher Nerve Regeneration Cells as Optical Fibres Novel Imaging-throughput cell analysis method for cancer diagnosis and stem cell sorting. The deformability of cells) and a cancerous cellhealthy (left) and a cancerous cell (right). The cancerous cell is more(right). The cancerous

Steiner, Ullrich

348

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

349

Adeno-Associated Virus Vector Expressing Nerve Growth Factor Enhances Cholinergic Axonal Sprouting after Cortical Injury in Rats  

Microsoft Academic Search

Nerve growth factor (NGF) is known to promote both the survival of cholinergic neurons after injury and the regeneration of damaged cholinergic axons. Recent evidence has implicated NGF in the regulation of cholinergic axonal sprouting by intact neurons projecting to the hippocampus of rats, sustaining a lesion of the entorhinal cortex. We explored the possibility that NGF may regulate this

Julio J. Ramirez; Jennifer L. Caldwell; Melanie Majure; David R. Wessner; Ronald L. Klein; Edwin M. Meyer; Michael A. King

2003-01-01

350

Study of regeneration in the garfish olfactory nerve  

PubMed Central

Previous studies of the olfactory nerve, mainly in higher vertebrates, have indicated that axonal injury causes total degeneration of the mature neurons, followed by replacement of new neuronal cells arising from undifferentiated mucosal cells. A similar regeneration process was confirmed in the garfish olfactory system. Regeneration of the nerve, crushed 1.5 cm from the cell bodies, is found to produce three distinct populations of regenerating fibers. The first traverses the crush site 1 wk postoperative and progresses along the nerve at a rate of 5.8 +/- 0.3 mm/d for the leading fibers of the group. The second group of fibers traverses the crush site after 2 wk postcrush and advances at a rate of 2.1 +/- 0.1 mm/d for the leading fibers. The rate of growth of this group of fibers remains constant for 60 d but subsequently falls to 1.6 +/- 0.2 for the leading population of fibers. The leading fibers in the third group of regenerating axons traverse the crush site after 4 wk and advance at a constant rate of 0.8 +/- 0.2 mm/d. The multiple populations of regenerating fibers with differing rates of growth are discussed in the context of precursor cell maturity at the time of nerve injury and possible conditioning effects of the lesion upon these cells. Electron microscopy indicates that the number of axons decreases extensively after crush. The first two phases of regenerating axons represent a total of between 6 and 10% of the original axonal population and are typically characterized by small fascicles of axons surrounded by Schwann cells and large amounts of collagenous material. The third phase of fibers represents between 50 and 70% of the original axonal population. PMID:7358798

1980-01-01

351

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

352

VAGUS NERVE STIMULATION REGULATES HEMOSTASIS IN SWINE  

PubMed Central

The central nervous system regulates peripheral immune responses via the vagus nerve, the primary neural component of the cholinergic anti-inflammatory pathway. Electrical stimulation of the vagus nerve suppresses pro-inflammatory cytokine release in response to endotoxin, I/R injury, and hypovolemic shock and protects against lethal hypotension. To determine the effect of vagus nerve stimulation on coagulation pathways, anesthetized pigs were subjected to partial ear resection before and after electrical vagus nerve stimulation. We observed that electrical vagus nerve stimulation significantly decreased bleeding time (pre–electrical vagus nerve stimulation = 1033 ± 210 s versus post–electrical vagus nerve stimulation = 585 ± 111 s; P < 0.05) and total blood loss (pre–electrical vagus nerve stimulation = 48.4 ± 6.8 mL versus post–electrical vagus nerve stimulation = 26.3 ± 6.7 mL; P < 0.05). Reduced bleeding time after vagus nerve stimulation was independent of changes in heart rate or blood pressure and correlated with increased thrombin/antithrombin III complex generation in shed blood. These data indicate that electrical stimulation of the vagus nerve attenuates peripheral hemorrhage in a porcine model of soft tissue injury and that this protective effect is associated with increased coagulation factor activity. PMID:19953009

Czura, Christopher J.; Schultz, Arthur; Kaipel, Martin; Khadem, Anna; Huston, Jared M.; Pavlov, Valentin A.; Redl, Heinz; Tracey, Kevin J.

2010-01-01

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. PMID:25422788

Gonçalves, Vítor M.; Gonçalves, Victor

2014-01-01

354

Rapid reorganization of adult rat motor cortex somatic representation patterns after motor nerve injury.  

PubMed Central

The potential for peripheral nerve injury to reorganize motor cortical representations was investigated in adult rats. Maps reflecting functional connections between the motor cortex and somatic musculature were generated with intracortical electrical stimulation techniques. Comparison of cortical somatotopic maps obtained in normal rats with maps generated from rats with a facial nerve lesion indicated that the forelimb and eye/eyelid representations expanded into the normal vibrissa area. Repeated testing from an electrode placed chronically in the motor cortex showed a shift from vibrissa to forelimb within hours after facial nerve transection. These comparatively quick changes in motor cortex representation pattern suggest that synaptic relations between motor cortex and somatic musculature are continually reshaped in adult mammals. Images PMID:3162322

Sanes, J N; Suner, S; Lando, J F; Donoghue, J P

1988-01-01

355

Primary neurolymphomatosis of the lower cranial nerves presenting as Dysphagia and hoarseness: a case report.  

PubMed

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

2014-08-01

356

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

357

Acute periodontal lesions.  

PubMed

This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case. PMID:24738591

Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

2014-06-01

358

Cranial nerves XIII and XIV: nerves in the shadows  

PubMed Central

It has been known for over a century that these cranial nerves exist, and that they are not typographical errors nor a sensational event reported in the medical literature. A number of scientific articles on anatomy highlight how textbooks on descriptive anatomy do not always consider variables such as differences related to the geographical areas where people live, and these differences do exist. This is an important concept not only for surgeons, but also for all medical professionals who use manual techniques when treating their patients, ie, osteopaths, chiropractors, physiotherapists, and other manual therapists. This paper highlights the latest developments regarding these cranial nerves, offering at the same time some ideas for further reflection when looking at clinical scenarios that appear to bear little relationship to each other. Inclusion of these concepts in everyday anamnesis is encouraged. PMID:23516138

Bordoni, Bruno; Zanier, Emiliano

2013-01-01

359

Acquired toxoplasmosis accompanied by facial nerve palsy in an immunocompetent 5-year-old child.  

PubMed

Acquired toxoplasmosis, although relatively common in children, is usually asymptomatic but can also be clinically manifested by a benign and self-limited infectious mononucleosis-like syndrome. Neurological complications are very rare in immunocompetent children. The authors report a 5-year-old boy who presented with cervical lymphadenopathy because of acquired toxoplasmosis accompanied with unilateral facial nerve paralysis. Toxoplasma gondii DNA detection in blood by polymerase chain reaction, as well as elevated specific immunoglobulin M antibodies against it, established the diagnosis. Characteristic brain lesions on magnetic resonance imaging were absent and ophthalmologic examination revealed no inflammatory lesions in the retina and choroid. Treatment with pyrimethamine, sulfadiazine, and folic acid resulted in a complete recovery after 2 months of therapy. Although rare, acute facial nerve paralysis of unknown origin can be caused by acquired toxoplasmosis even in the immunocompetent pediatric population. Elevated titers of specific antibodies and the presence of parasite's DNA are key findings for the correct diagnosis. PMID:21148450

Galli-Tsinopoulou, Assimina; Kyrgios, Ioannis; Giannopoulou, Eleni Z; Gourgoulia, Styliani; Maggana, Ioanna; Katechaki, Elina; Chatzidimitriou, Dimitrios; Evangeliou, Athanasios E

2010-12-01

360

Cystic schwannoma of the recurrent laryngeal nerve: a rare finding posing diagnostic difficulties.  

