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1

Ulnar nerve damage (image)  

MedlinePLUS

The ulnar nerve originates from the brachial plexus and travels down arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near the surface of the body where ...

2

Ulnar Nerve Compression after Silastic Ulnar Head Replacement  

PubMed Central

A patient with silastic radiocarpal and ulnar head replacement arthroplasty presented six years after the operation with symptoms of ulnar neuropathy. Bone resorption of the distal ulna resulted in volar subluxation of the ulnar head implant which compressed the ulnar nerve at its entrance into Guyon's canal. Removal of the implant and decompression of the nerve resulted in recovery of ulnar nerve funcions. Compression neuropathy of the ulnar nerve should be considered a potential complication of the use of silastic ulnar head replacements. ImagesFigure 1Figure 2

El-Gammal, Tarek A.; Blair, William F.

1991-01-01

3

Outcome following Nerve Repair of High Isolated Clean Sharp Injuries of the Ulnar Nerve  

PubMed Central

Objective The detailed outcome of surgical repair of high isolated clean sharp (HICS) ulnar nerve lesions has become relevant in view of the recent development of distal nerve transfer. Our goal was to determine the outcome of HICS ulnar nerve repair in order to create a basis for the optimal management of these lesions. Methods High ulnar nerve lesions are defined as localized in the area ranging from the proximal forearm to the axilla just distal to the branching of the medial cord of the brachial plexus. A meta-analysis of the literature concerning high ulnar nerve injuries was performed. Additionally, a retrospective study of the outcome of nerve repair of HICS ulnar nerve injuries at our institution was performed. The Rotterdam Intrinsic Hand Myometer and the Rosén-Lundborg protocol were used. Results The literature review identified 46 papers. Many articles presented outcomes of mixed lesion groups consisting of combined ulnar and median nerves, or the outcome of high and low level injuries was pooled. In addition, outcome was expressed using different scoring systems. 40 patients with HICS ulnar nerve lesions were found with sufficient data for further analysis. In our institution, 15 patients had nerve repair with a median interval between trauma and reconstruction of 17 days (range 0–516). The mean score of the motor and sensory domain of the Rosen's Scale instrument was 58% and 38% of the unaffected arm, respectively. Two-point discrimination never reached less then 12 mm. Conclusion From the literature, it was not possible to draw a definitive conclusion on outcome of surgical repair of HICS ulnar nerve lesions. Detailed neurological function assessment of our own patients showed that some ulnar nerve function returned. Intrinsic muscle strength recovery was generally poor. Based on this study, one might cautiously argue that repair strategies of HICS ulnar nerve lesions need to be improved.

Post, Rene; de Boer, Kornelis S.; Malessy, Martijn J. A.

2012-01-01

4

Transfer of median and ulnar nerve fascicles for lesions of the posterior cord in infraclavicular brachial plexus injury: report of 2 cases.  

PubMed

In infraclavicular lesions of brachial plexus, severe lesions of the posterior cord often occur when medial and lateral cord function is preserved to a greater or lesser extent. In these cases, shoulder function may be preserved by activity of the muscles innervated by the suprascapular nerve, but complete paralysis exists in the deltoid, triceps, and brachioradialis, and all wrist and finger extensors. Classical reconstruction procedures consist of nerve grafts, but their results in adults are disappointing. We report an approach transferring: (1) an ulnar nerve fascicle to the motor branch of the long portion of the triceps brachii muscle, (2) a median nerve branch from the pronator teres to the motor branch of the extensor carpi radialis longus, and (3) a median nerve branch from the flexor carpi radialis to the posterior interosseous nerve. We describe the procedure and report 2 clinical cases showing the effectiveness of this technique for restoring extension of the elbow, wrist, and fingers in the common infraclavicular lesions of the brachial plexus affecting the posterior cord. PMID:23021172

García-López, Antonio; Perea, David

2012-10-01

5

ANTERIOR SUBFASCIAL TRANSPOSITION OF THE ULNAR NERVE  

Microsoft Academic Search

After anterior subfascial transposition, the ulnar nerve lies superficial to the flexor-pronator muscle group but deep to its fascia. Eight patients with cubital tunnel syndrome were treated with this method and reviewed retrospectively. The average age at the time of operation was 52 years. All patients had severe cubital tunnel syndrome based on Dellon's classification. The average follow-up period was

L. C TEOH; F. C YONG; S. H TAN; Y. H ANDREW CHIN

2003-01-01

6

Anomalous muscle causing ulnar nerve compression at Guyon's canal.  

PubMed

We report a rare anatomical variation of an anomalous supernumerary muscle in a male cadaver. It was crossing Guyon's canal, superficial to the ulnar nerve and ulnar artery, and inserted into the aponeurosis of the little finger. This muscle could potentially cause entrapment of the ulnar nerve in Guyon's canal. PMID:22747362

Paraskevas, Georgios K; Ioannidis, Orestis; Economou, Dimitrios S

2012-09-01

7

A biomechanical study of the ulnar nerve at the elbow  

Microsoft Academic Search

The relative elongation with elbow flexion of the ulnar nerve, proximal and distal to the cubital tunnel, and of the cubital tunnel retinaculum, was measured in cadaver specimens by stereophotogrammetry. The proximal part of the ulnar nerve elongated significantly with full elbow flexion. No significant change of length was measured in the distal part of the nerve. The length of

F. A. Schuind; D. Goldschmidt; C. Bastin; F. Burny

1995-01-01

8

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

9

A rare manifestation of sarcoidosis with sensomotoric neuropathy of the ulnar nerve as the only symptom.  

PubMed

A 79-year-old woman was admitted complaining of progressive weakness and numbness of the right hand. The patient was otherwise healthy. The patient's history was unremarkable. Clinical and electrophysiological examination revealed a compression of the ulnar nerve in the ulnar sulcus and in Guyon's canal. Ultrasound evaluation showed a suspicious tumour proximal to the elbow close to the ulnar nerve. The ulnar sulcus was then released and an epineural and perineural lesion 3-4 cm proximal to the sulcus was excised under microscope. The histopathology confirmed the lesion as non-caseating sarcoid granulomas. The patient showed no other signs of systemic sarcoidosis, as neuropathy was the only symptom and the condition improved postoperatively. Sensory deficits and paraesthesia resolved fully. The extension of the minor finger remained slightly inferior compared with the not affected side. Sarcoid neuropathy is a rare neurological complication of sarcoidosis and has to be included in differential diagnosis of nerve conduction impairments. PMID:23192580

Mattiassich, Georg; Schubert, Heinrich; Hutarew, Georg; Wechselberger, Gottfried

2012-01-01

10

Ulnar nerve at the elbow - normative nerve conduction study  

PubMed Central

Introduction A goal of our work was to perform nerve conduction studies (NCSs) of the ulnar nerve focused on the nerve conduction across the elbow on a sufficiently large cohort of healthy subjects in order to generate reliable reference data. Methods We examined the ulnar nerve in a position with the elbow flexion of 90o from horizontal. Motor response was recorded from the abductor digiti minimi muscle (ADM) and the first dorsal interosseous muscle (FDI). Results In our sample of 227 healthy volunteers we have examined 380 upper arms with the following results: amplitude (Amp)-CMAP(wrist) for ADM 9.6 ± 2.3 mV, MNCV at the forearm 60.4 ± 5.2 m/s, MNCV across the elbow 57.1 ± 5.9 m/s. Discussion Our study showed that motor NCSs of the ulnar nerve above elbow (AE) and below elbow (BE) in a sufficiently large cohort using methodology recommended by AANEM gave results well comparable for registration from FDI and ADM.

2013-01-01

11

Anterior subcutaneous transfer of the ulnar nerve in the athlete  

Microsoft Academic Search

To evaluate the effectiveness of subcutaneous subfas cial anterior transfer of the ulnar nerve in the surgical treatment of cubital tunnel syndrome in athletes, we retrospectively reviewed athletes undergoing subcuta neous anterior transfer of the ulnar nerve at the elbow. Criteria for inclusion in the study included active partic ipation in athletic activity, confirmed cubital tunnel syn drome, failure to

Arthur C. Rettig; James R. Ebben

1993-01-01

12

Direct radial to ulnar nerve transfer to restore intrinsic muscle function in combined proximal median and ulnar nerve injury: case report and surgical technique.  

PubMed

A distal median to ulnar nerve transfer for timely restoration of critical intrinsic muscle function is possible in isolated ulnar nerve injuries but not for combined ulnar and median nerve injuries. We used a distal nerve transfer to restore ulnar intrinsic function in the case of a proximal combined median and ulnar nerve injury. Transfer of the nonessential radial nerve branches to the abductor pollicis longus, extensor pollicis brevis, and extensor indicis proprius to the motor branch of the ulnar nerve was performed in a direct end-to-end fashion via an interosseous tunnel. This method safely and effectively restored intrinsic function before terminal muscle degeneration. PMID:24836915

Phillips, Benjamin Z; Franco, Michael J; Yee, Andrew; Tung, Thomas H; Mackinnon, Susan E; Fox, Ida K

2014-07-01

13

Functional outcome of anterior transposition of the vascularized ulnar nerve for cubital tunnel syndrome  

Microsoft Academic Search

Anterior transposition of the ulnar nerve is a widely used treatment for cubital tunnel syndrome, but neurolysis performed at the time of surgery may impair the blood supply to the ulnar nerve. This study compared the results of intramuscular anterior transposition of the ulnar nerve with or without preserving the extrinsic vessels of the ulnar nerve in 35 patients. The

A. Asami; K. Morisawa; T. Tsuruta

1998-01-01

14

Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicentre study by the GEL  

Microsoft Academic Search

The objective is to determine the normal appearance of the ulnar nerve on a posterior axial sonogram section of the elbow through the medial epicondyle and the humeroulnar joint space. Ultrasound evaluation was carried out on 400 elbows with measurement of the ulnar nerve cross-sectional area and ulnar nerve-cortex distance, as well as recording of apparent ulnar nerve division. Factors

D. Jacob; V. Creteur; C. Courthaliac; R. Bargoin; B. Sassus; C. Bacq; J. L. Rozies; J. P. Cercueil; J. L. Brasseur

2004-01-01

15

Compression of the deep branch of the ulnar nerve in Guyon’s canal by a ganglion: two cases  

Microsoft Academic Search

Introduction  Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of\\u000a only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion\\u000a compressing the nerves.\\u000a \\u000a \\u000a \\u000a Materials and methods  We present two cases of compression of deep branch of ulnar nerve by a

P. K. Inaparthy; F. Anwar; R. Botchu; H. Jähnich; M. V. Katchburian

2008-01-01

16

The anatomy of ulnar nerve branches in anterior transposition.  

PubMed

Cubital tunnel syndrome is the second most common nerve entrapment neuropathy. When non-operative treatments fail, surgical intervention is indicated. Although there remains no consensus between simple decompression and anterior transposition, there is a growing recognition of improved clinical outcomes in the latter. Few details of ulnar nerve branches around the elbow are available however and their sacrifice may be necessary to facilitate anterior transposition. Therefore, ten cadaveric upper extremities were dissected to delineate the course and branching pattern of the ulnar nerve around the elbow joint; anterior transposition was also performed in the cadaveric specimens. Digital photographs of the dissection study were analyzed using the Image J package. Results show that distal ulnar nerve branches are distributed more laterally towards the olecranon and may potentially restrict transposition more than has been recognized; proximal branches may also overlap incision lines of such transposition procedures. PMID:24156569

Ng, Zhi Yang; Mitchell, Jennifer H; Fogg, Quentin A; Hart, Andrew M

2013-01-01

17

Diagnostic ultrasonography of the ulnar nerve in cubital tunnel syndrome  

Microsoft Academic Search

Thirty-two elbows in 31 patients diagnosed as having cubital tunnel syndrome underwent ultrasonographic examination to assess morphological changes in the ulnar nerve and its surrounding tissues. On longitudinal images, the site of constriction due to the fibrous band and proximal swelling of the nerve were observed by ultrasonography and were confirmed intraoperatively. On axial images, the lengths of the major

M. Okamoto; M. Abe; H. Shirai; N. Ueda

2000-01-01

18

DIAGNOSTIC ULTRASONOGRAPHY OF THE ULNAR NERVE IN CUBITAL TUNNEL SYNDROME  

Microsoft Academic Search

Thirty-two elbows in 31 patients diagnosed as having cubital tunnel syndrome underwent ultrasonographic examination to assess morphological changes in the ulnar nerve and its surrounding tissues. On longitudinal images, the site of constriction due to the fibrous band and proximal swelling of the nerve were observed by ultrasonography and were confirmed intraoperatively. On axial images, the lengths of the major

M. OKAMOTO; M. ABE; H. SHIRAI; N. UEDA

2000-01-01

19

Influence of age, gender, and sidedness on ulnar nerve conduction.  

PubMed

Anatomic variation and susceptibility for injuries depending on gender were described for the ulnar nerve. The aim of this study was to investigate the association between gender and ulnar never motor conductance and the influence of sidedness for this association. Study was conducted as a retrospective study using nerve conduction study data of ulnar nerve of 2,526 patients. Influences of age, gender, and sidedness on ulnar never motor conduction velocity (UMV) were investigated. Regression analysis was conducted to compare the relationship between UMV and age. Regression was significantly higher in males (-0.253 vs. -0.113), suggesting higher influence of age on UMV in males than in females. When analyzing right and left sides separately, influence of age on UMV is higher in males (-0.286 vs. -0.109) only in right side. Multiple regression analysis was done comparing the influence of age, gender, and sidedness on UMV, and it found that the order of influence is gender, age, and sidedness (Beta values 0.153, -0.140, and 0.029). Ulnar nerve motor conductance depends on gender, age, and sidedness. Males are having lower UMV than females. Age-dependant change of UMV is more prominent in males than in females and is more prominent in right hand than in left hand in males. PMID:23377450

Kommalage, Mahinda; Gunawardena, Sampath

2013-02-01

20

Delayed ulnar nerve palsy secondary to ulnar artery pseudoaneurysm distal to Guyon's canal following penetrating trauma to the hand.  

PubMed

Compression of the ulnar nerve in Guyon's canal is an uncommon phenomenon. Reports of ulnar nerve palsy secondary to ulnar artery pseudoaneurysm at this anatomical location are very rare and equivalent pathology just distal to this site is unheard of. Here we present such a case, which featured a delayed onset of symptoms. This followed penetrating trauma to the hand. Our methods for diagnosis, operative planning and surgical treatment are included. PMID:23838486

Dobson, P F; Purushothaman, B; Michla, Y; England, S; Krishnan, M K; Tourret, L

2013-07-01

21

Retrograde regeneration following neurotmesis of the ulnar nerve.  

PubMed

A 41-year-old woman experienced a gunshot wound to the forearm with neurotmesis of the ulnar nerve. Surgery 9 months later revealed a neuroma-in-continuity in the midforearm. Intraoperative nerve stimulation failed to elicit direct nerve responses or motor responses from the first dorsal interosseous (FDI) and abductor digiti minimi (ADM) muscles. However, neurotonic discharges in response to mechanical irritation of the neuroma were recorded in the FDI, but not the ADM. Surprisingly, after resecting the ulnar nerve distal to the neuroma, neurotonic discharges were still elicited in the FDI following perturbation of the neuroma. Moreover, neurotonic discharges were elicited during ulnar nerve resection 2 cm proximal to the neuroma. No anastomoses or anomalous branches were noted. The findings suggest that regenerating fibers did not reach the FDI through the distal nerve segment. Rather, we speculate that nerve fibers regenerating at random, or impeded by scar tissue, contacted the proximal nerve portion, at which point growth became polarized in a retrograde direction. Retrograde regeneration may have proceeded to a branch point in the forearm (possibly an undetected anomalous branch or fibrous adhesion), where growth of regenerating fibers extended outward into surrounding damaged tissue planes before redirecting distally to reach the FDI. PMID:14506726

Leis, A Arturo; Lancon, John A; Stokic, Dobrivoje S

2003-10-01

22

Tendon Transfers Part II: Transfers for Ulnar Nerve Palsy and Median Nerve Palsy  

PubMed Central

Objectives After reading this article (part II of II), the participant should be able to: 1. Describe the anatomy and function of the median and ulnar nerves in the forearm and hand. 2. Describe the clinical deficits associated with injury to each nerve. 3. Describe the indications, benefits, and drawbacks for various tendon transfer procedures used to treat median and ulnar nerve palsy.4. Describe the treatment of combined nerve injuries. 5. Describe postoperative care and possible complications associated with these tendon transfer procedures. Summary This article discusses the use of tendon transfer procedures for treatment of median and ulnar nerve palsy as well as combined nerve palsies. Postoperative management and potential complications are also discussed.

Sammer, Douglas M.; Chung, Kevin C.

2009-01-01

23

Ulnar nerve measurements in healthy individuals to obtain reference values.  

PubMed

The aim of this study was to obtain the ultrasonographical reference values of ulnar nerve cross-sectional areas at the common areas of nerve entrapment as well as any differences related to age, sex, weight, height, dominant arm. Cross-sectional areas of the ulnar nerves of 72 healthy volunteers were measured bilaterally at the level of the epicondyle, 2 cm proximal to and 2 cm distal to the epicondyle, just at the entrance of cubital tunnel, at arterial split, at Guyon's canal. Age, sex, body weight, height, body mass index, and dominant extremity were recorded. The mean ulnar nerve cross-sectional area was 5.8 ± 1.1 mm(2) at 2 cm proximal to medial epicondyle, 6.2 ± 1.1 mm(2) at the medial epicondyle, 5.6 ± 0.9 mm(2) at the entrance of the cubital tunnel, 5.6 ± 1.0 mm(2) at 2 cm distal to medial epicondyle (inside the flexor carpi ulnaris), 5.0 ± 0.6 mm(2) at arterial split, and 4.9 ± 0.6 mm(2) at Guyon's canal. There was statistically no difference between the dominant and nondominant sides (p > 0.05). Females had statistically smaller nerves than males (p < 0.05). There was a significant correlation with height at all levels; also, weight was significantly correlated with cross-sectional areas except at two levels: tip of medial epicondyle and 2 cm distal. This study provides normative data of ulnar nerve ultrasonography and as well as any differences related to age, sex, height, weight, and dominant arm. PMID:22948543

Yalcin, Elif; Onder, Burcu; Akyuz, Mufit

2013-05-01

24

Synovial osteochondromatosis associated with osteoarthrits causing ulnar nerve palsy  

PubMed Central

Synovial oteochondromatosis has been described in the knee joint commonly but this case was in the elbow and was associated with ulnar nerve palsy. Generally it has been the belief that synovial osteochondromatosis is not associated with ostearthritis of the joint but, in this case it was clearly associated with osteoarthritis of the elbow. Therefore the authors wish to report this case of a rare condition with an unusual association.

Weerasuriya, Thisara; Swaminathan, Raja

2011-01-01

25

Synovial osteochondromatosis associated with osteoarthrits causing ulnar nerve palsy.  

PubMed

Synovial oteochondromatosis has been described in the knee joint commonly but this case was in the elbow and was associated with ulnar nerve palsy. Generally it has been the belief that synovial osteochondromatosis is not associated with ostearthritis of the joint but, in this case it was clearly associated with osteoarthritis of the elbow. Therefore the authors wish to report this case of a rare condition with an unusual association. PMID:22673717

Weerasuriya, Thisara; Swaminathan, Raja

2011-01-01

26

Anatomical basis for a technique of ulnar nerve transposition  

Microsoft Academic Search

Summary  There are five major anatomical locations where the ulnar nerve may be compressed near the elbow. Multiple sites of compression\\u000a are often noted clinically; in other cases, the site of compression is difficult to identify. Clinical experience and results\\u000a of a series of 20 anatomical dissections suggest that local decompression or subcutaneous transfer may be performed without\\u000a necessarily exposing all

Peter C Amadio

1986-01-01

27

[Experimental radiologic imaging of ulnar and median nerves].  

PubMed

This experimental study presents a new method of neurography of the ulnar and median nerves. Subcutaneous injection of water soluble iodine contrast medium (Urotrast 75%-Krka Yugoslavia) in the vicinity of the nerve immediately followed by 12V D.C. electrostimulation resulted in proximal flow of contrast medium along the epineural space versus all other structures of the nerve trunk. On X-ray films epineural space appeared as two parallel linear shadows delineating a lucent stripe which comprises all other nerve structures. By means of this method nerve X-ray images of very high quality have been accomplished for significantly shorter time than required in other procedures. The method is harmless for the patient and easily applicable. PMID:2280380

Goldner, B; Penevex, B; Pisteljic, D; Nakev, K

1990-10-01

28

Intraneural topography of the ulnar nerve in the cubital tunnel facilitates anterior transposition  

Microsoft Academic Search

The surgical management of cubital tunnel syndrome includes anterior transposition of the ulnar nerve. The success of all transposition procedures is dependent on placement of the nerve anterior to the medial epicondyle without tension. Fifteen cadaveric upper extremities underwent anterior transposition followed by anterior transposition with separation of the most proximal motor branches from the main ulnar nerve for a

Greg P. Watchmaker; Gilbert Lee; Susan F. Mackinnon

1994-01-01

29

Risk factors for dislocation of the ulnar nerve after simple decompression for cubital tunnel syndrome.  

PubMed

Anterior dislocation of the ulnar nerve is occasionally encountered after simple decompression of the nerve for treatment of cubital tunnel syndrome. The purpose of this study was to determine whether the incidence of dislocation of the nerve following simple decompression of the nerve is correlated with the patient's preoperative characteristics and/or elbow morphology. We studied 51 patients with cubital tunnel syndrome who underwent surgery at our institution. Intraoperatively, we simulated dislocation of the nerve after simple decompression by flexing the elbow after releasing the nerve in each patient. Univariate and multiple logistic regression analysis showed that young age and a small ulnar nerve groove angle are positively correlated with dislocation of the nerve. Our results suggest that patients who are young and/or have a sharply angled ulnar nerve groove identified radiographically have a high probability of experiencing anterior dislocation of the ulnar nerve after simple decompression. PMID:24641735

Murata, K; Omokawa, S; Shimizu, T; Nakanishi, Y; Kawamura, K; Yajima, H; Tanaka, Y

2014-01-01

30

Ulnar nerve strain at the elbow in patients with cubital tunnel syndrome: effect of simple decompression.  

PubMed

Simple decompression of the ulnar nerve at the elbow has not been shown to reduce nerve strain in cadavers. In this study, ulnar nerve strain at the elbow was measured intraoperatively in 11 patients with cubital tunnel syndrome, before and after simple decompression. Statistical analysis was performed using a paired Student's t-test. Mean ulnar nerve strain before and after simple decompression was 30.5% (range 9% to 69%) and 5.5% (range -2% to 11%), respectively; this difference was statistically significant (p < 0.01) with a statistical power of 96%. Simple decompression reduced ulnar nerve strain in all patients by an average of 24.5%. Our results suggest that the pathophysiology of cubital tunnel syndrome may be multifactorial, being neither a simple compression neuropathy nor a simple traction neuropathy, and simple decompression may be a favourable surgical procedure for cubital tunnel syndrome in terms of decompression and reduction of strain in the ulnar nerve. PMID:23100298

Ochi, K; Horiuchi, Y; Nakamura, T; Sato, K; Arino, H; Koyanagi, T

2013-06-01

31

Spontaneous rupture of ulnar nerve due to neglected cubital tunnel syndrome associated with rheumatoid arthritis.  

PubMed

A case of spontaneous rupture of the ulnar nerve due to neglected cubital tunnel syndrome associated with rheumatoid arthritis is reported. Earlier decompression and anterior transposition in this patient may have prevented nerve rupture. PMID:17762458

Kalaci, Aydiner; Aslan, Bahadir; Yanat, Ahmet Nedim

2007-08-01

32

Outcome study of ulnar nerve compression at the elbow treated with simple decompression and an early programme of physical therapy  

Microsoft Academic Search

Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper limb. This paper presents the experience of treating cubital tunnel syndrome with simple decompression in 131 patients (164 ulnar nerves) over the past 12 years. 85% of these patients had mild or moderate ulnar nerve disease. In 146\\/164 ulnar nerves (89%), simple decompression resulted in good or

P. A. Nathan; R. C. Keniston; K. D. Meadows

1995-01-01

33

Submuscular transposition of the ulnar nerve for the treatment of cubital tunnel syndrome.  

PubMed

THE ULNAR NERVE is compressed at the cubical notch in patients with cubital tunnel syndrome. To definitively alleviate this compression, the nerve can be transposed under the pronator teres and flexor carpi ulnaris muscles. This procedure is also known as medianization of the ulnar nerve because it then courses parallel to the median nerve. In the current article the procedure is described in a step-by-step fashion. PMID:18981838

Janjua, Rashid M; Fernandez, Julius; Tender, Gabriel; Kline, David G

2008-10-01

34

Median nerve entrapment and ulnar nerve palsy following elbow dislocation in a child.  

PubMed

This report presents a rare case of a child who presented with neglected intra-articular entrapment of the median nerve, ulnar nerve palsy, and intra-articular incarceration of the medial epicondyle following closed reduction of an elbow dislocation. In the present case, as in most other cases, the diagnosis and treatment were delayed. Careful initial and postreduction neurological examination, as well as careful interpretation of the plain radiographs, is necessary for early detection of any nerve complications and associated fractures of an elbow dislocation. The authors' opinion is that a child with an elbow dislocation, which is initially neurologically intact but advances to a median or ulnar nerve deficit after the reduction, must undergo early surgical exploration, especially when the dislocation is associated with a medial epicondyle fracture. PMID:23199945

Petratos, Dimitrios V; Stavropoulos, Nikolaos A; Morakis, Emmanouil A; Matsinos, George S

2012-01-01

35

Malignant mesenchymoma of ulnar nerve: combined sarcoma of nerve sheath and rhabdomyosarcoma.  

PubMed Central

Malignant mesenchymoma within the right ulnar nerve of an 8 year old boy is described. The patient did not have stigmata of von Recklinghausen's neurofibromatosis. The growing and painful tumour was excised five and a half detection, and recurred five months later. Mingling of the nerve sheath sarcoma and rhabdomyosarcoma was noted within the same mass which was separated from the adjacent striated muscles. It is suggested that this mesenchymoma arose from mesenchymal cells or cells of mesenchymal type comprising the peripheral nerve sheath which is derived from ectomesenchyme of the neural crest. Images

Shuangshoti, S; Chongchet, V

1979-01-01

36

Comparative study of different surgical transposition methods for ulnar nerve entrapment at the elbow.  

PubMed

This study compared the therapeutic effects of two techniques for surgical decompression treatment for ulnar nerve entrapment at the elbow: subcutaneous transposition and modified submuscular transposition with Z-lengthening of the pronator teres origin. A total of 278 patients with ulnar nerve entrapment (McGowan grades I - III) were randomly assigned to undergo one of these techniques. All patients were followed-up for 2 years. The effects were assessed by preoperative and postoperative cross-sectional area, motor conduction velocity, sensory conduction velocity and nerve action potential. All of these parameters improved after surgery in both groups. For patients with grade I disease, there were no significant differences between the two techniques. For patients with grade II and III disease, modified submuscular transposition was associated with significantly greater improvements compared with subcutaneous transposition. In conclusion, subcutaneous ulnar nerve transposition is recommended for grade I patients and modified submuscular ulnar nerve transposition for grade II and III patients. PMID:22117977

Zhong, W; Zhang, W; Zheng, X; Li, S; Shi, J

2011-01-01

37

Concomitant compression of median and ulnar nerves in a hemophiliac patient: a case report.  

PubMed

A 15-year-old boy, with a diagnosis of hemophilia A, suffered bleeding into his left forearm 5 months before being admitted to our medical center. His neurological examination revealed a pronounced median neuropathy and a minor ulnar neuropathy on the left side. There was marked muscle atrophy on the thenar side and, to a lesser degree, on the hypothenar side and in the forearm. Electromyographic findings demonstrated an evident, nearly complete, sensorimotor axonal loss in the median nerve. Magnetic resonance imaging studies showed atrophy in muscles of the left forearm and median nerve. The patient was diagnosed as having median nerve axonotmesis and ulnar nerve neuropraxia due to compartment syndrome. In hemophiliac patients, frequent single nerve compressions (often involving the femoral nerve) can be seen. However, concomitant median and ulnar nerve injuries with differing severity are rare. PMID:12537271

Kaymak, Bayram; Ozçakar, Levent; Cetin, Alp; Erol, Kutlu; Birsin Ozçakar, Z

2002-12-01

38

The Traumatic Nerve-Vascular Lesions  

Microsoft Academic Search

The elbow represents an important point of passage between vascular (brachial artery) and nervous (median, radial, and ulnar\\u000a nerve) structures, susceptible to direct trauma when there is intra-articular trauma to an elbow.

Roberto Adani; Giovanni Leo; Luigi Tarallo

39

On the use of upper extremity proximal nerve action potentials in the localization of focal nerve lesions producing axonotmesis.  

PubMed

Ulnar, median, and radial proximal nerve action potentials (PNAPs) were recorded from the axilla and supraclavicularly, with stimulation of the nerves at the elbow or the radial groove, in 30 control subjects for each nerve. In addition to routine nerve conduction studies, wrist to elbow median nerve action potentials were recorded proximal to the lesion in 76 patients with carpal tunnel syndrome of varying degrees of severity to determine the effect that the distal lesion might have on more proximal nerve conduction. Utilizing this information, PNAPs, standard nerve conduction studies, and needle electrode examinations were carried out in patients with focal elbow area nerve or brachial plexus lesions producing axonotmesis. PNAPs confirmed the site of the lesions producing axonotmesis when localization was possible with standard nerve conduction and/or needle electrode studies and were the sole means by which localization of the lesions producing only sensory axonotmesis was accomplished. PMID:9313994

White, J C

1997-09-01

40

Intermediate and long-term outcomes following simple decompression of the ulnar nerve at the elbow  

Microsoft Academic Search

Introduction. – There is currently little consensus regarding the appropriate surgical approach to treatment of cubital tunnel syndrome (CubTS), and few studies have reported long-term follow-up of patients who have received surgical treatment for ulnar nerve compression at the elbow.Method. – Seventy-four patients with a total of 102 cases of CubTS treated with simple decompression of the ulnar nerve were

P. A. Nathan; J. A. Istvan; K. D. Meadows

2005-01-01

41

Endoscopically assisted release of the ulnar nerve for cubital tunnel syndrome  

Microsoft Academic Search

Purpose  Recently, the simple decompression of the ulnar nerve has been advocated as the best surgical approach for the treatment of\\u000a the cubital tunnel syndrome. Encouraged by the positive results observed with the use of the endoscopic approach for the treatment\\u000a of the carpal tunnel syndrome, there have been reports about the use of endoscopes for decompression of the ulnar nerve

Leandro Pretto Flores

2010-01-01

42

Conduction in ulnar nerve bundles that innervate the proximal and distal muscles: a clinical trial  

PubMed Central

Background This study aims to investigate and compare the conduction parameters of nerve bundles in the ulnar nerve that innervates the forearm muscles and hand muscles; routine electromyography study merely evaluates the nerve segment of distal (hand) muscles. Methods An electrophysiological evaluation, consisting of velocities, amplitudes, and durations of ulnar nerve bundles to 2 forearm muscles and the hypothenar muscles was performed on the same humeral segment. Results The velocities and durations of the compound muscle action potential (CMAP) of the ulnar nerve bundle to the proximal muscles were greater than to distal muscles, but the amplitudes were smaller. Conclusions Bundles in the ulnar nerve of proximal muscles have larger neuronal bodies and thicker nerve fibers than those in the same nerve in distal muscles, and their conduction velocities are higher. The CMAPs of proximal muscles also have smaller amplitudes and greater durations. These findings can be attributed to the desynchronization that is caused by a wider range of distribution in nerve fiber diameters. Conduction parameters of nerve fibers with different diameters in the same peripheral nerve can be estimated.

2010-01-01

43

Ultrasound-guided ulnar nerve catheter placement in the forearm for postoperative pain relief and physiotherapy.  

PubMed

Consistent identification of peripheral nerves as well as placement of catheters for post-operative pain relief is possible with the aid of ultrasound. By blocking a single nerve rather than the entire extremity, pain can be eliminated without impairing motor function of the entire extremity, providing greater patient comfort. This report describes a case in which ultrasound-guided ulnar nerve catheter placement was performed in the forearm for post-operative pain relief following arthrolysis and tenolysis of the fifth finger. The ulnar nerve catheter allowed for excellent pain relief and completely painless physiotherapy without impairing motor function of the operated finger. PMID:19032570

Lurf, M; Leixnering, M

2009-02-01

44

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

PubMed

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

Yildirim, Serkan

2005-01-01

45

Bilateral ulnar nerve entrapment by the M. anconeus epitrochlearis. A case report and literature review.  

PubMed

Ulnar neuropathy at the elbow is the second most common entrapment neuropathy. Ulnar nerve entrapment has several causes. A case report is presented with the presence of the M. anconeus epitrochlearis at both sides. The patient contacted our department with chronic, diffuse bilateral elbow pain irradiating into both forearms. She experienced typical nocturnal paresthesias involving digit IV and V of both hands. Tinel's sign was present just proximal to the medial epicondyle. A bilateral ulnar nerve entrapment was clinically suspected. An electromyographic (EMG) investigation revealed slowing of the motor conduction velocity in the ulnar nerve across the elbow. An ultrasound and MRI investigation demonstrated the presence of an anomalous muscle, called the M. anconeus epitrochlearis, at both sides. Treatment consisted of bilateral surgical excision of the muscle and retinacular release, followed by physical therapy. The outcome was favourable. PMID:22555819

Dekelver, Ingrid; Van Glabbeek, Francis; Dijs, Henk; Stassijns, Gaëtane

2012-07-01

46

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

PubMed

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

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

2013-01-01

47

Ulnar nerve elongation and excursion in the cubital tunnel after decompression and anterior transposition  

Microsoft Academic Search

We studied the elongation and excursion of cadaveric ulnar nerves during elbow flexion in control conditions and after in situ decompression and anterior subcutaneous transposition. We found that the normal nerve had the greatest elongation (23%) and excursion (14 mm) in the epicondylar groove. Decompression did not alter the excursion, but significantly reduced the elongation in the groove (6%) and

R. Grewal; S. E. VARITIMIDIS; D. G. Vardakas; F. H. Fu; D. G. Sotereanos

2000-01-01

48

Intraneural lipoma of the ulnar nerve at the elbow: A case report and literature review  

PubMed Central

Intraneural lipomas of the ulnar nerve or its branches are rare benign tumours. Although most intraneural lipomas present as asymptomatic tumours, some may present as compression neuropathies due to their location. In the majority of cases these tumours can be enucleated without damage to the nerve fibres.

Balakrishnan, Anila; Chang, Yeon Jen; Elliott, David A; Balakrishnan, Chenicheri

2012-01-01

49

Intraneural lipoma of the ulnar nerve at the elbow: A case report and literature review.  

PubMed

Intraneural lipomas of the ulnar nerve or its branches are rare benign tumours. Although most intraneural lipomas present as asymptomatic tumours, some may present as compression neuropathies due to their location. In the majority of cases these tumours can be enucleated without damage to the nerve fibres. PMID:23997597

Balakrishnan, Anila; Chang, Yeon Jen; Elliott, David A; Balakrishnan, Chenicheri

2012-01-01

50

Bilateral additional slips of triceps brachii forming osseo-musculo-fibrous tunnels for ulnar nerves.  

PubMed

Rare additional slips of triceps brachii muscle was found bilaterally in a sixty two year old South Indian male cadaver during routine dissection of upper limb for undergraduate students at Melaka-Manipal Medical College, Manipal University, Manipal, India. On left side, the variant additional muscle slip took origin from the lower part of the medial intermuscular septum about 4 cm proximal to the medial humeral epicondyle. From its origin, the muscle fibres were passing over the ulnar nerve and were joining the triceps muscle to get inserted to the upper surface of olecranon process of ulna. On right side, the additional muscle slip was larger and bulkier and was arising from the lower part of the medial border of the humerus about 4 cm proximal to the medial epicondyle in addition to its attachment to the medial intermuscular septum. On both sides, the additional slips were supplied by twigs from the radial nerve. On both sides, the ulnar nerve was passing between variant additional slip and the lower part of the shaft of the humerus in an osseo-musculo-fibrous tunnel. Such variant additional muscle slips may affect the function of triceps muscle and can lead to snapping of medial head of triceps and ulnar nerve over medial epicondyle and also can dynamically compress the ulnar nerve during the contraction of triceps leading to ulnar neuropathy around the elbow. PMID:24116332

Swamy, Rs; Rao, Mkg; Somayaji, Sn; Raghu, J; Pamidi, N

2013-07-01

51

Bilateral Additional Slips of Triceps Brachii Forming Osseo-Musculo-Fibrous Tunnels for Ulnar Nerves  

PubMed Central

Rare additional slips of triceps brachii muscle was found bilaterally in a sixty two year old South Indian male cadaver during routine dissection of upper limb for undergraduate students at Melaka-Manipal Medical College, Manipal University, Manipal, India. On left side, the variant additional muscle slip took origin from the lower part of the medial intermuscular septum about 4 cm proximal to the medial humeral epicondyle. From its origin, the muscle fibres were passing over the ulnar nerve and were joining the triceps muscle to get inserted to the upper surface of olecranon process of ulna. On right side, the additional muscle slip was larger and bulkier and was arising from the lower part of the medial border of the humerus about 4 cm proximal to the medial epicondyle in addition to its attachment to the medial intermuscular septum. On both sides, the additional slips were supplied by twigs from the radial nerve. On both sides, the ulnar nerve was passing between variant additional slip and the lower part of the shaft of the humerus in an osseo-musculo-fibrous tunnel. Such variant additional muscle slips may affect the function of triceps muscle and can lead to snapping of medial head of triceps and ulnar nerve over medial epicondyle and also can dynamically compress the ulnar nerve during the contraction of triceps leading to ulnar neuropathy around the elbow.

Swamy, RS; Rao, MKG; Somayaji, SN; Raghu, J; Pamidi, N

2013-01-01

52

Effect of anterior versus posterior in situ decompression on ulnar nerve subluxation.  

PubMed

We sought to determine the effect anterior versus posterior in situ decompression with 360° external neurolysis on ulnar nerve subluxation. Ten cadaveric specimens were used, with anterior release performed on 5 specimens and posterior release the other 5 specimens. Each specimen was released for 4 cm centered over the cubital tunnel followed by 12 cm, 20 cm, and 20 cm with 360° external neurolysis. After release, the elbow was brought through a range of motion from 0° to 140° of flexion. Compared with posterior release, anterior release demonstrated significantly more total subluxation of the ulnar nerve for all release types from 80° to 120° of flexion (P<.05). At 140° of flexion, the 4-cm release, the 12-cm release, and the 20-cm release with 360° external neurolysis also demonstrated significantly more total subluxation with anterior release (P<.05). Ulnar nerve subluxation was significantly lower with posterior release, compared with anterior release for limited and complete in situ decompression. PMID:23805419

Hsu, Patricia A; Hsu, Andrew R; Sutter, Edward G; Levitz, Seth P; Rose, David M; Segalman, Keith A; Lee, Steve K

2013-06-01

53

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

PubMed Central

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

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

2011-01-01

54

MORPHOLOGY AND DYNAMICS OF THE ULNAR NERVE IN THE CUBITAL TUNNEL  

Microsoft Academic Search

We examined 200 normal elbows to assess the usefulness of ultrasonography in examining the ulnar nerve in the cubital tunnel. On longitudinal images in elbow extension, the nerve changed its course at the fibrous band region 11.5 (SD 2.8) mm distal to the medial epicondyle. On axial images, the diameter of the major axis of the nerve was 3.1 (0.5)

M. OKAMOTO; M. ABE; H. SHIRAI; N. UEDA

2000-01-01

55

Use of a pedicled adipose flap as a sling for anterior subcutaneous transposition of the ulnar nerve.  

PubMed

In patients with primary cubital tunnel syndrome, we hypothesize that using a vascularized adipose sling to secure the ulnar nerve during anterior subcutaneous transposition will lead to improved patient outcomes. The adipose flap is designed to surround the ulnar nerve with a pliable, vascularized fat envelope, mimicking the natural fatty environment of peripheral nerves. This technique may offer advantages in securing the anteriorly transposed ulnar nerve and reducing instances of postoperative perineural scarring. Patients experience good functional outcomes; most experience resolution of symptoms. PMID:24503232

Danoff, Jonathan R; Lombardi, Joseph M; Rosenwasser, Melvin P

2014-03-01

56

Elemental Mercury Exposure: Correlation of Urine Mercury Indices with Ulnar Nerve Conduction Studies,  

National Technical Information Service (NTIS)

An electrophysiological evaluation was made of the ulnar nerve in 18 men who were exposed to elemental mercury (7439976) vapor in the course of their jobs at a mercury cell chlorine plant. The men averaged 31 years of age, ranging from 19 to 56. Urinary m...

S. P. Levine G. D. Cavender G. D. Langolf J. W. Albers

1988-01-01

57

Subcutaneous anterior transposition of the ulnar nerve for failed decompression of cubital tunnel syndrome  

Microsoft Academic Search

The current literature universally suggests that submuscular anterior transposition is the standard operative treatment for recurrent cubital tunnel syndrome. Regardless of the type of initial failed procedure, including submuscular transposition, 20 patients underwent anterior subcutaneous transposition of the ulnar nerve. All patients were monitored for a minimum of 2 years after surgery. The most common sites of compression were the

Andrew E. Caputo; H. Kirk Watson

2000-01-01

58

The clinical anatomy of the communications between the radial and ulnar nerves on the dorsal surface of the hand  

Microsoft Academic Search

Sensations of the dorsal surface of the hand are supplied by the radial and ulnar nerves with the boundary between these two\\u000a nerves classically being the midline of the fourth digit. Overlap and variations of this division exist and a communicating\\u000a branch (RUCB) between the radial and ulnar nerves could potentially explain variations in the sensory examination of the dorsal

Marios Loukas; Robert G. Louis Jr; Christopher T. Wartmann; R. Shane Tubbs; Senem Turan-Ozdemir; Jessica Kramer

2008-01-01

59

Severe ulnar nerve palsy caused by synovial chondromatosis arising from the pisotriquetral joint: a case report and review of literature.  

PubMed

We report here the unique case of 60-year-old man with severe ulnar nerve palsy caused by synovial chondromatosis arising from the pisotriquetral joint. At operation, the tumor entrapped the ulnar nerve proximal to the Guyon canal so that it was severely paralyzed. The ulnar neurovascular bundle could be separated safely under the microscope. To our knowledge, this type of severe neuropathy has not been reported before. Although synovial chondromatosis associated with peripheral nerve neuropathy is extremely rare, we should be aware of the existence of this type of compression neuropathy in the upper limb. PMID:23563745

Muramatsu, Keiichi; Hashimoto, Takahiro; Tominaga, Yasuhiro; Seto, Shinichiro; Taguchi, Toshihiko

2013-06-01

60

Ulnar Nerve Entrapment at the Elbow (Cubital Tunnel Syndrome)  

MedlinePLUS

... 2013 by the American Academy of Orthopaedic Surgeons. Nerve conduction studies. These tests can determine how well ... to keep your elbow in a straight position. Nerve gliding exercises. Some doctors think that exercises to ...

61

Compression neuropathy of the ulnar digital nerves in the thumbs of a massage therapist.  

PubMed

Compression neuropathies of digital nerves, caused by hypertrophied or anomalous muscles, are rare compared with such occurrences above the wrist. We reported a case of compression neuropathy of the ulnar digital nerves in bilateral thumbs of a massage therapist. Entrapment of the digital nerves by the hypertrophied first dorsal interosseous and adductor pollicis muscles over the first web space of the right hand was detected by magnetic resonance imaging. Surgical debulking of the muscles and neurolysis were performed on the dominant right hand. The left hand was successfully treated with botulinum toxin. No recurrence was noted in a follow-up of 36 months. PMID:23486120

Chen, Chien-Chang; Chien, Hsiung-Fei; Chen, Chien-Lian

2014-06-01

62

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

PubMed Central

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

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

2012-01-01

63

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, A; Verma, S; Senger, M; Agarwal, A; Bansal K, K; Gupta, R

2014-04-01

64

Changes of the ratio between myelin thickness and axon diameter in human developing sural, femoral, ulnar, facial, and trochlear nerves  

Microsoft Academic Search

Previous studies on sural nerves were extended to human femoral, ulnar, facial and trochlear nerves. An asynchronous development of axon diameter and myelin sheath thickness was noted in all nerves studied. Whereas axons reach their maximal diameter by or before 5 years of age, maximal myelin sheath thickness is not attained before 16–17 years of age, i.e., more than 10

J. M. Schröder; J. Bohl; U. Bardeleben

1988-01-01

65

Refinements in the technique of 'awake' electrical nerve stimulation in the management of chronic low ulnar nerve injuries.  

PubMed

The standard technique in the management of chronic low ulnar nerve injuries includes excision of the neuroma and reconstruction using sural nerve grafts in the fully anaesthetised patient. It has been shown that using this standard technique, disappointing results may be observed and that significant improvement in results could be obtained if intra-operative matching of sensory and motor fascicles is performed. This study reports on eight patients with chronic ulnar nerve injuries managed using the technique of electrical fascicular orientation and sural nerve grafting. In all patients, intra-operative electrical stimulation of the fascicles in the proximal stump was done in the awake state. Several refinements in technique are described including detailing pre-operative patient education, anaesthetic considerations and in the technique of nerve dissection. Assessment was done using a sensory grading system mainly based on static two-point discrimination and a motor grading system based on intrinsic muscle function and key pinch power. At final follow up satisfactory sensory (S3+ or S4) and motor (M3 or M4) recovery was obtained in almost all cases. It was concluded that intra-operative electrical fascicular orientation was reliable and that our refinements in the technique ensured better communication with the patient during surgery, resulted in a smoother awakening without apprehension, and provided an easier nerve dissection with preservation of the blood supply of the distal nerve segment. PMID:15488501

Al-Qattan, M M

2004-11-01

66

Oberlin partial ulnar nerve transfer for restoration in obstetric brachial plexus palsy of a newborn: case report  

PubMed Central

An 8 month old male infant with Erb's birth palsy was treated with two peripheral nerve transfers. Except for rapid motor reinnervations, elbow flexion was obtained by an Oberlin's partial ulnar nerve transfer, while shoulder abduction was restored by an accessory-to-suprascapular nerve transfer. The initial contraction of the biceps muscle occurred two months after surgery. Forty months after surgery, elbow flexion reached M5 without functional loss of the ulnar nerve. This case demonstrates an excellent result of an Oberlin's nerve transfer for restoration of flexion of the elbow joint in Erb's birth palsy. However, at this time partial ulnar nerve transfer for Erb's birth palsy is an optional procedure; a larger number of cases will need to be studied for it to be widely accepted as a standard procedure for Erb's palsy at birth.

2006-01-01

67

Anterior intramuscular transposition of the ulnar nerve for cubital tunnel syndrome  

Microsoft Academic Search

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

Keith A Glowacki; Arnold-Peter C Weiss

1997-01-01

68

Anterior submuscular transposition of the ulnar nerve for cubital tunnel syndrome  

Microsoft Academic Search

48 patients with 50 involved limbs were retrospectively analyzed to determine factors influencing the outcome of surgical treatment for cubital tunnel syndrome. All patients were treated by anterior submuscular transposition of the ulnar nerve with Z-lengthening of the flexor-pronator origin. There were 24 men and 24 women with an average age of 42 years? 16.4 years (range, 5–75 years). The

C. B. Pasque; G. M. Rayan

1995-01-01

69

Ulnar nerve compression in Guyon's canal: MRI does not always have the answer.  

PubMed

Lipoma is a rare cause of ulnar nerve compression in Guyon's canal. All four previously reported cases from 2000 to 2009 have been accurately diagnosed on MRI. We present a case report where the MRI and surgical findings differed and a summary of the previous cases in the literature. We conclude that although MRI remains the best investigation for this condition, it is not always accurate and clinical findings still provide the best basis for surgical treatment. PMID:24963936

Paget, James; Patel, Neil; Manushakian, Jacob

2013-01-01

70

[Two anomalous muscles of a forearm revealed by ulnar nerve compressions, a Double Crush syndrome].  

PubMed

This article describes the concomitant presence of two anomalous muscles on a left forearm in a 40-year-old man. The anconeus epitrochlearis muscle was responsible for a cubital tunnel syndrome and the unusual origin of the flexor digiti minimi brevis muscle was responsible for a compartment syndrome with ulnar nerve compression at the level of Guyon's canal during effort diagnosed by MRI. Resection of these muscles relieved the symptoms and allowed the patient to return to work. PMID:22534512

Guidicelli, T; Londner, J; Gonnelli, D; Magalon, G

2014-06-01

71

Results of ulnar nerve neurotization to biceps brachii muscle in brachial plexus injury  

PubMed Central

OBJECTIVE: To evaluate the factors influencing the results of ulnar nerve neurotization at the motor branch of the brachii biceps muscle, aiming at the restoration of elbow flexion in patients with brachial plexus injury. METHODS: 19 patients, with 18 men and 1 woman, mean age 28.7 years. Eight patients had injury to roots C5-C6 and 11, to roots C5-C6-C7. The average time interval between injury and surgery was 7.5 months. Four patients had cervical fractures associated with brachial plexus injury. The postoperative follow-up was 15.7 months. RESULTS: Eight patients recovered elbow flexion strength MRC grade 4; two, MRC grade 3 and nine, MRC <3. There was no impairment of the previous ulnar nerve function. CONCLUSION: The surgical results of ulnar nerve neurotization at the motor branch of brachii biceps muscle are dependent on the interval between brachial plexus injury and surgical treatment, the presence of associated fractures of the cervical spine and occipital condyle, residual function of the C8-T1 roots after the injury and the involvement of the C7 root. Signs of reinnervation manifested up to 3 months after surgery showed better results in the long term. Level of Evidence: IV, Case Series.

Rezende, Marcelo Rosa De; Rabelo, Neylor Teofilo Araujo; Silveira, Clovis Castanho; Petersen, Pedro Araujo; Paula, Emygdio Jose Leomil De; Mattar, Rames

2012-01-01

72

Ulnar tunnel syndrome.  

PubMed

Ulnar tunnel syndrome could be broadly defined as a compressive neuropathy of the ulnar nerve at the level of the wrist. The ulnar tunnel, or Guyon's canal, has a complex and variable anatomy. Various factors may precipitate the onset of ulnar tunnel syndrome. Patient presentation depends on the anatomic zone of ulnar nerve compression: zone I compression, motor and sensory signs and symptoms; zone II compression, isolated motor deficits; and zone III compression; purely sensory deficits. Conservative treatment such as activity modification may be helpful, but often, surgical exploration of the ulnar tunnel with subsequent ulnar nerve decompression is indicated. PMID:23026462

Bachoura, Abdo; Jacoby, Sidney M

2012-10-01

73

Evaluation and treatment of failed ulnar nerve release at the elbow.  

PubMed

Failure after ulnar nerve decompression at the elbow can be defined as either no change in the patient's symptoms or an initial improvement with recurrence, making the patient history essential in the work-up. Failure may be due to diagnostic, technical, or biologic factors. Technical errors and the development of perineural fibrosis necessitate revision surgery, while nerve damage due to chronic severe compression should be observed. We do not believe any one procedure is superior in the revision setting as long as a complete decompression is achieved with a compression free, stable transposition of the surgeon's choice. PMID:23026464

Nellans, Kate; Tang, Peter

2012-10-01

74

Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: a case report and surgical approach.  

PubMed

Cubital tunnel syndrome is the second most common peripheral nerve compression syndrome. It is the most common peripheral neuropathy of the ulnar nerve. The surgical treatment of the cubital tunnel syndrome is widely described in the literature, however the variations of the standard muscular anatomy in the medial humeral epicondyle region may create technical difficulties during surgical management. The epitrochleoanconeus muscle, which is an aberrant muscle of this region, is a rare cause of cubital tunnel syndrome. A case with ulnar nerve compression at the elbow caused by an uncommon etiological factor, hypertrophic epitrochleoanconeus muscle, and its surgical management is reported. PMID:24831373

Uscetin, Ilker; Bingol, Derya; Ozkaya, Ozay; Orman, Cagdas; Akan, Mithat

2014-01-01

75

Acute ulnar nerve entrapment after closed reduction of a posterior fracture dislocation of the elbow: a case report.  

PubMed

We present the case of a child who had a posterior-lateral elbow dislocation with an intact ulnar nerve documented before an attempted reduction, with subsequent loss of ulnar nerve function after the elbow was reduced.Dislocations of the elbow in children represent only 3% to 6% of all elbow injuries. Posterior elbow dislocations are the most common, with more than one half involving an associated fracture about the elbow. The most common associated fracture is the medial epicondyle. Even though it is known that injury to the ulnar nerve can occur in elbow dislocations, we found only 1 other case report describing intra-articular entrapment of the ulnar nerve after an elbow dislocation.This case demonstrates several important clinical issues. First, it highlights the potential risk of ulnar nerve entrapment after closed reduction of elbow dislocations in children. Second, it confirms the importance of careful prereduction and postreduction examinations in the pediatric patient presenting with a dislocated elbow. PMID:22668664

Reed, Maranda Walker; Reed, Dale Nicholas

2012-06-01

76

Repair of Intrinsic minus Deformity of the Hand after Ulnar Nerve Injury at the Level of the Wrist: the Fascial Loop Technique  

Microsoft Academic Search

Objective The superiority of a fascial loop technique to the classic Stiles-Bunnell split flexor digitorum superficialis transfer to the lateral bands was investigated as to correcting intrinsic minus deformity after low ulnar nerve palsy. Materials and methods: 6 patients presenting low ulnar nerve palst, 2 with a flexible intrinsic minus deformity, 4 with a fixed deformity were operated upon. Fascial

Sherif M Amr; Ahmed Essam Kandil; Ahmad M Kholeif

2008-01-01

77

Minimal-incision in situ ulnar nerve decompression at the elbow.  

PubMed

With initiatives to decrease operative morbidity, complications, and associated costs, minimalincision techniques have found an expanding role within multiple specialties. Minimal-incision in situ open techniques for ulnar nerve release at the elbow provide adequate exposure and reproducible, satisfactory outcomes. Furthermore, there is no need for endoscopic equipment and the resultant dependence on staff adequately trained to operate and troubleshoot equipment. More robust research with a focus on complications and standard outcome measures will be required to further define the role of minimal-incision techniques. This technical modification, however, augments the increasing armamentarium of the hand surgeon. PMID:24286744

Adkinson, Joshua M; Chung, Kevin C

2014-02-01

78

Ulnar nerve transposition using a mini-invasive approach: case series of 30 patients.  

PubMed

The treatment of ulnar nerve compression at the elbow remains controversial. No single technique has yet proven its superiority. We describe a technique combining the advantages of the mini-invasive approach with those of transposition. We present the results of 30 patients, of mean age 52 years, who underwent anterior subcutaneous transposition of the ulnar nerve using a mini-invasive approach with a follow-up of more than six months. The incision measures 3 cm. The results were evaluated by measuring pain intensity, quick disabilities of the arm shoulder and hand (DASH), grip strength and pinch, and McGowan score, pre- and post-operatively. All parameters were improved post-operative. The mean pain score went from 5.5 to 4, the quick DASH from 48 to 38, mean grip strength from 28 to 31 kg, and mean pinch strength from 4.7 to 6.4 kg. The McGowan score was also improved; pre-operatively, there were 16 patients at stage III, seven patients stage II, seven patients stage I, and post-operatively there was one patient stage III, three patients stage II, 16 patients stage I, and 10 patients stage 0. Analysis of our series shows that a 3 cm incision without endoscopy allows subcutanous transposition, with results at least as good as those with other techniques. The advantages of our technique are that it is easy, has a limited approach, preserves blood supply, allows placement of the nerve in a favourable environment, and decreases nerve stretching during elbow flexion. PMID:22869908

Lequint, T; Naito, K; Awada, T; Facca, S; Liverneaux, P

2013-06-01

79

The largest reported epineural ganglion of the ulnar nerve causing cubital tunnel syndrome: case report and review of the literature.  

PubMed

We describe the largest reported epineural ganglion of the ulnar nerve arising in the cubital tunnel. A 54-year-old male, driver presented with progressive symptoms of left sided cubital tunnel syndrome. Surgery demonstrated a 11 × 3 cm ganglion which was successfully removed. Post-operatively the patient demonstrated partial recovery with no recurrence of the ganglion. PMID:23141969

Sinha, Shiba; Pinder, Richard M; Majumder, Sanjib

2013-01-01

80

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

81

[Rehabilitation of peripheral nerve lesions].  

PubMed

After reporting the pathophysiology of denervation the authors deal with the changes that affect nerves while going through reinnervation. A review of the drugs that may help healing and general care to be adopted in order to avoid sequential pathological phenomena related to paralysis are shown. Rehabilitative treatment is discussed, the Authors dwell upon rehabilitation of neurogenous bladder of patients with spina bifida and rehabilitation of patients with paralysis of brachial plexus. Facial paralysis has been discussed before dealing with benefits and complications of electrotherapy. The use of electromagnetotherapy and electromyography are shown with a rich photographic and bibliographic support. PMID:9410662

Grasso, A; Arena, M; Sofia, V; La Bua, V; Biondi, R; Sicurella, L; Patti, F

1997-09-01

82

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

83

Low-volume ulnar nerve block within the axillary sheath for the treatment of reflex sympathetic dystrophy  

Microsoft Academic Search

A case is described of reflex sympathetic dystrophy (RSD) of the upper limb following cerebral arteriography via the subclavian\\u000a artery. The pain started in the hand and forearm but, over several weeks, spread to involve the whole arm. After identifying\\u000a the ulnar nerve in the axillary bundle with a stimulator, a series of small volume injections (bupivacaine 0.5% with epinephrine

David S. Klein; Peggy W. Klein

1991-01-01

84

[Idiopathic ulnar nerve entrapment at the elbow: report of 20 cases].  

PubMed

We report a retrospective study of 20 patients treated for idiopathic cubital tunnel syndrome in a period of 10 years (2002-2011). The average age was 46 years. A profession at risk was present in the majority of cases. The treatment was surgical in all the cases. The indication for surgery was related to the importance of sensory-motor deficit, the long duration of symptoms, and the failure of conservative treatment. Two surgical techniques were used in this work: isolated neurolysis and neurolysis with anterior transposition of the ulnar nerve. There were no complications or recurrence of symptoms. After a mean follow-up of 12 months, our results evaluated thanks to the classification of Bishop were considered as excellent or good in 85% of cases and fair in 15% of cases. Prognosis factors were advanced age (more than 60 years), severity of the disease, and duration of symptoms (more than one year). The management of this affection must go through a better knowledge of the disease, for early diagnosis and appropriate treatment, only guarantees for a good result. PMID:23499267

Allagui, M; Hamdi, M F; Fekih, A; Koubaa, M; Aloui, I; Abid, A

2013-04-01

85

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

PubMed Central

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

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

2012-01-01

86

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.

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

2014-01-01

87

Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study  

PubMed Central

Background: Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent. Materials and Methods: We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves. Results and Conclusion: We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

Kar, Sumit; Krishnan, Ajay; Singh, Neha; Singh, Ramji; Pawar, Sachin

2013-01-01

88

Giant solitary synovial osteochondromatosis of the elbow causing ulnar nerve neuropathy: a case report and review of literature  

PubMed Central

Introduction Giant or solitary osteochondroma is part of a rare disorder known as synovial osteochondromatosis. It forms part of a spectrum of disease characterized by metaplastic changes within the joint synovium that are eventually extruded as loose bodies. It has been suggested that solitary synovial osteochondroma forms as progression of synovial osteochondromatosis through a process of either coalescence of multiple smaller bodies or the growth of a dominant synovial osteochondroma. Previous studies have shown that it occurs as a late phase of the disease. We report a rare case of giant synovial osteochondromatosis at the elbow causing ulnar nerve neuropathy and mechanical symptoms which has not been previously reported in the literature. Case report We report a case of a 56 year old Western European gentleman who presented with ulnar nerve neuropathy and swelling behind the elbow. The patient underwent MR imaging and subsequent biopsy that demonstrated synovial osteochondromatosis. Initially the patient declined surgery and opted for a watch and wait approach. Five years later he returned with worsening symptoms and underwent successful surgical resection of a giant solitary synovial osteochondroma. Conclusion The unique outcome in our patient despite the long interval between presentation and surgical treatment resulted in early full resolution of symptoms within a short period. It may suggest an improved prognosis as compared to multiple synovial osteochondromatosis in terms of mechanical and neurological outcomes.

2013-01-01

89

Morphologic changes in the ulnar nerve at the elbow with flexion and extension: A magnetic resonance imaging study with 3-dimensional reconstruction  

Microsoft Academic Search

We evaluated the morphology of the ulnar nerve and cubital tunnel with noninvasive magnetic resonance imaging (MRI). We used fresh human cadavers with the elbow in full extension, 90° of flexion, and full flexion. For each elbow, 1-mm slices were imaged interpolated, and reconstructed into 3-dimensional data volumes, and then manually segmented before they were examined with sequential transverse sections,

Vikas V Patel; Fred P Heidenreich; Randip R Bindra; Ken Yamaguchi; Richard H Gelberman

1998-01-01

90

Symptomatic epineural ganglion cyst of the ulnar nerve in the cubital tunnel: a case report and brief review of the literature  

Microsoft Academic Search

An unusual case of pain and weakness in the hand and forearm due to a ganglion cyst of the ulnar nerve at the elbow is presented. The patient was managed initially as a case of cervical disc disease and cervical spondylosis and later as a case of carpal tunnel syndrome at an another institution. Cervical radiography and cervical magnetic resonance

R. R. Sharma; S. J. Pawar; A. Delmendo; A. K. Mahapatra

2000-01-01

91

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

PubMed

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

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

2014-06-01

92

Simple Decompression or Subcutaneous Anterior Transposition of the Ulnar Nerve for Cubital tunnel Syndrome  

Microsoft Academic Search

The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and\\/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. Thirty-two patients underwent nerve decompression without transposition and 34 underwent subcutaneous transposition

A. Nabhan; F. Ahlhelm; J. Kelm; W. Reith; K. Schwerdtfeger; W. I. Steudel

2005-01-01

93

Electron microscopic observations on nerve cell regeneration and degeneration after axon lesions  

Microsoft Academic Search

The neuronal changes were studied in the facial nucleus of mice after crush lesions and complete section of the facial nerve. These lesions were followed by complete nerve cell regeneration and extensive nerve cell disintegration, respectively.

Ansgar Torvik; Fredrik Skjörten

1971-01-01

94

Electron microscopic observations on nerve cell regeneration and degeneration after axon lesions  

Microsoft Academic Search

The glial reaction was examined in the facial nucleus of adult mice after crush lesions and complete section of the facial nerve. These lesions were followed by complete nerve cell regeneration and extensive nerve cell disintegration, respectively.

Ansgar Torvik; Fredrik Skjörten

1971-01-01

95

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

96

[Sciatic nerve in gluteal portion: application of sciatic nerve post injection lesion].  

PubMed

In our regions malaria is endemic and intraguteal injection is a common procedure. One unfortunate complication of that procedure appeared to be a sciatic nerve injury. The purpose of our study was to set up the anatomical feature and basis of this post injection lesion. We performed sciatic nerve gluteal dissection on 10 adults black African fresh cadavers on both side. The pathway of the nerve was 19 times in the subpiriformis canal. Only in one cadaver, the outlet of the nerve was above the piriformis muscle. In each case the pathway is identical with an oblique and vertical portion running down through the ischio-trochanteric channel. The nerve was crossed between its two portions by an arteriole coming from the inferior gluteal artery. The cutaneous projection of the sciatic nerve is distant from the upper lateral quadrant of the buttock. Intra-gluteal injections in this area doesn't damage the nerve. The anatomical variations of this nerve pathway are almost nonexistent. So, other hypothesis of sciatic nerve post injection lesion should be considered. We think that the local toxicity of quinine and its diffusion in the neurovascular gluteal area might explain the nerve lesion. Thus, the intramuscular injections should be replaced by the intravenous or rectal administration in children. PMID:15641650

Ndiaye, A; Sakho, Y; Fall, F; Dia, A; Sow, M L

2004-10-01

97

Ultrasound study is useful to discriminate between axonotmesis and neurotmesis also in very small nerves: a case of sensory digital ulnar branch study.  

PubMed

Discrimination between axonotmesis and neurotmesis is crucial in traumatic nerve injury. We present the case of a 43-year-old woman which presented hypoesthesia in the fourth and fifth right fingers, started after surgery for Dupuytren syndrome. At ultrasound study, the ulnar digital sensory branch was identified. Before the division into the two terminal branches, a neuroma was observed, while neurotmesis was excluded. This case shows the utility of ultrasonography in peripheral nervous system examination and the possibility of visualization of very small nerves and their terminal branches. PMID:23243650

Renna, Rosaria; Rosaria, Renna; Coraci, Daniele; Daniele, Coraci; De Franco, Paola; Erra, Carmen; Ceruso, Massimo; Padua, Luca

2012-12-01

98

Ulnar malignant peripheral nerve sheath tumour diagnosis in a mixed-breed dog as a model to study human: histologic, immunohistochemical, and clinicopathologic study  

PubMed Central

Canine Malignant Peripheral Nerve Sheath Tumors (MPNSTs) are uncommonly reported in the ulnar, since they are underestimated relative to the more common spindle cell tumours of soft tissue. In dogs, MPNST accounts for 27% of nervous system tumours. In man, MPNST represents 5-10% of all soft tissue sarcomas and is often associated with neurofibromatosis type 1 (NF-1).An 8-year-old, 9 kg, female mixed-breed dog with a subcutaneous mass on the upper right side of the ulnar region was presented to the small animal research and teaching hospital of Tehran University. The dog was anorexic with general weakness. The mass (7 × 4 cm) was removed surgically and processed routinely. Microscopically, the mass was composed of highly cellular areas with a homogeneous population of round or spindle cells, high cellular pleomorphism, high mitotic index and various morphologic patterns. Furthermore, spindle cells arranged in densely or loosely sweeping fascicles, interlacing whorls, or storiform patterns together with wavy cytoplasm, nuclear palisades, and round cells were arranged in sheets or cords with a meshwork of intratumoral nerve fibers. In addition, in this case the presence of neoplastic cells within the blood vessels was observed. Immunohistochemically, tumor was positive for vimentin and S-100 protein. The histopathologic features coupled with the S-100 and vimentin immunoreactivity led to a diagnosis of malignant neurofibroma. To the best of our knowledge, primary ulnar MPNST has not been reported in animals. This is the first documentation of an ulnar malignant peripheral nerve sheath tumour in a dog. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1310907815984587

2013-01-01

99

[Electromyography and electroneurography in peripheral nerve lesions. Part I].  

PubMed

First, the possible forms of the lesion of peripheral nerves are defined in the form of a survey: pressure damage (neurapraxia), axon interruption with maintained envelope structures (axonotmesis) and complete separation of the nerve (neurotmesis). From these, the various prognostic characteristics of a nerve lesion can be derived. An neurological examination is not sufficient for a thorough study of these phenomena. A particularly valuable aid is offered by the neuroelectrodiagnostic methods of electromyography and electroneurography. The technical fundamentals of these are briefly dealt with by the authors and indications are derived from them for the use of the two methods. In case of the open nerve lesion, the methods are used for a demonstration of intact nerve fibres, and, in the later phase, for the proof of returning spontaneous activity as well as the degree of the progress of a reinnervation. As far as chronic pressure damage is concerned, for example in bottle-necks, information regarding the seat and the degree of the nerve damage can be derived. And finally, EMG and ENG permit to make statements about the segmental height of radicular damage; this is necessary in case of plexus damage, but also for the demarcation of distal lesions. In the second part, the combination with the clinical practice and therapy will be dealt with in greater detail. PMID:7234230

Reichel, G; Wagner, A

1980-01-01

100

Lesions of the inferior alveolar nerve arising from endodontic treatment.  

PubMed

A lesion of the IAN following endodontic treatment of the lower molars and premolars is not a rare event and presents an uncomfortable situation both for the dental surgeon and the patient. Injury can result on the one hand by direct intrusion of the instrument through the apex into the mandibular canal, and on the other by the filling material which becomes forced into the mandibular canal. In the latter case, a nerve lesion will only result when the filling material contains neurotoxic substances such as paraformaldehyde. With a direct lesion or when forcing of resorbable filling material into the mandibular canal is suspected, one should first employ a wait-and-see approach, because usually the only nerve damage is in the form of neuropraxy or axonotmesis for which there is a high rate of spontaneous regeneration. However, if neurotoxic filling material is introduced into the direct vicinity of the nerves, the mandibular canal should be opened and the filling material should be removed as early as possible. If the filling material is forced directly within the endoneurium between the nerve bundles, the damaged nerve sections must be resected and bridged using transplants from the sural or greater auricular nerves. PMID:11359285

Dempf, R; Hausamen, J E

2000-08-01

101

[Nerve lesions after minimally invasive total hip arthroplasty].  

PubMed

Although there is no clear evidence, minimally invasive hip arthroplasty seems to be associated with slightly higher complication rates compared to standard procedures. Major nerve palsy is one of the least common but most distressing complications. The key for minimizing the incidence of nerve lesions is to analyze preoperative risk factors, accurate knowledge of the anatomy and minimally invasive techniques. Once clinical signs of nerve injury are evident, the first diagnostic steps are localization of the lesion and quantification of the damage pattern. Therefore, clinical assessment of the neurological deficits should be performed as soon as possible. Apart from rare cases of isolated transient conduction blockade or complete transection, the damage pattern is mostly combined. Thus, there can be evidence for dysfunction of nerve conduction (neuropraxia) and structural nerve damage (axonotmesis or neurotmesis) simultaneously. Because the earliest signs of denervation are detectable via electromyography after 1 week, it is not possible to make any reliable prognosis within the first days after nerve injury using electrophysiological methods. This review article should serve as a guideline for prevention, diagnostics and therapy of neural lesions in minimally invasive hip arthroplasty. PMID:22581146

Holzapfel, B M; Heinen, F; Holzapfel, D E; Reiners, K; Nöth, U; Rudert, M

2012-05-01

102

Distal lesion of the lateral femoral cutaneous nerve.  