PubMed

A 49-year-old woman with a painless mass in the neck was examined by the surgeon. Imaging and cytology prior to surgery suggested the mass to be either a thyroid cyst or a branchial cleft cyst. After surgery, the patient reported a hoarse voice and the pathologist confirmed the removed lesion to be a cystic schwannoma of the left recurrent laryngeal nerve. The inconclusive imaging results, combined with colloid-like material in the punctate should prompt the investigator to include cystic schwannoma in the differential diagnosis. With the probability of a neurogenic origin of the mass in mind, nerve-sparing surgery can be performed. As a future prospect, positron emission tomography scans are mentioned as a modality with possibilities to discriminate a cystic schwannoma from other common cystic lesions. PMID:24769666

Knulst, Rowan; Bosman, Willem-Maarten; Ritchie, Ewan D; da Costa, Andy

2014-01-01

361

Mapping the entire human corneal nerve architecture  

PubMed Central

We developed an approach to generate a three-dimensional map that facilitates the assessment of epithelial nerve density in different corneal areas to define aging and gender influence on human corneal nerve architecture. Twenty-eight fresh human eyes from 14 donors of different ages were studied. Corneal nerves were stained and consecutive images acquired with a fluorescence microscope, recorded at the same plane, and merged for viewing the complete epithelial and stromal nerve architecture. After whole mount examination, the same cornea was also used for transection. Stromal nerves entered the cornea in a radial pattern, subsequently dividing into smaller branches. Some branches connected at the center of the stroma, but most penetrated upward into the epithelium. No differences were observed between nerve densities in the four corneal quadrants. Epithelial innervation in the limbal and most of the peripheral area was supplied by a superficial network surrounding the limbal area. Central epithelial nerves were supplied by branches of the stromal nerve network. Epithelial nerve density and terminal numbers were higher in the center of the cornea, rather than the periphery. There were no differences in epithelial nerve density between genders, but there was a progressive nerve density reduction concomitant with aging, mainly in eye samples of donors 70-years of age and older. The modified technique of tissue preparation used for this study allowed for observation of new nerve structure features and, for the first time, provided a complete view of the human corneal nerve architecture. Our study reveals that aging decreases the number of central epithelial nerve terminals, and increases the presence of irregular anomalies beneath the basal layer. PMID:20650270

He, Jiucheng; Bazan, Nicolas G.; Bazan, Haydee E.P.

2010-01-01

362

Input from muscle and cutaneous nerves of the hand and forearm to neurones of the precentral gyrus of baboons and monkeys  

PubMed Central

1. The precentral bank of the Rolandic fissure of the cortical arm area has been explored with extracellular micro-electrodes in primates (baboons and monkeys) under nitrous oxide and oxygen anaesthesia, supplemented by small doses of Parkesernyl® and chloralose. The results in baboons and monkeys were the same. 2. Single units were classified as pyramidal tract neurones or non-pyramidal tract neurones according to their antidromic responsiveness to stimuli applied in the dorsolateral funiculus at C1-2. 3. Responses to electrical stimulation of the deep (motor) radial nerve, the deep palmar (motor) branch of the ulnar nerve, and the superficial (cutaneous) radial nerve could be recorded in the majority of neurones of the motor cortex provided that short trains of strong stimuli were used. Minimal responses to muscle nerve stimulation were observed in a few neurones at 1·4 × group I threshold, but most units reacted only with higher stimulus intensities (2-3 × group I threshold). 4. The latencies to peripheral nerve stimulation were measured from the first peak of the incoming volley recorded at the root entry zone. The mean response latencies of pyramidal tract cells were between 20 and 25 msec; non-pyramidal tract cells were activated at slightly shorter mean latencies, the difference being significant for superficial radial nerve stimulation only (4 msec). These latencies are more than twice as long as those recorded in the postcentral gyrus, and the probability of discharge is lower than for postcentral neurones. 5. A further difference between neurones of the postcentral and precentral gyrus is the pronounced convergence from different nerves and also from different modalities (cutaneous and muscle afferents) in units of the precentral cortex in contrast to units of the postcentral cortex. 6. The high thresholds, necessary to activate precentral neurones by muscle nerve stimulation, make it unlikely that group I muscle afferents are involved. This is, furthermore, indicated by the lack of responsiveness to intravenous injection of succinylcholine which was, however, effective for driving neurones of the specific projection area for group I afferents, area 3a. The present experiments are consistent with the view that sensitivity of precentral neurones to muscle stretch (described in previous studies) is due to activation of secondary muscle spindle endings and their ascending pathways. 7. The original hypothesis of a load compensating `pyramidal reflex' with an oligosynaptic afferent contribution from the spindle primaries can be discarded. The present findings indicate that there is a feed-back from secondary muscle spindle afferents which, by way of a more complex pathway, can modulate the firing frequency of neurones in the motor cortex. PMID:4265508

Wiesendanger, M.

1973-01-01

363

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

364

Inflammatory pseudotumor of the nasopharynx with spread along the trigeminal nerve.  

PubMed

Inflammatory pseudotumor of the nasopharynx is a rare diagnosis that is often misinterpreted as carcinoma or lymphoma. It has been referred to as a tumefactive fibroinflammatory lesion, idiopathic pseudotumor, and fibrosing inflammatory pseudotumor. We present a rare case of a 40-year-old African American female from Kenya with inflammatory pseudotumor of the nasopharynx with perineural spread of disease along the trigeminal nerve to discuss the diagnosis and treatment of such an uncommon entity. PMID:23369511

Gadde, Judith; Franck, Bryan; Liu, Xiang; Teixido, Michael; Rizk, Habib

2013-01-01

365

[Critical remarks on examination methods to determine nerve injuries of the hand].  

PubMed

The diagnosis of peripheral nerve lesions remains difficult despite the sophisticated technology which is currently available. Experience with the Doppler, photoelectrical plethysmography and flow studies is analysed. Recording of antidromic sensory action potentials in dependence on acral thermometry as the only objective diagnostic procedure proved correct when compared with the indirect procedures via arterial vascular system, namely Doppler, photoelectrical plethysmography and flow studies. The application of the above techniques in a case report with sphygmographic assessment is described. PMID:7250801

Pohl, G; Netzler, J; Kosowski, H; Müller, D; Netzler, D

1980-01-01

366

Dynamics of axonal regeneration in adult and aging zebrafish reveal the promoting effect of a first lesion  

PubMed Central

Axonal regeneration is a major issue in the maintenance of adult nervous systems, both after nerve injuries and in neurodegenerative diseases. However, studying this process in vivo is difficult or even impossible in most vertebrates. Here we show that the posterior lateral line (PLL) of zebrafish is a suitable system to study axonal regeneration in vivo because of both the superficial location and reproducible spatial arrangement of neurons and targets, and the possibility of following reinnervation in live fish on a daily basis. Axonal regeneration after nerve cut has been demonstrated in this system during the first few days of life, leading to complete regeneration within 24 h. However, the potential for PLL nerve regeneration has not been tested yet beyond the early larval stage. We explore the regeneration potential and dynamics of the PLL nerve in adult zebrafish and report that regeneration occurs throughout adulthood. We observed that irregularities in the original branching pattern are faithfully reproduced after regeneration, suggesting that regenerating axons follow the path laid down by the original nerve branches. We quantified the extent of target reinnervation after a nerve cut and found that the latency before the nerve regenerates increases with age. This latency is reduced after a second nerve cut at all ages, suggesting that a regeneration-promoting factor induced by the first cut facilitates regeneration on a second cut. We provide evidence that this factor remains present at the site of the first lesion for several days and is intrinsic to the neurons. PMID:24474787

Graciarena, Mariana; Dambly-Chaudière, Christine; Ghysen, Alain

2014-01-01

367

Mechanisms of nerve injury in leprosy.  

PubMed

All patients with leprosy have some degree of nerve involvement. Perineural inflammation is the histopathologic hallmark of leprosy, and this localization may reflect a vascular route of entry of Mycobacterium leprae into nerves. Once inside nerves, M leprae are ingested by Schwann cells, with a wide array of consequences. Axonal atrophy may occur early in this process; ultimately, affected nerves undergo segmental demyelination. Knowledge of the mechanisms of nerve injury in leprosy has been greatly limited by the minimal opportunities to study affected nerves in man. The nine-banded armadillo provides the only animal model of the pathogenesis of M leprae infection. New tools available for this model enable the study and correlation of events occurring in epidermal nerve fibers, dermal nerves, and nerve trunks, including neurophysiologic parameters, bacterial load, and changes in gene transcription in both neural and inflammatory cells. The armadillo model is likely to enhance understanding of the mechanisms of nerve injury in leprosy and offers a means of testing proposed interventions. PMID:25432810

Scollard, David M; Truman, Richard W; Ebenezer, Gigi J

2015-01-01

368

Rare involvement of herpes zoster in the mandibular branch of the trigeminal nerve: A case report and review of the literature.  