PubMed

We report three patients with a typical clinical picture of unilateral meralgia paresthetica in whom routine nerve conduction studies were normal. However, cortical somatosensory evoked potentials were absent after lateral femoral cutaneous nerve (LFCN) stimulation on the affected side. After stimulation of the LFCN in the anterosuperior iliac spine (ASIS) region and recording the responses distal to conventional sites (20 cm from the ASIS), sensory nerve action potentials (SNAPs) were absent in the symptomatic leg, but present in the normal leg. We suggest that thigh paresthesias may be caused by a distal LFCN lesion. Eliciting this requires recording SNAPs distal to conventional sites. PMID:17685466

Kushnir, Mark; Klein, Colin; Kimiagar, Yitzhak; Pollak, Lea; Rabey, Jose M

2008-01-01

103

Occurrence of nerve entrapment lesion in chronic inflammatory demyelinating polyneuropathy  

Microsoft Academic Search

Objective: To evaluate the occurrence of nerve entrapment syndrome in chronic inflammatory demyelinating polyneuropathy (CIDP).Methods: We retrospectively evaluated neurophysiologic results of 41 (25 male and 16 female, mean age 49.8, range 11–87) patients with CIDP. We evaluated the frequency of focal neurophysiologic lesion at entrapment site distinguishing two kinds of lesion: (a) true entrapment; and (b) false entrapment on the

L Padua; P Caliandro; I Aprile; M Sabatelli; F Madia; P Tonali

2004-01-01

104

Clinical and Electrodiagnostic Work-up of Peripheral Nerve Lesions  

Microsoft Academic Search

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

Stefan Kiechl

105

Posterior tibial nerve lesions in ankle arthroscopy.  

PubMed

Ankle arthroscopy provides a minimally invasive approach to the diagnosis and treatment of certain ankle disorders. Neurological complications resulting from ankle arthroscopy have been well documented in orthopaedic and podiatric literature. Owing to the superficial location of the ankle joint and the abundance of overlying periarticular neurovascular structures, complications reported in ankle arthroscopy are greater than those reported for other joints. In particular, all reported neurovascular injuries following ankle arthroscopy have been the direct result of distractor pin or portal placement. The standard posteromedial portal has recognized risks because of the proximity of the posterior neurovascular structures. There can be considerable variability in the course of these portals and their proximity to the neurovascular structures. We found one report of intra-articular damage to the posterior tibial nerve as a result of ankle arthroscopy in the English-language literature and we report this paper as a second case described in the literature. PMID:17618442

Cugat, Ramon; Ares, Oscar; Cuscó, Xavier; Garcia, Montserrat; Samitier, Gonzalo; Seijas, Roberto

2008-05-01

106

Snoring-Induced Nerve Lesions in the Upper Airway  

PubMed Central

The prevalence of habitual snoring is extremely high in the general population, and is reported to be roughly 40% in men and 20% in women. The low-frequency vibrations of snoring may cause physical trauma and, more specifically, peripheral nerve injuries, just as jobs which require workers to use vibrating tools over the course of many years result in local nerve lesions in the hands. Histopathological analysis of upper airway (UA) muscles have shown strong evidence of a varying severity of neurological lesions in groups of snoring patients. Neurophysiological assessment shows evidence of active and chronic denervation and re-innervation in the palatopharyngeal muscles of obstructive sleep apnoea (OSA) patients. Neurogenic lesions of UA muscles induced by vibration trauma impair the reflex dilation abilities of the UA, leading to an increase in the possibility of UA collapse. The neurological factors which are partly responsible for the progressive nature of OSAS warrant the necessity of early assessment in habitual snorers.

Poothrikovil, Rajesh P; Al Abri, Mohammed A

2012-01-01

107

Neovascularization occurs in response to crush lesions of adult frog optic nerves  

Microsoft Academic Search

Summary The capacity of the adult frog optic nerve to regenerate following a crush lesion is well established and is in contrast to the lack of regeneration of mammalian optic nerves after similar lesions. One factor which may contribute to the enhanced regenerative capacity of amphibian optic nerves is the rapid removal of cellular debris from the nerve after injury.

F. J. Liuzzi; R. H. Miller

1990-01-01

108

Axonal transcription factors signal retrogradely in lesioned peripheral nerve.  

PubMed

Retrograde axonal injury signalling stimulates cell body responses in lesioned peripheral neurons. The involvement of importins in retrograde transport suggests that transcription factors (TFs) might be directly involved in axonal injury signalling. Here, we show that multiple TFs are found in axons and associate with dynein in axoplasm from injured nerve. Biochemical and functional validation for one TF family establishes that axonal STAT3 is locally translated and activated upon injury, and is transported retrogradely with dynein and importin ?5 to modulate survival of peripheral sensory neurons after injury. Hence, retrograde transport of TFs from axonal lesion sites provides a direct link between axon and nucleus. PMID:22246183

Ben-Yaakov, Keren; Dagan, Shachar Y; Segal-Ruder, Yael; Shalem, Ophir; Vuppalanchi, Deepika; Willis, Dianna E; Yudin, Dmitry; Rishal, Ida; Rother, Franziska; Bader, Michael; Blesch, Armin; Pilpel, Yitzhak; Twiss, Jeffery L; Fainzilber, Mike

2012-03-21

109

Axonal transcription factors signal retrogradely in lesioned peripheral nerve  

PubMed Central

Retrograde axonal injury signalling stimulates cell body responses in lesioned peripheral neurons. The involvement of importins in retrograde transport suggests that transcription factors (TFs) might be directly involved in axonal injury signalling. Here, we show that multiple TFs are found in axons and associate with dynein in axoplasm from injured nerve. Biochemical and functional validation for one TF family establishes that axonal STAT3 is locally translated and activated upon injury, and is transported retrogradely with dynein and importin ?5 to modulate survival of peripheral sensory neurons after injury. Hence, retrograde transport of TFs from axonal lesion sites provides a direct link between axon and nucleus.

Ben-Yaakov, Keren; Dagan, Shachar Y; Segal-Ruder, Yael; Shalem, Ophir; Vuppalanchi, Deepika; Willis, Dianna E; Yudin, Dmitry; Rishal, Ida; Rother, Franziska; Bader, Michael; Blesch, Armin; Pilpel, Yitzhak; Twiss, Jeffery L; Fainzilber, Mike

2012-01-01

110

Lingual nerve lesion during ranula surgical treatment: case report.  

PubMed

Iatrogenic lingual nerve (LN) injuries are quite common in oral surgery both in maxillo-facial surgery and in oral surgery. LN runs superficially into the lateral mouth floor just beneath the mucous layer and this position enhances damage frequency. This article lists the different aetiologies of iatrogenic LN injuries and it almost focuses on lesions due to surgical treatment of ranulas. In the case report a LN lesion due to oral ranula excision is discussed; the patient experienced anaesthesia and hyperpatia in the corrisponded tongue side. It was treated with a microneurosugical anastomosis of LN, after amputation neuroma excision. The partial and definitive recovery of perception happened in six months and was deemed satisfying with 70% of functionality restored (results compared with the functionality of the contralateral side). An algorithm for diagnosis and therapy indication for iatrogenic injuries to nerves is also proposed. In case of surgical treatment, funcitonal recovery manifests after 4-6 month; a functional recovery of 70% of total nerve function is possible. The variable that most affects nerve functional recovery is surgical treatment timing; it must be performed as soon as possible. PMID:21048548

Biglioli, F; Battista, V; Marelli, S; Valassina, D; Colombo, V; Bardazzi, A; Tarabbia, F; Colletti, G; Rabbiosi, D; Autelitano, L

2010-10-01

111

[Sciatic and gluteal nerve lesions during coma and anesthesia (author's transl)].  

PubMed

We observed 5 patients with sciatic nerve lesions after coma or general anesthesia; in 2 cases there were also the gluteal nerves involved. These lesions are probably caused by direct nerve pressure. In 4 cases axonotmesis with a delayed and incomplete recovery was seen. PMID:1051414

Stöhr, M

1976-12-01

112

Dermatological and immunological conditions due to nerve lesions  

PubMed Central

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

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

2013-01-01

113

Evaluation of Ulnar neuropathy on hemodialysis patients  

PubMed Central

Background: Ulnar nerve entrapment at the elbow is the second most common upper extremity nerve involvement after median nerve involvement at the wrist or carpal tunnel syndrome (CTS) considering the frequency of occurrence in the upper limb with variable causes. Hemodialysis, because of elbow positioning during dialysis, upper extremity vascular-access, and underlying disease is one cause of ulnar entrapment. This study considers evaluating the effect of elbow positioning on ulnar involvement prevalence during dialysis. Materials and Methods: This cross-sectional study started in June 2011 and completed in December 2011. The patients receiving dialysis with at least one symptom or sign of ulnar nerve involvement underwent nerve conduction studies. Electromyography testing (EMG) performed to confirm the ulnar neuropathy. To review the ulnar nerve, patients must be in supine position with arm in 90° abduction and elbow in 135° flexion. We stimulated the ulnar nerve at three different points, including 6 cm above and 4 cm below the elbow and over the wrist. According to the electrophysiological data, the intensity of nerve entrapment and possibility of associated polyneuropathy determined. Results: Clinically and electrodiagnostically, evidence confirmed that ulnar neuropathy was present in 11 (27.5%) of 40 hemodialysis patients and in 10 (25%) of 40 peritoneal patients (P value: 0.83). Also, the prevalence of median neuropathy in hemodialysis and peritoneal dialysis patients was 14 (35%) and 10 (25%), respectively (P value: 0.33). Conclusion: The frequency of median and ulnar neuropathy in hemodialysis patients is more than peritoneal dialysis, but this different is not significant. In addition, comparing sitting position with prolonged elbow flexion and supine position with elbow extension during hemodialysis, recommended doing hemodialysis in later position with using an elbow pad.

Vahdatpour, Babak; Maghroori, Razieh; Mortazavi, Mojgan; Khosrawi, Saeid

2012-01-01

114

Remyelination of optic nerve lesions: spatial and temporal factors.  

PubMed

Optic neuritis provides an in vivo model to study demyelination. The effects of myelin loss and recovery can be measured by the latency of the multifocal visual evoked potentials. We investigated whether the extent of initial inflammatory demyelination in optic neuritis correlates with the remyelinating capacity of the optic nerve. Forty subjects with acute unilateral optic neuritis and good visual recovery underwent multifocal visual evoked potentials testing at 1, 3, 6 and 12 months. Average latency changes were analyzed. Extensive latency delay at baseline significantly improved over time with rate of recovery slowed down after 6 months. Magnitude of latency recovery was independent of initial latency delay. Latency recovery ranged from 7 to 17 ms across the whole patient cohort (average = 11.3 (3.1) ms) despite the fact that in a number of cases the baseline latency delay was more than 35-40 ms. Optic nerve lesions tend to remyelinate at a particular rate irrespective of the size of the initial demyelinated zone with smaller lesions accomplishing recovery more completely. The extent of the initial inflammatory demyelination is probably the single most important factor determining completeness of remyelination. The time period favorable to remyelination is likely to be within the first 6 months after the attack. PMID:20530125

Klistorner, Alexandr; Arvind, Hemamalini; Garrick, Raymond; Yiannikas, Con; Paine, Mark; Graham, Stuart L

2010-07-01

115

Facial nerve palsy associated with a cystic lesion of the temporal bone.  

PubMed

Facial nerve palsy results in the loss of facial expression and is most commonly caused by a benign, self-limiting inflammatory condition known as Bell palsy. However, there are other conditions that may cause facial paralysis, such as neoplastic conditions of the facial nerve, traumatic nerve injury, and temporal bone lesions. We present a case of facial nerve palsy concurrent with a benign cystic lesion of the temporal bone, adjacent to the tympanic segment of the facial nerve. The patient's symptoms subsided after facial nerve decompression via a transmastoid approach. PMID:24652558

Kim, Na Hyun; Shin, Seung-Ho

2014-03-01

116

Low-power laser efficacy in peripheral nerve lesion treatment  

NASA Astrophysics Data System (ADS)

In order to establish the low energy laser (LEL) effects on nervous tissue regeneration in clinical practice, we evaluated in double blind, placebo controlled study, the efficacy of LEL in the functional recovery of 46 patients with distal forearm post- traumatic nerve lesion, after surgical suture. The patients were divided into two groups: A-26 patients were treated with LEL; B- 20 patients, as control, were treated with placebo lasers and classical medical and physical therapy. Lasers used were: HeNe, 632.5 nm wavelength, 2 mW power, and GaAlAs diode laser, 880 nm wavelength, pulsed emission with an output power about 3 mW. Before, during and after the treatment, electromyography (EMG) and electroneurography (ENG) were done in order to measure objectively the efficacy of the treatment. We obtained good results after 4 - 5 months at 80.7% patients from group A and about the same results at 70% patients from group B, but after at least 8 months. The good results were noticed concerning the improvement of EMG and ENG registrations and on the involution of pain, inflammations, movements and force of the fingers. Finally we can say that the favorable results were obtained in at least half the time with LEL treatment faster than with classical therapy.

Antipa, Ciprian; Nacu, Mihaela; Bruckner, Ion I.; Bunila, Daniela; Vlaiculescu, Mihaela; Pascu, Mihai L.; Ionescu, Elena

1998-07-01

117

Neurographic assessment of intramedullary motoneurone lesions in cervical spinal cord injury: consequences for hand function  

Microsoft Academic Search

Examination of hand function and neurography of the median- and ulnar nerves was performed in 15 patients with acute and 26 patients with chronic tetraplegia due to cervical spinal cord injury (SCI). 30% of patients showed a mild and 20% a severe axonal lesion of motor fibres of both nerves. The latter is caused by intramedullary damage of ventral horn

Armin Curt; Volker Dietz

1996-01-01

118

Ulnar neuropathy with prominent proximal Martin-Gruber anastomosis.  

PubMed

Martin-Gruber anastomosis (MGA) is the most common nerve anastomosis in the upper extremities and it crosses from the median nerve to the ulnar nerve. Proximal MGA is an under recognized anastomosis between the ulnar and median nerves at or above the elbow and should not be missed during nerve conduction studies. We presented two patients with ulnar neuropathy mimicking findings including numbness and tingling of the 4th and 5th digits and mild weakness of intrinsic hand muscles. However, both cases had an apparently remarkable conduction block between the below- and above-elbow sites that was disproportionate to their clinical findings. To explain this discrepancy, a large MGA was detected with stimulation of the median nerve at the elbow. Thus, proximal MGA should be considered in ulnar neuropathy at the elbow when apparent conduction block or/and discrepancy between clinical and electrodiagnostic findings is found. PMID:24147570

Burakgazi, Ahmet Z; Russo, Mary; Bayat, Elham; Richardson, Perry K

2014-07-01

119

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

PubMed

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

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

2012-06-01

120

Median Nerve Somatosensory Evoked Potentials Recorded with Cephalic and Noncephalic References in Central and Peripheral Nervous System Lesions  

Microsoft Academic Search

Somatosensory evoked potentials (SSEP) to electrical stimulation of the median nerve by using cephalic and noncephalic references were studied to detect the generator sources of short latency evoked potentials in 29 patients with cerebral, brainstem, spinal and peripheral nerve lesions.Patients were divided into six groups according to the localization of their lesions: group 1: cortical and subcortical lesions, group 2:

Umit Hidir Ulas; Fatih Özdag; Erdal Eroglu; Zeki Odabasi; Yasar Kutukcu; Seref Demirkaya; Zeki Gökçil; Kemal Hamamcioglu; Okay Vural

2001-01-01

121

Multifocal acquired demyelinating sensory and motor neuropathy presenting as a peripheral nerve tumor.  

PubMed

A man with multifocal acquired demyelinating sensory and motor neuropathy (MADSAM), or Lewis-Sumner syndrome, presented with a progressive left lumbosacral plexus lesion resembling a neurofibroma. After 7 years he developed a left ulnar nerve lesion with conduction block in its upper segment. Treatment with intravenous immunoglobulin improved the symptoms and signs of both lesions. We conclude that inflammatory neuropathy must be considered in the differential diagnosis of peripheral nerve tumors, and that unifocal lesions may precede multifocal involvement in MADSAM by several years. In addition, we discuss the clinical features in 9 patients attending a specialist peripheral nerve clinic and review the literature. PMID:16609974

Allen, David C; Smallman, Clare A; Mills, Kerry R

2006-09-01

122

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.

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

2013-01-01

123

[Is differential diagnosis between soft tissue paraneural lesions and optic nerve tumors using computer tomography possible?].  

PubMed

The results of computer tomogram images analysis of 32 patients (32 orbits) with soft tissue orbital tumors are presented. 22 patients appeared to have cavernous hemangioma, 10--optic nerve meningioma. The technique of three dimensional reconstruction of orbital soft tissue is described and its diagnostic value in patients with cavernous hemangioma and optic nerve meningioma is analyzed. The density of lesions and its variability were studied. Indications for two and three dimensional imaging were proposed to differentiate these tumors. PMID:21394997

Brovkina, A F; Iatsenko, O Iu

2010-01-01

124

[Pathogenesis, diagnosis and therapy of nerve lesions following combined (surgical-radiotherapy) cancer therapy].  

PubMed

Classical cancer therapy (surgical and/or radiotherapeutic measures) is not uncommonly subject to late complications which frequently confront the patient and therapist with problems which are difficult to resolve. Typical examples of such late complications are damage to the nerve plexuses which are usually associated with pain, functional deficits and pareses which can hardly be influenced. The topography of these two nerve plexuses as well as the pathogenesis, clinical symptoms and therapy of plexus lesions is reported with reference to two cases: plexus lesion after combined therapy a) of a malignant testicular tumor and b) of a breast cancer. PMID:2773557

Trettin, H

1989-07-01

125

Biophysical and pathological effects of cryogenic nerve lesion.  

PubMed

Changes in endoneurial fluid pressure (EFP) and morphology were studied in rat sciatic nerves frozen for 60 seconds with a cryoprobe designed for human cryoanalgesia. The onset of increased EFP was rapid, and a peak of 23 cm H2O was reached within 90 minutes after injury. EFP levels returned to normal 32 days after freezing. The peak value represents the highest EFP yet recorded in an experimental neuropathy. Microscopic examination revealed severe vascular injury as the probable mechanism of edema, with leakage of horseradish peroxidase tracer at the site of injury and diapedesis of polymorphonuclear cells through vessel walls. Wallerian degeneration was also observed in segments of nerve distal to the site of injury. Analysis of EFP data revealed a biphasic pattern of endoneurial edema: initial marked pressure elevation subsides within hours but is followed by a second peak several days later. We interpret this to suggest superposition of two separate pathological processes following cold injury. At first, extensive vascular damage permits plasma and cellular extravasation, which rapidly increases EFP. Subsequently, nerve fibers undergo wallerian degeneration, a process associated with elevated EFP, which is maximal 6 days after injury. PMID:7305300

Myers, R R; Powell, H C; Heckman, H M; Costello, M L; Katz, J

1981-11-01

126

Idiopathic peripheral neuropathy in the horse with knuckling: muscle and nerve lesions in additional cases  

Microsoft Academic Search

We have previously reported a pathological investigation of peripheral neuropathy in a horse with knuckling. This report\\u000a describes details of the muscle and peripheral nerve lesions in two additional cases of light horse yearlings with knuckling.\\u000a The skeletal muscles showed neurogenic atrophy characterized by scattered single angular fibers, fiber grouping, and fiber-type\\u000a grouping. The severity of muscle lesions increased distally;

H. Furuoka; R. Okamoto; S. Kitayama; S. Asou; T. Matsui; K. Miyahara

1998-01-01

127

Lacrimal gland and perioptic nerve lesions due to Langerhans cell histiocytosis (2007: 9b)  

Microsoft Academic Search

We report a patient presenting with bilateral lacrimal gland involvement and perioptic nerve sheath lesions due to Langerhans\\u000a cell histiocytosis (LCH) invasion. LCH is a rare multisystemic disease characterized by a clonal proliferation of Langerhans\\u000a cells. All organs may be involved with a clinical spectrum ranging from a solitary bone lesion to a severe life-threatening\\u000a multisystem disease. Osteolytic orbital bone

M. Herman; P. Demaerel; G. Wilms; S. Van Gool; I. Casteels

2007-01-01

128

Electrodiagnostic evaluation of carpal tunnel syndrome and ulnar neuropathies.  

PubMed

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

Werner, Robert A

2013-05-01

129

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

130

Peripheral nerve injuries in athletes. Treatment and prevention.  

PubMed

Peripheral nerve lesions are uncommon but serious injuries which may delay or preclude an athlete's safe return to sports. Early, accurate anatomical diagnosis is essential. Nerve lesions may be due to acute injury (e.g. from a direct blow) or chronic injury secondary to repetitive microtrauma (entrapment). Accurate diagnosis is based upon physical examination and a knowledge of the relative anatomy. Palpation, neurological testing and provocative manoeuvres are mainstays of physical diagnosis. Diagnostic suspicion can be confirmed by electrophysiological testing, including electromyography and nerve conduction studies. Proper equipment, technique and conditioning are the keys to prevention. Rest, anti-inflammatories, physical therapy and appropriate splinting are the mainstays of treatment. In the shoulder, spinal accessory nerve injury is caused by a blow to the neck and results in trapezius paralysis with sparing of the sternocleidomastoid muscle. Scapular winging results from paralysis of the serratus anterior because of long thoracic nerve palsy. A lesion of the suprascapular nerve may mimic a rotator cuff tear with pain a weakness of the rotator cuff. Axillary nerve injury often follows anterior shoulder dislocation. In the elbow region, musculocutaneous nerve palsy is seen in weightlifters with weakness of the elbow flexors and dysesthesias of the lateral forearm. Pronator syndrome is a median nerve lesion occurring in the proximal forearm which is diagnosed by several provocative manoeuvres. Posterior interosseous nerve entrapment is common among tennis players and occurs at the Arcade of Froshe--it results in weakness of the wrist and metacarpophalangeal extensors. Ulnar neuritis at the elbow is common amongst baseball pitchers. Carpal tunnel syndrome is a common neuropathy seen in sport and is caused by median nerve compression in the carpal tunnel. Paralysis of the ulnar nerve at the wrist is seen among bicyclists resulting in weakness of grip and numbness of the ulnar 1.5 digits. Thigh injuries include lateral femoral cutaneous nerve palsy resulting in loss of sensation over the anterior thigh without power deficit. Femoral nerve injury occurs secondary to an iliopsoas haematoma from high energy sports. A lesion of the sciatic nerve may indicate a concomitant dislocated hip. Common peroneal nerve injury may be due to a direct blow or a traction injury and results in a foot drop and numbness of the dorsum of the foot. Deep and superficial peroneal nerve palsies could be secondary to an exertional compartment syndrome. Tarsal tunnel syndrome is a compressive lesion of the posterior tibial nerve caused by repetitive dorsiflexion of the ankle--it is common among runners and mountain climbers.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8378668

Lorei, M P; Hershman, E B

1993-08-01

131

[A particular nervous traumatology: lesions of sciatic nerve by quinine intragluteal injections (author's transl)].  

PubMed

These lesions of the sciatic nerve have a significant frequency in Africa, as a consequence of quinine intragluteal injections made by insufficiency trained nurses. Infants and children are most frequently affected. The lesions are a sclerous scar with or without a damage of the neural trunk. The clinical aspect is that of an algo-paralysis. Medical treatment by vitamins, alphachymotrypsine and physiotherapy must be applied early and during two months to have a chance bringing recovery. If it fails, surgical neurolysis is then necessary. Results vary according to the extent of the lesions. PMID:6287159

Bourrel, P; Souvestre, R

1982-01-01

132

MicroRNA machinery responds to peripheral nerve lesion in an injury-regulated pattern  

PubMed Central

Recently, functional and potent RNA interference (RNAi) has been reported in peripheral nerve axons transfected with short-interfering RNA (siRNA). In addition, components of RNA-induced silencing complex (RISC) have been identified in axotomized sciatic nerve fibers as well as in regenerating dorsal root ganglia (DRG) neurons in vitro. Based on these observations, and on the fact that siRNA and microRNAs (miRNA) share the same effector enzymes, we hypothesized that the endogenous miRNA biosynthetic pathway would respond to peripheral nerve injury. To answer this question, we investigated changes in the expression of miRNA biosynthetic enzymes following peripheral nerve crush injury in mice. Here we show that several pivotal miRNA biosynthetic enzymes are expressed in an injury-regulated pattern in sciatic nerve in vivo, and in DRG axons in vitro. Moreover, the sciatic nerve lesion induced expression of mRNA-processing bodies (P-bodies), which are the local foci of mRNA degradation in DRG axons. In addition, a group of injury-regulated miRNAs was identified by miRNA microarray and validated by qPCR and in situ hybridization analyses. Taken together, our data support the hypothesis that the peripheral nerve regeneration processes may be regulated by miRNA pathway.

Wu, Di; Raafat, Mohamed; Pak, Elena; Hammond, Scott; Murashov, Alexander K.

2011-01-01

133

Loiasis with Peripheral Nerve Involvement and Spleen Lesions  

PubMed Central

Loiasis, which is caused by the filarial nematode Loa loa, affects millions of persons living in the rainforest areas and savannah regions of central Africa. Typical manifestations are calabar swellings and the eyeworm. We report a case of loiasis with unusual clinical complications: a peripheral neuropathy and focal hypo-echogenic lesions of the spleen, which disappeared after treatment with albendazole and ivermectin. The literature reports that L. loa infection can be associated with various manifestations, some of them being serious. More information is needed to better characterize the protean manifestations of the disease in loiasis-endemic areas to evaluate the true incidence of loiasis.

Gobbi, Federico; Boussinesq, Michel; Mascarello, Marta; Angheben, Andrea; Gobbo, Maria; Rossanese, Andrea; Corachan, Manuel; Bisoffi, Zeno

2011-01-01

134

Ulnar tunnel syndrome.  

PubMed

Ulnar neuropathy at or distal to the wrist, the so-called ulnar tunnel syndrome, is an uncommon but well-described condition. However, diagnosis of ulnar tunnel syndrome can be difficult. Paresthesias may be nonspecific or related to coexisting pathologies, such as carpal tunnel syndrome, cubital tunnel syndrome, thoracic outlet syndrome, C8-T1 radiculopathy, or peripheral neuropathy, which makes accurate diagnosis challenging. The advances in electrodiagnosis, ultrasonography, computed tomography, and magnetic resonance imaging have improved the diagnostic accuracy. This article offers an updated view of ulnar tunnel syndrome as well as its etiologies, diagnoses, and treatments. PMID:24559635

Chen, Shih-Heng; Tsai, Tsu-Min

2014-03-01

135

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup  

PubMed Central

Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared.

Kang, Keum Nae; Park, In Kyung; Suh, Jeong Hun; Leem, Jeong Gill

2010-01-01

136

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

PubMed Central

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

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

2012-01-01

137

[Neuropathic pain following lesions of the infrapatellar branch of the femoral nerve : an important differential diagnosis in anterior knee pain].  

PubMed

We report on two patients with neuropathic knee pain following lesions of the infrapatellar branch of the femoral nerve due to knee joint replacement. In one patient, the neuropathic pain syndrome was complicated by the development of complex regional pain syndrome (CPRS II, causalgia). Patients exhibit a sharp, burning pain, often induced by exercise, and sensory impairment in the skin area supplied by the infrapatellar nerve. This nerve is a branch of the femoral nerve medial to the fascia lata and is responsible for the skin sensation of the anterior and medial part of the knee. Clinical features, anatomy, diagnostic methods and therapeutic options are reviewed. PMID:19499251

Rommel, O; Finger, L; Bös, E; Eichbaum, A; Jäger, G

2009-08-01

138

An Unusual Cause of Pseudomedian Nerve Palsy  

PubMed Central

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

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

2011-01-01

139

[Lesions of the peripheral nerves after surgical treatment of fractures of the distal humerus].  

PubMed

In the work we have examined 44 patients (16 women and 28 men), which the break of distal humerus is saned with operation, using adequate OSM. The average years of women patients was 29 (from 3 to 79), and of male patients 24 (from 1 to 75). After thr operative sanitary breaks distal part of humerus, using adequate OSM (fillo Kurschneri, platho metalico, clavo spiralis), it can come on lesion of perifer nerves of the arm, and mostly of n. radialis. Lesions of n. radialis we have notice on 5 patients. The rehabilitation our patients was made with prevention contraction of shoulder, elbow, hand and fingers using kinesitherapy, hydrotherapy and electrotherapy paralysis musculature with intentional exercises to the reinervation of perifer motor neuron and raising the force of musculus. PMID:12822381

Avdi?, Dijana; Gavrankapetanovi?, Ismet; Gavrankapetanovi?, Faris

2003-01-01

140

Ulnar head replacement.  

PubMed

Recent years have seen an increasing awareness of the anatomical and biomechanical significance of the distal radioulnar joint (DRUJ). With this has come a more critical approach to surgical management of DRUJ disorders and a realization that all forms of "excision arthroplasty" can only restore forearm rotation at the expense of forearm stability. This, in turn, has led to renewed interest in prosthetic replacement of the ulnar head, a procedure that had previously fallen into disrepute because of material failures with early implants, in particular, the Swanson silicone ulnar head replacement. In response to these early failures, a new prosthesis was developed in the early 1990s, using materials designed to withstand the loads across the DRUJ associated with normal functional use of the upper limb. Released onto the market in 1995 (Herbert ulnar head prosthesis), clinical experience during the last 10 years has shown that this prosthesis is able to restore forearm function after ulnar head excision and that the materials (ceramic head and noncemented titanium stem), even with normal use of the limb, are showing no signs of failure in the medium to long term. As experience with the use of an ulnar head prosthesis grows, so does its acceptance as a viable and attractive alternative to more traditional operations, such as the Darrach and Sauve-Kapandji procedures. This article discusses the current indications and contraindications for ulnar head replacement and details the surgical procedure, rehabilitation, and likely outcomes. PMID:17536532

Herbert, Timothy J; van Schoonhoven, Joerg

2007-03-01

141

Recovery of baroreflex control of renal sympathetic nerve activity after spinal lesions in the rat.  

PubMed

Spinal cord injury (SCI) has serious long-term consequences on sympathetic cardiovascular regulation. Orthostatic intolerance results from insufficient baroreflex regulation (BR) of sympathetic outflow to maintain proper blood pressure upon postural changes. Autonomic dysreflexia occurs due to insufficient inhibition of spinal sources of sympathetic activity. Both of these conditions result from the inability to control sympathetic activity caudal to SCI. It is well established that limited motor ability recovers after incomplete SCI. Therefore, the goal of this study was to determine whether recovery of BR occurs after chronic, left thoracic spinal cord hemisection at either T(3) or T(8). Baroreflex tests were performed in rats by measuring the reflex response of left (ipsilateral) renal sympathetic nerve activity to decreases and increases in arterial pressure produced by ramped infusions of sodium nitroprusside and phenylephrine, respectively. One week after a T(3) left hemisection, BR function was modestly impaired. However, 8 wk after a T(3) left hemisection, BR function was normal. One week after a T(8) left hemisection, BR function was significantly impaired, and 8 wk after a T(8) left hemisection, BR function was significantly improved. These results indicate that BR of renal sympathetic nerve activity in rats may partially recover after spinal cord hemisections, becoming normal by 8 wk after a T(3) lesion, but not after a T(8) lesion. The nature of the spinal cord and/or brain stem reorganization that mediates this recovery remains to be determined. PMID:21900643

Zahner, Matthew R; Kulikowicz, Ewa; Schramm, Lawrence P

2011-11-01

142

Implications of the failure of nerve resection and graft to cure chronic pain produced by nerve lesions  

Microsoft Academic Search

Seven patients had developed pain and abnormal sensitivity in the area supplied by a single nerve which had been injured. They were treated unsuccessfully for periods ranging from 3 to 108 months by conservative methods including neurolysis, local anaesthesia, sympathetic blocks, guanethidine, transcutaneous stimulation and analgesics. All then had the damaged nerve resected and in five cases a sural nerve

W Noordenbos; P D Wall

1981-01-01

143

Effects of ?-tocopherol on nerve conduction velocity and regeneration following a freeze lesion in immature diabetic rats  

Microsoft Academic Search

We investigated whether anti-oxidant treatment with ?-tocopherol (1?g kg–1 day–1) could prevent the blunting of the normal maturational increase in motor and sensory nerve conduction velocity when diabetes\\u000a is induced by streptozotocin in young rats. A further study in the same rats examined effects on myelinated fibre regeneration\\u000a distance 14 days after a punctate sciatic nerve lesion by a liquid

A. Love; M. A. Cotter; N. E. Cameron

1996-01-01

144

Nerve abscess in primary neuritic leprosy.  

PubMed

Nerve abscess is an infrequently reported complication of leprosy. We describe a patient with a pure neuritic type of leprosy with multiple nerve abscesses, who presented with tingling and numbness in the medial aspect of his right forearm and hand. Subsequently he developed pain, redness and swelling over the medial side of his right elbow and the flexor aspect of his right wrist. High-resolution ultrasound showed diffuse thickening of the right ulnar nerve with hypoechoic texture housing a cystic lesion with internal debris suggesting an abscess, at the cubital tunnel. Histopathological examination of the pus and tissue obtained from the abscess revealed presence of granulomas with lepra bacilli. The patient responded to surgery and multidrug therapy. In conclusion, the nerve abscess as the first manifestation of leprosy is uncommon and a high index of suspicion is required to make a correct diagnosis. PMID:24171239

Rai, Dheeraj; Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Goel, Madhu Mati; Malhotra, Kiran Preet; Kumar, Vijay; Singh, Arun Kumar; Jain, Amita; Kohli, Neera; Singh, Shailesh Kumar

2013-06-01

145

[Biopercular polymicrogyria associated with congenital ophthalmoplegia caused by nuclear lesion of the common oculomotor nerve].  

PubMed

Developmental pseudobulbar palsies seem to be different from the adult form described by Foix, Chavany and Marie. They usually include a major speech delay and severe epileptic seizures. In one clinicopathological case, neuroradiological imaging showed a macrogyric aspect of both rolandic operculi and unilateral destruction of pes pedunculari. Microscopic examination showed a four-layered polymicrogyria involving the first temporal gyrus and in the brainstem a selective destruction of the left oculomotor nucleus. Thus, the macrogyric aspect could be related to post migratory disorder occurring late in the cortical development. The brain stem lesion, destroying unilaterally the third cranial nerve nucleus gives a good example of the complex somatotopia of this oculomotor nucleus. PMID:7878323

Routon, M C; Expert-Bezançon, M C; Bursztyn, J; Mselati, J C; Robain, O

1994-01-01

146

Neuroprotective activity of thioctic acid in central nervous system lesions consequent to peripheral nerve injury.  

PubMed

Peripheral neuropathies are heterogeneous disorders presenting often with hyperalgesia and allodynia. This study has assessed if chronic constriction injury (CCI) of sciatic nerve is accompanied by increased oxidative stress and central nervous system (CNS) changes and if these changes are sensitive to treatment with thioctic acid. Thioctic acid is a naturally occurring antioxidant existing in two optical isomers (+)- and (-)-thioctic acid and in the racemic form. It has been proposed for treating disorders associated with increased oxidative stress. Sciatic nerve CCI was made in spontaneously hypertensive rats (SHRs) and in normotensive reference cohorts. Rats were untreated or treated intraperitoneally for 14 days with (+/-)-, (+)-, or (-)-thioctic acid. Oxidative stress, astrogliosis, myelin sheets status, and neuronal injury in motor and sensory cerebrocortical areas were assessed. Increase of oxidative stress markers, astrogliosis, and neuronal damage accompanied by a decreased expression of neurofilament were observed in SHR. This phenomenon was more pronounced after CCI. Thioctic acid countered astrogliosis and neuronal damage, (+)-thioctic acid being more active than (+/-)- or (-)-enantiomers. These findings suggest a neuroprotective activity of thioctic acid on CNS lesions consequent to CCI and that the compound may represent a therapeutic option for entrapment neuropathies. PMID:24527432

Tomassoni, Daniele; Amenta, Francesco; Di Cesare Mannelli, Lorenzo; Ghelardini, Carla; Nwankwo, Innocent E; Pacini, Alessandra; Tayebati, Seyed Khosrow

2013-01-01

147

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

PubMed

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

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

2010-11-01

148

Differentiating c8-t1 radiculopathy from ulnar neuropathy: a survey of 24 spine surgeons.  

PubMed

Study Design?Questionnaire. Objective?To evaluate the ability of spine surgeons to distinguish C8-T1 radiculopathies from ulnar neuropathy. Methods?Twenty-four self-rated "experienced" cervical spine surgeons completed a questionnaire with the following items. (1) If the ulnar nerve is cut at the elbow, which of the following would be numb: ulnar forearm, small and ring fingers; only the ulnar forearm; only the small and ring fingers; or none of the above? (2) Which of the following muscles are weak with C8-T1 radiculopathies but intact with ulnar neuropathy at the elbow: flexor digiti minimi brevis, flexor pollicis brevis, abductor digiti minimi, abductor pollicis brevis, adductor pollicis, opponens digiti minimi, opponens pollicis, medial lumbricals, lateral lumbricals, dorsal interossei, palmar interossei? Results?Fifteen of 24 surgeons (63%) correctly answered the first question-that severing the ulnar nerve results in numbness of the fifth and fourth fingers. None correctly identified all four nonulnar, C8-T1-innervated options in the second question without naming additional muscles. Conclusion?The ulnar nerve provides sensation to the fourth and fifth fingers and medial border of the hand. The medial antebrachial cutaneous nerve provides sensation to the medial forearm. The ulnar nerve innervates all intrinsic hand muscles, except the abductor and flexor pollicis brevis, opponens pollicis, and lateral two lumbricals, which are innervated by C8 and T1 via the median nerve. By examining these five muscles, one can clinically differentiate cubital tunnel syndrome from C8-T1 radiculopathies. Although all participants considered themselves to be experienced cervical spine surgeons, this study reveals inadequate knowledge regarding the clinical manifestations of C8-T1 radiculopathies and cubital tunnel syndrome. PMID:24494175

Stoker, Geoffrey E; Kim, Han Jo; Riew, K Daniel

2014-02-01

149

Peripheral nerve lesions associated with a dominant missense mutation, E33D, of the lamin A/C gene.  

PubMed

Some mutations of the lamin A/C gene may be responsible for a combination of distinct phenotypes, such as muscular dystrophy and peripheral neuropathy. We describe muscle and peripheral nerve lesions in a patient with a dominant lamin A/C missense mutation, E33D. Myopathic and neurogenic patterns coexisted on muscle biopsy specimens, whereas the peripheral nerve presented a mixture of axonopathy and Schwann cell hypertrophy. A few abnormal nuclei were found in muscle fibers and Schwann cells. Our morphological findings in this case attest to the predominant axonal damage, but suggest possible involvement of Schwann cells in neuropathies related to laminopathies. PMID:16084085

Vital, Anne; Ferrer, Xavier; Goizet, Cyril; Rouanet-Larrivière, Marie; Eimer, Sandrine; Bonne, Gisèle; Vital, Claude

2005-10-01

150

Axonal Regeneration after Sciatic Nerve Lesion Is Delayed but Complete in GFAP- and Vimentin-Deficient Mice  

PubMed Central

Peripheral axotomy of motoneurons triggers Wallerian degeneration of injured axons distal to the lesion, followed by axon regeneration. Centrally, axotomy induces loss of synapses (synaptic stripping) from the surface of lesioned motoneurons in the spinal cord. At the lesion site, reactive Schwann cells provide trophic support and guidance for outgrowing axons. The mechanisms of synaptic stripping remain elusive, but reactive astrocytes and microglia appear to be important in this process. We studied axonal regeneration and synaptic stripping of motoneurons after a sciatic nerve lesion in mice lacking the intermediate filament (nanofilament) proteins glial fibrillary acidic protein (GFAP) and vimentin, which are upregulated in reactive astrocytes and Schwann cells. Seven days after sciatic nerve transection, ultrastructural analysis of synaptic density on the somata of injured motoneurons revealed more remaining boutons covering injured somata in GFAP–/–Vim–/– mice. After sciatic nerve crush in GFAP–/–Vim–/– mice, the fraction of reinnervated motor endplates on muscle fibers of the gastrocnemius muscle was reduced 13 days after the injury, and axonal regeneration and functional recovery were delayed but complete. Thus, the absence of GFAP and vimentin in glial cells does not seem to affect the outcome after peripheral motoneuron injury but may have an important effect on the response dynamics.

Berg, Alexander; Zelano, Johan; Pekna, Marcela; Wilhelmsson, Ulrika; Pekny, Milos; Cullheim, Staffan

2013-01-01

151

Co-Transplantation of Olfactory Ensheathing Cells from Mucosa and Bulb Origin Enhances Functional Recovery after Peripheral Nerve Lesion  

PubMed Central

Olfactory ensheathing cells (OECs) represent an interesting candidate for cell therapy and could be obtained from olfactory mucosa (OM-OECs) or olfactory bulbs (OB-OECs). Recent reports suggest that, depending on their origin, OECs display different functional properties. We show here the complementary and additive effects of co-transplanting OM-OECs and OB-OECs after lesion of a peripheral nerve. For this, a selective motor denervation of the laryngeal muscles was performed by a section/anastomosis of the recurrent laryngeal nerve (RLN). Two months after surgery, recovery of the laryngeal movements and synkinesis phenonema were analyzed by videolaryngoscopy. To complete these assessments, measure of latency and potential duration were determined by electrophysiological recordings and myelinated nerve fiber profiles were defined based on toluidine blue staining. To explain some of the mechanisms involved, tracking of GFP positive OECs was performed. It appears that transplantation of OM-OECs or OB-OECs displayed opposite abilities to improve functional recovery. Indeed, OM-OECs increased recuperation of laryngeal muscles activities without appropriate functional recovery. In contrast, OB-OECs induced some functional recovery by enhancing axonal regrowth. Importantly, co-transplantation of OM-OECs and OB-OECs supported a major functional recovery, with reduction of synkinesis phenomena. This study is the first which clearly demonstrates the complementary and additive properties of OECs obtained from olfactory mucosa and olfactory bulb to improve functional recovery after transplantation in a nerve lesion model.

Bon-Mardion, Nicolas; Duclos, Celia; Genty, Damien; Jean, Laetitia; Boyer, Olivier; Marie, Jean-Paul

2011-01-01

152

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

153

Hypertrophic ancenous epitrochlearis muscle as a cause of ulnar neuropathy at elbow.  

PubMed

We report herein a 35-year-old man who suffered from pain at his left elbow and numbness in his left hand. Electromyographic studies demonstrated a localized nerve conduction block in the left elbow region. Ultrasonographic evaluation revealed enlargement of the ulnar nerve at the level of the medial epicondyle as well as bilateral anconeus epitrochlearis muscles, one of which was hypertrophic, causing the ulnar neuropathy at the symptomatic site. We emphasize with this case report the complementary role of ultrasound in peripheral nerve pathologies, as it confirmed the entrapment and determined the underlying cause. PMID:23629545

Yalcin, Elif; Demir, Sibel Ozbudak; Dizdar, Dilek; Buyukvural, S?d?ka; Akyuz, Mufit

2013-01-01

154

[Iatrogenic lesions of cranial nerves during endarterectomy of the carotid artery].  

PubMed

Cranial nerve injuries may result from carotid endarterectomy. In a retrospective study of 222 surgical procedures, from July 1982 through June 1990 only three cranial nerve injuries were documented (1.35%). In a prospective study of 79 carotid endarterectomies performed from July 1990 through June 1992, there were 11 nerve injuries (13.9%), fortunately most of them were temporary. We conclude that carotid endarterectomy is associated with a much higher incidence of local nerve injury than retrospective surveys would indicate. PMID:7991198

Vasquez, G; Mascoli, F; Buccoliero, F; Occhionorelli, S; Santini, M; Donini, I

1994-09-01

155

Sensory axon targeting is increased by NGF gene therapy within the lesioned adult femoral nerve  

PubMed Central

Even though peripheral nerves regenerate well, axons are often misrouted and reinnervate inappropriate distal pathways post-injury. Misrouting most likely occurs at branch points where regenerating axons make choices. Here, we show that the accuracy of sensory axon reinnervation is enhanced by overexpression of the guidance molecule nerve growth factor (NGF) distal to the bifurcation. We used the femoral nerve as model, which contains both sensory and motor axons that intermingle in the parent trunk and distally segregate into the saphenous (SB) and motor branch (MB). Transection of the parent trunk resulted in misrouting of axon reinnervation to SB and MB. To enhance sensory axon targeting, recombinant adenovirus encoding NGF was injected along the SB close to the bifurcation one week post-injury. The accuracy of axon reinnervation was assessed by retrograde tracing at 3 or 8 weeks after nerve injury. NGF overexpression significantly increased the accuracy of SB axon reinnervation to the appropriate nerve branch, in a manner independent of enhancing axon regeneration. This novel finding provides in vivo evidence that gradient expression of neurotrophin can be used to enhance targeting of distal peripheral pathways to increase axon regeneration into the appropriate nerve branch.

Hu, Xinhua; Cai, Jie; Yang, Jun; Smith, George M.

2009-01-01

156

Subluxation-related ulnar neuropathy (SUN) syndrome related to distal radioulnar joint instability.  

PubMed

Ulnar neuropathy coexistent with distal radioulnar joint (DRUJ) instability has previously been observed in our practice. The aim of this study was to define this phenomenon and investigate the hypothesis that the cause of this intermittent, positional ulnar neuropathy is related to kinking of the ulnar nerve about the DRUJ. Ulna neuropathy was present in 10/51 (19.6%) of a historical cohort of patients who presented with DRUJ instability. Nine subsequent patients with DRUJ instability and coexistent ulnar neuropathy underwent 3-T magnetic resonance imaging to better understand the mechanism of the observed syndrome. Both 3D qualitative and quantitative analyses were used to assess the presence of nerve 'kinking', displacing the nerve from its normal course and causing nerve compression/distraction in the distal forearm and Guyon's canal. Results of the quantitative analysis were statistically significant (p < 0.05). The clinical features of the condition have been delineated and termed subluxation-related ulnar neuropathy or SUN syndrome. The imaging study was a level II diagnostic study. PMID:22193951

Malone, P S C; Hutchinson, C E; Kalson, N S; Twining, C J; Terenghi, G; Lees, V C

2012-09-01

157

Effect of crush lesion on radiolabelling of ganglioside in rat peripheral nerve.  

PubMed

Left sciatic nerves of adult male Sprague-Dawley rats were crushed and allowed to recover for 0, 1, 2, 4, 7, or 14 days. At each of these times both L-5 dorsal root ganglia were injected with 100 microCi of [3H]glucosamine. Two days later, dorsal root ganglia, lumbosacral trunks, and sciatic nerves were removed bilaterally. The amounts of radiolabelled ganglioside in crushed lumbosacral trunks were consistently higher than in the controls, with the largest difference occurring within 2 days from simultaneous crush and injection to killing (specimens labelled day 0). The largest difference in the amount of radiolabelled ganglioside between crushed and control sciatic nerve (4-9 days from crush to killing) occurred later than that of lumbosacral trunk, but no significant difference occurred within the first 3 days following crush. There was only a slightly higher radioactivity in gangliosides totalled from all three anatomical specimens of crushed than in control nerves. The neutral nonganglioside lipid and acid-precipitable fraction followed patterns of synthesis and accumulation similar to those of the gangliosides. These findings indicate that after nerve crush gangliosides, glucosamine-labelled neutral nonganglioside lipids, and glycoproteins accumulate close to the proximal end of the regenerating axon. This accumulation could serve as a reservoir to increase the ganglioside concentration in the growth cone membrane. PMID:3335841

Guzman-Harty, M; Warner, J K; Mancini, M E; Pearl, D K; Yates, A J

1988-01-01

158

Peripheral nerve pathology in two rottweilers with neuronal vacuolation and spinocerebellar degeneration.  

PubMed

Neuronal vacuolation and spinocerebellar degeneration in young Rottweiler dogs is a neurodegenerative condition characterized by neuronal vacuolation of several nuclei in the central nervous system and degeneration of the spinal cord white matter. Here, we describe the morphologic and ultrastructural findings in laryngeal muscles and peripheral nerves of a 16-week-old female and a 32-week-old female Rottweiler dog affected by progressive ataxia and tetraparesis associated with laryngeal paralysis. Lesions were characterized by neurogenic muscle atrophy of the intrinsic laryngeal muscles, and a loss of large myelinated fibers in the recurrent laryngeal nerve, accompanied by demyelinating/remyelinating features affecting the small myelinated fibers. No significant changes were detected in the cranial laryngeal, vagus, phrenic, ulnar, or peroneal nerves. These findings were indicative of a selective distal neuropathy of the recurrent laryngeal nerve with early severe axonal degeneration, mainly of the large myelinated fibers. PMID:16301586

Salvadori, C; Tartarelli, C L; Baroni, M; Mizisin, A; Cantile, C

2005-11-01

159

The median palmar cutaneous nerve in normal subjects and CTS  

Microsoft Academic Search

ObjectiveThe neurophysiological confirmation of carpal tunnel syndrome (CTS) relies on detecting abnormal median nerve transcarpal conduction in the presence of unaffected comparator nerves. We compare the palmar cutaneous median branch (PCBm) with the ulnar sensory nerve conduction to digit 5 (US5) as comparator nerves for diagnosing CTS.

Rahul Rathakrishnan; Aravinda Kannan Therimadasamy; Y. H. Chan; E. P. Wilder-Smith

2007-01-01

160

Posttraumatic ulnar neuropathy versus non-traumatic cubital tunnel syndrome: Clinical features and response to surgery  

Microsoft Academic Search

Summary The outcome of 53 patients operated on either for posttraumatic ulnar neuropathy (PUN) or non-traumatic cubital tunnel syndrome (CTS) was reviewed after 3 years follow-up. Results were analyzed and compared considering the surgical technique used (neurolysis versus anterior transposition or combined) and a variety of clinical features that could influence outcome after nerve release. In the whole series, excellent

C. Barrios; C. Ganoza; J. de Pablos; J. Cafiadell

1991-01-01

161

Slowed motor conduction in lumbosacral nerve roots in cauda equina lesions: a new diagnostic technique  

Microsoft Academic Search

New techniques have been developed for the electrophysiological assessment of patients with suspected cauda equina lesions using transcutaneous spinal stimulation (500-1500 V: time constant 50 microseconds) to measure motor latencies to the external and sphincter and puborectalis muscles from L1 and L4 vertebral levels. These latencies represent motor conduction in the S3 and S4 motor roots of the cauda equina

M Swash; S J Snooks

1986-01-01

162

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

163

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

NASA Astrophysics Data System (ADS)

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

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

1996-01-01

164

Light and ultrastructural study of sciatic nerve lesions induced using intraneural injection of viable Mycobacterium leprae in normal and immunosuppressed Swiss white mice.  

PubMed

Freshly harvested M. leprae were microinjected into the sciatic nerves of nonimmunosuppressed (non-TR) and immunosuppressed (TR) mice using the technique described by Wisniewski and Bloom. The lesions thus induced, on bypassing the blood-nerve barrier, were biopsied at regular intervals beginning 24 hr and followed up to one year. The fate of M. leprae and the ensuing inflammation and nerve damage were studied using light and electron microscopy. The lesions in both non-TR and TR mice at 24 hr showed an influx of polymorphonuclear leukocytes and an increase in mast cells. The influx and peaking of lymphocytes were delayed by two weeks and 6 weeks, respectively, in TR mice, but the density of lymphocytes at the peak intervals was comparable in both. The plasma cells denoting the humoral response were seen in both, but there was a delay of 3 weeks in non-TR mice. The lesions in non-TR mice showed differentiation of macrophages into epithelioid cells and the formation of giant cells depicting borderline tuberculoid leprosy (BT), Whereas in TR mice, the macrophages showed foamy cytoplasmic changes depicting borderline lepromatous leprosy (BL). Other significant observations common to both non-TR and TR mice were: a) The lesions remained highly localized and showed signs of regression at the 6th and the 12th month intervals. b) The characteristic segmental demyelination and some attempt at remyelination were seen at the site. c) The influx of lymphocytes concorded well with demyelination. d) Bacteria were only seen in the macrophages and never in the Schwann cells or endothelial cells. e) Bacteria persisted in the macrophages, but appeared progressively degenerate at the 6th and 12th post-inoculation months, suggesting loss of viability. The study shows that there was a very effective containment of the infection and that the Schwann cells were resistant to M. leprae infection in the neural milieu. Nerve damage and Schwann cell bacillation do not go hand-in-hand. PMID:12120037

Shetty, Vanaja Prabhakar; Antia, Noshir Hormusji

2002-03-01

165

Arthroscopic wafer procedure for ulnar impaction syndrome.  

PubMed

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

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

2014-02-01

166

Arthroscopic Wafer Procedure for Ulnar Impaction Syndrome  

PubMed Central

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

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

2014-01-01

167

Anomalous superficial ulnar artery based flap  

PubMed Central

Upper limb shows a large number of arterial variations. This case report describes the presence of additional superficial ulnar artery which was used to raise a pedicle flap to cover an arm defect thus avoided using the main vessel of the forearm - radial or ulnar artery. Vascular anomalies occurring in the arm and forearm tend to increase the likelihood of damaging the superficial anomalous arteries during surgery. Superficial ulnar or radial arteries have been described to originate from the upper third of the brachial artery; here we report the origin of the anomalous superficial ulnar artery originating from the brachial artery at the level of elbow with the concomitant presence of normal deep radial and ulnar arteries.

Ramani, C. V.; Kundagulwar, Girish K.; Prabha, Yadav S.; Dushyanth, Jaiswal

2014-01-01

168

Modular ulnar head decoupling force: case report.  

PubMed

Cobalt-chrome modular distal ulnar head replacement arthroplasty is a surgical option to restore stability to the distal radioulnar joint rendered unstable by hemi-resection arthroplasty or a total resection arthroplasty. However, the revision of dislocated modular cobalt-chrome ulnar head implants may pose an important intraoperative challenge. The Morse-taper disassembly force of modular ulnar head implants is not available in the current published literature. We present a case in which tremendous difficulty was encountered while revising a dislocated modular cobalt-chrome distal ulnar head implant. The mean Morse-taper disassembly force of the retrieved modular cobalt-chrome implant was 2958 N +/- 1272. At nearly 4.5 times the average body weight, the modular ulnar head Morse-taper disassembly strength presented a formidable force to overcome intraoperatively. PMID:19446967

Naidu, Sanjiv H; Radin, Alex

2009-01-01

169

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

PubMed

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

Horch, K W; Lisney, S J

1981-01-01

170

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

PubMed Central

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

Horch, K W; Lisney, S J

1981-01-01

171

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

172

Ulnar Collateral Ligament Injuries of the Thumb  

PubMed Central

Background: The clinical diagnosis of thumb ulnar collateral ligament disruption has been based on joint angulation during valgus stress testing. This report describes a definitive method of distinguishing between complete and partial ulnar collateral ligament injuries by quantifying translation of the proximal phalanx on the metacarpal head during valgus stress testing. Methods: Sixty-two cadaveric thumbs underwent standardized valgus stress testing under fluoroscopy with the ulnar collateral ligament intact, following an isolated release of the proper ulnar collateral ligament, and following a combined release of both the proper and the accessory ulnar collateral ligament (complete ulnar collateral ligament release). Following complete ulnar collateral ligament release, the final thirty-seven thumbs were also analyzed after the application of a valgus force sufficient to cause 45° of valgus angulation at the metacarpophalangeal joint to model more severe soft-tissue injury. Two independent reviewers measured coronal plane joint angulation (in degrees), ulnar joint line gap formation (in millimeters), and radial translation of the proximal phalanx on the metacarpal head (in millimeters) on digital fluoroscopic images that had been randomized. Results: Coronal angulation across the stressed metacarpophalangeal joint progressively increased through the stages of the testing protocol: ulnar collateral ligament intact (average [and standard deviation], 20° ± 8.1°), release of the proper ulnar collateral ligament (average, 23° ± 8.3°), and complete ulnar collateral ligament release (average, 30° ± 8.9°) (p < 0.01 for each comparison). Similarly, gap formation increased from the measurement in the intact state (5.1 ± 1.3 mm), to that following proper ulnar collateral ligament release (5.7 ± 1.5 mm), to that following complete ulnar collateral ligament release (7.2 ± 1.5 mm) (p < 0.01 for each comparison). Radial translation of the proximal phalanx on the metacarpal head did not increase after isolated release of the proper ulnar collateral ligament (1.6 ± 0.8 mm vs. 1.5 ± 0.9 mm in the intact state). There was a significant increase in translation following release of the complete ulnar collateral ligament complex (3.0 ± 0.9 mm; p < 0.01) and an additional increase after forcible angulation of the joint to 45° (4.1 ± 0.9 mm; p < 0.01). Translation 2 mm greater than that in the stressed control was 100% specific for complete disruption of the ulnar collateral ligament complex. Conclusions: While transection of the proper ulnar collateral ligament leads to an increase in metacarpophalangeal joint angulation and gapping on stress fluoroscopic evaluation, only release of both the accessory and the proper ulnar collateral ligament significantly increases translation of the proximal phalanx on the metacarpal head. Clinical Relevance: A finding of phalangeal translation on a stress fluoroscopic image distinguishes partial from complete tears of the thumb ulnar collateral ligament.

McKeon, Kathleen E.; Gelberman, Richard H.; Calfee, Ryan P.

2013-01-01

173

Chapter 4: Methods and protocols in peripheral nerve regeneration experimental research: part I-experimental models.  

PubMed

This paper addresses several basic issues that are important for the experimental model design to investigate peripheral nerve regeneration. First, the importance of carrying out adequate preliminary in vitro investigation is emphasized in light of the ethical issues and with particular emphasis on the concept of the Three Rs (Replacement, Reduction, and Refinement) for limiting in vivo animal studies. Second, the various options for the selection of the animal species for nerve regeneration research are reviewed. Third, the two main experimental paradigms of nerve lesion (axonotmesis vs. neurotmesis followed by microsurgical reconstruction) are critically outlined and compared. Fourth, the various nerve models that have most commonly been employed are overviewed focusing in particular on forearm mixed nerves and on behavioural tests for assessing their function: the ulnar test and the grasping test which is useful for assessing both median and radial nerves in the rat. Finally, the importance of considering the influence of various factors and diseases which could interfere with the nerve regeneration process is emphasized in the perspective of a wider adoption of experimental models which more closely mimic the environmental and clinical conditions found in patients. PMID:19682633

Tos, Pierluigi; Ronchi, Giulia; Papalia, Igor; Sallen, Vera; Legagneux, Josette; Geuna, Stefano; Giacobini-Robecchi, Maria G

2009-01-01

174

A Fully Implanted Drug Delivery System for Peripheral Nerve Blocks in Behaving Animals  

PubMed Central

Inhibiting peripheral nerve function can be useful for many studies of the nervous system or motor control. Accomplishing this in a temporary fashion in animal models by using peripheral nerve blocks permits studies of the immediate effects of the loss, and/or any resulting short-term changes and adaptations in behavior or motor control, while avoiding the complications commonly associated with permanent lesions, such as sores or self-mutilation. We have developed a method of quickly and repeatedly inducing temporary, controlled motor deficits in rhesus macaque monkeys via a chronically implanted drug delivery system. This assembly consists of a nerve cuff and a subdermal injection dome, and has proved effective for delivering local anesthetics directly to peripheral nerves for many months. Using this assembly for median and ulnar nerve blocks routinely resulted in over 80% losses in hand and wrist strength for rhesus monkeys. The assembly was also effective for inducing ambulatory motor deficits in rabbits through blocks of the sciatic nerve. Interestingly, while standard anesthetics were sufficient for the rabbit nerve blocks, the inclusion of epinephrine was essential for achieving significant motor blockade in the monkeys.

Pohlmeyer, Eric A.; Jordon, Luke R.; Kim, Peter; Miller, Lee E.

2009-01-01

175

The toe-spreading reflex of the rabbit revisited—functional evaluation of complete peroneal nerve lesions  

Microsoft Academic Search

Summary Although a variety of electrophysiological and morphological tests are available for studying nerve regeneration in animals, these endpoints do not necessarily correlate with the return of muscle function. Recent efforts have focusedon the assessment of function as the endpoint of nerve regeneration. One of the best known of these tests is the sciatic function index in rats. For rabbits,

H. Cristina Schmitz; G. M. Beer

2001-01-01

176

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

177

Fibrolipoma of multiple nerves in the wrist.  

PubMed

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

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

2009-08-01

178

Treatment of thumb ulnar collateral ligament ruptures with the Mitek bone anchor.  

PubMed

Complete thumb ulnar collateral ligament (UCL) injuries usually require primary repair. The ulnar collateral ligament is often torn from its insertion site and reattachment is difficult. Seven patients underwent repair with the Mitek bone anchor (Mitek Surgical Products, Norwood, MA) for complete ulnar collateral ligament disruptions. A Stener lesion was found in four patients. Follow-up examination was at approximately 1 year. All patients regained a stable metacarpophalangeal joint to valgus stress. X-ray films demonstrated accurate placement of the bone anchor with protraction of the metallic wings within cancellous bone. Range of motion revealed a 7% loss of metacarpophalangeal flexion-extension and a 21% loss of interphalangeal motion. Pinch strength in apposition averaged 98% and in opposition 97% of the uninvolved hand. Grip strength was 96% of the contralateral extremity. PMID:7574275

Kozin, S H

1995-07-01

179

The athlete's wrist: ulnar-sided pain.  

PubMed

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

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

2012-09-01

180

Electrodiagnostic evaluation of compressive nerve injuries of the upper extremities.  

PubMed

Electrodiagnostic testing includes electromyography and nerve conduction studies that are physiologic tests used in the diagnosis of peripheral nerve injuries. It is a supplement rather than a replacement for a physical examination. This article reviews the terminology as well as the findings seen and used in electrodiagnostic studies. Common compression nerve injuries including the median, ulnar, radial, axillary, and suprascapular nerves and their electrical findings are reviewed. PMID:23026456

Freedman, Mitchell; Helber, Garett; Pothast, Jason; Shahwan, T G; Simon, Jeremy; Sher, Liane

2012-10-01

181

Gait phase information provided by sensory nerve activity during walking: applicability as state controller feedback for FES  

Microsoft Academic Search

In this study, we extracted gait-phase information from natural sensory nerve signals of primarily cutaneous origin recorded in the forelimbs of cats during walking on a motorized treadmill. Nerve signals were recorded in seven cats using nerve cuff or patch electrodes chronically implanted on the median, ulnar, and\\/or radial nerves. Features in the electroneurograms that were related to paw contact

K. D. Strange; J. A. Hoffer; J. B. Wagenaar

1999-01-01

182

Ulnar shortening osteotomy utilizing a TriMed ulnar osteotomy system.  

PubMed

Ulnar impaction syndrome (UIS) is a degenerative condition of the ulnar wrist typically seen in patients with static or dynamic ulnar-positive variance. Impaction of the distal ulna on the proximal lunate and triquetrum leads to degeneration of the triangular fibrocartilage complex and/or the chondral surfaces of the lunate and triquetrum. Patients with UIS present with pain in the ulnar aspect of the wrist. In cases of UIS refractory to nonoperative treatment, several surgical techniques have been described, including arthroscopic triangular fibrocartilage complex debridement, arthroscopic wafer procedure, and ulnar shortening osteotomy (USO). USO has gained favor as a reliable technique to offload the forces seen at the ulnar wrist extra-articularly while preserving the distal radioulnar joint stabilizing structures. We describe a technique utilizing a jig-facilitated, oblique, diaphyseal USO and fixed with a TriMed ulnar osteotomy compression plate. This system allows for precise measured ulnar shortening and reliable compression across the osteotomy site, and has been shown to decrease operative times and achieve to high union rates. Plate prominence is minimized by utilizing the volar surface of the ulna, although plate prominence and subsequent need for hardware removal remain a relatively common complication. PMID:24614866

Pouliot, Michael; Yao, Jeffrey

2014-06-01

183

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

Microsoft Academic Search

Ciliary neurotrophic factor (CNTF) is ex- pressed in high quantifies in Schwann cells of periph- eral 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 physio- logical conditions. However, CNTF supports

M. Sendtner; K. A. Stiickli; H. Thoenen

1992-01-01

184

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.

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

2013-01-01

185

Post-traumatic humero-ulnar synostosis.  

PubMed

A humero-ulnar synostosis is a bony connection between the humerus and the ulna. This is a very rare finding and it results in a serious disability of the elbow. Usually, a synostosis of the elbow occurs as a congenital anomaly. In this case, a 6-year-old girl was seen with a post-traumatic humero-ulnar synostosis, which has never been reported in the literature before. Surgical resection of the humero-ulnar synostosis was performed. Along with rapid intensive physical therapy, almost full recovery of function was achieved. The short-term result is very satisfactory, but the long-term results and recurrence rate are still unknown. PMID:24732097

Mollen, Bas P; Heesterbeek, Petra J C; de Vos, Maarten J; ten Ham, Arno M

2014-07-01

186

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

187

The Ulnar Collateral Ligament Procedure Revisited  

PubMed Central

Context: The ulnar collateral ligament of the elbow (UCL) is frequently injured in throwing athletes, most commonly baseball pitchers. The ligament is reconstructed through bone tunnels using palmaris longus or gracilis autograft. Results: This study highlights the following technique for UCL reconstruction in over 2000 athletes.2 Conclusion: When conservative management fails, ligament reconstruction can allow the athlete to return to their sport.1

Andrews, James R.; Jost, Patrick W.; Cain, E. Lyle

2012-01-01

188

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

Code of Federal Regulations, 2010 CFR

... 2010-04-01 false Wrist joint ulnar (hemi-wrist) polymer prosthesis...Prosthetic Devices § 888.3810 Wrist joint ulnar (hemi-wrist) polymer prosthesis. (a) Identification. A wrist joint ulnar (hemi-wrist) polymer...

2010-04-01

189

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

Code of Federal Regulations, 2010 CFR

... 2009-04-01 false Wrist joint ulnar (hemi-wrist) polymer prosthesis...Prosthetic Devices § 888.3810 Wrist joint ulnar (hemi-wrist) polymer prosthesis. (a) Identification. A wrist joint ulnar (hemi-wrist) polymer...

2009-04-01

190

Ulnar dimelia variant: a case report.  

PubMed

We report a case of ulnar dimelia, commonly called mirror hand, in a 2-month-old female child who had restriction of elbow flexion and forearm rotation. There was no facial or other internal organ malformation. Radiographs revealed seven triphalangeal digits with double ulnae (one following the other) and absent radius. To the best of the authors' knowledge, this is the first report of this mirror hand deformity in which fingers are symmetrical while duplicated ulnae are not. PMID:21769660

Jameel, Javed; Khan, Abdul Qayyum; Ahmad, Sohail; Abbas, Mazhar

2011-09-01

191

[Prognosis of traumatic spinal cord lesions. Significance of clinical and electrophysiological findings].  

PubMed

The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques (somatosensory-evoked potentials (SSEP), motor-evoked potentials (MEP), electroneurography) to assess the extent and severity of a spinal cord injury. As essential advantage of these techniques in comparison with the clinical examination is that they can be reliably applied even in uncooperative patients. These techniques allow an early prognosis of the functional deficit in patients with acute spinal cord injury. Recordings of tibial nerve SSEP and MEP of the anterior tibial muscle allow to predict the outcome of ambulatory capacity, while recordings of pudendal nerve SSEP allow prognosis of the bladder function to be assessed. In tetraplegic patients median and ulnar nerve SSEP and MEP of the abductor digiti minimi muscle can indicate the development of hand function. Electroneurography allows to differentiate between the proportion of peripheral and central nervous lesions underlying the muscle paresis. This is of prognostic value with regard to the development of muscle tone and consequently for planning therapy. The electrophysiological examinations are of complementary value in the diagnostic assessment of spinal cord lesions, in the prediction of functional outcome, and in monitoring the course of neurological deficits. This is helpful for planning and selection of appropriate therapeutic approaches (e.g. functional electrical stimulation, application of botulinum toxin, splinting procedures) within the rehabilitation programme. PMID:9312682

Curt, A; Dietz, V

1997-06-01

192

[Neurological diagnosis and prognosis: significance of neurophysiological findings in traumatic spinal cord lesions].  

PubMed

The clinical examination of patients with spinal cord injury can be supplemented by electrophysiological techniques (somatosensory evoked potentials [SSEP], motor evoked potentials [MEP], and electroneuromyographic recordings [ENMG]) to assess the extent and severity of a spinal cord injury. An essential advantage of these techniques in comparison with clinical examination is that they can also be reliably applied in uncooperative patients. These techniques allow early prognosis regarding the functional deficit in patients with acute spinal cord injury. Recordings of tibial nerve somatosensory evoked potentials and motor evoked potentials of the anterior tibial muscle serve to predict the outcome of ambulatory capacity, and pudendal nerve somatosensory evoked potentials that of bladder function. In tetraplegic patients median and ulnar nerve somatosensory evoked potentials and motor evoked potentials of the abductor digiti min. muscle may indicate the outcome of hand function at an early stage. The electroneuromyographic recordings make it possible to differentiate between the proportion of peripheral and central nervous lesion underlying a muscle paresis. This is of prognostic value in regard to the development of muscle tone and consequently for planning of therapy. The electrophysiological examinations are of complementary value in the diagnostic assessment of spinal cord lesions, in the prediction of functional outcome, and in monitoring the course of neurological deficits. This is helpful for planning and selection of appropriate therapeutic approaches within the rehabilitation programme. PMID:10893751

Curt, A

2000-06-01

193

Interstitial deletion 4q32-34 with ulnar deficiency: 4q33 may be the critical region in 4q terminal deletion syndrome.  