PubMed

Herpes zoster (HZ) infections rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions may appear on the face, in the mouth, in the eye, or on the tongue. Additionally, this condition may be associated with devitalized teeth, internal resorption and spontaneous exfoliation of the teeth, and osteomyelitis of the alveolar bone. In this paper, the treatment of a case HZ of the mandibular branch of the trigeminal nerve is reported, and 22 articles on HZ cases with involvement of the mandibular branch are reviewed. This is the first literature review of HZ cases involving only the mandibular branch of the trigeminal nerve. PMID:25262672

Keskinruzgar, Aydin; Demirkol, Mehmet; Ege, Bilal; Aras, M Hamdi; Ay, Sinan

2015-02-01

369

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. PMID:25206536

Biazar, Esmaeil; Keshel, Saeed Heidari; Pouya, Majid; Rad, Hadi; Nava, Melody Omrani; Azarbakhsh, Mohammad; Hooshmand, Shirin

2013-01-01

370

[First case described of isolated, complete and fluctuating cranial nerve III palsy heralding multiple myeloma].  

PubMed

INTRODUCTION. Multiple myeloma is the most common plasma-cell malignancy. To be incurable, treatment aims to obtain the longest non-clinical survival time. Cranial nerve palsy in multiple myeloma is extremely rare and is usually due to an intracranial plasmacytoma. We present a multiple myeloma case, with an intracranial plasmacytoma, which debuted clinically with isolated, complete and fluctuating cranial nerve III palsy. CASE REPORT. A 63-year-old woman presented an oscillating clinical picture, consisting of horizontal binocular diplopia and later, headache. The neuro-ophthalmologic examination revealed a complete cranial nerve III palsy of the right eye. An urgent cranial CT-scan was requested. It showed multiple diploic osteolytic lesions, associating soft-parts component in the right superior orbital fissure. The patient was admitted, being diagnosed subsequently of IgA-kappa multiple myeloma. After receiving induction-chemotherapy and undergoing autologous stem cell transplantation, she achieved full remission. CONCLUSIONS. Multiple myeloma is a rare cranial nerves disorder, very uncommon cause of cranial nerve III full isolated paralysis and even less fluctuating, not having found any case published with this clinical onset. Awareness of possible multiple myeloma neuro-ophthalmic manifestations may bring about an early diagnosis and a positive impact on the disease course. PMID:25624087

Leon-Ruiz, M; Benito-Leon, J; Sierra-Hidalgo, F; Garcia-Soldevilla, M A; Izquierdo-Esteban, L; Tejeiro-Martinez, J; Cabrera-Valdivia, F; Garcia-Albea Ristol, E

2015-02-01

371

[Fibrolipomatous hamartoma of the nerve--a rare etiology of macrodactyly. A case report].  

PubMed

Fibrolipomatous hamartoma of nerve is a rare, tumor-like fibro-fatty growth arising from the epi- and perineurium. It mainly affects peripheral nerves and the median nerve in particular. An association with Klippel-Trenaunay syndrome and macrodactyly has been described. We present a 30-year-old patient, in whom the diagnosis of Klippel-Trenaunay syndrome had been made at the age of two, based on macrodactyly of the right hand. Because of increasing functional limitation and pain, the patient was referred to our department, after angiographic exclusion of Klippel-Trenaunay syndrome, for operative reduction of the tumor. Histologic examination revealed a fibrolipomatous hamartoma of the nerve. Further treatment consisted of surgical tumor reduction, which resulted in satisfactory recovery of function in the right hand. After eight months follow-up, the patient was able to perform all normal daily activities, and there was no evidence of recurrence of the lesion. Diagnostic evaluation of macrodactyly is necessary, since there may be an underlying cause such as fibrolipomatous hamartoma of a nerve, which if corrected early by surgical excision may prevent long-term disability. PMID:10080063

Ruppert, V; Friedel, R; Mentzel, T; Markgraf, E

1999-01-01

372

Interest of Electrostimulation of Peripheral Motor Nerves during Percutaneous Thermal Ablation  

SciTech Connect

Purpose: We present our experience of utilizing peripheral nerve electrostimulation as a complementary monitoring technique during percutaneous thermal ablation procedures; and we highlight its utility and feasibility in the prevention of iatrogenic neurologic thermal injury. Methods: Peripheral motor nerve electrostimulation was performed in 12 patients undergoing percutaneous image-guided thermal ablations of spinal/pelvic lesions in close proximity to the spinal cord and nerve roots. Electrostimulation was used in addition to existing insulation (active warming/cooling with hydrodissection, passive insulation with CO{sub 2} insufflation) and temperature monitoring (thermocouples) techniques. Impending neurologic deficit was defined as a visual reduction of muscle response or need for a stronger electric current to evoke muscle contraction, compared with baseline. Results: Significant reduction of the muscle response to electrostimulation was observed in three patients during the ablation, necessitating temporary interruption, followed by injection of warm/cool saline. This resulted in complete recovery of the muscle response in two cases, while for the third patient the response did not improve and the procedure was terminated. No patient experienced postoperative motor deficit. Conclusion: Peripheral motor nerve electrostimulation is a simple, easily accessible technique allowing early detection of impending neurologic injury during percutaneous image-guided thermal ablation. It complements existing monitoring techniques and provides a functional assessment along the whole length of the nerve.

Tsoumakidou, Georgia, E-mail: gtsoumakidou@yahoo.com; Garnon, Julien, E-mail: juliengarnon@gmail.com; Ramamurthy, Nitin, E-mail: nitin_ramamurthy@hotmail.com; Buy, Xavier, E-mail: xbuy@ymail.com; Gangi, Afshin, E-mail: gangi@unistra.fr [University Hospital of Strasbourg (France)] [University Hospital of Strasbourg (France)

2013-12-15

373

[Endometriosis of the ischio-rectal excavation at the contact of the sciatic nerve: a case report of neurolysis by pararectal incision].  

PubMed

Localisation of endometriosis on the sciatic nerve is exceptional. We report the case of a patient presenting an endometriotic nodule of the left ischio-rectal excavation, with an extension contiguous to the sciatic nerve, responsible of invalidating sciatalgia. Two laparoscopies did not allow to localise the lesion. Finally the endometriotic nodule was treated by a direct access of the left ischio-rectal excavation through a pararectal incision. In this article we discuss the means to localise such lesion and the surgical approach to propose. PMID:20022280

Chauvin, C; Azria, E; Mahieu-Caputo, D; Madelenat, P

2010-02-01

374

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

375

Congenital optic nerve pit in trisomy 18.  

PubMed

The authors report the first case of trisomy 18 associated with a clinically detectable optic nerve pit. A female infant with a birth weight of 2,150 g was born by cesarean section to a healthy 40-year-old woman at 38 weeks of gestation. Trisomy 18 had been diagnosed by prenatal genetic testing. Ophthalmologic examination was remarkable for bilateral narrowed palpebral fissures with punctal agenesis, corectopic pupils without reaction to light, bilateral inferior peripapillary retinochoroidal hypopigmentation, and significant optic nerve cupping in the left eye with associated temporal optic nerve pit. It has generally been accepted that optic nerve pits are a congenital anomaly. However, the pathophysiological background of optic nerve pits remains unclear and controversial. This is the first clinical and photographic documentation of an optic nerve pit in a neonate and in Edwards syndrome. PMID:24601433

Villegas, Victor M; Chang, Jonathan S; Hess, Ditte J; Berrocal, Audina M

2013-01-01

376

Congenital optic nerve pit in trisomy 18.  