PubMed

We report on an infant with Robin sequence; mild developmental delay; a left ulnar ray defect with absent ulna and associated metacarpals, carpals and phalanges; and a right ulnar nerve hypoplasia. He had a de novo interstitial deletion of 4q32-->q34. The critical region involved in the 4q terminal deletion syndrome may be 4q33. This conclusion was suggested by showing that del(4)(q31qter), del(4)(q32qter), and del(4)(q33qter) result in a similarly severe phenotype. In addition, we propose that genes for distal arm development, in particular for development of the left ulnar ray, central nervous system development, and cleft lip and palate, may be located at 4q33. PMID:11241465

Keeling, S L; Lee-Jones, L; Thompson, P

2001-03-01

194

Cubital Tunnel Syndrome: Anterior Transposition as a Logical Approach to Complete Nerve Decompression  

Microsoft Academic Search

In it's native position, deep to Osborne's ligament, within the retrocondylar groove of the elbow, the ulnar nerve courses with a significant lever distance posterior to the elbow axis of rotation. In this position, flexion of the elbow places longitudinal traction and local compression forces on the nerve. This biomechanical consideration, as well as variations in anatomy, may potentially contribute

William B. Kleinman

1999-01-01

195

Vascularized Nerve Grafts and Vascularized Fascia for Upper Extremity Nerve Reconstruction  

PubMed Central

Since 1976, experimental and clinical studies have suggested the superiority of vascularized nerve grafts. In this study, a 27-year experience of the senior author is presented regarding vascularized nerve grafts and fascia for complex upper extremity nerve reconstruction. The factors influencing outcomes as well as a comparison with conventional nerve grafts is presented. Since 1981, 21 vascularized nerve grafts, other than vascularized ulnar nerve, were used for reconstruction of nerve injuries in the upper extremity. Indications were prolonged denervation time, failure of the previously used conventional nerve grafts, and excessive scar in the recipient site. Injury was in the hand/wrist area (n?=?5), in the forearm (n?=?4), in the elbow (n?=?2), in the arm (n?=?4), or in the plexus (n?=?6). Vascularized sural (n?=?9), saphenous (n?=?8), superficial radial (n?=?3), and peroneal (superficial and deep) nerves were used. The mean follow-up was 31.4 months. Vascularized nerve grafts for upper extremity injuries provided good to excellent sensory return in severely scarred upper extremities in patients in whom conventional nerve grafts had failed. They have also provided relief of causalgia after painful neuroma resection and motor function recovery in selective cases even for above the elbow injuries. Small diameter vascularized nerve grafts should be considered for bridging long nerve gaps in regions of excessive scar or for reconstructions where conventional nerve grafts have failed.

Kostopoulos, Vasileios K.

2009-01-01

196

Peripheral nerve injuries in children.  

PubMed

Recovery after peripheral nerve injuries in children is more complete than in adults and is inversely related to the age of the patient. The prognosis for the return of sensation following laceration of the median, ulnar, or digital nerve depends upon recovery of two point discrimination (in millimeters approximately equal to the child's age) at the time of nerve repair. The better results in children probably reflect the greater adaptability of the immature central nervous system to the nerve injury. Operative exploration of an open wound when there is a potential for nerve injury in an uncooperative child is the only sure way of determining the status of the nerves. Primary repair of cleanly divided nerves in tidy wounds is advocated if it can be done competently. Secondary repair is indicated for avulsion injuries, gunshot wounds, crush injuries, and human or animal bites. Delicate, atraumatic technique and accurate repair of the divided nerve are stressed. The more exacting technique of funicular repair may yield better results. Interfascicular cable grafting is a new and useful alternative to extensive mobilization in closing nerve gaps. Nonoperative treatment of nerve injuries associated with closed fractures is advocated unless there are no signs of nerve regeneration in two to three months. Obstetrical brachial plexus injuries of the upper plexus carry a better prognosis than lower plexus or total plexus injury. Early range of motion exercises to prevent contractures are stressed. Maximal recovery takes place within two years. The acute nerve compression syndrome should be considered an emergency and may require surgical decompression if it is severe and if rapid return of function does not occur following reduction of the fracture. PMID:958691

Frykman, G K

1976-07-01

197

Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint with an intraosseous suture anchor.  

PubMed

Thirty-six consecutive patients with 37 complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal (MP) joint were treated with primary repair using a miniature intraosseous suture anchor. Thirty patients were evaluated by clinical examination or by questionnaire at an average of 11 months after repair. Loss of interphalangeal joint motion averaged 15 degrees on the involved side versus the other side, while loss of MP joint motion averaged 10 degrees. There was no significant difference on stress testing measurements between repaired and nonrepaired thumbs. There were no instances of nerve injury, infection, device failure, or reoperation. The authors concluded that this is a safe and effective method for repair of complete tears of the ulnar collateral ligament of the thumb MP joint. PMID:9260611

Weiland, A J; Berner, S H; Hotchkiss, R N; McCormack, R R; Gerwin, M

1997-07-01

198

Non-invasive stimulation of the vibrissal pad improves recovery of whisking function after simultaneous lesion of the facial and infraorbital nerves in rats  

Microsoft Academic Search

We have recently shown that manual stimulation of target muscles promotes functional recovery after transection and surgical\\u000a repair to pure motor nerves (facial: whisking and blink reflex; hypoglossal: tongue position). However, following facial nerve\\u000a repair, manual stimulation is detrimental if sensory afferent input is eliminated by, e.g., infraorbital nerve extirpation.\\u000a To further understand the interplay between sensory input and motor

H. Bendella; S. P. Pavlov; M. Grosheva; A. Irintchev; S. K. Angelova; D. Merkel; N. Sinis; K. Kaidoglou; E. Skouras; S. A. Dunlop; Doychin N. Angelov

2011-01-01

199

Variation in the hypothenar muscles and its impact on ulnar tunnel syndrome.  

PubMed

Compression of the ulnar nerve at Guyon's canal can be caused not only by tumor-like structures, a fibrotic arch, a ganglion, lipoma, aneurysm or thrombosis but also by anomalous hypothenar muscles which are reviewed here. For the search of relevant papers, PubMed and crucial anatomical textbooks were consulted. The abductor digiti minimi is the most variable hypothenar muscle. It can possess one to three muscle bellies. Additional heads can arise from the flexor retinaculum, the palmaris longus tendon, the pronator quadratus tendon or the deep fascia of the palmar side of the forearm. Our own case of an aberrant abductor digiti minimi appearing like connective tissue and originating in the antebrachial fascia is included here. Hematoxylin and eosin staining revealed that macroscopically non-muscle-like tissue contained skeletal muscle tissue. The muscle itself resembled other described cases. In addition, at the flexor digiti minimi accessory heads with origin from the flexor retinaculum, the antebrachial fascia or the long flexor muscles of the forearm can be detected. By contrast, the opponens digiti minimi mostly lacks variations and is sometimes missing. In our opinion, this is due to its hidden location. However, in few cases an additional head can arise from the lower arm aponeurosis. Furthermore, additional (fourth) hypothenar muscles might be expressed. These muscles are characterized by origins in the forearm and insertions on the head of the 5th metacarpal bone or on the 5th proximal phalanx. It must be noted that accessory hypothenar muscles might look like connective tissue at first glance. Often their origin extends to the antebrachial fascia. This can be explained by the phylogenetic fact that all intrinsic muscles of the hand are derived from muscle masses that originated in the forearm. In the opinion of several authors, ulnar nerve compression mostly is evoked by hyper trophied variant hypothenar muscles due to overuse as for example in carpenters. In some rare cases, an aberrant hypothenar muscle can also evoke median nerve compression. PMID:23558800

Claassen, Horst; Schmitt, Oliver; Schulze, Marko; Wree, Andreas

2013-12-01

200

Pinched Nerve  

MedlinePLUS

NINDS Pinched Nerve Information Page Table of Contents (click to jump to sections) What is Pinched Nerve? Is there any treatment? ... being done? Clinical Trials Organizations What is Pinched Nerve? The term "pinched nerve" is a colloquial term ...

201

Peripheral nerve surgery.  

PubMed

In treating the three main surgical problems of peripheral nerves--nerve sheath tumors, entrapment neuropathies, and acute nerve injuries--the overriding consideration is the preservation and restoration of neurologic function. Because of this, certain other principles may need to be compromised. These include achieving a gross total excision of benign tumors, employing conservative therapy as long as a disease process is not clearly progressing, and delaying repair of a nerve transection until the skin wound has healed. Only three pathophysiologic processes need be considered: neurapraxia (focal segmental dymyelination), axonotmesis (wallerian degeneration caused by a lesion that does not disrupt fascicles of nerve fibers), and neurotmesis (wallerian degeneration caused by a lesion that interrupts fascicles). With nerve sheath tumors and entrapment neuropathies, the goal is minimize the extent to which neurapraxia progresses to axonotmesis. The compressive force is relieved without carrying out internal neurolysis, a procedure that is poorly tolerated, presumably because a degree of nerve ischemia exists with any long-standing compression. When the nerve has sustained blunt trauma (through acute compression, percussion, or traction), the result can be a total loss of function and an extensive neuroma-in-continuity (scarring within the nerve). However, the neural pathophysiology may amount to nothing more than axonotmesis. Although this lesion, in time, leads to full and spontaneous recovery, it must be differentiated from the neuroma-in-continuity that contains disrupted fascicles requiring surgery. Finally, with open nerve transection, the priority is to match the fascicles of the proximal stump with those of the distal stump, a goal that is best achieved if primary neurorrhaphy is carried out. PMID:2991727

McQuarrie, I G

1985-05-01

202

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.

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

2012-01-01

203

Ulnar collateral ligament injuries in the throwing athlete.  

PubMed

Repetitive valgus forces on the throwing elbow place significant stress on that joint. This stress can cause structural damage and injury to the ulnar collateral ligament. Many acute injuries of the throwing elbow are caused by repetitive chronic wear. Although much work has been done on injury prevention in youth who are pitchers, overuse injury in throwing sports constitutes an epidemic. Failing nonsurgical management, ulnar collateral ligament reconstruction is a viable option to return the throwing athlete to competition. PMID:24788447

Bruce, Jeremy R; Andrews, James R

2014-05-01

204

The posterior Monteggia lesion.  

PubMed

Thirteen posterior Monteggia fracture-dislocations in adults were treated surgically at the Massachusetts General Hospital from 1980 to 1988. A characteristic lesion was observed, consisting of a proximal ulna fracture with a triangular or quandrangular fracture at or near the level of the coronoid, a posterior or posterolateral radiocapitellar dislocation, and, in 10 cases, a radial head fracture. Nine patients were women and four were men, with an average age of 56 years. Following reduction of the radiocapitellar dislocation, the ulnar fractures were treated with plates in each case. Seven fractured radial heads were excised, one replaced with a silicone prosthesis, and three treated by open reduction and internal fixation. The 11 surviving patients were observed using the performance index of Broberg and Morrey at an average follow-up time of 38.4 months. The conditions of three were rated excellent, three good, four fair, and one poor. Incomplete reduction of the ulnar fracture with residual posterior radiocapitellar subluxation was observed in four cases, all leading to loss of forearm supination. We believe this lesion to be more common than previously reported. Recognition of its specific anatomic features is essential to achieve a functional outcome. PMID:1761999

Jupiter, J B; Leibovic, S J; Ribbans, W; Wilk, R M

1991-01-01

205

Cranial Nerves IX, X, XI, and XII  

PubMed Central

This article concludes the series on cranial nerves, with review of the final four (IX–XII). To summarize briefly, the most important and common syndrome caused by a disorder of the glossopharyngeal nerve (craniel nerve IX) is glossopharyngeal neuralgia. Also, swallowing function occasionally is compromised in a rare but disabling form of tardive dyskinesia called tardive dystonia, because the upper motor portion of the glossopharyngel nerve projects to the basal ganglia and can be affected by lesions in the basal ganglia. Vagus nerve funtion (craniel nerve X) can be compromised in schizophrenia, bulimia, obesity, and major depression. A cervical lesion to the nerve roots of the spinal accessory nerve (craniel nerve XI) can cause a cervical dystonia, which sometimes is misdiagnosed as a dyskinesia related to neuroleptic use. Finally, unilateral hypoglossal (craniel nerve XII) nerve palsy is one of the most common mononeuropathies caused by brain metastases. Supranuclear lesions of cranial nerve XII are involved in pseudobulbar palsy and ALS, and lower motor neuron lesions of cranial nerve XII can also be present in bulbar palsy and in ALS patients who also have lower motor neuron involvement. This article reviews these and other syndromes related to cranial nerves IX through XII that might be seen by psychiatry.

Sanders, Richard D.

2010-01-01

206

Activating transcription factor 3 (ATF3) expression in the neural retina and optic nerve of zebrafish during optic nerve regeneration  

Microsoft Academic Search

Fish, unlike mammals, can regenerate axons in the optic nerve following optic nerve injury. We hypothesized that using microarray analysis to compare gene expression in fish which had experienced optic nerve lesion to fish which had undergone a similar operation but without optic nerve injury would reveal genes specifically involved in responding to optic nerve injury (including repair), reducing detection

Katherine E. Saul; Joseph R. Koke; Dana M. García

2010-01-01

207

Ultrasound-guided administration of lidocaine into the sciatic nerve in a porcine model: correlation between the ultrasonographic evolution of the lesions, locomotor function and histological findings.  

PubMed

Intraneural puncture of local anaesthetics has been associated with permanent or transitory nerve injury. The use of ultrasound (US)-guided techniques for the blockade of peripheral nerves has revealed that intraneural puncture is a relatively common complication, which is not frequently associated with neurological deficits. In this study, 2.5 mL of lidocaine were administered using US-guidance into the sciatic nerve (ScN) of 12 piglets. The punctured nerves were sequentially evaluated by US (cross sectional area and relative echogenicity) before and immediately after the injections, and then at 1, 2, 4, 7 and 14 days. At these times, animals were euthanased two by two at each time point, and ScN samples were removed for histological examination. Cross sectional area and relative echogenicity values were statistically different immediately after the injections, returning to pre-puncture values within 4 days. The inflammatory process observed by histopathology showed a similar trend indicating that the integrity of the perineurium was maintained. Locomotor deficits were not observed. The increase in size of the ScN produced by the injection of lidocaine intraneurally did not induce motor deficits in piglets in the current study. PMID:24594382

Belda, Eliseo; Laredo, Francisco G; Gil, Francisco; Soler, Marta; Murciano, José; Ayala, María D; Gómez, Serafín; Castells, María T; Escobar, Mayte; Agut, Amalia

2014-04-01

208

Use of tubes in peripheral nerve repair.  

PubMed

The use of tubes as an alternative to primary nerve suture in fresh nerve transections has been introduced as a biologic approach to nerve injuries, creating optimal conditions for axonal regeneration over a short empty space intentionally created between the proximal and distal nerve ends. The idea may seem controversial and has been criticized using the arguments that silicone in itself may create problems like inflammation and the tube may compress the nerve ends. With the use of appropriately sized tubes for bridging a maximum 5-mm gap in human median and ulnar nerves, the authors have found the technique to be useful and persistent at follow-up examinations for up to 4 to 5 years. In addition, from the intellectual point of view, the principle illustrates the concept by which emphasis is placed on the intrinsic healing capacities of the nerve rather than on the technical skill of the surgeon. The thin mesothelial lining found around the silicone tube lacks primary inflammatory signs at follow-up after 1 year, and no signs of compression are seen. It may be an advantage because it allows sliding of the repair site against the surrounding tissues. Tubes made of bioresorbable material may seem ideal, but they may introduce new problems associated with the resorption process in terms of a substantial unrestricted macrophage invasion, fibrosis, and disorganized axonal growth. For an extended nerve defect, the use of autologous nerve grafts is still the gold standard, because no tubular conduit or other conduit has so far proved equal to autologous nerve grafts, at least not for reconstruction of human median and ulnar nerve trunks. Alternatives other than tubes are currently being developed and investigated. For the future, the use of tubes for repair and reconstruction of nerves may have interesting potentials, because such a structure allows several types of tissue engineering. Various matrices containing, for instance, appropriate cells, factors, or other stimulating agents can be introduced in the tube lumen and can also be incorporated in a slow-release form in the walls of the tube and manipulated. Cultured Schwann cells or other cellular components, with or without manipulated production machinery, are probably the cells of choice for introduction in the tubes. Tubes may thus prove to be interesting alternatives to conventional repair techniques for primary repair of nerves and for reconstruction of segmental defects and for neuroma treatment in the future. PMID:11525212

Dahlin, L B; Lundborg, G

2001-04-01

209

[Radial nerve compression].  

PubMed

A new compression syndrome of the deep branch of the radial nerve is described, in which a sudden anterior displacement of a part of this nerve under maximal tension is followed by an axonotmesis. This happens in an area in which the deep branch of the radial nerve crossed some narrow structures which are unyielding and have more compression strength (tense cords of connective tissue Fig. 3). The operative finding of a torsion of the injured fascicles justifies the correctness of the immediate operative revision; otherwise the nerve regeneration would be impaired by the torted empty endoneural tubes. This description is a further constribution not observed before to the compression syndromes of the radial nerve, since in 1970 the author was able to give an explanation for the pathogenesis of compression palsies of the radial nerve, unclear up to that time but observed after forceful muscle contractions again and again since the beginning of this century. This observation gives the evidence that the occurrence of a peripheral compression lesion of nerves is not bound absolutely on the existence of a "physiological narrowness" (fibrous or osteofibrous tunnel etc.). This is also true for the median nerve. PMID:992486

Wilhelm, A

1976-01-01

210

Corrective osteotomy for symptomatic increased ulnar tilt of the distal end of the radius  

Microsoft Academic Search

Twelve wrists in 10 patients with a mean age of 23.6 years were treated for symptomatic increased ulnar inclination of the joint surface with corrective osteotomy of the radius. Diagnoses included mild ulnar dysplasia, posttraumatic deformity, Madelung's disease, and multiple hereditary exostosis. All patients had radial-sided wrist pain and an ulnarly displaced arc of radioulnar deviation. Preoperative radiographs showed excessive

Diego L. Fernandez; John T. Capo; Eduardo Gonzalez

2001-01-01

211

Parameters of the ulnar medullary canal for locked intramedullary nailing.  

PubMed

The development of a 'one shot' locked intramedullary device for rapid stabilization of adult ulnar fractures would benefit surgeon and patient alike, but before a prototype device can be manufactured, basic internal measurements of the ulnar medullary canal are needed. Various sections and measurements of 142 adult human cadaver ulnas were performed to determine the calibre, length and curvature of the medullary canal. These measurements revealed that the device can be of one calibre but will need manufactured in three different lengths. Because of the minimal curvature of the ulnar medullary canal and the ability to lock the nail both proximally and distally, the nail can be straight and inserted loosely. A prototype design is described. PMID:2002677

McFarlane, A G; Macdonald, L T

1991-01-01

212

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

Microsoft Academic Search

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

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

1998-01-01

213

Motor nerve conduction and repetitive nerve stimulation in captive ring-tailed coati (Nasua nasua).  

PubMed

There are few electrophysiologic studies in wild animals. The aim of this study was to determine normal data for motor nerve conduction studies and repetitive stimulation in sciatic-tibial and ulnar nerves in clinically normal captive coati. Eight adult ring-tailed coatis (Nasua nasua), two females and six males weighing 6-8 kg, were used. Average nerve conduction velocity was 70.81 m/sec (standard deviation [SD] = 3.98) and 56.93 m/ sec (SD = 4.31) for the sciatic-tibial and ulnar nerves, respectively. Repetitive stimulation responses demonstrated minimal variations of the area of the compound muscle action potentials at low (3 Hz) and high (20 Hz) frequencies. The maximal obtained decremental area response was 8%. These normal data of conduction studies may be used in assessing abnormalities for clinical diagnosis. In addition, the obtained normal repetitive stimulation data were similar to dogs and humans and may be used for post- and presynaptic disturbances of the neuromuscular transmission in coatis. PMID:23082506

Mortari, Ana Carolina; Rahal, Sheila Canevese; Resende, Luiz Antonio de Lima; Teixeira, Carlos Roberto; Teixeira, Rodrigo Hidalgo Friciello; Mendes, Guilherme Maia

2012-09-01

214

[Treatment of aseptic ulnar non-union in a patient with spastic hemiparesis by Ilizarov method].  

PubMed

Both-bone diaphyseal forearm fractures in children are common lesions. Non-union is very rare, almost exclusively in the ulna. We present a case of forearm fracture in a patient with spastic hemiparesis involving the injured forearm, treated initially with open reduction and intramedullary nailing. Ulnar deviation of both bones, with bending of intramedullary implants, occurred during postoperative period, due to spasticity of forearm flexors. An aseptic non-union of the ulna also developed. Both complications were treated by compression osteogenesis using a Ilizarov circular frame, the end results being excellent. The unusual and rare association between a preexisting neurologic spastic disorder and a forearm fracture can lead to malunion or/and nonunion, a more rigid method of initial osteosynthesis (locked compression plate) being an alternative in such cases. PMID:21495312

Botez, C; Aprodu, G; Candussi, Laura; Munteanu, V

2009-01-01

215

Oculomotor nerve palsies in children.  

PubMed

Fifty-four patients with oculomotor nerve palsy who presented over a 21-year period at our institution were reviewed retrospectively. There were 38 isolated third nerve lesions, and 16 with additional cranial nerve involvement. Eleven cases were congenital in origin, and 43 were acquired. Of the acquired group, 31 were traumatic, 7 infection-related, 3 attributed to migraine or other vascular causes, and 2 neoplastic. Average follow up was 36 months. The congenital lesions were predominantly right-sided; amblyopia, although common, responded well to treatment. Trauma and bacterial meningitis accounted for more cases of isolated oculomotor nerve palsy than seen in the previous literature. In distinct contrast to the adult population, no cases of diabetes, posterior communicating artery aneurysms, metastatic tumors, or pituitary lesions were found. PMID:1287170

Ing, E B; Sullivan, T J; Clarke, M P; Buncic, J R

1992-01-01

216

Primary optic nerve sheath meningioma  

Microsoft Academic Search

Fifty patients with optic nerve sheath meningiomas have been reviewed with a follow-up of up to 15 years. The median age at onset of their symptoms was 40.0 years. The majority were middle aged females with a slowly progressive lesion. More aggressive lesions were encountered in a younger, predominantly male group of patients with frequent intracranial involvement. Our experience indicates

J E Wright; A A McNab; W I McDonald

1989-01-01

217

The Pathomechanics of Ulnar Drift. A Biomechanical and Clinical Study.  

National Technical Information Service (NTIS)

A research project to identify any forces, either from within or without the hand, that could produce ulnar drift, and to investigate methods and results of operative treatment, found that the deformity cannot occur in the presence of normal anatomy. Ther...

A. E. Flatt

1971-01-01

218

Cubital Tunnel Reconstruction For Ulnar Neuropathy In Osteoarthritic Elbows  

Microsoft Academic Search

We operated on 16 patients for ulnar neuropathy associated with osteoarthritis of the elbow. They were all male manual workers, with an average age of 51 years at the time of surgery. The severity of the symptoms was McGowan grade 1 in five patients, grade 2 in nine and grade 3 in two. The mean follow-up was 36 months. The

Akihito Tsujino; Yoshiyasu Itoh; Koichiro Hayashi; Mitsuyoshi Uzawa

1997-01-01

219

Ulnar artery thrombosis: A sports-related injury  

Microsoft Academic Search

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

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

1986-01-01

220

Nicotine-mediated improvement in L-dopa-induced dyskinesias in MPTP-lesioned monkeys is dependent on dopamine nerve terminal function.  

PubMed

L-dopa-induced dyskinesias (LIDs) are abnormal involuntary movements that develop with long term L-dopa therapy for Parkinson's disease. Studies show that nicotine administration reduced LIDs in several parkinsonian animal models. The present work was done to understand the factors that regulate the nicotine-mediated reduction in LIDs in MPTP-lesioned nonhuman primates. To approach this, we used two groups of monkeys, one with mild-moderate and the other with more severe parkinsonism rendered dyskinetic using L-dopa. In mild-moderately parkinsonian monkeys, nicotine pretreatment (300 ?g/ml via drinking water) prevented the development of LIDs by ~75%. This improvement was maintained when the nicotine dose was lowered to 50 ?g/ml but was lost with nicotine removal. Nicotine re-exposure again decreased LIDs. By contrast, nicotine treatment did not reduce LIDs in monkeys with more severe parkinsonism. We next determined how nicotine's ability to reduce LIDs correlated with lesion-induced changes in the striatal dopamine transporter and (3)H-dopamine release in these two groups of monkeys. The striatal dopamine transporter was reduced to 54% and 28% of control in mild-moderately and more severely parkinsonian monkeys, respectively. However, basal, K(+), ?4?2* and ?6?2* nAChR-evoked (3)H-dopamine release were near control levels in striatum of mild-moderately parkinsonian monkeys. By contrast, these same release measures were reduced to a significantly greater extent in striatum of more severely parkinsonian monkeys. Thus, nicotine best improves LIDs in lesioned monkeys in which striatal dopamine transmission is still relatively intact. These data suggest that nicotine treatment would most effectively reduce LIDs in patients with mild to moderate Parkinson's disease. PMID:23009753

Quik, Maryka; Mallela, Archana; Chin, Matthew; McIntosh, J Michael; Perez, Xiomara A; Bordia, Tanuja

2013-02-01

221

Nicotine-mediated improvement in L-dopa-induced dyskinesias in MPTP-lesioned monkeys is dependent on dopamine nerve terminal function  

PubMed Central

L-Dopa-induced dyskinesias (LIDs) are abnormal involuntary movements that develop with long term L-dopa therapy for Parkinson’s disease. Studies show that nicotine administration reduced LIDs in several parkinsonian animal models. The present work was done to understand the factors that regulate the nicotine-mediated reduction in LIDs in MPTP-lesioned nonhuman primates. To approach this, we used two groups of monkeys, one with mild-moderate and the other with more severe parkinsonism rendered dyskinetic using L-dopa. In mild-moderately parkinsonian monkeys, nicotine pretreatment (300 ?g/ml via drinking water) prevented the development of LIDs by ~75%. This improvement was maintained when the nicotine dose was lowered to 50 ?g/ml but was lost with nicotine removal. Nicotine re-exposure again decreased LIDs. By contrast, nicotine treatment did not reduce LIDs in monkeys with more severe parkinsonism. We next determined how nicotine’s ability to reduce LIDs correlated with lesion-induced changes in the striatal dopamine transporter and 3H-dopamine release in these two groups of monkeys. The striatal dopamine transporter was reduced to 54% and 28% of control in mild-moderately and more severely parkinsonian monkeys, respectively. However, basal, K+, ?4?2* and ?6?2* nAChR-evoked 3H-dopamine release were near control levels in striatum of mild-moderately parkinsonian monkeys. By contrast, these same release measures were reduced to a significantly greater extent in striatum of more severely parkinsonian monkeys. Thus, nicotine best improves LIDs in lesioned monkeys in which striatal dopamine transmission is still relatively intact. These data suggest that nicotine treatment would most effectively reduce LIDs in patients with mild to moderate Parkinson’s disease.

Quik, Maryka; Mallela, Archana; Chin, Matthew; McIntosh, J. Michael; Perez, Xiomara A.; Bordia, Tanuja

2012-01-01

222

Piriformis syndrome surgery causing severe sciatic nerve injury.  

PubMed

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

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

2012-09-01

223

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

PubMed Central

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

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

2013-01-01

224

Nerve and Nerve Root Biomechanics  

Microsoft Academic Search

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

Kristen J. Nicholson; Beth A. Winkelstein

225

Intratemporal Hemangiomas Involving the Facial Nerve  

PubMed Central

Intratemporal vascular tumors involving the facial nerve are rare benign lesions. Because of their variable clinical features, they are often misdiagnosed preoperatively. This study presents a series of 21 patients with such lesions managed from 1977 to 1994. Facial nerve dysfunction was the most common complaint, present in 60% of the cases, followed by hearing loss, present in 40% of cases. High-resolution computed tomography, magnetic resonance imaging with gadolinium, and a high index of clinical suspicion is required for preoperative diagnosis of these lesions. Early surgical resection of these tumors permits acceptable return of facial nerve function in many patients. ImagesFigure 1Figure 2Figure 3

Bhatia, Sanjaya; Karmarkar, Sandeep; Calabrese, V.; Landolfi, Mauro; Taibah, Abdelkader; Russo, Alessandra; Mazzoni, Antonio; Sanna, Mario

1995-01-01

226

Morphological assessment of early axonal regeneration in end-to-side nerve coaptation models.  

PubMed

Histological changes were observed in peripheral nerves following end-to-side nerve coaptation to determine the effects of perineurial opening and deliberate donor nerve injury during surgery. Twenty rats were randomised into four groups as follows: group 1, end-to-side nerve coaptation without perineurial opening; group 2, end-to-side nerve coaptation with simple perineurial opening; group 3, end-to-side nerve coaptation with partial crush injury after perineurial opening; group 4, end-to-side nerve coaptation with partial neurotomy after perineurial opening. Seven days after coaptation of the musculocutaneous (recipient) nerve to the ulnar (donor) nerve, the nerves were immunohistochemically analysed using antibodies against neurofilament-H (RT97) and phosphorylated GAP-43 (p-GAP-43). The former labels all axons, including regenerating axons and degenerated axonal debris, while the latter only labels regenerating axons. Results demonstrated no regenerating nerves in the recipient nerve of group 1. In group 2, because nerve herniation from the perineurial opening partially injured donor nerve fibres, some regenerating axons extended proximally and distally along the partially injured fibres in the donor nerve; some of these regenerating axons also extended into the recipient nerve via the perineurial opening. In groups 3 and 4, thin regenerating axons were more prominent in recipient and donor nerves compared with group 2. Statistical evaluation revealed increased efficacy of perineurial opening and deliberate donor nerve injury in end-to-side nerve coaptation, suggesting that partial nerve fibre herniation with partial axonotmesis or neurotomesis was important for effective axonal regeneration in end-to-side nerve coaptation. PMID:22931136

Oyamatsu, Hiroshi; Koga, Daisuke; Igarashi, Michihiro; Shibata, Minoru; Ushiki, Tatsuo

2012-10-01

227

Optic Nerve Cysticercosis: Imaging Findings  

Microsoft Academic Search

Summary: We present the imaging findings of retrobulbar optic nerve cysticercosis in a 50-year-old woman with a 6- month history of vision loss. Contrast-enhanced CT re- vealed an approximately 7-mm ring-enhancing cyst with a mural nodule located in the anterior portion of the left op- tic nerve. A contrast-enhanced MR imaging study revealed a cystic lesion with peripheral enhancement of

Satish Chandra; Sushma Vashisht; Vimla Menon; Manorama Berry; Suresh K. Mukherji

228

Peripheral Nerve Tumors  

Microsoft Academic Search

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

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

229

Cranial Nerve II: Vision.  

PubMed

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

Gillig, Paulette Marie; Sanders, Richard D

2009-09-01

230

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

PubMed Central

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

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

2009-01-01

231

Occupational True Aneurysm of the Ulnar Artery: A Case Report of Hypothenar Hammer Syndrome  

PubMed Central

A 32-year-old male patient was admitted to the hospital with a pulsing mass of the right palm. He was an electrical construction engineer who frequently used a screwdriver. Computed tomography (CT) examination revealed a 22- × 30-mm saccular aneurysm of the right ulnar artery. The ulnar artery aneurysm was resected, and we could perform direct anastomosis of the ulnar artery. The dilated true aneurysm was compatible with a traumatic origin. A postoperative enhanced CT examination showed smooth reconstruction of the palmar arch. An occupational true aneurysm of the ulnar artery could be treated by resection and direct anastomosis.

2013-01-01

232

Reconstructed animation from four-phase grip MRI of the wrist with ulnar-sided pain.  

PubMed

In order to visualize dynamic variations related to ulnar-sided wrist pain, animation was reconstructed from T2* coronal-sectioned magnetic resonance imaging in each of the four phases of grip motion for nine wrists in patients with ulnar pain. Eight of the nine wrists showed a positive ulnar variance of less than 2 mm. Ulnocarpal impaction and triangular fibrocartilage complex injury were assessed on the basis of animation and arthroscopy, respectively. Animation revealed ulnocarpal impaction in four wrists. In one of the four wrists, the torn portion of the articular disc was impinged between the ulnar head and ulnar proximal side of the lunate. In another wrist, the ulnar head impacted the lunate directly through the defect in the articular disc that had previously been excised. An ulnar shortening osteotomy successfully relieved ulnar wrist pain in all four cases with both ulnocarpal impaction and Palmer's Class II triangular fibrocartilage complex tears. This method demonstrated impairment of the articular disc and longitudinal instability of the distal radioulnar joint simultaneously and should be of value in investigating dynamic pathophysiology causing ulnar wrist pain. PMID:23390153

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

2013-09-01

233

Cortical plasticity induced by different degrees of peripheral nerve injuries: a rat functional magnetic resonance imaging study under 9.4 Tesla  

PubMed Central

Background Major peripheral nerve injuries not only result in local deficits but may also cause distal atrophy of target muscles or permanent loss of sensation. Likewise, these injuries have been shown to instigate long-lasting central cortical reorganization. Methods Cortical plasticity changes induced after various types of major peripheral nerve injury using an electrical stimulation technique to the rat upper extremity and functional magnetic resonance imaging (fMRI) were examined. Studies were completed out immediately after injury (acute stage) and at two weeks (subacute stage) to evaluate time affect on plasticity. Results After right-side median nerve transection, cortical representation of activation of the right-side ulnar nerve expanded intra-hemispherically into the cortical region that had been occupied by the median nerve representation After unilateral transection of both median and ulnar nerves, cortical representation of activation of the radial nerve on the same side of the body also demonstrated intra-hemispheric expansion. However, simultaneous electrical stimulation of the contralateral uninjured median and ulnar nerves resulted in a representation that had expanded both intra- and inter-hemispherically into the cortical region previously occupied by the two transected nerve representations. Conclusions After major peripheral nerve injury, an adjacent nerve, with similar function to the injured nerve, may become significantly over-activated in the cortex when stimulated. This results in intra-hemispheric cortical expansion as the only component of cortical plasticity. When all nerves responsible for a certain function are injured, the same nerves on the contralateral side of the body are affected and become significantly over-activated during a task. Both intra- and inter-hemispheric cortical expansion exist, while the latter dominates cortical plasticity.

2013-01-01

234

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.

2012-01-01

235

Lumbosacral intrathecal nerve roots: an anatomical study  

Microsoft Academic Search

Background  The lumbosacral intrathecal anatomy is complex because of the density of nerve roots in the cauda equina. Space-occupying\\u000a lesions, including disc herniation, trauma and tumor, within the spinal canal may compromise the nerve roots, causing severe\\u000a clinical syndromes. The goal of this study is to provide spinal surgeons with a detailed anatomical description of the intrathecal\\u000a nerve roots and to

Mehmet Arslan; Ayhan Cömert; Halil ?brahim Açar; Mevci Özdemir; Alaittin Elhan; ?brahim Tekdemir; Shane R. Tubbs; Ayhan Attar; Hasan Ça?lar U?ur

2011-01-01

236

Primary nerve repair following resection of a neurenteric cyst of the oculomotor nerve.  