PubMed

The authors report the first case of trisomy 18 associated with a clinically detectable optic nerve pit. A female infant with a birth weight of 2,150 g was born by cesarean section to a healthy 40-year-old woman at 38 weeks of gestation. Trisomy 18 had been diagnosed by prenatal genetic testing. Ophthalmologic examination was remarkable for bilateral narrowed palpebral fissures with punctal agenesis, corectopic pupils without reaction to light, bilateral inferior peripapillary retinochoroidal hypopigmentation, and significant optic nerve cupping in the left eye with associated temporal optic nerve pit. It has generally been accepted that optic nerve pits are a congenital anomaly. However, the pathophysiological background of optic nerve pits remains unclear and controversial. This is the first clinical and photographic documentation of an optic nerve pit in a neonate and in Edwards syndrome. PMID:23739588

Villegas, Victor M; Chang, Jonathan S; Hess, Ditte J; Berrocal, Audina M

2013-01-01

377

Spontaneous intraneural hematoma of the sural nerve.  

PubMed

Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient's history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery. PMID:25311865

Richardson, Shawn S; McLawhorn, Alexander S; Mintz, Douglas N; DiCarlo, Edward F; Weiland, Andrew J

2015-04-01

378

An unusual cause of radial nerve palsy.  

PubMed

Neurapraxia frequently occurs following traction injury to the nerve intraoperatively, leading to radial nerve palsy which usually recovers in 5-30 weeks. In our case, we had operated a distal one-third of humeral shaft fracture and fixed it with 4.5 mm limited contact dynamic compression plate. The distal neurovascular status of the limb was assessed postoperatively in the recovery room and was found to be intact and all the sensory-motor functions of the radial nerve were normal. On the second postoperative day, following the suction drain removal and dressing, patient developed immediate radial nerve palsy along with wrist drop. We reviewed the literature and found no obvious cause for the nerve palsy and concluded that it was due to traction injury to the radial nerve while removing the suction drain in negative pressure. PMID:24889983

Agrawal, Hemendra Kumar; Khatkar, Vipin; Garg, Mohit; Singh, Balvinder; Jaiman, Ashish; Sharma, Vinod Kumar

2014-06-01

379

Ultrasonographic cross-sectional area of spinal nerve roots in cervical radiculopathy: a pilot study.  

PubMed

Recently, sonographic assessment has been considered an alternative method for evaluating cervical root lesions. The aim of this pilot study was to measure cross-sectional areas (CSAs) of cervical spinal nerve roots using high-resolution ultrasonography in patients with cervical radiculopathy, to compare the CSA of nerve roots between the affected and unaffected sides. Patients with a clinical diagnosis of unilateral cervical radiculopathy, who were referred to the Department of Physical Medicine and Rehabilitation in the University General Hospital by general practitioners, were prospectively recruited. The selected nerve roots were sonographically imaged at the most proximal location possible, where they exited over the transverse processor, just distal to that point. The CSA was measured three times using the trace tool available on the ultrasonography device. The CSA of each contralateral nerve root served as a control. Twenty-four patients (9 women; mean age, 53.7 yrs) were enrolled in this study. The CSAs were measured by ultrasonography in 5 pairs of C5 roots, 12 pairs of C6 roots, and 7 pairs of C7 roots. The mean CSAs of the affected and unaffected sides were 9.74 ± 1.95 and 9.47 ± 1.95 mm, respectively (P = 0.019). Spearman rank-order correlation test showed a positive relationship between the CSA of the affected nerve root and the duration of symptoms (?22 = 0.467, P = 0.021).This is, to the authors' knowledge, the first comparative study to obtain the CSA of spinal nerve roots in cervical radiculopathy. Increased CSA of the affected nerve root relative to the unaffected side, as demonstrated by ultrasonography, may be useful as an additive clue for the diagnosis of cervical radiculopathy. PMID:25415392

Kim, Eunkuk; Yoon, Joon-Shik; Kang, Hyo Jung

2015-02-01

380

Annular bullous lesions with atypical erythema multiforme in leprosy.  

PubMed

Erythema nodosum leprosum (ENL) is an immune complex-mediated reaction that may complicate the course of multibacillary leprosy. Bullous lesions in Type II reaction, though reported, are exceedingly rare. We report the case of a 32 year old female patient who presented initially at our OPD with erythema nodosum. Cutaneous examination revealed impaired sensation over dorsum of right foot and thickened right lateral popliteal nerve. Slit skin smear (SSS) from ear lobes revealed AFB with a bacteriological index of 2+. She was started on MDT, tablet ofloxacin 200 mg twice a day, and 30 mg oral prednisolone. Two months later, she presented with generalised pruritus, large target lesions over the back, and hemorrhagic bullae over lower extremities and annular pattern of bullae, over both arms. A SSS was repeated which was positive for AFB. Histopathology from bullous lesions was consistent with ENL. Direct Immunofluorescence (DIF) study was negative. Our patient improved rapidly after she was started on thalidomide 100 mg twice daily, with withdrawal of ofloxacin. Erythema Multiforme (EMF) and annular bullous lesions have been reported in patients on treatment with ofloxacin. This case is being presented due to the unusual and varied manifestation of Type II lepra reaction in a 34 year old female patient. PMID:25509721

Shah, Aishani; Mahajan, Rashmi; Ninama, Kishan; Bilimoria, Freny

2014-09-01

381

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

382

Ventral nerve cord in Phoronopsis harmeri larvae.  

PubMed

The nervous system organization is considered a phylogenetically important character among metazoans. The phylum Phoronida is included in a supraphyletic taxon known as Lophotrochozoa. Many lophotrochozoans possess a metameric ventral nerve cord as adults or larvae. Phoronids do not exhibit external metamery either as larvae or as adults. The current study describes the ventral nerve cord in the young larva of Phoronopsis harmeri. This structure is apparent both in the serotonergic and FMRF-amidergic nervous system in young larvae. The ventral nerve cord extends from the mouth to the tentacular ridge. Both serotonergic and FMRF-amidergic components consist of two ventrolateral nerves, each with several unipolar neurons. The ventrolateral nerves connect to each other by means of thin repetitive transversal nerves ("commissures"). The abundance of neurons and nerves in the epidermis of the oral field of actinotrocha larva likely reflects the importance of this area in collection of food particles. The ventral nerve cords of the actinotrocha and the metatrochophore differ in their positions with respect to ciliated bands: the cord is located between the preoral and postoral ciliated bands in the actinotrocha but between the postoral ciliated band and telotroch in the metatrochophore. The presence of the ventral nerve cord, which contains repetitive elements (neurons and "commissures"), in the early development of P. harmeri may recapitulate some stages of nervous system development during phoronid phylogeny. The larval nervous system does not contain nervous centers under the tentacular ridge that can correlate with the catastrophic metamorphosis and unique body plan of phoronids. PMID:21898789

Temereva, Elena N

2012-01-15

383

Facial nerve paralysis following pediatric cardiac surgery.  

PubMed

A newborn female diagnosed with transposition of the great vessels with restrictive ventricular septal defect presented left facial peripheral nerve paralysis following anatomical surgery correction (arterial switch) by cardiopulmonary bypass. We have not found any causal factor either in the anesthesia or postoperative period. The electromyogram presented signs of peripheral nerve impairment, and the cerebral echography and electroencephalogram were normal. The facial nerve paralysis was almost recovered seven weeks after surgery. This is the first pediatric patient reported with peripheral facial nerve paralysis after cardiac surgery. PMID:8869372

Alcaraz, A; Lopez-Herce, J; Castro, P; Bustinza, A; Moroto, C

1995-09-01

384

Characterization of Peripheral Nerve Sheath Tumors with 3T Proton MR Spectroscopy  

PubMed Central

Background and Purpose The characterization of peripheral nerve sheath tumors is challenging. The purpose here was to investigate the diagnostic value of quantitative proton MR spectroscopy at 3T for the characterization of peripheral nerve sheath tumors as benign or malignant, compared with PET. Materials and Methods Twenty participants with 24 peripheral nerve sheath tumors underwent MR spectroscopy by use of a point-resolved sequence (TE, 135 ms). Six voxels were placed in 4 histologically proven malignant peripheral nerve sheath tumors and 22 voxels in 20 benign peripheral nerve sheath tumors (9 histologically proven, 11 with documented stability). The presence or absence of a trimethylamine signal was evaluated, the trimethylamine concentration estimated by use of phantom replacement methodology, and the trimethylamine fraction relative to Cr measured. MR spectroscopy results for benign and malignant peripheral nerve sheath tumors were compared by use of a Mann-Whitney test, and concordance or discordance with PET findings was recorded. Results In all malignant tumors and in 9 of 18 benign peripheral nerve sheath tumors, a trimethylamine peak was detected, offering the presence of trimethylamine as a sensitive (100%), but not specific (50%), marker of malignant disease. Trimethylamine concentrations (2.2 ± 2.8 vs 6.6 ± 5.8 institutional units; P < .049) and the trimethylamine fraction (27 ± 42 vs 88 ± 22%; P < .012) were lower in benign than malignant peripheral nerve sheath tumors. A trimethylamine fraction threshold of 50% resulted in 100% sensitivity (95% CI, 58.0%–100%) and 72.2% (95% CI, 59.5%–75%) specificity for distinguishing benign from malignant disease. MR spectroscopy and PET results were concordant in 12 of 16 cases, (2 false-positive results for MR spectroscopy and PET each). Conclusions Quantitative measurement of trimethylamine concentration by use of MR spectroscopy is feasible in peripheral nerve sheath tumors and shows promise as a method for the differentiation of benign and malignant lesions. Trimethylamine presence within a peripheral nerve sheath tumor is a sensitive marker of malignant disease, but quantitative measurement of trimethylamine content is required to improve specificity. PMID:24287094

Fayad, L.M.; Wang, X.; Blakeley, J.O.; Durand, D.J.; Jacobs, M.A.; Demehri, S.; Subhawong, T.K.; Soldatos, T.; Barker, P.B.

2014-01-01

385

Thalamic Lesions: A Radiological Review  

PubMed Central

Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions). Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations. PMID:25100900

Renard, Dimitri; Campello, Chantal; Bouly, Stephane; Le Floch, Anne; Thouvenot, Eric; Waconge, Anne; Taieb, Guillaume

2014-01-01

386

Lesions after sphincterotomy.  

PubMed

Within the last years 70 transduodenal sphincterotomies at stringent indication have been carried out at the Department of Surgery of the RWTH Aachen. This means 9.2% of all operations caused by cholelithiasis. The lethality was 4.2%. The following postoperative complications where stated: a) the bleeding from the divided duct of sphincter with or without haemobile (1.4%), b) the post-sphincterotomy pancreatitis (9.5%) owing to lesion of the pancreatic duct, c) the retroperitoneal abscess with biliary peritonitis (1.8%), d) insufficiency of the duodenal wall or duodenal fistula (1.9%), e) postoperative disturbances of passage of the transsected sphincter Oddi. The haemorrhagic necrosing pancreatitis, the insufficiency of the duodenal wall, the retroperitoneal abscess and the bleeding postsphincterotomy force us to immediate re-operation, while functional disturbances like a spasm or an oedema are controllable pharmacologically and functionally for a short time. PMID:302546

Raguse, T; Lynen, F K; Geukens, T

1977-01-01

387

Ginsenoside Rg1 promotes peripheral nerve regeneration in rat model of nerve crush injury  

Microsoft Academic Search

Searching for effective drugs which are capable of promoting nerve regeneration after nerve injuries has gained extensive attention. Ginsenoside Rg1 (GRg1) is one of the bioactive compounds extracted from ginseng. GRg1 has been shown to be neuroprotective in many in vitro studies, which raises the possibility of using GRg1 as a neuroprotective agent after nerve injuries. However, such a possibility

Junxiong Ma; Wenxian Li; Ruifeng Tian; Wei Lei

2010-01-01

388

Regeneration of perivascular adrenergic innervation in rat tibial nerve after nerve crush.  

PubMed

Adrenergic innervation of blood vessels in the rat tibial nerve during degeneration and regeneration was studied using the formaldehyde-induced fluorescence method. The left sciatic nerve was crushed with suture threads to produce a 4-mm length of crushed nerve. At 1, 3, 7, 14, 28, 56 and 84 days after nerve crush, degenerative and regenerative changes in the nerve were verified using light microscopy. At each time point, adrenergic innervation was examined in epi-perineurial whole mount and nerve cross-section preparations. One day after nerve crush, fluorescence of adrenergic nerve fibers in the endoneurium was absent. Fluorescent adrenergic nerve fibers reappeared in the endoneurium at day 56 and reached the control density by 84 days. In the epi-perineurium, adrenergic innervation of small and medium-size arterioles was absent at 3 days, in large arterioles at 7 days. At 56 days, all epi-perineurial arterioles were reinnervated by a faint, sparse adrenergic network, which reached the control density at 84 days. The results suggest that adrenergic innervation in the rat peripheral nerve is lost during nerve degeneration, but recovers when the nerve has regenerated. PMID:1713392

Koistinaho, J; Wadhwani, K C; Balbo, A; Rapoport, S I

1991-01-01

389

Facial nerve palsy, headache, peripheral neuropathy and Kaposi's sarcoma in an elderly man.  

PubMed

We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate (ESR) and no fever. A presumptive diagnosis of giant cell arteritis was made and the patient was treated with high-dose steroids. A temporal artery biopsy was negative. Several months later, while on 16 mg of methylprednisolone daily, he presented with severe sensorimotor peripheral symmetric neuropathy, muscle wasting and inability to walk, uncontrolled blood sugar and psychosis. A work-up for malignancy was initiated with the suspicion of a paraneoplastic process. At the same time a biopsy of the macular skin lesions that had appeared on the skin of the left elbow and right knee almost simultaneously was inconclusive, whereas a repeat biopsy from the same area of the lesions that had become nodular, a month later, was indicative of Kaposi's sarcoma. Finally, a third biopsy of a similar lesion, after spreading of the skin process, confirmed the diagnosis of Kaposi's sarcoma. He was treated with interferon ? and later was seen in very satisfactory condition, with no clinical evidence of neuropathy, normal muscle strength, no headache, normal electrophysiologic nerve studies, involution of Kaposi's lesions and a normal ESR. PMID:24945015

Daoussis, Dimitrios; Chroni, Elisabeth; Tsamandas, Athanassios C; Andonopoulos, Andrew P

2014-06-16

390

Facial nerve palsy, headache, peripheral neuropathy and Kaposi’s sarcoma in an elderly man  

PubMed Central

We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate (ESR) and no fever. A presumptive diagnosis of giant cell arteritis was made and the patient was treated with high-dose steroids. A temporal artery biopsy was negative. Several months later, while on 16 mg of methylprednisolone daily, he presented with severe sensorimotor peripheral symmetric neuropathy, muscle wasting and inability to walk, uncontrolled blood sugar and psychosis. A work-up for malignancy was initiated with the suspicion of a paraneoplastic process. At the same time a biopsy of the macular skin lesions that had appeared on the skin of the left elbow and right knee almost simultaneously was inconclusive, whereas a repeat biopsy from the same area of the lesions that had become nodular, a month later, was indicative of Kaposi’s sarcoma. Finally, a third biopsy of a similar lesion, after spreading of the skin process, confirmed the diagnosis of Kaposi’s sarcoma. He was treated with interferon ? and later was seen in very satisfactory condition, with no clinical evidence of neuropathy, normal muscle strength, no headache, normal electrophysiologic nerve studies, involution of Kaposi’s lesions and a normal ESR. PMID:24945015

Daoussis, Dimitrios; Chroni, Elisabeth; Tsamandas, Athanassios C; Andonopoulos, Andrew P

2014-01-01

391

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 2014-04-01 false Electrical peripheral nerve stimulator. 868...Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator...

2014-04-01

392

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Electrical peripheral nerve stimulator. 868...Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator...

2010-04-01

393

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 2011-04-01 false Electrical peripheral nerve stimulator. 868...Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator...

2011-04-01

394

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 2013-04-01 false Electrical peripheral nerve stimulator. 868...Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator...

2013-04-01

395

21 CFR 868.2775 - Electrical peripheral nerve stimulator.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 2012-04-01 false Electrical peripheral nerve stimulator. 868...Monitoring Devices § 868.2775 Electrical peripheral nerve stimulator. (a) Identification. An electrical peripheral nerve stimulator...

2012-04-01

396

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...Diagnostic Devices § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is...