PubMed

Neurenteric cysts are rare congenital lesions of endodermal origin occurring in the spinal canal and infrequently in the posterior cranial fossa. The authors report the case of a 3-year-old child who presented with a recurrent third cranial nerve palsy. Magnetic resonance imaging showed a large cystic mass lesion in the ambient cistern on the right side, with compression of the anterolateral aspect of the brainstem. The patient underwent a craniotomy, complete excision, and a primary third cranial nerve repair. While there have been 3 reported cases of neurenteric cysts arising from the oculomotor nerve, this is the first documented case with a primary nerve repair. PMID:22208320

Turner, Scott J; Dexter, Mark A; Smith, James E H; Ouvrier, Robert

2012-01-01

237

Congenital nuclear syndrome of oculomotor nerve.  

PubMed

A patient is reported who suffered from a fixed, non-progressive encephalopathy caused by a lesion involving the left portion of both the mesencephalon and basal ganglia; the lesion was caused by an acquired prenatal vascular insult. The clinical expression of third cranial nerve palsy corresponds to a nuclear syndrome of the left oculomotor nerve, affecting both eyes asymmetrically, later developing into aberrant reinnervation. PMID:7605557

Prats, J M; Monzon, M J; Zuazo, E; Garaizar, C

1993-01-01

238

Clinical and X-Ray Investigations on Congenital Radio-Ulnar Synostosis.  

National Technical Information Service (NTIS)

Out of 13 patients with cogenital radio-ulnar synostosis, 10 could be subjected to clinical and X-ray examination and chromosome analysis. In all the family histories the radio-ulnar synostosis was an isolated event. In no case was definite heredity of th...

A. Heisel

1982-01-01

239

Management Distal Radius and Distal Ulnar Fractures with Fragment Specific Plate  

PubMed Central

This article describes the use of a new generation low profile dorsal rim plate for management of distal radius fractures from the dorsal approach. This plate was designed to maximize stability while minimizing complications from the extensor tendons. A volar ulnar plate designed to specifically stabilize fractures of the ulnar head and neck is also described.

Geissler, William B.

2013-01-01

240

Nerve repair, grafting, and nerve transfers.  

PubMed

Advances in the field of peripheral nerve surgery have increased our understanding of the complex cellular and molecular events involved in nerve injury and repair. Application of these important discoveries has led to important developments in the techniques of nerve repair, nerve grafting, nerve allografts, end-to-side repairs, and nerve-to-nerve transfers. As our understanding of this dynamic field increases, further improvement in functional outcomes after nerve injury and repair can be expected. PMID:12737353

Dvali, Linda; Mackinnon, Susan

2003-04-01

241

Common peroneal nerve dysfunction  

MedlinePLUS

Neuropathy - common peroneal nerve; Peroneal nerve injury; Peroneal nerve palsy ... The peroneal nerve is a branch of the sciatic nerve, which supplies movement and sensation to the lower leg, foot and ...

242

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

PubMed

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

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

2014-01-01

243

[Bilateral hypoglossal nerve palsy following intubation].  

PubMed

Hypoglossal nerve palsy following intubation is a rare complication that can be reversible depending on the extent of nerve damage. A 63-year-old male with a sigma carcinoma was repeatedly intubated orotracheally due to postoperative complications. After the fourth intubation, bilateral, complete hypoglossal nerve palsy with severe dysarthria and swallowing disability was observed. A percutaneous endoscopic gastrostomy tube was inserted for nutrition and to prevent aspiration. Cerebral MRI showed no pathological findings, particularly in the brainstem. Electromyographic studies revealed pathological spontaneous activity of both glossal muscles without any motor unit potential consistent with an axonal lesion of both hypoglossal nerves. Nevertheless, complete clinical and electromyographical recovery occurred within 7 months. The bilateral hypoglossal nerve palsy in our patient was probably due to mechanical alteration during intubation, leading to axonotmesis. Hypoglossal nerve palsy following intubation might have a favourable prognosis as long as continuity of the nerve sheath is maintained. PMID:16133427

Bramer, S; Koscielny, S; Witte, O W; Terborg, C

2006-02-01

244

The recurrent laryngeal nerve (RLN): application to transhiatal oesophagectomy  

Microsoft Academic Search

To emphasize the risks of recurrent laryngeal nerve lesions during transhiatal oesophagectomy an anatomical study of the course of the recurrent laryngeal nerve (RLN) was performed. Twenty RLN were dissected in their thoracic portion. This work showed the constancy of the low origin of the nerve in the adult under the aortic arch, and its course in the tracheal angle.

A. Dia; D. Valleix; B. Dixneuf; D. Philippi; B. Descottes; M. Caix; A. Ndiaye; M. L. Sow

1998-01-01

245

Tolerance of cranial nerves of the cavernous sinus to radiosurgery  

Microsoft Academic Search

Stereotactic radiosurgery is becoming a more accepted treatment option for benign, deep seated intracranial lesions. However, little is known about the effects of large single fractions of radiation on cranial nerves. This study was undertaken to assess the effect of radiosurgery on the cranial nerves of the cavernous sinus. The authors examined the tolerance of cranial nerves (II-VI) following radiosurgery

Roy B Tishler; Jay S Loeffler; E. Alexander; H. M. Kooy; L. D. Lunsford; C. Duma; John C Flickinger

1993-01-01

246

Ulnar neuropathy at the elbow: an evidence-based algorithm.  

PubMed

Ulnar neuropathy at the elbow is the second most common compression neuropathy of the upper extremity and poses a challenge for treating physicians. Lack of a standardized grading system, outcome measures, or surgical indications can make treatment decisions difficult to justify. Conclusions drawn from the available literature include similar rates of good to excellent outcomes for in situ decompression; transposition in the subcutaneous, submuscular, or intramuscular planes; and endoscopic decompression. Outcomes for revision surgery are generally less favorable. Development of standardized outcomes measures will be important in improving the quality and comparability of the literature on this subject. PMID:23895724

Chimenti, Peter C; Hammert, Warren C

2013-08-01

247

Ulnar Shaft Stress Fracture in a High School Softball Pitcher  

PubMed Central

This article presents a case of a 17-year-old softball pitcher with insidious onset of right forearm pain. On presentation, the patient had tenderness on palpation of the midshaft of the ulna, pain with resisted pronation, and pain with fulcrum-type stressing of the forearm. A bone scan revealed increased uptake in the right ulna, and a subsequent magnetic resonance imaging revealed bone marrow edema and numerous small ulnar stress fractures. She was treated with bone stimulation and complete rest and is in the process of returning to pitching.

Bigosinski, Krystian; Palmer, Trish; Weber, Kathleen; Evola, Jennifer

2010-01-01

248

Unilateral Abducens Nerve Palsy as an Early Feature of Multiple Mononeuropathy Associated with Anti-GQ1b Antibody  

PubMed Central

Patients with anti-GQ1b antibody syndrome show various combinations of ophthalmoplegia, ataxia, areflexia, or altered sensorium as clinical features. We describe herein a unique case with unilateral abducens nerve palsy as an early feature of multiple mononeuropathy involving dysfunctions of the inferior dental plexus and the ulnar nerve, which was thought to be associated with anti-GQ1b antibody. A 27-year-old man presented with acute-onset diplopia. He subsequently experienced numbness not only in the right lower teeth and gums but also on the ulnar side of the left hand. Neurological examinations revealed dysfunctions of the right abducens nerve, the right inferior dental plexus, and the left ulnar nerve, suggesting multiple mononeuropathy. Serum anti-GQ1b antibody was positive. This is a rare case report of a patient with unilateral abducens nerve palsy as an early feature of multiple mononeuropathy associated with anti-GQ1b antibody. We suggest that anti-GQ1b antibody syndrome should be taken into consideration as a differential diagnosis of acute multiple mononeuropathy if ophthalmoplegia is present unilaterally.

Kinno, Ryuta; Ichikawa, Hiroo; Tanigawa, Hiroto; Itaya, Kazuhiro; Kawamura, Mitsuru

2011-01-01

249

Outcome of axillary nerve injuries treated with nerve grafts.  

PubMed

This study evaluates the outcome of axillary nerve injuries treated with nerve grafting. Thirty-six patients were retrospectively reviewed after a mean of 53 months (minimum 12 months). The mean interval from injury to surgery was 6.5 months. Recovery of deltoid function was assessed by the power of both abduction and retropulsion, the deltoid bulk and extension lag. The deltoid bulk was almost symmetrical in nine of 34 cases, good in 22 and wasted in three. Grade M4 or M5* was achieved in 30 of 35 for abduction and in 32 of 35 for retropulsion. There was an extension lag in four patients. Deltoid bulk continued to improve with a longer follow-up following surgery. Nerve grafting to the axillary nerve is a reliable method of regaining deltoid function when the lesion is distal to its origin from the posterior cord. PMID:21546415

Okazaki, M; Al-Shawi, A; Gschwind, C R; Warwick, D J; Tonkin, M A

2011-09-01

250

Intraneural fibroma of the median nerve at the wrist.  

PubMed

Distal median neuropathy from carpal tunnel syndrome is the most well known lesion affecting the median nerve. Mass lesions may affect the nerve at the wrist. We present to our knowledge the first histologically confirmed case of an intraneural fibroma. PMID:24291475

Burrows, Anthony M; Folpe, Andrew L; Wenger, Doris E; Spinner, Robert J

2014-06-01

251

Posterior femoral cutaneous nerve entrapment neuropathy: operative exposure and technique.  

PubMed

An isolated posterior femoral cutaneous nerve lesion is rare. There have been seven reported cases to date. We report a 51-year-old male with pain in the posterolateral thigh, atypical from the classic anatomical description. Somatosensory evoked potentials were suggestive of a posterior femoral cutaneous nerve lesion. We describe our operative exposure and technique for decompression of the posterior femoral cutaneous nerve and include a comparative anatomical explanation for the unusual area of our patient's pain. PMID:12201406

Mobbs, R J; Szkandera, B; Blum, P

2002-06-01

252

Primary optic nerve sheath meningioma.  

PubMed Central

Fifty patients with optic nerve sheath meningiomas have been reviewed with a follow-up of up to 15 years. The median age at onset of their symptoms was 40.0 years. The majority were middle aged females with a slowly progressive lesion. More aggressive lesions were encountered in a younger, predominantly male group of patients with frequent intracranial involvement. Our experience indicates that a more aggressive surgical approach to these lesions is needed to prevent this sequence of events. Meningiomas in older individuals often do not need treatment, though radiotherapy can be beneficial. Images

Wright, J E; McNab, A A; McDonald, W I

1989-01-01

253

Results of untreated peripheral nerve injuries.  

PubMed

Closed injuries involving peripheral nerves are likely to occur in a severely comminuted fracture, a dislocated or stretched joint, or a fracture adjacent to a joint. Peripheral neuropathy associated with fractures are usually neurapraxia lesions and have an excellent prognosis for spontaneous recovery. Peripheral neuropathy associated with open injuries has a prognosis related to the etiology; lacerations are usually neurotmesis lesions and should be completely examined, explored, and sutured; shotgun wounds demand debridement and visualization of involved peripheral nerves; high-velocity missile wounds often create axonotmesis lesions, and involved peripheral nerves have a better prognosis for spontaneous recovery than peripheral neuropathy associated with low-velocity missile wounds. Complete and precise physical examination of peripheral nerve function at the time of injury is the best baseline for management. Electrodiagnostic studies should be initiated after one month and recorded periodically to evaluate the course of clinical recovery. It is appropriate to explore at three to four months the total nerve lesion associated with missile and shotgun wounds above the elbow or knee, stretch injuries from dislocated joints, and fractures that are severely comminuted or adjacent to joints. Many of these nerves will have a neuroma-in-continuity, and precise techniques for evaluation of nerve conduction must be utilized. PMID:7067246

Omer, G E

1982-03-01

254

Oblique ulnar shortening osteotomy by a single saw cut.  

PubMed

Ulnar shortening osteotomy is an effective treatment in patients with ulnar impaction syndrome. Accurate shortening and bony apposition can be obtained for a wide range of shortening lengths with a single-cut osteotomy technique. The saw kef produced by a single saw pass cuts a bony defect with parallel walls. The amount of shortening produced by using standard power bone saws can be increased by stacking as many as three blades together on the saw and by varying the angle at which the cut is made. The amount of shortening is a function of the angle at which the cut is made. The amount of shortening can be increased by a factor of twice the saw kerf if the cut is made at 60 degrees. We tabulated the shortening expected from over 100 combinations of power saw blades and cut angles. Using a series of experimental osteotomies, we demonstrated that the single-cut technique produces a more predictable amount of shortening than the technique of using two parallel cuts to remove a cuff of bone. The single-cut technique is useful for shortening any long bone. PMID:8775195

Labosky, D A; Waggy, C A

1996-01-01

255

Lesions in Nerves and Plexus after Radiotherapy.  

National Technical Information Service (NTIS)

Apart from the typical, radiation-induced changes in the skin, common secondary findings were oedemas, radiation-induced ulceration, fibroses of the mediastinum and lungs, pleura adhesions, and osteoradionecroses. In one patient with radiogenic paresis of...

W. Vees

1978-01-01

256

Cranial nerve injuries associated with carotid endarterectomy. A prospective study.  

PubMed

To determine the incidence and nature of cranial nerve damage in connection with carotid artery surgery, 139 patients were studied before and after 162 operations. Nerve damage was detected in association with 19.8% of the operations. The hypoglossal nerve was most commonly affected. The injuries were of benign character and usually resolved within 4 to 6 weeks. Apart from damage to the great auricular nerve, all lesions resolved within 5 months. The incidence of nerve disturbance was greater than that found in a retrospective study from the same hospital. Gentleness of technique is important in carotid artery surgery, in order to avoid nerve damage. PMID:4090884

Forssell, C; Takolander, R; Bergqvist, D; Bergentz, S E; Gramming, P; Kitzing, P

1985-01-01

257

Electrodiagnostic study of peripheral nerves in high-voltage electrical injury.  

PubMed

It is well known that peripheral nerves are very vulnerable to electricity. However, only a small portion of individuals who have had high-voltage electrical injury exhibit peripheral nerve damage. The aim of this study was to investigate peripheral nerve damage in high-voltage electrical injury, which often occurs in the industrial field. The authors reviewed the medical records of patients who were admitted to their hospital from January 2009 to December 2011, because of electrical injuries. The results of nerve conduction studies (NCSs) were reviewed retrospectively. NCS data of the injured site were compared with those of the opposite noninjured site and follow-up data. Thirty-seven extremities were reviewed. The authors found that 18 of 33 median nerves (48.6%) showed abnormalities in at least one parameter and 15 of 36 ulnar nerves (41.7%) exhibited abnormalities. There was no evidence of demyelination. Eight patients had undergone NCS on the opposite normal extremities. The compound muscle action potential and nerve conduction velocity were higher at the normal site. Follow-up NCS were performed in 14 patients: the compound muscle action potential and nerve conduction velocity values of all patients were improved. High-voltage electricity damaged peripheral nerves by causing axonal injury rather than demyelinating injury. Hence, even if NCSs yield normal findings, peripheral nerves may be damaged. F/U studies and opposite examinations are required for the exact evaluation of peripheral nerve damage. PMID:23877148

Kwon, Ki Han; Kim, Se Hoon; Minn, Yang Ki

2014-01-01

258

Optic Nerve Drusen  

MedlinePLUS

... Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Drusen En Español Read in Chinese What are optic nerve drusen? Optic nerve drusen are abnormal globular collections ...

259

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

260

Nerve conduction in relation to vibration exposure - a non-positive cohort study  

PubMed Central

Background Peripheral neuropathy is one of the principal clinical disorders in workers with hand-arm vibration syndrome. Electrophysiological studies aimed at defining the nature of the injury have provided conflicting results. One reason for this lack of consistency might be the sparsity of published longitudinal etiological studies with both good assessment of exposure and a well-defined measure of disease. Against this background we measured conduction velocities in the hand after having assessed vibration exposure over 21 years in a cohort of manual workers. Methods The study group consisted of 155 male office and manual workers at an engineering plant that manufactured pulp and paper machinery. The study has a longitudinal design regarding exposure assessment and a cross-sectional design regarding the outcome of nerve conduction. Hand-arm vibration dose was calculated as the product of self-reported occupational exposure, collected by questionnaire and interviews, and the measured or estimated hand-arm vibration exposure in 1987, 1992, 1997, 2002, and 2008. Distal motor latencies in median and ulnar nerves and sensory nerve conduction over the carpal tunnel and the finger-palm segments in the median nerve were measured in 2008. Before the nerve conduction measurement, the subjects were systemically warmed by a bicycle ergometer test. Results There were no differences in distal latencies between subjects exposed to hand-arm vibration and unexposed subjects, neither in the sensory conduction latencies of the median nerve, nor in the motor conduction latencies of the median and ulnar nerves. Seven subjects (9%) in the exposed group and three subjects (12%) in the unexposed group had both pathological sensory nerve conduction at the wrist and symptoms suggestive of carpal tunnel syndrome. Conclusion Nerve conduction measurements of peripheral hand nerves revealed no exposure-response association between hand-arm vibration exposure and distal neuropathy of the large myelinated fibers in a cohort of male office and manual workers.

2010-01-01

261

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.

Ellanti, Prasad; Harrington, Paul

2012-01-01

262

Direct nerve suture and knee immobilization in 90? flexion as a technique for treatment of common peroneal, tibial and sural nerve injuries in complex knee trauma  

PubMed Central

There are different ways to treat peripheral nerve injuries with concomitant defects in the lower extremity. One option is a direct nerve suture followed by immobilization of the knee in flexion as it is described for gunshot wounds that lead to lesions of the sciatic nerve and its terminal branches as well as isolated nerve lesions. We used this technique to treat a case of multiple nerve injuries of the lower extremity combined with a complex knee trauma including a lesion of both bones and the posterior capsule. To our knowledge, this technique has not yet been described for such a combined injury in literature.

Doring, Robert; Ciritsis, Bernhard; Giesen, Thomas; Simmen, Hans-Peter; Giovanoli, Pietro

2012-01-01

263

Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity(R) catheter system and the EnligHTN(TM) multi-electrode renal denervation catheter  

PubMed Central

Aims Catheter-based renal nerve ablation (RNA) using radiofrequency energy is a novel treatment for drug-resistant essential hypertension. However, the local endothelial and vascular injury induced by RNA has not been characterized, although this importantly determines the long-term safety of the procedure. Optical coherence tomography (OCT) enables in vivo visualization of morphologic features with a high resolution of 10–15 µm. The objective of this study was to assess the morphological features of the endothelial and vascular injury induced by RNA using OCT. Methods and results In a prospective observational study, 32 renal arteries of patients with treatment-resistant hypertension underwent OCT before and after RNA. All pre- and post-procedural OCT pullbacks were evaluated regarding vascular changes such as vasospasm, oedema (notches), dissection, and thrombus formation. Thirty-two renal arteries were evaluated, in which automatic pullbacks were obtained before and after RNA. Vasospasm was observed more often after RNA then before the procedure (0 vs. 42%, P < 0.001). A significant decrease in mean renal artery diameter after RNA was documented both with the EnligHTN™ (4.69 ± 0.73 vs. 4.21 ± 0.87 mm; P < 0.001) and with the Simplicity® catheter (5.04 ± 0.66 vs. 4.57 ± 0.88 mm; P < 0.001). Endothelial-intimal oedema was noted in 96% of cases after RNA. The presence of thrombus formations was significantly higher after the RNA then before ablation (67 vs. 18%, P < 0.001). There was one evidence of arterial dissection after RNA with the Simplicity® catheter, while endothelial and intimal disruptions were noted in two patients with the EnligHTN™ catheter. Conclusion Here we show that diffuse renal artery constriction and local tissue damage at the ablation site with oedema and thrombus formation occur after RNA and that OCT visualizes vascular lesions not apparent on angiography. This suggests that dual antiplatelet therapy may be required during RNA.

Templin, Christian; Jaguszewski, Milosz; Ghadri, Jelena R.; Sudano, Isabella; Gaehwiler, Roman; Hellermann, Jens P.; Schoenenberger-Berzins, Renate; Landmesser, Ulf; Erne, Paul; Noll, Georg; Luscher, Thomas F.

2013-01-01

264

Posterior femoral cutaneous nerve conduction.  

PubMed

The posterior femoral cutaneous nerve is a sensory nerve comprised of fibers originating from the anterior and posterior divisions of the first three sacral segments. It exists the pelvis distal to the piriformis muscle and proceeds distally, superficial to and between the medial and lateral hamstring musculature. The nerve's major cutaneous distribution is the posterior aspect of the thigh and a variable area of the posterior calf. An electrophysiologic technique to assess the peripheral axons of the posterior femoral cutaneous nerve is described. A recording electrode is placed 6cm proximal to the midpopliteal fossa and the nerve is stimulated supramaximally 12cm proximally on a line between the active electrode and the ischial tuberosity. A ground electrode is placed just proximal to the active recording electrode. The lower extremities of 40 individuals with a mean age of 34 years (20 to 78 years) were examined. The mean peak latency of the response is 2.8 (2.3 to 3.4) msec +/- 0.2msec with a mean amplitude of 6.5 (4.1 to 12.0) microV +/- 1.5 microV. This technique may facilitate the proximal evaluation of lower extremity peripheral neuropathies, lesions of the posterior femoral cutaneous nerve, or the assessment of the peripheral nervous system in persons with lower extremity amputations. PMID:2241545

Dumitru, D; Nelson, M R

1990-11-01

265

Advances of Peripheral Nerve Repair Techniques to Improve Hand Function: A Systematic Review of Literature  

PubMed Central

Concepts of neuronal damage and repair date back to ancient times. The research in this topic has been growing ever since and numerous nerve repair techniques have evolved throughout the years. Due to our greater understanding of nerve injuries and repair we now distinguish between central and peripheral nervous system. In this review, we have chosen to concentrate on peripheral nerve injuries and in particular those involving the hand. There are no reviews bringing together and summarizing the latest research evidence concerning the most up-to-date techniques used to improve hand function. Therefore, by identifying and evaluating all the published literature in this field, we have summarized all the available information about the advances in peripheral nerve techniques used to improve hand function. The most important ones are the use of resorbable poly[(R)-3-hydroxybutyrate] (PHB), epineural end-to-end suturing, graft repair, nerve transfer, side to side neurorrhaphy and end to side neurorrhaphy between median, radial and ulnar nerves, nerve transplant, nerve repair, external neurolysis and epineural sutures, adjacent neurotization without nerve suturing, Agee endoscopic operation, tourniquet induced anesthesia, toe transfer and meticulous intrinsic repair, free auto nerve grafting, use of distal based neurocutaneous flaps and tubulization. At the same time we found that the patient’s age, tension of repair, time of repair, level of injury and scar formation following surgery affect the prognosis. Despite the thorough findings of this systematic review we suggest that further research in this field is needed.

P, Mafi; S, Hindocha; M, Dhital; M, Saleh

2012-01-01

266

The boundary effect in magnetic stimulation. Analysis at the peripheral nerve.  

PubMed

The optimal stimulus position for a figure-8-shaped coil for magnetic stimulation of the ulnar nerve at the wrist was not coincident with the optimal electrical stimulus point but was shifted 18.3 mm to the ulnar side (P < 0.01). For the median nerve the optimal stimulus site was 9.6 mm radial to the optimal position for electrical stimulation (P < 0.05). This shift of the stimulus point for magnetic stimulation is significantly smaller after interposition of a homogenous electrically conducting medium between coil and arm but not changed after interposition of distilled water. This so-called boundary effect is therefore due to the different conductivities of the medium interposed between coil and nerve. It may also distort precise localisation of other excitable structures such as cranial nerves, nerve roots and cortical areas by means of magnetic stimuli. The amplitudes of the compound muscle action potentials elicited with identical magnetic stimulus strength were larger after the interposition of isotonic solution between coil and skin but not after interposition of distilled water. Consideration of the boundary effect provided an improved response amplitude to magnetic stimulation, but this could not adequately compensate for its poor localisation compared to electrical stimulation. PMID:7489685

Mathis, J; Seemann, U; Weyh, T; Jakob, C; Struppler, A

1995-10-01

267

Peripheral nerve regeneration through optic nerve grafts  

Microsoft Academic Search

Grafts of optic nerve were placed end-toend with the proximal stumps of severed common peroneal nerves in inbred mice. It was found that fraying the proximal end of adult optic nerve grafts to disrupt the glia limitans increased their chances of being penetrated by regenerating peripheral nerve fibres. Suturing grafts to the proximal stump also enhanced their penetration by axons.

P. N. Anderson; P. Woodham; M. Turmaine

1989-01-01

268

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).

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

2014-01-01

269

[Carpal tunnel syndrome and other nerve entrapment syndromes].  

PubMed

The carpal tunnel syndrome is the most common entrapment syndrome of the upper limb. Compression of the median nerve is most often idiopathic and typically occurs in women aged 50. The diagnosis is clinical and must look for signs of gravity (hypoesthesia, thenar atrophy). The electromyogram is not required but recommended for surgical indication, It assesses the severity of the disease and identifies other injury. Conservative treatment is available in the beginner to moderate forms. In case of failure of this treatment or with severe objective signs, treatment is surgical. The ulnar nerve at the elbow comes in the second position of the upper limb entrapment syndromes. Clinical examination looks for signs of serious problems with objectives symptoms. Treatment is usually surgical. PMID:24422297

Gouzou, Stéphanie; Liverneaux, Philippe

2013-11-01

270

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

271

Nerve regeneration using tubular scaffolds from biodegradable Polyurethane  

Microsoft Academic Search

\\u000a \\u000a Introduction  In severe nerve lesion, nerve defects and in brachial plexus reconstruction, autologous nerve grafting is the golden standard.\\u000a Although, nerve grafting technique is the best available approach a major disadvantages exists: there is a limited source\\u000a of autologous nerve grafts.\\u000a \\u000a This study presents data on the use of tubular scaffolds with uniaxial pore orientation from experimental biodegradable polyurethanes\\u000a coated with

T. Hausner; R. Schmidhammer; S. Zandieh; R. Hopf; A. Schultz; S. Gogolewski; H. Hertz; H. Redl

272

Pure peroneal intraneural ganglion cyst ascending along the sciatic nerve.  

PubMed

Peroneal nerve entrapment is most commonly seen in the popliteal fossa. It is rarely caused by a ganglion. Intraneural ganglia, although uncommon and seldom cause serious complications, are well recognized and most commonly affect the common peroneal (lateral popliteal) nerve. Ganglionic cysts developing in the sheath of a peripheral nerve or joint capsule may cause compression neuropathy. The differential diagnosis should involve L5 root lesions, posttraumatic intraneural hemorrhage, nerve compression near the tendinous arch located at the fibular insertion of the peroneal longus muscle and nerve-sheath tumors. We present a unique case of a pure intraneural ganglion of the common peroneal nerve ascending along the sciatic nerve. This case underscores the importance of consideration of an intraneural ganglion cyst with sciatic nerve involvement. PMID:21534214

Tehli, Ozkan; Celikmez, Ramazan Cengiz; Birgili, Baris; Solmaz, Ilker; Celik, Ertugrul

2011-01-01

273

Perspectives in regeneration and tissue engineering of peripheral nerves.  

PubMed

Peripheral nerve injury is a common casualty and although peripheral nerve fibers retain a considerable regeneration potential also in the adult, recovery is usually rather poor, especially in case of large nerve defects. The aim of this paper is to address the perspectives in regeneration and tissue engineering after peripheral nerve injury by reviewing the relevant experimental studies in animal models. After a brief overview of the morphological changes related to peripheral nerve injury and regeneration, the paper will address the evolution of peripheral nerve tissue engineering with special focus on transplantation strategies, from organs and tissues to cells and genes, that can be carried out, particularly in case of severe nerve lesions with substance loss. Finally, the need for integrated research which goes beyond therapeutic strategies based on single approaches is emphasized, and the importance of bringing together the various complimentary disciplines which can contribute to the definition of effective new strategies for regenerating the injured peripheral nerve is outlined. PMID:21474294

Raimondo, Stefania; Fornaro, Michele; Tos, Pierluigi; Battiston, Bruno; Giacobini-Robecchi, Maria G; Geuna, Stefano

2011-07-01

274

Malignant peripheral nerve sheath tumour following radiotherapy for pituitary adenoma.  

PubMed

Intracranial malignant peripheral nerve sheath tumour (MPNST) is an extremely rare lesion. We report a patient with an MPNST in the sellar region following radiotherapy for pituitary adenoma. PMID:23830587

Guo, Fuyou; Song, Laijun; Meng, Yanju

2014-01-01

275

Mechanical injury of peripheral nerves. Fine structure and dysfunction.  

PubMed

In summary we have examined the morphology of the normal peripheral nerve, presented the types of mechanical nerve injury and associated histopathology, and discussed possible mechanisms responsible for symptoms of pain, paresthesiae, and weakness associated with these lesions. Neurapraxia consists of intussusception of axon and myelin through the nodes of Ranvier resulting in prolonged nerve conduction block. Axonotmesis and neurotmesis describe more severe disruptions of nerve fiber architecture, are difficult to distinguish electrophysiologically, and have poorer prognoses for functional regenerative repair. Chronic entrapment lesions consist of telescoping myelin internodes and tapering of the sheaths with bulbous polarization of internodes away from the site of injury. Both acute and chronic lesions chiefly involve large myelinated fibers and both may create neuralgia, although the mechanism by which this occurs is poorly understood. Presently, increasing evidence suggests ectopic impulse generators and ephaptic transmission may be responsible for sensorimotor phenomena in these lesions. PMID:6323088

Castaldo, J E; Ochoa, J L

1984-01-01

276

Optic Nerve Imaging  

MedlinePLUS

Optic Nerve Imaging email Send this article to a friend by filling out the fields below: Your name: Your ... measurements of nerve fiber damage (or loss). The Nerve Fiber Analyzer (GDx) uses laser light to measure ...

277

Cervical Radiculopathy (Pinched Nerve)  

MedlinePLUS

... American Academy of Orthopaedic Surgeons. Cervical Radiculopathy (Pinched Nerve) Some people have neck pain that may radiate ... an injury near the root of a spinal nerve. A nerve root injury is sometimes referred to ...

278

Femoral nerve damage (image)  

MedlinePLUS

The femoral nerve is located in the leg and supplies the muscles that assist help straighten the leg. It supplies sensation ... leg. One risk of damage to the femoral nerve is pelvic fracture. Symptoms of femoral nerve damage ...

279

Nerve conduction velocity  

MedlinePLUS

Nerve conduction velocity (NCV) is a test to see how fast electrical signals move through a nerve. ... surface electrodes are placed on the skin over nerves at various locations. Each patch gives off a ...

280

Optic Nerve Pit  

MedlinePLUS

... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Pit What is optic nerve pit? An optic nerve pit is a ... may be seen in both eyes. How is optic pit diagnosed? If the pit is not affecting ...

281

Cranial nerve assessment: a concise guide to clinical examination.  

PubMed

Examination of the cranial nerves is an integral and important part of a complete neurological examination. Historically, these skills were crucial for diagnosing specific lesions. With the development of modern imaging modalities, the significance of clinical examination techniques has perhaps been undermined. The authors present an overview of each cranial nerve with a concise summary of examination techniques. PMID:24307604

Damodaran, Omprakash; Rizk, Elias; Rodriguez, Julian; Lee, Gabriel

2014-01-01

282

Ophthalmoplegic migraine and aberrant regeneration of the oculomotor nerve.  

PubMed Central

A patient with ophthalmoplegic migraine developed aberrant regeneration of the oculomotor nerve. This finding supports the view that the oculomotor nerve lesion in ophthalmoplegic migraine is peripheral, but its rarity suggests that the underlying mechanism may be ischaemic rather than compression by an oedematous intracavernous internal carotid artery. Images

O'Day, J; Billson, F; King, J

1980-01-01

283

Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study  

Microsoft Academic Search

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

Agha

1983-01-01

284

Etifoxine improves peripheral nerve regeneration and functional recovery  

Microsoft Academic Search

Peripheral nerves show spontaneous regenerative responses, but recovery after injury or peripheral neuropathies (toxic, diabetic, or chronic inflammatory demyelinating polyneuropathy syndromes) is slow and often incomplete, and at present no efficient treatment is available. Using well-defined peripheral nerve lesion paradigms, we assessed the therapeutic usefulness of etifoxine, recently identified as a ligand of the translocator protein (18 kDa) (TSPO), to

Christelle Girard; Song Liu; Françoise Cadepond; David Adams; Catherine Lacroix; Marc Verleye; Jean-Marie Gillardin; Etienne-Emile Baulieu; Michael Schumacher; Ghislaine Schweizer-Groyer

2008-01-01

285

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

PubMed

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

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

2008-12-01

286

Neurinoma originating from the recurrent nerve: report of a case.  

PubMed

Schwannoma is an uncommon, peripheral nerve sheath tumor of the neck that can occur either as an isolated lesion or multiple lesions. Multiple schwannomas, as seen in neurofibromatosis, occur less frequently. The rare occurrence and poorly defined symptoms of these tumors often make their preoperative diagnosis difficult. This report describes an unusual case of recurrent nerve Schwannoma which was successfully identified by color Doppler sonography. PMID:18612788

Varaldo, Emanuela; Crespi, Giovanni; Ansaldo, Gian Luca; Borgonovo, Giacomo; Boccardo, Francesco; Torre, Giancarlo

2008-01-01

287

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

288

Laparoscopic nerve-sparing transperitoneal approach for endometriosis infiltrating the pelvic wall and somatic nerves: anatomical considerations and surgical technique  

Microsoft Academic Search

Purpose  Endometriotic or fibrotic involvement of sacral plexus and pudendal and sciatic nerves may be quite frequently the endopelvic\\u000a cause of ano-genital and pelvic pain. Feasibility of a laparoscopic transperitoneal approach to the somatic nerves of the\\u000a pelvis was determined and showed by Possover et al. for diagnosis and treatment of ano-genital pain caused by pudendal and\\/or\\u000a sacral nerve roots lesions

Marcello Ceccaroni; Roberto Clarizia; Carlo Alboni; Giacomo Ruffo; Francesco Bruni; Giovanni Roviglione; Marco Scioscia; Inge Peters; Giuseppe De Placido; Luca Minelli

2010-01-01

289

Distal ulnar-basilic fistula as the first hemodialysis access.  

PubMed

Purpose: A distal forearm ulnar-basilic (UB) arteriovenous fistula (AVF) can be chosen if a radial-cephalic (RC)-AVF is not suitable for a primary AVF. However, limited data are available on the feasibility of using a distal forearm UB-AVF as an option for primary AVF.Methods: This retrospective analysis included 446 patients for whom AVFs (417 RC and 29 UB) had been newly created from January 2003 to December 2009, at our hospital. Patients in whom the arterial or venous anatomy precluded RC-AVF creation, UB-AVF was established as distally as possible on the forearm. Patency, defined as access survival after creation, was calculated using Kaplan-Meier analysis. The difference in patency between the two groups was examined using log-rank test.Results: The primary patency of UB-AVFs was significantly lower than that of RC-AVFs (p=0.037, log-rank test). The primary patency rate at 1 year was 25.0% versus 44.7%, respectively. However, there was no significant difference in secondary patency between the two groups. The secondary patency rate at 1 year was 85.5% for UB-AVFs versus 82.9% for RC-AVFs. The incidence rate of percutaneous angioplasty until access abandonment per patient-years was 1.100 for UB-AVFs versus 0.671 for RC-AVFs. There was no difference in the time to maturation between the two groups.Conclusions: The secondary patency rate of UB-AVF is similar to that of RC-AVF. We recommend the creation of an UB-AVF when an RC-AVF is not a suitable option for the primary AVF. PMID:24101419

Shintaku, Sadanori; Kawanishi, Hideki; Moriishi, Misaki; Bansyodani, Masataka; Tsuchiya, Shinichiro

2014-05-01

290

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

NASA Technical Reports Server (NTRS)

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

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

1993-01-01

291

Anatomic basis of ulnar index metacarpal reverse flow vascularized bone graft for index distal bone loss.  