2011-04-01

397

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...Diagnostic Devices § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is...

2012-04-01

398

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...Diagnostic Devices § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is...

2013-04-01

399

21 CFR 882.1550 - Nerve conduction velocity measurement device.  

Code of Federal Regulations, 2014 CFR

... 2014-04-01 false Nerve conduction velocity measurement device. 882...Diagnostic Devices § 882.1550 Nerve conduction velocity measurement device. (a) Identification. A nerve conduction velocity measurement device is...

2014-04-01

400

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 ...

401

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. PMID:25426384

Vasudevan, Srikanth; Huang, Jiying; Botterman, Barry; Matloub, Hani S.; Keefer, Edward

2014-01-01

402

Neuromuscular rehabilitation by treadmill running or electrical stimulation after peripheral nerve injury and repair.  

PubMed

Numerous studies have been devoted to the regeneration of the motor pathway toward a denervated muscle after nerve injury. However, the regeneration of sensory muscle endings after repair by self-anastomosis are little studied. In previous electrophysiological studies, our laboratory showed that the functional characteristics of tibialis anterior muscle afferents are differentially affected after injury and repair of the peroneal nerve with and without chronic electrostimulation. The present study focuses on the axonal regeneration of mechano- (fibers I and II) and metabosensitive (fibers III and IV) muscle afferents by evaluating the recovery of their response to different test agents after nerve injury and repair by self-anastomosis during 10 wk of treadmill running (LSR). Data were compared with control animals (C), animals with nerve lesion and suture (LS), and animals with lesion, suture, and chronic muscle rehabilitation by electrostimulation (LSE) with a biphasic current modulated in pulse duration and frequency, eliciting a pattern mimicking the activity delivered by the nerve to the muscle. Compared with the C group, results indicated that 1) muscle weight was smaller in LS and LSR groups, 2) the fatigue index was greater in the LS group and smaller in the LSE group, 3) metabosensibility remained altered in the LS and LSE groups, and 4) mechanosensitivity presented a large increase of the activation pattern in the LS and LSE groups. Our data indicated that chronic muscle electrostimulation partially favors the recovery of muscle properties (i.e., muscle weight and twitch response were close to the C group) and that rehabilitation by treadmill running also efficiently induced a better functional muscle afferent recovery (i.e., the discharge pattern was similar to the C group). The effectiveness of the chronic electromyostimulation and the treadmill exercise on afferent recovery is discussed with regard to parameters listed above. PMID:14634028

Marqueste, Tanguy; Alliez, Jean-Roch; Alluin, Olivier; Jammes, Yves; Decherchi, Patrick

2004-05-01

403

Immediate versus delayed primary nerve repair in the rabbit sciatic nerve  

PubMed Central

It is well known that peripheral nerve injury should be treated immediately in the clinic, but in some instances, repair can be delayed. This study investigated the effects of immediate versus delayed (3 days after injury) neurorrhaphy on repair of transected sciatic nerve in New Zealand rabbits using stereological, histomorphological and biomechanical methods. At 8 weeks after immediate and delayed neurorrhaphy, axon number and area in the sciatic nerve, myelin sheath and epineurium thickness, Schwann cell morphology, and the mechanical property of nerve fibers did not differ obviously. These results indicate that delayed neurorrhaphy do not produce any deleterious effect on sciatic nerve repair. PMID:25206663

Piskin, Ahmet; Altunkaynak, Berrin Zühal; Ç?tlak, Atilla; Sezgin, Hicabi; Yaz?c?, Ozgür; Kaplan, Süleyman

2013-01-01

404

Two-level motor nerve transfer for the treatment of long thoracic nerve palsy.  

PubMed

The authors report a case of long thoracic nerve (LTN) palsy treated with two-level motor nerve transfers of a pectoral fascicle of the middle trunk, and a branch of the thoracodorsal nerve. This procedure resulted in near-total improvement of the winged scapula deformity, and a return of excellent shoulder function. A detailed account of the postoperative physical therapy regimen is included, as this critical component of the favorable result cannot be overlooked. This case establishes the two-level motor nerve transfer as a new option for treating LTN palsy, and demonstrates that nerve transfers should be considered in the therapeutic algorithm of an idiopathic mononeuritis. PMID:21699477

Ray, Wilson Z; Pet, Mitchell A; Nicoson, Michael C; Yee, Andrew; Kahn, Lorna C; Mackinnon, Susan E

2011-10-01

405

Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in rat sciatic nerve.  

PubMed

In order to further improve and explore the role of lasers for nerve reconstruction, this study was designed to investigate regeneration of sharply transected peripheral nerves repaired with a CO(2) milliwatt laser in combination with three different suture materials and a bovine albumin protein solder as an adjunct to the welding process. Unilateral sciatic nerve repair was performed in 44 rats. In the laser group, nerves were gently apposed, and two stay sutures (10-0 nylon, 10-0 polyglycolic acid, or 25 microm stainless steel) were placed epi/perineurially. Thereafter, the repair site was fused at 100 mW with pulses of 1.0 s. In the subgroup of laser-assisted nerve repair (LANR), albumen was used as a soldering agent to further reinforce the repair site. The control group consisted of nerves repaired by conventional microsurgical suture repair (CMSR), using 4-6 10-0 nylon sutures. Evaluation was performed at 1 and 6 weeks after surgery, and included qualitative and semiquantitative light microscopy. LANR performed with a protein solder results in a good early peripheral nerve regeneration, with an optimal alignment of nerve fibers and minimal connective tissue proliferation at the repair site. All three suture materials produced a foreign body reaction; the least severe was with polyglycolic acid sutures. CMSR resulted in more pronounced foreign-body granulomas at the repair site, with more connective-tissue proliferation and axonal misalignment. Furthermore, axonal regeneration in the distal nerve segment was better in the laser groups. Based on these results, CO(2) laser-assisted nerve repair with soldering in combination with absorbable sutures has the potential of allowing healing to occur with the least foreign-body reaction at the repair site. Further experiments using this combination are in progress. PMID:12740882

Menovsky, Tomas; Beek, Johan F

2003-01-01

406

Nerve Sprouting and Sudden Cardiac Death  

Microsoft Academic Search

The factors that contribute to the occurrence of sudden cardiac death (SCD) in patients with chronic myocardial infarction (MI) are not entirely clear. The present study tests the hypothesis that augmented sympathetic nerve regeneration (nerve sprouting) increases the probability of ventricular tachycardia (VT), ventricular fibrillation (VF), and SCD in chronic MI. In dogs with MI and complete atrioventricular (AV) block,

Ji-Min Cao; Lan S. Chen; Bruce H. KenKnight; Toshihiko Ohara; Moon-Hyoung Lee; Jerome Tsai; William W. Lai; Hrayr S. Karagueuzian; Paul L. Wolf; Michael C. Fishbein; Peng-Sheng Chen

407

Maternal anticonvulsants and optic nerve hypoplasia.  

PubMed Central

Seven patients with optic nerve hypoplasia, born of epileptic mothers, are presented. All the mothers took anticonvulsants during pregnancy. The possibility that maternal anticonvulsant therapy may play a role in the genesis of optic nerve hypoplasia is discussed in the light of what is known about the teratogenicity of these agents. Images PMID:415754

Hoyt, C. S.; Billson, F. A.

1978-01-01

408

Occipital nerve stimulation for chronic migraine.  

PubMed

Occipital nerve stimulation may be effective in treating chronic migraine. Six studies, including three double-blind studies, were performed, with five showing evidence of benefit. However, of the three randomized, controlled trials, none has met a primary endpoint successfully. A separate study suggested a benefit for combined supraorbital and greater occipital nerve stimulation. PMID:24474153

Young, William B

2014-02-01

409

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

410

Role of lumbricus extract in the nerve amplification effect during peripheral nerve regeneration  

PubMed Central

Among the methods of the peripheral nerve repair, artificial conduit bridging surgery is superior to epineurium and perineurium neurorrhaphy because of supplying enough space for nerve regeneration. Artificial conduit provides important microenvironment for peripheral nerve regeneration, especially for nerve amplification effect. Amplification phenomenon has been demonstrated in many studies using artificial conduit. When a finer nerve is used as a donor to connect to a distal nerve after injury, the donor nerve regenerates more lateral buds than its own fibers, which grow into distal endoneurial tubes and finally dominate the target organs. In this study, we used artificial conduit to investigate the amplification phenomenon in rats treated with Lumbricus extract as adjuvant treatment. The rats were divided into three groups at random. In the surgical groups, the proximal common peroneal nerve was used as a donor nerve to connect the distal tibial nerve. Rats in the normal group were not performed surgery. Postoperatively, the treatment group was administered Lumbricus extract as adjuvant treatment, while the model group and normal group were not given treatment. The results showed that the nerve conduction velocity, the morphometric measurements, the histological analysis and the amplification ratio in the treatment group were better than in the model group. PMID:25628798

Zhang, Peixun; Wang, Zhiyong; Kou, Yuhui; Han, Na; Xu, Chungui; Yin, Xiaofeng; Wang, Yanhua; Feng, Xue

2014-01-01

411

Corticial lesions in multiple sclerosis  

Microsoft Academic Search

Summary Although previous studies have shown that the lesions of multiple sclerosis may involve the cerebral cortex, there is little published research on the prevalence and distribution of such lesions. Using neuropathological techniques and MRI, a series of studies has been undertaken in order to assess this, in particular to identify their relationship to cortical veins. A serial MRI study

D. Kidd; F. Barkhof; R. McConnell; P. R. Algra; I. V. Allen; T. Revesz

1999-01-01

412

Skin lesions in diabetic patients  

Microsoft Academic Search

Objective It is yet unknown the relationship between diabetes and determinants or triggering factors of skin lesions in diabetic patients. The purpose of the present study was to investigate the presence of unreported skin lesions in diabetic patients and their relationship with metabolic control of diabetes. Methods A total of 403 diabetic patients, 31% type 1 and 69% type 2,

N T Foss; D P Polon; M H Takada; M C Foss-Freitas; M C Foss

413

Brain lesions and eating disorders  

Microsoft Academic Search

Objective: To evaluate the relation between lesions of various brain structures and the development of eating disorders and thus inform the neurobiological research on the aetiology of these mental illnesses.Method: We systematically reviewed 54 previously published case reports of eating disorders with brain damage. Lesion location, presence of typical psychopathology, and evidence suggestive of causal association were recorded.Results: Although simple

R Uher; J Treasure

2005-01-01

414

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

415

Fortuitously discovered liver lesions.  

PubMed

The fortuitously discovered liver lesion is a common problem. Consensus might be expected in terms of its work-up, and yet there is none. This stems in part from the fact that there is no preventive campaign involving the early detection of liver tumors other than for patients with known liver cirrhosis and oncological patients. The work-up (detection and differential diagnosis) of liver tumors comprises theoretical considerations, history, physical examination, laboratory tests, standard ultrasound, Doppler ultrasound techniques, contrast-enhanced ultrasound (CEUS), computed tomography and magnetic resonance imaging, as well as image-guided biopsy. CEUS techniques have proved to be the most pertinent method; these techniques became part of the clinical routine about 10 years ago in Europe and Asia and are used for a variety of indications in daily clinical practice. CEUS is in many cases the first and also decisive technical intervention for detecting and characterizing liver tumors. This development is reflected in many CEUS guidelines, e.g., in the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) guidelines 2004, 2008 and 2012 as well as the recently published World Federation for Ultrasound in Medicine and Biology-EFSUMB guidelines 2012. This article sets out considerations for making a structured work-up of incidental liver tumors feasible. PMID:23745019

Dietrich, Christoph F; Sharma, Malay; Gibson, Robert N; Schreiber-Dietrich, Dagmar; Jenssen, Christian

2013-06-01

416

Fine needle aspiration cytology as an aid to diagnosis, categorization and treatment when pure neuritic leprosy presents as nerve abscess  

PubMed Central

Background: Pure neuritic leprosy (PNL) usually presents with neurological symptoms without skin involvement. Fine needle aspiration can play an important role in the management of PNL cases presenting as nerve abscesses. Aim: To assess the role of fine needle aspiration cytology (FNAC) in diagnosing and categorizing PNL cases presenting as nerve abscesses in the absence of neurological symptoms. Materials and Methods: Five patients with subcutaneous nerve related swellings without clinically evident neurological deficits were subjected to FNAC. As the cytological features were suggestive of nerve abscesses due to leprosy, Fite stain was performed in all cases. As none of the patients had any leprosy skin lesions, they were diagnosed as cases of PNL. Features like cellularity, caseous necrosis, presence or absence of lymphocytes, macrophages, epithelioid cells, granulomas, Langhans giant cells and nerve elements were analyzed with the bacteriological index, to categorize PNL according to the Ridley-Jopling classification. Results: Based on the cytological features and bacteriological indices, 3 cases were cytologically categorized into tuberculoid (TT)/borderline tuberculoid (BT) leprosy and the other two, as BT/borderline lepromatous (BL) and BL leprosy respectively in spite of having similar clinical presentation. Based on the cytological diagnoses, category-specific treatment could be instituted with clinical improvement. Conclusions: The simple and minimally invasive FNAC procedure allows diagnosis and a reasonably accurate categorization of PNL presenting as nerve abscess and therefore, highly useful in its clinical management. PMID:24648666

Kiran, C M; Menon, Roshni

2013-01-01

417

Imaging of auriculotemporal nerve perineural spread  

PubMed Central

Importance: Adenoid cystic carcinomas (ACCs) are relatively rare tumours, notorious for wide local infiltration and perineural spread. Perineural extension commonly occurs along branches of the trigeminal and facial nerves, and its presence represents a poor prognostic factor with implications for treatment approach. Observations: We report the case of a 61-year-old female presenting with worsening left facial numbness and weakness. On magnetic resonance imaging, the patient was found to have perineural spread of a left parotid tumour along the auriculotemporal nerve. There was involvement of the V2 and V3 branches of the trigeminal nerve. An ultrasound-guided biopsy of the mass demonstrated ACC. Conclusions and relevance: The auriculotemporal nerve may serve as a route for tumour spread, particularly in the setting of head and neck malignancy. Moreover, this particular suspicion should be raised when patients with known malignancy experience concomitant trigeminal (V) and facial (VII) nerve dysfunctions. PMID:24282445

Chan, Michael; Dmytriw, Adam A.; Bartlett, Eric; Yu, Eugene

2013-01-01

418

On the terminology of cranial nerves.  

PubMed

The present contribution adopts various points of view to discuss the terminology of the twelve nervi craniales. These are paired nerves and have dual names, terms with Roman ordinal numerals, i.e., the nerves are numbered in the top-to-bottom direction, and descriptive historical names. The time of origin and motivation behind the investigated terms are determined. The majority of terms come from the 17th and 18th centuries. The motivation behind most of them is (a) nerve localization, as this is in conformity with anatomical nomenclature in general, (b) nerve function, and rarely (c) nerve appearance. The occurrence of synonymous names and variants is also a focus of attention. In several cases, reference is made to the process called terminologization, meaning when a certain expression acquires technical meaning and the characteristic/feature of the term. PMID:21724380

Simon, František; Mare?ková-Štolcová, Elena; Pá?, Libor

2011-10-20

419

OCT image segmentation of the prostate nerves  

NASA Astrophysics Data System (ADS)

The cavernous nerves course along the surface of the prostate and are responsible for erectile function. Improvements in identification, imaging, and visualization of the cavernous nerves during prostate cancer surgery may improve nerve preservation and postoperative sexual potency. In this study, 2-D OCT images of the rat prostate were segmented to differentiate the cavernous nerves from the prostate gland. Three image features were employed: Gabor filter, Daubechies wavelet, and Laws filter. The features were segmented using a nearestneighbor classifier. N-ary morphological post-processing was used to remove small voids. The cavernous nerves were differentiated from the prostate gland with a segmentation error rate of only 0.058 +/- 0.019.

Chitchian, Shahab; Weldon, Thomas P.; Fried, Nathaniel M.

2009-08-01

420

Peripheral nerve allografting - why and how?  