PubMed

Well-known advantages of vascularized bone grafts led us to determine the anatomical basis of a metacarpal vascularized bone graft to find a solution for distal index bone loss. Seventeen adult human hands from fresh cadavers were dissected and analyzed. For each hand, we studied the second dorsal metacarpal artery, the ulnar dorsal proper digital artery of index, and the ulnar palmar proper digital artery of the index. Location, diameters, origins, and anastomoses were observed, and at the end, the vascularised bone graft was raised. The second dorsal metacarpal artery was present in all hands, always arising from the dorsal carpal arch with a 1-mm mean diameter. The ulnar dorsal proper digital artery of index was isolated on all dissections, with a subcutaneous location on the ulno-dorsal side of the proximal phalanx. The mean diameter of ulnar dorsal proper digital artery at the level of index proximal phalanx was 0.4 mm. We found anastomotic branches between the ulnar dorsal and palmar proper digital artery of index at the level of the proximal phalanx which permitted us to elevate a vascularised bone graft. We succeeded in removing the graft in all specimens. Its pivot point was always more distal than the middle of the proximal phalanx. The arc of rotation allowed the graft to reach the distal phalanx in 80% of the cases. This anatomical study has demonstrated the theoretical possibility of a reversed pedicled bone graft taken from the ulnar neck of the second metacarpal. This graft brings the following benefits: (a) the use of a minor vascular axis, (b) a surgical technique with a dorsal approach allowing the elevation and the use of the graft at the same time. It can be used on the index for failures of DIP joint arthrodesis, huge chondroma, or traumatology. PMID:20461513

Ardouin, L; Le Nen, D; Geffard, B; Hanouz, N; Vielpeau, C; Salame, E

2010-10-01

292

High division of the axillary artery. A rare case of superficial ulnar artery.  

PubMed

A case is presented here in which the axillary artery divided into two branches, the lateral branch being situated more deeply with respect to the medial branch. The superficial branch gave rise to only thin muscular branches in the arm and coursed along the ulnar artery in the forearm but did not provide the branches which should arise from this artery. On the other hand, the deeply coursing artery provided the branches of the brachial artery in the arm and from the cubital fossa downwards it provided the branches which normally arise from the ulnar artery. PMID:7879595

Ozan, H; Sim?ek, C; Ondero?lu, S; Kirici, Y; Ba?ar, R

1994-01-01

293

Benign neural sheath tumours of major nerves: Characteristics in 119 surgical cases  

Microsoft Academic Search

Summary Peripheral benign nerve sheath tumours are infrequent tumours and affect major nerve trunks. Some authors have indicated a high and prohibitive incidence of neurological injury in resection of these lesions. The authors describe their findings in a retrospective study comprising 119 patients with spontaneous benign nerve sheath tumours of the peripheral nervous system. Seventy-three patients had a schwannoma, 41

M. Artico; L. Cervoni; V. Wierzbicki; V. D'Andrea; F. Nucci

1997-01-01

294

Intrasellar malignant peripheral nerve sheath tumor (MPNST)  

Microsoft Academic Search

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

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

2007-01-01

295

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

296

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

297

Effects of 940 nm light-emitting diode (led) on sciatic nerve regeneration in rats  

Microsoft Academic Search

The objective of the present study was to evaluate the effect of 940 nm wavelength light emitting diode (LED) phototherapy\\u000a on nerve regeneration in rats. Forty male Wistar rats weighing approximately 300 g each were divided into four groups: control\\u000a (C); control submitted to LED phototherapy (CLed); Sciatic Nerve Lesion without LED phototherapy (L); Sciatic Nerve Lesion\\u000a with LED phototherapy (LLed). The

Karla Guivernau Gaudens Serafim; Solange de Paula Ramos; Franciele Mendes de Lima; Marcelo Carandina; Osny Ferrari; Ivan Frederico Lupiano Dias; Dari de Oliveira Toginho Filho; Cláudia Patrícia Cardoso Martins Siqueira

298

Neonatal ventral hippocampus lesion leads to reductions in nerve growth factor inducible-B mRNA in the prefrontal cortex and increased amphetamine response in the nucleus accumbens and dorsal striatum  

Microsoft Academic Search

Converging evidence in schizophrenia suggests prefrontal cortical neuronal deficits that correlate with exaggerated subcortical dopamine (DA) functions: Excitotoxic lesion of the ventral hippocampus (VH) in neonatal rats is widely considered a putative animal model of schizophrenia as they lead to characteristic post-pubertal emergence of behavioral and cognitive abnormalities suggesting a developmental change in the neural circuits comprising the prefrontal cortex

S. K. BHARDWAJ; G. BEAUDRY; D. LEVESQUEb; L. K. SRIVASTAVAa

2003-01-01

299

Disability following combat-sustained nerve injury of the upper limb.  

PubMed

Injuries to the limb are the most frequent cause of permanent disability following combat wounds. We reviewed the medical records of 450 soldiers to determine the type of upper limb nerve injuries sustained, the rate of remaining motor and sensory deficits at final follow-up, and the type of Army disability ratings granted. Of 189 soldiers with an injury of the upper limb, 70 had nerve-related trauma. There were 62 men and eight women with a mean age of 25 years (18 to 49). Disabilities due to nerve injuries were associated with loss of function, neuropathic pain or both. The mean nerve-related disability was 26% (0% to 70%), accounting for over one-half of this cohort's cumulative disability. Patients injured in an explosion had higher disability ratings than those injured by gunshot. The ulnar nerve was most commonly injured, but most disability was associated with radial nerve trauma. In terms of the final outcome, at military discharge 59 subjects (84%) experienced persistent weakness, 48 (69%) had a persistent sensory deficit and 17 (24%) experienced chronic pain from scar-related or neuropathic pain. Nerve injury was the cause of frequent and substantial disability in our cohort of wounded soldiers. PMID:24493193

Rivera, J C; Glebus, G P; Cho, M S

2014-02-01

300

Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions.  

PubMed

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

Ahlawat, Shivani; Chhabra, Avneesh; Blakely, Jaishri

2014-02-01

301

Pudendal nerve branch injury during radical perineal prostatectomy.  

PubMed

We report the first case of direct surgical injury to a pudendal nerve branch during radical perineal prostatectomy. A 65-year-old patient presented with typical symptoms of a pudendal nerve lesion after radical perineal prostatectomy. As the patient did not respond to conservative treatment, surgical exploration and exeresis of the injured sensory branch of the pudendal nerve was necessary, resulting in pain improvement. Urologic surgeons should be aware of the typical symptoms after iatrogenic injury to the pudendal nerve or its branches. Early diagnosis and neurosurgical intervention are important to obtain a more favorable outcome. PMID:16461104

Gillitzer, R; Hampel, C; Wiesner, C; Pahernik, S; Melchior, S W; Thüroff, J W

2006-02-01

302

The Primary Sauve–Kapandji Procedure—For Treatment of Comminuted Distal Radius and Ulnar Fractures  

Microsoft Academic Search

We have performed primary Sauve–Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The

E. HORII; T. OHMACHI; R. NAKAMURA

2005-01-01

303

Design and implementation of an instrumented ulnar head prosthesis to measure loads in vitro  

Microsoft Academic Search

The development of a novel instrumented implant for ulnar head replacement is presented in this study. This implant was instrumented with strain gauges to quantify bending moments about the anatomic axes of the distal ulna, and subsequently the distal radioulnar joint (DRUJ) reaction force magnitude. The implant was surgically inserted in seven cadaveric upper extremities, which were subsequently mounted in

Karen D. Gordon; Angela E. Kedgley; Louis M. Ferreira; Graham J. W. King; James A. Johnson

2006-01-01

304

Comminuted fracture of the ulnar carpal bone in a Labrador retriever dog  

PubMed Central

A 4-year-old male Labrador retriever dog was evaluated for acute lameness without weight-bearing in the right forelimb after an 8-meter fall. Radiographs revealed a comminuted fracture of the ulnar carpal bone that required removal of bone fragments. This appears to be the first report of such a condition.

Vedrine, Bertrand

2013-01-01

305

Elbow Ulnar Collateral Ligament Reconstruction in Javelin Throwers at a Minimum 2Year Follow-up  

Microsoft Academic Search

Background: There are several large series of outcomes after ulnar collateral ligament (UCL) reconstruction that have 1 or 2 javelin throwers included. To our knowledge, however, there are no reports that focus solely on the results of UCL reconstruction in this group of athletes.Hypothesis\\/Purpose: We hypothesize that by using modern UCL reconstruction techniques, javelin throwers can reliably expect to return

Joshua S. Dines; Kristofer J. Jones; Cynthia Kahlenberg; Andrew Rosenbaum; Daryl C. Osbahr; David W. Altchek

2012-01-01

306

Valgus Laxity of the Ulnar Collateral Ligament of the Elbow in Collegiate Athletes  

Microsoft Academic Search

In this investigation, we determined the patterns of valgus laxity and acquired valgus laxity of the ulnar collateral ligament in the elbows of collegiate athletes involved in overhead and nonoverhead sports. Acquired valgus laxity of the elbow is defined as the differential amount of stress valgus opening between the dominant and nondominant elbows. Forty-eight asymptomatic male athletes involved in sports

Hardayal Singh; Daryl C. Osbahr; M. Quinn Wickham; Donald T. Kirkendall; Kevin P. Speer

2001-01-01

307

Reconstruction of an ulnar-sided thumb in central deficiency: a case report.  

PubMed

The thumb, which is normally located on the radial border of the hand, requires adequate sensibility to perceive its environment and adequate mobility to oppose to the other digits. We present a case in which the most ulnar digit of the hand was surgically augmented to function as a thumb. PMID:11172366

Segalman, K A; McClinton, M A; Anthony, M S

2001-01-01

308

Sensory nerve action potentials and sensory perception in women with arthritis of the hand  

PubMed Central

Background Arthritis of the hand can limit a person’s ability to perform daily activities. Whether or not sensory deficits contribute to the disability in this population remains unknown. The primary purpose of this study was to determine if women with osteoarthritis (OA) or rheumatoid arthritis (RA) of the hand have sensory impairments. Methods Sensory function in the dominant hand of women with hand OA or RA and healthy women was evaluated by measuring sensory nerve action potentials (SNAPs) from the median, ulnar and radial nerves, sensory mapping (SM), and vibratory and current perception thresholds (VPT and CPT, respectively) of the second and fifth digits. Results All SNAP amplitudes were significantly lower for the hand OA and hand RA groups compared with the healthy group (p?ulnar and radial nerves. Less apparent were losses in conduction speed or sensory perception.

2012-01-01

309

Vascularized sural nerve graft and extracorporeally irradiated osteochondral autograft for oncological reconstruction of wrist sarcoma: case report and review of literature.  

PubMed

For tumors that are located beside the main peripheral nerve, combined wide resection of both the tumor and peripheral nerve is mandatory. We here present an interesting case with synovial sarcoma of the wrist. An 8 cm of ulnar nerve defect was reconstructed by vascularized, folded sural nerve graft with the peroneal flap, whereas an 8 cm of distal ulna was reconstructed using extracorporeally irradiated osteochondral autograft. Our case showed excellent nerve regeneration. Extracorporeal irradiated osteochondral graft was a good option for reconstruction of the distal ulna. This procedure should be indicated for the reconstruction of non-weight-bearing joints. These kinds of reconstruction have been addressed in only a few cases of oncological reconstruction. PMID:24051468

Muramatsu, Keiichi; Moriya, Atsushi; Miyoshi, Tomoyuki; Tominaga, Yasuhiro; Seto, Shinichiro; Taguchi, Toshihiko

2013-11-01

310

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.

Arora, Abhishek J.

2014-01-01

311

Avoidance of transection of the palmar cutaneous branch of the median nerve in carpal tunnel release.  

PubMed

The course of the palmar cutaneous branch of the median nerve (PCBMN) was studied in 25 fresh cadaveric upper extremities in order to identify its relation to local structures and commonly used incisions for carpal tunnel release. The PCBMN was found to closely underlie the thenar crease (average, 0-2 mm radial to crease; range, 6 mm ulnar to 6 mm radial to thenar crease), suggesting that an incision fashioned in the thenar crease would lead to frequent PCBMN injury. The PCBMN was also found to cross the axis of the ring finger when the axis was determined with the finger flexed into the palm. The axis of the ring finger, as drawn with the ring finger extended, projected in a more ulnar direction. The PCBMN was an average of 9 mm radial to this projection (range, 1-16 mm). An analysis of 100 human volunteer hands demonstrated that the deepest point between the thenar and hypothenar eminencies was a constant landmark in the proximal palm (interthenar depression). The PCBMN traveled an average of 5 mm radial to the interthenar depression (range, 0-12 mm radial). Thenar crease anatomy and ring finger projection were highly variable both in absolute location and configuration, providing a poor basis for incision placement. An incision placed approximately 5 mm ulnar to the interthenar depression, extending in the direction of the third web space, will decrease the incidence of injury to the PCBMN. PMID:8842959

Watchmaker, G P; Weber, D; Mackinnon, S E

1996-07-01

312

Evaluation of Tookad-mediated photodynamic effect on peripheral nerve and pelvic nerve in a canine model  

NASA Astrophysics Data System (ADS)

Photodynamic therapy (PDT) mediated with a novel vascular targeting photosensitizer pd-bacteriopheophorbide (Tookad) has been investigated as an alternative modality for the treatment of prostate cancer and other diseases. This study investigated, for the first time, the vascular photodynamic effects of Tookad-PDT on nerve tissues. We established an in situ canine model using the cutaneous branches of the saphenous nerve to evaluate the effect of Tookad-PDT secondary to vascular damage on compound-action potentials. With Tookad dose of 2 mg/kg, treatment with 50 J/cm2 induced little change in nerve conduction. However, treatment with 100 J/cm2 resulted in decreases in nerve conduction velocities, and treatment with 200 J/cm2 caused a total loss of nerve conduction. Vasculature surrounding the saphenous nerve appeared irritated. The nerve itself looked swollen and individual fibers were not as distinct as they were before PDT treatment. Epineurium had mild hemorrhage, leukocyte infiltration, fibroplasias and vascular hypertrophy. However, the nerve fascicles and nerve fibers were free of lesions. We also studied the effect of Tookad-PDT secondary to vascular damage on the pelvic nerve in the immediate vicinity of the prostate gland. The pelvic nerve and saphenous nerve showed different sensitivity and histopathological responses to Tookad-PDT. Degeneration nerve fibers and necrotic neurons were seen in the pelvic nerve at a dose level of 1 mg/kg and 50 J/cm2. Adjacent connective tissue showed areas of hemorrhage, fibrosis and inflammation. Our preliminary results suggest that possible side effects of interstitial PDT on prostate nerve tissues need to be further investigated.

Hetzel, Fred W.; Chen, Qun; Dole, Kenneth C.; Blanc, Dominique; Whalen, Lawrence R.; Gould, Daniel H.; Huang, Zheng

2006-03-01

313

Bilateral phasic increases in dorsal root ganglia nerve growth factor synthesis after unilateral sciatic nerve crush.  

PubMed

The amount of nerve growth factor (NGF) in the L5, L6, and cervical dorsal root ganglia of rats was examined from 1 to 30 days after a unilateral crush lesion of the sciatic nerve and adjacent branches of the lumbar plexus at the level of the sciatic notch. Unilateral nerve crush produced increases in NGF content of lumbar ganglia at 1, 4, and 7-8 days after injury, with increased NGF mRNA at 4 and 7-8 days. Increases in NGF at 1 and 4 days were most pronounced on the unlesioned side while increases at days 7 and 8 were most pronounced on the lesioned side. NGF content increased in cervical ganglia of nerve-lesioned animals at 3 and 7 days after injury and in lumbar and cervical ganglia of sham-operated animals 3-5 days after surgery, with no comparable changes in NGF mRNA. Elevations of ganglionic NGF coincide temporally with some of the alterations in metabolism and morphology which occur in dorsal root ganglion neurons after sciatic nerve crush. However, the bilateral nature of increases in NGF demonstrates that the factor(s) producing the response is not restricted to ganglia axotomized by the injury. The data suggest that ganglionic NGF may be regulated by systemic factors, produced during stress or trauma, as well as by factors from the denervated target tissue and/or regenerating axons. PMID:7843302

Wells, M R; Vaidya, U; Schwartz, J P

1994-01-01

314

Hypoglossal nerve monitoring, a potential application of intraoperative nerve monitoring in head and neck surgery  

PubMed Central

Background Intraoperative nerve monitoring (IONM) has many applications in different surgical fields. In head and neck surgery, IONM has been used to perform surgery of the parotid, thyroid and parathyroid glands, preserving the facial and recurrent nerves. However, hypoglossal nerve neuromonitoring has not been addressed with such relevance. Material and methods A retrospective review of surgeries performed on patients with special tongue and floor of mouth conditions was undertaken to examine the indications that prompted its use. Particular attention was given to the pathology, intraoperative findings and the final outcome of each patient. Results Four patients, aged between 6 years and 68 years, with complex oral tongue and floor of mouth lesions were reviewed. Three patients were male, aged 22 years and younger, and two of these patients had oral tongue cancers with previous surgery. Oral tongue and neck conditions are challenging since the functions of the hypoglossal nerve are put at risk. The use of IONM technology allowed us to preserve nerve functions, speech and swallowing. Conclusions Although IONM of the hypoglossal nerve is not a common indication in tongue and floor of mouth lesions, under special conditions its application can be extrapolated to challenging surgical cases, like the ones described.

2013-01-01

315

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

PubMed

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

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

2014-01-01

316

Extensor tendon rupture caused by instability of the ulnar head with an osteoarthritic distal radioulnar joint: a case report  

PubMed Central

Introduction Although spontaneous extensor tendon rupture often occurs in association with rheumatoid arthritis, extensor tendon rupture associated with osteoarthritis of the distal radioulnar joint has been rarely reported. Case presentation We present the case of a 74-year-old Asian woman with a fourth and fifth extensor tendon rupture caused by instability of the ulnar head associated with an osteoarthritic distal radioulnar joint. Intraoperative findings showed that the cause of the dorsal capsular perforation and extensor tendon rupture was mechanical friction with the unstable ulnar head, which had no osteophytes or roughness. After tendon transfer and resection of the ulnar head, our patient can extend her ring and little fingers without difficulty for her daily activities. Conclusions When a patient with osteoarthritic distal radioulnar joint has instability of the ulnar head and the ‘scallop sign’ on radiography, physicians should consider the possibility of extensor tendon rupture as a complication.

2013-01-01

317

Nerve Injuries in Athletes.  

ERIC Educational Resources Information Center

Over a two-year period this study evaluated the condition of 65 athletes with nerve injuries. These injuries represent the spectrum of nerve injuries likely to be encountered in sports medicine clinics. (Author/MT)

Collins, Kathryn; And Others

1988-01-01

318

Radial nerve dysfunction (image)  

MedlinePLUS

The radial nerve travels down the arm and supplies movement to the triceps muscle at the back of the upper arm. ... the wrist and hand. The usual causes of nerve dysfunction are direct trauma, prolonged pressure on the ...

319

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

320

Diabetes and nerve damage  

MedlinePLUS

Nerve damage that occurs in people with diabetes is called diabetic neuropathy. This condition is a complicaiton ... In people with diabetes, the body's nerves can be damaged by ... level . This condition is more likely when blood sugar level ...

321

Electronic Nerve Agent Detector.  

National Technical Information Service (NTIS)

A personal field chemical warfare nerve agent detector has therein a transducer having two microchemical cantilever oscillators. One of the cantilever oscillators has deposited, as an end-mass, a chemically selective substance on the cantilever. The nerve...

E. S. Kolesar

1983-01-01

322

Combined Flexor-Pronator Mass and Ulnar Collateral Ligament Injuries in the Elbows of Older Baseball Players  

Microsoft Academic Search

Background: Ulnar collateral ligament reconstruction techniques have afforded baseball players up to a reported 90% return to prior or higher level of play. A subpopulation exists with less impressive clinical outcomes potentially related to the presence of a concomitant flexor-pronator mass injury.Hypothesis\\/Purpose: Combined flexor-pronator and ulnar collateral ligament injuries occur in older players, and results in this group are inferior

Daryl C. Osbahr; Swarup S. Swaminathan; Answorth A. Allen; Joshua S. Dines; Struan H. Coleman; David W. Altchek

2010-01-01

323

Engineering peripheral nerve repair.  

PubMed

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

Marquardt, Laura M; Sakiyama-Elbert, Shelly E

2013-10-01

324

Cortical Brain Mapping of Peripheral Nerves Using Functional Magnetic Resonance Imaging in a Rodent Model  

PubMed Central

The regions of the body have cortical and subcortical representation in proportion to their degree of innervation. The rat forepaw has been studied extensively in recent years using functional magnetic resonance imaging (fMRI)—typically by stimulation using electrodes directly inserted into the skin of the forepaw. Here, we stimulate using surgically implanted electrodes. A major distinction is that stimulation of the skin of the forepaw is mostly sensory, whereas direct nerve stimulation reveals not only the sensory system but also deep brain structures associated with motor activity. In this paper, we seek to define both the motor and sensory cortical and subcortical representations associated with the four major nerves of the rodent upper extremity. We electrically stimulated each nerve (median, ulnar, radial, and musculocutaneous) during fMRI acquisition using a 9.4T Bruker scanner. A current level of 0.5-1.0 mA and a frequency of 5 Hz were used while keeping the duration constant. A distinct pattern of cortical activation was found for each nerve that can be correlated with known sensorimotor afferent and efferent pathways to the rat forepaw. This direct nerve stimulation rat model can provide insight into peripheral nerve injury.

Cho, Younghoon R.; Jones, Seth R.; Pawela, Christopher P.; Li, Rupeng; Kao, Dennis S.; Schulte, Marie L.; Runquist, Matthew L.; Yan, Ji-Geng; Hudetz, Anthony G.; Jaradeh, Safwan S.; Hyde, James S.; Matloub, Hani S.

2008-01-01

325

Cranial Nerves Model  

NSDL National Science Digital Library

Lesson is designed to introduce students to cranial nerves through the use of an introductory lecture. Students will then create a three-dimensional model of the cranial nerves. An information sheet will accompany the model in order to help students learn crucial aspects of the cranial nerves.

Juliann Garza (University of Texas-Pan American Physician Assistant Studies)

2010-08-16

326

Laryngeal nerve damage  

MedlinePLUS

Laryngeal nerve damage is injury to one or both of the nerves that are attached to the voice box. ... Injury to the laryngeal nerves is uncommon. It it does occur, it can be from: A complication of neck or chest surgery (especially thyroid, lung, ...

327

Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow.  

PubMed

Because of a lack of biomechanical studies of lateral elbow ligament reconstruction in the literature, the initial stability afforded by 3 different techniques of lateral ulnar collateral ligament reconstruction was evaluated in 8 cadaveric elbows. The arm was mounted in a testing apparatus, and passive flexion was performed with the arm in varus and valgus orientations. A pivot shift test was performed with the arm in the vertical orientation. An electromagnetic tracking device was used to quantify motion pathways. After intact testing, each specimen underwent sectioning of the radial collateral and lateral ulnar collateral ligaments from the lateral epicondyle. Reconstruction of the lateral ulnar collateral ligament was performed in a randomized sequence, consisting of proximal single-strand, distal single-strand, and double-strand tendon grafts. Division of the radial collateral and lateral ulnar collateral ligaments from the lateral epicondyle caused a significant decrease in rotational stability when the pivot shift test was being performed (P <.0001). Varus-valgus stability also decreased after transection of the radial collateral and lateral ulnar collateral ligaments (P <.0001). Reconstruction of the lateral ulnar collateral ligament restored elbow stability to that of the intact state. There was no significant difference in stability between the single- and double-strand repair techniques (P >.05). This study demonstrates that both single- and double-strand reconstructions restore varus and posterolateral elbow stability and may be considered appropriate reconstructive procedures in patients with symptomatic insufficiency of the lateral ligaments of the elbow. PMID:11845151

King, Graham J W; Dunning, Cynthia E; Zarzour, Zane D S; Patterson, Stuart D; Johnson, James A

2002-01-01

328

Effects of cisapride on constipation due to a neurological lesion.  

PubMed

Two patients with intractable constipation and an atonic bladder due to a partial spinal cord lesion and sacral nerve lesion are described. Treatment with cisapride (4 x 10 mg daily) was undertaken. After a few days the stool passed spontaneously. The effect was dose-dependent and has been maintained for at least 40 months. Normal bladder function was not achieved. PMID:3419861

de Groot, G H; de Pagter, G F

1988-06-01

329

The primary Sauve-Kapandji procedure--for treatment of comminuted distal radius and ulnar fractures.  

PubMed

We have performed primary Sauve-Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 76 degrees , the mean pronation/supination arc was 135 degrees, and grip strength was 64% of the contralateral side. All patients returned to their work or daily activities within short time period without any additional surgical treatment, except for removal of implants in three patients. The primary Sauve-Kapandji procedure is effective for the reconstruction of severely combined distal radius and ulnar fractures. PMID:15620494

Horii, E; Ohmachi, T; Nakamura, R

2005-02-01

330

[Foot lesions].  

PubMed

The foot is the target organ of a variety of internal diseases. Of upmost importance is the diabetic foot syndrome (DFS). Its complex pathophysiology is driven by the diabetic neuropathy, a vastly worsening effect is contributed by infection and ischemia. Seemingly localised lesions have the potential for phlegmone and septicaemia if not diagnosed and drained early. The acral lesions of peripheral artery occlusive disease (PAOD) have unique features as well. However, their life-threatening potential is lower than that of DFS even if the limb is critical. Notably, isolated foot lesions with a mere venous cause may arise from insufficient perforator veins; the accompanying areas of haemosiderosis will lead the diagnostic path. Cholesterol embolization (blue toe syndrome, trash foot) elicits a unique clinical picture and will become more frequent with increasing numbers of catheter-based procedures. Finally, descriptions are given of podagra and of foot mycosis as disease entities not linked to perfusion. The present review focuses on the depiction of disease and its diagnosis, leaving therapeutic considerations untouched. PMID:24114468

Stelzner, C; Schellong, S; Wollina, U; Machetanz, J; Unger, L

2013-11-01

331

The diagnostic value of provocative clinical tests in ulnar neuropathy at the elbow is marginal  

Microsoft Academic Search

Background:Provocative clinical tests are often performed in the diagnosis of ulnar neuropathy at the elbow (UNE) although the evidence for the usefulness of these tests is limited. The aim of this study was to determine the diagnostic value of provocative clinical tests in the diagnosis of UNE in a relevant spectrum of patients and controls.Methods:A prospective cohort study was performed

R. Beekman; A H C M L Schreuder; C. A. M. Rozeman; P. J. Koehler; B. M. J. Uitdehaag

2009-01-01

332

Nerve cell injury in the brain of stroke-prone spontaneously hypertensive rats  

Microsoft Academic Search

The brain lesions in stroke-prone spontaneously hypertensive rats (SHRSP) are characterized by multifocal microvascular and spongy-cystic parenchymal alterations particularly in the gray matter. An essential feature of the lesions is the presence of edema with massive extravasation of plasma constituents as evidenced by specific gravity measurements, Evans blue technique and immunohistochemistry. The nerve cell injury occurring in the brain lesions

K. Fredrikssonl; H. Kalimo; C. Nordborg; B. B. Johansson; Y. Olsson

1988-01-01

333

Can therapeutic ultrasound influence the regeneration of peripheral nerves?  

PubMed

An experimental study of the influence of the therapeutic ultrasound on the regeneration of the sciatic nerve submitted to a controlled crush injury was carried out in rats. Twenty female Wistar rats weighing 250 g on average were used and divided into two groups of 10 animals each, respectively, submitted to: (1) crush injury followed by ultrasound irradiation and (2) crush injury only. Under general anaesthesia the sciatic nerve was exposed on the right thigh and crushed with a device especially developed and built for this purpose, with a 15,000g constant load for 10 min, affecting a 5mm-long segment of the nerve proximal to its bifurcation. Pulsed ultrasound irradiation (1:5, 1 MHz, 0.4 W/cm(2), 2 min duration) was started the day after the operation and repeated for 10 consecutive days. The sciatic functional index (SFI) was evaluated at weekly intervals up to the third week, when the animal was killed for histologic and nerve fiber density studies of the sciatic nerve carried out on the lesion site and on the segments immediately proximal and distal to it. The SFI progressively improved for both treated and untreated nerves but in a more marked and significant way for the treated nerves (73 and 55%, respectively). Nerve fiber density did no return to normal in either case but was significantly higher in the treated nerves, with predominance of small diameter thin myelin sheath fibers typical of nerve regeneration in the treated nerves, as opposed to large diameter thin myelin sheath fibers in the untreated nerves. The authors conclude that low intensity therapeutic ultrasound enhances nerve regeneration, as demonstrated with significance on the 21st postoperative day. PMID:15698658

Raso, Vanessa Vilela Monte; Barbieri, Cláudio Henrique; Mazzer, Nilton; Fasan, Valéria Sassoli

2005-03-30

334

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.

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

1991-01-01

335

Unusual Branching Pattern of Axillary Artery Associated with the High Origin of Ulnar Artery  

PubMed Central

Axillary artery is a continuation of subclavian artery, extending from the outer border of first rib to the lower border of teres major muscle. During routine dissection for the undergraduate medical students, a rare variations was seen in an approximately 55-year-old male cadaver. This case showed a variation in branching pattern of right axillary and subscapular arteries. The subscapular artery originated from 2nd part of axillary artery, gave origin to posterior circumflex humeral and lateral thoracic arteries in addition to its normal branches. The ulnar artery originated from the 3rd part of the axillary artery, just above the lower border of teres major muscle. The variant ulnar artery passed deep to the median cubital vein, bicipital aponeurosis, and tendon of palmaris longus muscle. Then, it passed superficial to flexor digitorum superficialis muscle and flexor retinaculum to enter the palm. In the palm, it formed the superficial palmar arch. This variant ulnar artery was much smaller in caliber than the radial artery.

Swamy, RS; Rao, MKG; Kumar, N; Sirasanagandla, SR; Nelluri, VM

2013-01-01

336

Peripheral nerves: ultrasound-guided interventional procedures.  

PubMed

Specific ultrasound (US)-guided interventional procedures on peripheral nerves are reviewed in this article including regional anesthesia, biopsy of neural lesions, and some injection therapies. For these procedures, US is the best modality to provide a safe imaging guidance because of its excellent spatial resolution and real-time capabilities. With US guidance, the radiologist can visualize the needle tip continuously and ensure that the needle is placed precisely in the desired location, avoiding the risk of inadvertent nerve damage. Practical tips and tricks for US-guided needle placement, biopsy of neural lesions, and US-guided therapy are reviewed in this article. The use of US-guided injections in specific clinical settings, such as the percutaneous treatment of carpal tunnel syndrome, Morton's and saphenous neuromas, painful stump neuromas, piriformis syndrome, and meralgia paresthetica are also illustrated here. US allows the clinician to inject drugs with little or no patient discomfort. PMID:21072732

Tagliafico, Alberto; Bodner, Gerd; Rosenberg, Ilan; Palmieri, Federigo; Garello, Isabella; Altafini, Luisa; Martinoli, Carlo

2010-11-01

337

Neuromagnetic recordings of the human peripheral nerve with planar SQUID gradiometers  

NASA Astrophysics Data System (ADS)

Magnetic fields produced by a travelling volley in the human ulnar nerve have been successfully measured in a lightly shielded environment. Recordings of the tangential component of the magnetic field were made using a planar second-order gradiometer integrated with a first-order gradiometric superconducting quantum interference device (SQUID). Devices were fabricated in our clean-room facility at the University of Strathclyde and measurements taken in an eddy-current shielded room at the Wellcome Biomagnetism Unit. We use no additional shielding and no electronic differencing or field-nulling techniques. Evoked magnetic fields of 60 fT peak-to-peak were obtained after 1536 averages but they could be seen easily as early as 512 averages. Measurements were made over four points above the ulnar nerve on the upper arm and from these the conduction velocity was calculated as .

Lang, G.; Shahani, U.; Weir, A. I.; Maas, P.; Pegrum, C. M.; Donaldson, G. B.

1998-08-01

338

Neural fibrolipoma of the digital nerve: a case report.  

PubMed

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

Gundes, Hakan; Alici, Tugrul; Sahin, Mustafa

2011-04-01

339

Evaluation and management of peripheral nerve injury.  

PubMed

Common etiologies of acute traumatic peripheral nerve injury (TPNI) include penetrating injury, crush, stretch, and ischemia. Management of TPNI requires familiarity with the relevant anatomy, pathology, pathophysiology, and the surgical principles, approaches and concerns. Surgical repair of TPNI is done at varying time intervals after the injury, and there are a number of considerations in deciding whether and when to operate. In neurapraxia, the compound muscle and nerve action potentials on stimulating distal to the lesion are maintained indefinitely; stimulation above the lesion reveals partial or complete conduction block. The picture in axonotmesis and neurotmesis depends on the time since injury. The optimal timing for an electrodiagnostic study depends upon the clinical question being asked. Although conventional teaching usually holds that an electrodiagnostic study should not be done until about 3 weeks after the injury, in fact a great deal of important information can be obtained by studies done in the first week. Proximal nerve injuries are problematic because the long distance makes it difficult to reinnervate distal muscles before irreversible changes occur. Decision making regarding exploration must occur more quickly, and exploration using intraoperative nerve action potential recording to guide the choice of surgical procedure is often useful. PMID:18482862

Campbell, William W

2008-09-01

340

Mandibular nerve paresthesia caused by endodontic treatment.  