PubMed

The authors briefly present the methods of reconstruction of peripheral nerve gaps. Of these methods, the reconstruction with nerve allografts is reviewed mainly in what concerns the ways to achieve host tolerance for the allograft. The authors underline the fact that, for the recipient it is better to suppress the graft antigenicity than to suppress the host immune response. Further, the authors present the most important methods to denaturate a nerve allograft in order to make it nonantigenic and insist upon developing methods that can be used in human beings. The authors conclude that reconstruction of nerve defects with peripheral nerve allografts is a very rewarding method that should be extended in clinical practice. PMID:25375041

B?doiu, S C; Lasc?r, I; Enescu, D M

2014-01-01

421

Peripheral nerve morphogenesis induced by scaffold micropatterning  

PubMed Central

Several bioengineering approaches have been proposed for peripheral nervous system repair, with limited results and still open questions about the underlying molecular mechanisms. We assessed the biological processes that occur after the implantation of collagen scaffold with a peculiar porous microstructure of the wall in a rat sciatic nerve transection model compared to commercial collagen conduits and nerve crush injury using functional, histological and genome wide analyses. We demonstrated that within 60 days, our conduit had been completely substituted by a normal nerve. Gene expression analysis documented a precise sequential regulation of known genes involved in angiogenesis, Schwann cells/axons interactions and myelination, together with a selective modulation of key biological pathways for nerve morphogenesis induced by porous matrices. These data suggest that the scaffold’s microstructure profoundly influences cell behaviors and creates an instructive micro-environment to enhance nerve morphogenesis that can be exploited to improve recovery and understand the molecular differences between repair and regeneration. PMID:24559639

Memon, Danish; Boneschi, Filippo Martinelli; Madaghiele, Marta; Brambilla, Paola; Del Carro, Ubaldo; Taveggia, Carla; Riva, Nilo; Trimarco, Amelia; Lopez, Ignazio D.; Comi, Giancarlo; Pluchino, Stefano; Martino, Gianvito; Sannino, Alessandro; Quattrini, Angelo

2014-01-01

422

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

423

Endoscopic approach to subepithelial lesions  

PubMed Central

Endoscopy and endoscopic ultrasound (EUS) play a critical role in the detection and management of subepithelial lesions of the gastrointestinal tract. The most common subepithelial lesions detected by endoscopists are gastrointestinal stromal tumors (GISTs), leiomyomas, lipomas, granular cell tumors (GCTs), pancreatic rests and carcinoid tumors. These lesions can be classified based on unique histochemical staining and the gastrointestinal layer of origin. While the majority of the lesions are considered benign, some tumors such as GISTs and carcinoids have a strong propensity for malignant transformation. Therefore, appropriate endoscopic versus surgical management based on size and location is crucial in the prevention of malignant transformation and metastasis. In this review, we provide a systematic approach to the diagnosis, management and treatment of commonly encountered subepithelial lesions. PMID:24790643

Menon, Laila

2014-01-01

424

Baseline Magnetic Resonance Imaging of the Optic Nerve Provides Limited Predictive Information on Short-Term Recovery after Acute Optic Neuritis  

PubMed Central

Background In acute optic neuritis, magnetic resonance imaging (MRI) may help to confirm the diagnosis as well as to exclude alternative diagnoses. Yet, little is known on the value of optic nerve imaging for predicting clinical symptoms or therapeutic outcome. Purpose To evaluate the benefit of optic nerve MRI for predicting response to appropriate therapy and recovery of visual acuity. Methods Clinical data as well as visual evoked potentials (VEP) and MRI results of 104 patients, who were treated at the Department of Neurology with clinically definite optic neuritis between December 2010 and September 2012 were retrospectively reviewed including a follow up within 14 days. Results Both length of the Gd enhancing lesion (r = -0.38; p = 0.001) and the T2 lesion (r = -0.25; p = 0.03) of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. Although visual acuity pre-treatment was little but nonsignificantly lower if Gd enhancement of the optic nerve was detected via orbital MRI, improvement of visual acuity after adequate therapy was significantly better (0.40 vs. 0.24; p = 0.04). Intraorbitally located Gd enhancing lesions were associated with worse visual improvement compared to canalicular, intracranial and chiasmal lesions (0.35 vs. 0.54; p = 0.02). Conclusion Orbital MRI is a broadly available, valuable tool for predicting the improvement of visual function. While the accurate individual prediction of long-term outcomes after appropriate therapy still remains difficult, lesion length of Gd enhancement and T2 lesion contribute to its prediction and a better short-term visual outcome may be associated with detection and localization of Gd enhancement along the optic nerve. PMID:25635863

Berg, Sebastian; Kaschka, Iris; Utz, Kathrin S.; Huhn, Konstantin; Lämmer, Alexandra; Lämmer, Robert; Waschbisch, Anne; Kloska, Stephan; Lee, De-Hyung; Doerfler, Arnd; Linker, Ralf A.

2015-01-01

425

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.

426

Fiber composition of the rat sciatic nerve.  

PubMed

The rat sciatic nerve originates from the spinal segments L4-L6. It is unifascicular at the trochanter; 5-7 mm distally, the nerve splits into two and then into four fascicles. The tibial portion gives rise to the tibial and the sural nerves, and the peroneal portion gives rise to the peroneal nerve and a cutaneous branch that perforates the lateral hamstring muscles to innervate the proximolateral face of the calf. The number and type of the axons in these branches were determined in light and electron micrographs of normal nerves, and after de-efferentation or sympathectomy. Deafferentation was technically not feasible because spinal ganglia and ventral roots were supplied by the same vascular plexus. The tibial nerve contained 1,000 motor and 3,500 myelinated afferent axons, 3,700 sympathetic axons, and 5,400 unmyelinated afferent axons. The peroneal nerve contained 600 motor and 1,300 myelinated afferent axons, 1,100 sympathetic axons and 3,000 unmyelinated afferent axons. The sural nerve contained 1,100 myelinated and 2,800 unmyelinated afferent axons; in addition, there were 1,500 unmyelinated sympathetic axons. The cutaneous branch consisted of 400 myelinated and 1,800 unmyelinated afferent axons. Thus, the entire sciatic nerve at midthigh is composed of about 27,000 axons; 6% are myelinated motor axons, 23% and 48% are myelinated and unmyelinated sensory axons, respectively, and 23% are unmyelinated sympathetic axons. The techniques used did not demonstrate sympathetic axons in the cutaneous branch and did not reveal the few motor axons contained in the sural nerve. PMID:3706794

Schmalbruch, H

1986-05-01

427

NERVE GROWTH FACTOR, NEUROPEPTIDES AND CUTANEOUS NERVES IN ATOPIC DERMATITIS  

PubMed Central

Introduction: Neurogenic components, as neurotrophic factors and neuropeptides, are probably involved in the pathogenesis of atopic dermatitis (AD) with the neuroimmunocutaneous system as they modify the functions of immunoactive cells in the skin. Nerve growth factor (NGF) is the best-characterized member of the neurotrophin family. Both NGF and neuropeptides (NPs) may be associated with the disease pathogenesis. Aim: This study aims to evaluate the plasma level of NGF and NPs in AD patients and correlate them with the disease activity and nerve changes in the skin by electron microscopy. Materials and Methods: Plasma levels of NGF and vasoactive intestinal peptide (+VIP) were measured by an immunoenzymatic assay while plasma levels of calcitonine gene related peptide (CGRP) and neuropeptide Y (NPY) were measured by radioimmunoassay in 30 AD patients in comparison to 10 normal non-atopic controls. Electron microscopic study was done in 10 AD patients. Results: It has been found that there is significant increase of plasma levels of NGF and NPs in AD patients compared with controls. There is a positive correlation between the plasma levels of NGF and disease activity (correlation coefficient = 0.750, P<0.005). There is a significant correlation between the number of Schwann axon complex, evidenced by electron microscopic examination and plasma level of NGF in AD patients. Conclusion: It has been concluded that these neurogenic factors; NGF and NPs modulate the allergic response in AD, probably through interactions with cells of the immune-inflammatory component. NGF might be considered as a marker of the disease activity. PMID:20606880

Hodeib, Abeer; El-Samad, Zeinab Abd; Hanafy, Hesham; El-Latief, Amani Abd; El-bendary, Amal; Abu-Raya, Azza

2010