PubMed

The paresthesias of the inferior dental nerve consists of a complication that can occur after performing various dental procedures such as cystectomies, extraction of impacted teeth, apicoectomies, endodontic treatments, local anesthetic deposition, preprosthetic or implantologic surgery. The possible mechanisms of nervous lesions are mechanical, chemical and thermal. Mechanical injury includes compression, stretching, partial or total resection and laceration. The lesion can cause a discontinuity to the nerve with Wallerian degeneration of the distal and integrated fibers of the covering (axonotmesis) or can cause the total sectioning of the nerve (neurotmesis). Chemical trauma can be due to certain toxic components of the endodontic filling materials (paraformaldehyde, corticoids or eugenol) and irrigating solutions (sodium hypochlorite) or local anesthetics. Thermal injury is a consequence of bone overheating during the execution of surgical techniques. We present a clinical case of paresthesia of the inferior dental nerve after the introduction of a gutta-percha point in the mandibular canal during the performance of a root canal therapy of the inferior first molar. The etiology and the treatment of this endodontic complication are described. PMID:12937392

Gallas-Torreira, M Mercedes; Reboiras-López, M Dolores; García-García, Abel; Gándara-Rey, José

2003-01-01

341

Nerve injury in adult rats causes abnormalities in the motoneuron dendritic field that differ from those seen following neonatal nerve injury  

Microsoft Academic Search

Disruption of neuromuscular contact by nerve-crush during the early postnatal period causes increased activity and abnormal reflex responses in affected motoneurons, but such changes are not found after nerve-crush in adult animals. We found previously that neonatally lesioned cells develop an abnormal dendritic field, which may explain the functional changes. Here we have studied the dendritic morphology of the same

Graham M. O'Hanlon; Margaret B. Lowrie

1995-01-01

342

Does the technique of lateral cross-wiring (Dorgan’s technique) reduce iatrogenic ulnar nerve injury?  

Microsoft Academic Search

In this study we compared the results of patients with displaced supracondylar humeral fractures who had been treated with\\u000a all lateral cross-wire and medio-lateral cross-wire fixation techniques. Only the 139 patients who were able to attend the\\u000a final examination were included in the assessment. The patients were allocated retrospectively into two groups according to\\u000a the pin configuration used. Group 1

Kaya Memisoglu; Cumhur Cevdet Kesemenli; Halil Atmaca

2011-01-01

343

Experimental model of nervous anastomosis between intercostal and lumbar nerves in the rabbit.  

PubMed

The authors propose a new experimental model of nervous anastomosis between intercostal and lumbar nerves in rabbit with the purpose of providing a technique to by-pass a spinal lesion. Before carrying out the surgical experiments, an histological study has been performed on the donor and receiver nerves which demonstrated the great difference in number of nervous fiber between these two nerves. The purpose of the method is thus to reinnerve a lumbar nerve by means of two intercostal nerves. Histological controls are performed on the 120th day. PMID:6536710

de Divitiis, E; Donzelli, R; Caputi, F; Crisci, C; Gargiulo, G; Francica, D

1984-01-01

344

Paresis of cranial nerves III, IV, and VI: clinical manifestation and differential diagnosis.  

PubMed

Successful identification of the cranial nerve and ocular muscle responsible for a subjective complaint of diplopia requires an evaluation of the type and character of the double vision and not infrequently the use of a red glass or Maddox rod, especially in incomplete and subtle cases. An isolated third nerve lesion is most commonly seen with a supraclinoid aneurysm (pupil dilated and fixed), vascular disease (pupil spared), and trauma. Mild frontal head trauma and vascular disease are the most common etiologies associated with an isolated fourth nerve paresis. Tumor, vascular disease and trauma should be prime considerations when a patient presents with an isolated sixth nerve paresis. A child's diagnostic possibilities will differ from the adult: third nerve (congenital), fourth nerve (congenital), and sixth nerve (brainstem glioma, postviral or inflammatory). Finally, myasthenia gravis can readily mask or mimic an isolated or mixed cranial nerve palsy. A Tensilon test is always indicated in unexplained diplopia with ophthalmoplegia and normal pupils. PMID:2486113

Carlow, T J

1989-01-01

345

Gastric mucosal nerve density  

PubMed Central

Background: Autonomic neuropathy is a frequent diagnosis for the gastrointestinal symptoms or postural hypotension experienced by patients with longstanding diabetes. However, neuropathologic evidence to substantiate the diagnosis is limited. We hypothesized that quantification of nerves in gastric mucosa would confirm the presence of autonomic neuropathy. Methods: Mucosal biopsies from the stomach antrum and fundus were obtained during endoscopy from 15 healthy controls and 13 type 1 diabetic candidates for pancreas transplantation who had secondary diabetic complications affecting the eyes, kidneys, and nerves, including a diagnosis of gastroparesis. Neurologic status was evaluated by neurologic examination, nerve conduction studies, and skin biopsy. Biopsies were processed to quantify gastric mucosal nerves and epidermal nerves. Results: Gastric mucosal nerves from diabetic subjects had reduced density and abnormal morphology compared to control subjects (p < 0.05). The horizontal and vertical meshwork pattern of nerve fibers that normally extends from the base of gastric glands to the basal lamina underlying the epithelial surface was deficient in diabetic subjects. Eleven of the 13 diabetic patients had residual food in the stomach after overnight fasting. Neurologic abnormalities on clinical examination were found in 12 of 13 diabetic subjects and nerve conduction studies were abnormal in all patients. The epidermal nerve fiber density was deficient in skin biopsies from diabetic subjects. Conclusions: In this observational study, gastric mucosal nerves were abnormal in patients with type 1 diabetes with secondary complications and clinical evidence of gastroparesis. Gastric mucosal biopsy is a safe, practical method for histologic diagnosis of gastric autonomic neuropathy.

Selim, M.M.; Wendelschafer-Crabb, G.; Redmon, J.B.; Khoruts, A.; Hodges, J.S.; Koch, K.; Walk, D.; Kennedy, W.R.

2010-01-01

346

Restoration of Elbow Flexion by Transfer of the Phrenic Nerve to Musculocutaneous Nerve after Brachial Plexus Injuries  

Microsoft Academic Search

Traumatic brachial plexus injuries are a devastating injury that results in partial or total denervation of the muscles of\\u000a the upper extremity. Treatment options that include neurolysis, nerve grafting, or neurotization (nerve transfer) has become\\u000a an important procedure in the restoration of function in patients with irreparable preganglionic lesions. Restoration of elbow\\u000a flexion is the primary goal in treating patients

Ricardo Monreal

2007-01-01

347

Interleukin1 regulates synthesis of nerve growth factor in non-neuronal cells of rat sciatic nerve  

Microsoft Academic Search

The Schwann cells and fibroblast-like cells of the intact sciatic nerve of adult rats synthesize very little nerve growth factor (NGF) (ref. 1). After lesion, however, there is a dramatic increase in the amounts of both NGF-mRNA and NGF protein synthesized by the sciatic non-neuronal cells1,2. This local increase in NGF synthesis partially replaces the interrupted NGF supply from the

Dan Lindholm; Rolf Heumann; Michael Meyer; Hans Thoenen

1987-01-01

348

Posterior femoral cutaneous nerve mononeuropathy: a case report.  

PubMed

Isolated posterior femoral cutaneous nerve (PFCN) lesions are rare, with only six cases reported in the modern literature and one case documented with a nerve conduction study. A 25-year-old woman had sensory loss in the posterolateral thigh after two right gluteal intramuscular injections. Nerve conduction studies using Dumitru's technique showed a 9microV response on the asymptomatic side, but no response on the symptomatic side, and no abnormalities on needle examination of the back and lower extremities. Although a single case does not prove the validity of a technique, this case provides the rare opportunity to demonstrate the utility of Dumitru's technique. PMID:10943764

Tong, H C; Haig, A

2000-08-01

349

Changes in sensation after nerve injury or amputation: the role of central factors.  

PubMed Central

Dynamic changes in somatosensory cortical maps are known to occur in experimental animals subjected to peripheral nerve transection or amputation. To study the sensory effects of central nervous system adaptation to temporary or permanent loss of input from a part of the hand, multimodality quantitative sensory tests were carried out in 11 patients with complete traumatic division and repair of the median or ulnar nerves and in six patients who had undergone amputation of one or more digits. As expected, vibration, two point discrimination, and tactile thresholds were raised in the territory of the injured nerve in a graded fashion, sensitivity being poorest in the patients with the most recent injuries. Surprisingly, localisation was better in the tips than at the base of the hypoaesthetic fingers, suggesting a central attentional gradient. Stimulus-response curves conformed to a power function whose exponent was higher in denervated than in normal skin. Changes in psychophysical functions were also discernible in the intact hand. There was no hyperaesthesia in the territory of the nerve adjacent to the injured one or in the stump in the case of amputees. Central factors contribute to the sensory changes seen after nerve injury, but the functional effects of the cortical reorganisation that follows partial deafferentation are more subtle than a simple heightening of sensitivity in the surrounding skin.

Braune, S; Schady, W

1993-01-01

350

Protecting the genitofemoral nerve during direct/extreme lateral interbody fusion (DLIF/XLIF) procedures.  

PubMed

A 77-year-old male presented with a history of severe lower back pain for 10 years with radiculopathy, positive claudication type symptoms in his calf with walking, and severe "burning" in his legs bilaterally with walking. Magnetic resonance imaging (MRI) revealed lumbar stenosis at the L3-L4 and L4-L5 levels. During the direct or extreme lateral interbody fusion (DLIF/XLIF) procedure, bilateral posterior tibial, femoral, and ulnar nerve somatosensory evoked potentials (SSEPs) were recorded with good morphology of waveforms observed. Spontaneous electromyography (S-EMG) and triggered electromyography (T-EMG) were recorded from cremaster and ipsilateral leg muscles. A left lateral retroperitoneal transpsoas approach was used to access the anterior disc space for complete discectomy, distraction, and interbody fusion. T-EMG ranging from 0.05 to 55.0 mA with duration of 200 microsec was used for identification of the genitofemoral nerve using a monopolar stimulator during the approach. The genitofemoral nerve (L1-L2) was identified, and the guidewire was redirected away from the nerve. Post-operatively, the patient reported complete pain relief and displayed no complications from the procedure. Intraoperative SSEPs, S-EMG, and T-EMG were utilized effectively to guide the surgeon's approach in this DLIF thereby preventing any post-operative neurological deficits such as damage to the genitofemoral nerve that could lead to groin pain. PMID:21313792

Jahangiri, Faisal R; Sherman, Jonathan H; Holmberg, Andrea; Louis, Robert; Elias, Jeff; Vega-Bermudez, Francisco

2010-12-01

351

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

352

Major peripheral nerve injuries.  

PubMed

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

Isaacs, Jonathan

2013-08-01

353

Blood-nerve barrier: ultrastructural and endothelial surface charge alterations following nerve crush.  

PubMed

Nerve crush results in an enhanced vascular permeability of the endoneurial vessels distal to the lesion. Vascular permeability at the blood-nerve barrier (BNB) to serum proteins is influenced by many factors, including anionic surface charge, endothelial vesicular transcytosis and the presence or absence of fenestrated vessels. Using mice and rats, the present ultrastructural investigation examined the effect of nerve crush (axonotmesis) on: (1) the distribution of endothelial anionic sites and (2) the appearance of fenestrations in endoneurial vessels after 4 and 14 day intervals as demonstrated with cationic probes. Transient anionic fenestrations developed in a minority of mouse endoneurial vessels in 4-day crushed nerves, but were not found in 14-day crushed nerves of mice nor in crushed nerves of rats. The known increase in the permeability of endoneurial vessels in rats and mice was not associated with reduced luminal labelling with cationic ferritin at physiological pH. At pH 2.0 the labelling of glycocalyx moieties (such as sialic acid) with cationic colloidal gold was disrupted in some epi- and endoneurial vessels of 4-day rats, but in a greater proportion after 14 days. The enhanced permeability of the BNB during degeneration and regeneration is related to the formation of anionic fenestrations in endoneurial vessels of mice and to the reduced and uneven distribution of endothelial glycocalyx moieties that are anionic at pH 2.0 in rats. PMID:8474598

Bush, M S; Reid, A R; Allt, G

1993-02-01

354

Intravenous Transplantation of Mesenchymal Stromal Cells to Enhance Peripheral Nerve Regeneration  

PubMed Central

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

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

2013-01-01

355

What's a Funny Bone?  

MedlinePLUS

... of your elbow is a nerve called the ulnar nerve . The ulnar nerve lets your brain know about feelings in ... hand. You get that funny feeling when the ulnar nerve is bumped against the humerus (say: HYOO- ...

356

[Greater occipital neuralgia associated with occipital osteolytic lesion. Case report].  

PubMed

The anatomic distribution of the greater occipital nerve during its path permits a close relationship with muscular structures, tendons, vessels and bones. The rupture of this relationship can origin its irritation and headache. We describe an uncommon association between an osteolytic lesion on occipital bone and greater occipital nerve. The patient, female 50, has been presenting headache for two years on the right occipital region spreading to the hemicranic and ipsilateral supraorbital region. The symptoms started spontaneously or by pressure on the trapezius tendon. The pain lasted about 30 minutes, compressive, mild intensity, with no autonomic symptoms and no improvement after the infiltration in the greater occipital nerve. The total improvement of the symptoms after releasing the nerve has allowed us to associate this lesion to the presence of algic symptoms. PMID:10347737

Piovesan, E J; Werneck, L C; Kowacs, P A; Tatsui, C; Lange, M C; Carraro Júnior, H; Wittig, E O

1999-03-01

357

Ultrasound-Guided Popliteal Nerve Block in a Patient with Malignant Degeneration of Neurofibromatosis 1  

PubMed Central

A 41-year-old female patient with neurofibromatosis 1 presented with new neurologic deficits secondary to malignant degeneration of a tibial lesion. Ultrasound mapping of the popliteal nerve revealed changes consistent with an intraneural neurofibroma. Successful popliteal nerve blockade was achieved under ultrasound guidance.

Desai, Arjun; Carvalho, Brendan; Hansen, Jenna; Hill, Jonay

2012-01-01

358

Localising patterns of optic nerve hypoplasia--retina to occipital lobe.  

PubMed Central

Six cases are presented which provide clinical evidence that optic nerve hypoplasia can occur as a result of a lesion at any site in the developing visual system. The mechanisms of hypoplasia are discussed in the light of recent understanding of optic nerve development. Images

Novakovic, P; Taylor, D S; Hoyt, W F

1988-01-01

359

Schwannoma of Extraocular Nerves  

PubMed Central

An unusual case of schwannoma arising from the third cranial nerve in a thirteen year old male is reported. The patient presented with paresis of the right oculomotor nerve and ipsilateral hemiparesis. The clinical features of this case are discussed and the pertinent medical literature reviewed. ImagesFigure 1p220-bFigure 2Figure 3Figure 4Figure 5Figure 6

Niazi, Wasim; Boggan, James E.

1994-01-01

360

Biphasic cellular response to transection in the newt optic nerve: Glial reactivity precedes axonal degeneration  

Microsoft Academic Search

Summary Morphological interactions between axons and glia within the lesioned newt optic nerve were studied at time periods prior to the onset of Wallerian degeneration. Optic nerves were transected 0.5 mm from the eye, animals were killed at 5,10,20 and 30 min post-lesion, and the intracranial half of the tract was examined with light and electron microscopy. A sequence of

L. L. Phillips; J. E. Turner

1991-01-01

361

Ophthalmoplegic migraine with reversible enhancement of intraparenchymal abducens nerve on MRI.  

PubMed

We describe a patient with ophthalmoplegic migraine and right abducens nerve palsy, in whom serial magnetic resonance imaging showed a transient, gadolinium-enhancing lesion in the right lower pons, during both headache and the headache-free period. The enhancing linear lesion was felt to represent intraparenchymal fibers of the affected abducens nerve. The possible pathophysiology of this unique finding is discussed. PMID:12005290

Lee, Te Gyu; Choi, Woo-Suk; Chung, Kyung-Cheon

2002-02-01

362

Predominant Patterns of Median Nerve Displacement and Deformation during Individual Finger Motion in Early Carpal Tunnel Syndrome.  

PubMed

Idiopathic carpal tunnel syndrome (CTS) is a common neuropathy, yet the pathologic changes do not explain the fleeting dynamic symptoms. Dynamic nerve-tendon interaction may be a contributing factor. Based on dynamic ultrasonographic examination of the carpal tunnel, we quantified nerve-tendon movement in thumb, index finger and middle finger flexion in normal subjects and those with mild-idiopathic CTS. Predominant motion patterns were identified. The nerve consistently moves volar-ulnarly. In thumb and index finger flexion, the associated tendons move similarly, whereas the tendon moves dorsoradially in middle finger flexion. Nerve displacement and deformation increased from thumb to index finger to middle finger flexion. Predomination motion patterns may be applied in computational simulations to prescribe specific motions to the tendons and to observe resultant nerve pressures. By identification of the greatest pressure-inducing motions, CTS treatment may be better developed. Symptomatic subjects displayed reduced nerve movement and deformation relative to controls, elucidating the physiologic changes that occur during mild CTS. PMID:24785444

Liong, Kyrin; Lahiri, Amitabha; Lee, Shujin; Chia, Dawn; Biswas, Arijit; Lee, Heow Pueh

2014-08-01

363

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.

2013-01-01

364

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

365

Bilateral ulnar neuropathy at the elbow secondary to neuropathic arthropathy associated with syringomyelia.  

PubMed

Neuropathic arthropathy (NA), also known as Charcot joint, refers to a chronic progressive degenerative arthritis that is associated with an underlying central or peripheral neurologic disorder. The elbow is rarely reported to be involved in NA, but when affected, it is commonly a result of a cervical syrinx or tabes dorsalis. Few reports in the literature describe ulnar neuropathy at the elbow (UNE) associated with NA of the elbow, and none describe bilateral UNE in association with a cervicothoracic syrinx. We present a unique case of bilateral UNE resulting from NA of the elbow associated with a cervicothoracic syrinx. PMID:23790822

Aly, Abdel-Rahman; Rajasekaran, Sathish; Obaid, Haron; Bernacki, Barry

2013-06-01

366

Crohn's Disease Initially Accompanied by Deep Vein Thrombosis and Ulnar Neuropathy without Metronidazole Exposure  

PubMed Central

Extraintestinal manifestations are not uncommon in Crohn's disease, and a thromboembolic event is a disastrous potential complication. Deep vein thrombosis is the most common manifestation of a thromboembolic event and typically occurs in association with active inflammatory disease. Peripheral neuropathy in Crohn's disease has rarely been reported and is considered an adverse effect of metronidazole therapy. Here, we describe a patient who was initially diagnosed with Crohn's disease complicated with deep vein thrombosis and ulnar neuropathy without metronidazole exposure. The simultaneous occurrence of these complications in the early stage of Crohn's disease has never been reported in the English literature.

Kim, Woohyeon; Kang, Borami; Kim, Joon Sung; Lee, Hae-Mi; Lim, Eun-Joo; Kim, Jong In; Kang, Bong-Koo; Ji, Jeong-Seon; Lee, Bo-In; Choi, Hwang

2013-01-01

367

The distribution of acetylcholine in normal and in regenerating nerves.  

PubMed

1. The distribution of acetylcholine (ACh) in various nerves which had been regenerating for different periods after crushing has been compared with that in uncrushed nerves.2. Normal ventral roots from cats contained 78.1 +/- 22.7 (S.D.) mumole ACh/kg (blotted wet wt.); rabbit ventral roots contained 48.0 mumole/kg +/- 19.0 (S.D.) and rabbit sciatic nerves 16.6 +/- 7.3 (S.D.) mumole/kg. In the sciatic nerves the distal cm of 5 cm lengths taken from the thigh contained 30% more ACh than the most central cm portion. Possible explanations for this difference have been discussed.3. After both sciatic nerves and ventral roots had been crushed, there was an initial build-up (4 times control) of ACh central to the lesion and a decline ((1/4) control) distal to the lesion. These changes were maximum around 5 days after crushing. In sciatic nerves in which long periods of regeneration were investigated, the central build-up fell off to 1(1/2) times control by 25 days and the distal decline reversed to 2 times control in about 10 days. It then again decreased towards the control level by 25 days after crushing. These changes have been discussed in relation to the morphological changes which occur in a nerve following crushing.4. A peak of ACh content moved distally along the nerve from the crushed region at a rate of 1.0-1.5 mm/day. This was considered to represent an average rate of regeneration of the bulk of the axons. The amplitude of the peak declined progressively with time in the more distal parts of the nerve, probably because of dispersion as axons regenerated at different rates. PMID:6051808

Evans, C A; Saunders, N R

1967-09-01

368

[Carpal instability and secondary degenerative changes in lesions of the radio-carpal ligaments with various etiology].  

PubMed

Rotational subluxation of the scaphoid (RSS) and ulnar translocation of the carpus (UT) result from distinct lesions of the radiocarpal ligament complex. Trauma, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition (CPDD) and neurologic disease can lead to this ligament defect. The radiological features are identical despite different etiologies of the ligament failure. The secondary degenerative changes in RSS develop in three stages: starting with osteoarthritis at the styloid process, then progression of the degeneration into the mid-carpal joint from central towards ulnar. This mechanism is identical in posttraumatic, inflammatory, neurogenic or CPDD related instability. In cases with rheumatoid arthritis related instability, RSS and UT can be found simultaneously. The knowledge of these radiological features can be helpful in clarifying reasons for carpal changes and in determining the time of onset of the primary ligament failure. PMID:2283104

Stäbler, A; Baumeister, R G; Berger, H

1990-11-01

369

Skin-derived stem cells transplanted into resorbable guides provide functional nerve regeneration after sciatic nerve resection.  

PubMed

The regeneration in the peripheral nervous system is often incomplete and the treatment of severe lesions with nerve tissue loss is primarily aimed at recreating nerve continuity. Guide tubes of various types, filled with Schwann cells, stem cells, or nerve growth factors are attractive as an alternative therapy to nerve grafts. In this study, we evaluated whether skin-derived stem cells (SDSCs) can improve peripheral nerve regeneration after transplantation into nerve guides. We compared peripheral nerve regeneration in adult rats with sciatic nerve gaps of 16 mm after autologous transplantation of GFP-labeled SDSCs into two different types of guides: a synthetic guide, obtained by dip coating with a L-lactide and trimethylene carbonate (PLA-TMC) copolymer and a collagen-based guide. The sciatic function index and the recovery rates of the compound muscle action potential were significantly higher in the animals that received SDSCs transplantation, in particular, into the collagen guide, compared to the control guides filled only with PBS. For these guides the morphological and immunohistochemical analysis demonstrated an increased number of myelinated axons expressing S100 and Neurofilament 70, suggesting the presence of regenerating nerve fibers along the gap. GFP positive cells were found around regenerating nerve fibers and few of them were positive for the expression of glial markers as S-100 and glial fibrillary acidic protein. RT-PCR analysis confirmed the expression of S100 and myelin basic protein in the animals treated with the collagen guide filled with SDSCs. These data support the hypothesis that SDSCs could represent a tool for future cell therapy applications in peripheral nerve regeneration. PMID:17203471

Marchesi, C; Pluderi, M; Colleoni, F; Belicchi, M; Meregalli, M; Farini, A; Parolini, D; Draghi, L; Fruguglietti, M E; Gavina, M; Porretti, L; Cattaneo, A; Battistelli, M; Prelle, A; Moggio, M; Borsa, S; Bello, L; Spagnoli, D; Gaini, S M; Tanzi, M C; Bresolin, N; Grimoldi, N; Torrente, Y

2007-03-01

370

Post-irradiation lesions of the caudal roots.  

PubMed

The article reports on 3 patients suffering from muscular atrophy after radiotherapy of the para-aortal lymph nodes for malignant testicular tumor without any sensory, bladder, or bowel disturbances. By neurophysiological examination, a lesion of the lumbal plexus and the peripheral nerves of the lower extremities were excluded. On EMG-examination there were no giant motor unit potentials, as they can be found in anterior horn cell lesions. Though there were no sensory deficits, a distinct prolongation of latencies and reduction of amplitudes could be found for lumbar dermatomal somatosensory evoked potentials (SSEP) and those after stimulation of some peripheral nerves of the lower extremities. PMID:2554633

Feistner, H; Weissenborn, K; Münte, T F; Heinze, H J; Malin, J P

1989-10-01

371

Dumb-bell neurinoma of the hypoglossal nerve1  

PubMed Central

A unique case of dumb-bell neurinoma of the hypoglossal nerve is presented. The importance of hemiatrophy of the tongue is stressed for early diagnosis of the lesion. The myelocisternogram is the single most important contrast study confirming the intracranial extension of the tumour. Total dissection of the tumour capsule may not be feasible in all cases. Images

Bartal, A. D.; Djaldetti, M. M.; Mandel, E. M.; Lerner, M. A.

1973-01-01

372

Lipofibromatous hamartoma of the superficial peroneal nerve: Two case reports  

Microsoft Academic Search

Lipofibromatous hamartoma, a rarely occurring nerve hamartoma, can present as an acrochordon, cutaneous cyst or other soft tissue tumor and is usually seen within the first three decades of life. The lesion presents as a slowly growing mass that is largely composed of fat and fibrous tissue with epineural and perineural proliferation. Although such tumors are rare, it is important

Ying-Ling Kuo; Yu-Hung Wu; Pa-Fan Hsiao; Ya-Ju Hsieh

373

Spinal myoclonus following a peripheral nerve injury: a case report  

Microsoft Academic Search

Spinal myoclonus is a rare disorder characterized by myoclonic movements in muscles that originate from several segments of the spinal cord and usually associated with laminectomy, spinal cord injury, post-operative, lumbosacral radiculopathy, spinal extradural block, myelopathy due to demyelination, cervical spondylosis and many other diseases. On rare occasions, it can originate from the peripheral nerve lesions and be mistaken for

Feray Karaali Savrun; Derya Uluduz; Gokhan Erkol; Meral E Kiziltan

2008-01-01

374

Palsies of the third, fourth, and sixth cranial nerves.  

PubMed

Diplopia is one of the most vexing problems to confront a physician. When diplopia is binocular, it commonly results from dysfunction of one or more of the ocular motor nerves. Ocular motor dysfunction may result from injury anywhere along the neuraxis, from the ocular motor nucleus to the myoneural junction. Identifying the location of the lesion is important for determining the etiology and prognosis of third-, fourth-, and sixth-nerve injuries. In this article, an anatomic approach is presented for the diagnosis and treatment of ocular motor nerve lesions. Emphasis is placed on the identification of associated neurologic and ophthalmologic findings that are critical for management of patients with acquired and congenital ocular motor palsies. PMID:11370565

Bennett, J L; Pelak, V S

2001-03-01

375

The Effects on Locomotion of Lesions to the Visuo-Motor System in Octopus.  

National Technical Information Service (NTIS)

The visuo-motor system in cephalopods was investigated by observing behavioural changes immediately after surgical interference to different parts of it. Lesions were made that removed the optic and peduncle lobes and sectioned the optic nerves bilaterall...

J. B. Messenger

1966-01-01

376

Glossopharyngeal Nerve Schwannoma  

PubMed Central

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

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

1999-01-01

377

Macrovascular decompression of the median nerve for posttraumatic neuralgic limb pain.  

PubMed

Neuropathic pain is rare in children, and few reports provide adequate guidelines for treatment. The authors describe the successful treatment of tardy neuropathic pain via macrovascular decompression in a 15-year-old boy who presented with progressive pain 11 years following trauma to the upper extremity that had required surgical repair of the brachial artery. Examination revealed mild chronic median and ulnar motor neuropathy as well as recent progressive lancinating pain and a Tinel sign at the prior scar. A soft tissue mass in the neurovascular bundle at the site of previous injury was noted on MRI. Surgical exploration demonstrated an altered anatomical relationship of the previously repaired brachial artery and the median nerve, resulting in pulsatile compression of the median nerve by the brachial artery. Neurolysis and decompression of the median nerve with physical separation from the brachial artery resulted in immediate pain relief. This is the first report of macrovascular decompression of a major peripheral nerve with complete symptom resolution. Noninvasive imaging together with a thorough history and physical examination can support identification of this potential etiology of peripheral neuralgic pain. Recognition and treatment of this uncommon problem may yield improved outcomes for children with neuropathic pain. PMID:23829379

Pabaney, Aqueel; Hervey-Jumper, Shawn L; Domino, Joseph; Maher, Cormac O; Yang, Lynda J S

2013-09-01

378

Peripheral nerve structure and function in long-term galactosemic dogs: morphometric and electron microscopic analyses.  

PubMed

Experimental galactosemia for activating the polyol pathway is used extensively to explore the pathogenesis of diabetic complications. However, despite the presence of severe neuropathy in galactosemic rats, changes in the peripheral nerve have not been well established in galactosemic dogs. We therefore conducted biochemical, electrophysiological, and morphometric studies on peripheral nervous systems (PNS) in dogs given a 30% galactose diet for 44 months. Age- and sex-matched dogs given a 30% cellulose diet were used as control. Chronic galactosemia resulted in accumulation of galactitol and decrease in myo-inositol in the sciatic nerve. Electrophysiological and teased fiber analyses demonstrated no significant abnormalities in the ulnar and peroneal nerves in galactosemic dogs. Morphometric analyses revealed a tendency of myelinated fiber atrophy (24% reduction of average fiber size) associated with 20% decrease (P < 0.05 vs control) in mean myelinated fiber occupancy rate in the peroneal nerve in galactosemic dogs. In the anterior mesenteric ganglion, there was a slight but significant increase (8%) in mean neuronal cell size in galactosemic dogs (P < 0.05 vs control). Electron microscopy revealed that galactosemia did not produce dystrophic and degenerative changes in the autonomic ganglion in dogs. We conclude that structural and functional changes in the PNS of galactosemic dogs are mild and different from those of the rat model. These findings suggest that the severity of peripheral neuropathy induced by chronic galactosemia may be species dependent. PMID:10208276

Sugimoto, K; Kasahara, T; Yonezawa, H; Yagihashi, S

1999-04-01

379

[Median nerve neuropathy after perilunate dislocation injuries].  

PubMed

Purpose: The purpose of this retrospective study was to investigate the frequency and appearance of median nerve neuropathy following perilunate dislocation injuries with respect to the preceding surgical decompression and the clinical outcome. Patients and Methods: 32 patients were followed for a mean of 65 months after surgery for perilunate dislocation, including carpal tunnel release in 13 patients. 10 of 11 patients with clinical symptoms of median nerve affection at follow-up had additionally an electrophysiological examination. Median neuropathy was assumed if 2 or more parameters were pathologic. Patients with and without median neuropathy were compared. The DASH score, pain, wrist motion, grip strength and the Mayo wrist score were used to rate the outcome. Results: In 6 patients, neuropathy of the median nerve persisted since injury in spite of carpal tunnel release in 5 of them. 3 patients showed secondary, delayed median nerve affection. Patients with median neuropathy had a worse result with regard to pain at rest, grip force, the DASH score, and the Mayo wrist score. The difference was statistically significant for pain with activities. Conclusion: Median neuropathy following perilunar dislocation injuries is frequent. It appears rather like a chronic neural lesion than a typical compression syndrome. A primary carpal tunnel release cannot always prevent persistent neural disorders. PMID:24940631

Mühldorfer-Fodor, M; Hohendorff, B; Saalabian, A A; Hahne, M; van Schoonhoven, J; Prommersberger, K-J

2014-06-01

380

Mouse Tbx3 Mutants Suggest Novel Molecular Mechanisms for Ulnar-Mammary Syndrome  

PubMed Central

The transcription factor TBX3 plays critical roles in development and TBX3 mutations in humans cause Ulnar-mammary syndrome. Efforts to understand how altered TBX3 dosage and function disrupt the development of numerous structures have been hampered by embryonic lethality of mice bearing presumed null alleles. We generated a novel conditional null allele of Tbx3: after Cre-mediated recombination, no mRNA or protein is detectable. In contrast, a putative null allele in which exons 1-3 are deleted produces a truncated protein that is abnormally located in the cytoplasm. Heterozygotes and homozygotes for this allele have different phenotypes than their counterparts bearing a true null allele. Our observations with these alleles in mice, and the different types of TBX3 mutations observed in human ulnar-mammary syndrome, suggest that not all mutations observed in humans generate functionally null alleles. The possibility that mechanisms in addition to TBX3 haploinsufficiency may cause UMS or other malformations merits investigation in the human UMS population.

Frank, Deborah U.; Emechebe, Uchenna; Thomas, Kirk R.; Moon, Anne M.

2013-01-01

381

Ulnar subluxation of the extensor digitorum communis tendon: a case report and review of the literature.  

PubMed Central

Ulnar subluxation of the extensor digitorum communis tendon at the MCP joint occurs infrequently in the nonrheumatoid patient and is secondary to one of four reported etiologies: traumatic, spontaneous, congenital, or epileptic. If symptomatic, patients may present with pain, swelling, a sensation of the tendon "snapping", "catching", "locking", or the inability to fully extend the MCP joint. Conservative and operative interventions have been recommended as treatment options. In the acute traumatic dislocation (less than ten days post injury), satisfactory results may be obtained with simple splinting with the MCP joint in extension. Patients who have failed conservative management or have a more chronic or degenerative dislocation may require surgical correction. The successful surgical repair must meet two requirements: (1) the tendon must be accurately aligned over the MCP joint to diminish the forces causing the dislocation to occur, and (2) the repair must be able to withstand the ulnar forces incurred during flexion of the joint. Realignment of the extensor tendon and direct repair of the radial sagittal band may be sufficient in acute traumatic, congenital, or spontaneous cases if the tissue is sufficient. In chronic dislocations or in cases with atrophic or degenerative tissue, reconstruction with augmentation of the radial restraints to the extensor hood is advised. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6a and 6b

Andruss, R. J.; Herndon, J. H.

1993-01-01

382

Information from cochlear potentials and genetic mutations helps localize the lesion site in auditory neuropathy  

Microsoft Academic Search

Auditory neuropathy (AN) is a disorder characterized by disruption of auditory nerve activity resulting from lesions involving\\u000a the auditory nerve (postsynaptic AN), inner hair cells and\\/or the synapses with auditory nerve terminals (presynaptic AN).\\u000a Affected subjects show impairment of speech perception beyond that expected for the hearing loss, abnormality of auditory\\u000a brainstem potentials and preserved outer hair-cell activities. Furthermore, AN

Rosamaria Santarelli

2010-01-01

383

[Nerve injuries and posttraumatic therapy].  

PubMed

Peripheral nerve injuries are a common clinical problem and can represent a major challenge, especially after trauma. In order to achieve optimal therapy, an early and adequate diagnosis with subsequent therapy is critical for functional preservation and restoration. Especially after complete severance of a peripheral nerve, the surgical techniques for nerve coaptation are an important prerequisite for peripheral nerve regeneration. The importance and necessity of adequate nerve coaptation and nerve transplantation are presented in detail. In addition, the types of primary and secondary nerve reconstruction procedures are described as well as the optimal time point of nerve repair. This article provides a comprehensive overview of the possibilities for diagnosis and intervention after nerve injury, additionally including an algorithm for surgical intervention. Furthermore, possible pitfalls and factors for improving the functional outcome are presented to optimize results with trauma-related nerve injury. PMID:24903504

Radtke, C; Vogt, P M

2014-06-01

384

Sacral nerve stimulation.  

PubMed

The current concept of recruiting residual function of an inadequate pelvic organ by electrostimulation involves stimulation of the sacral spinal nerves at the level of the sacral canal. The rationale for applying SNS to fecal incontinence was based on clinical observations of its effect on bowel habits and anorectal continence function in urologic patients (increased anorectal angulation and anal canal closure pressure) and on anatomic considerations: dissection demonstrated a dual peripheral nerve supply of the striated pelvic floor muscles that govern these functions. Because the sacral spinal nerve site is the most distal common location of this dual nerve supply, stimulating here can elicit both functions. Since the first application of SNS in fecal incontinence in 1994, this technique has been improved, the patient selection process modified, and the spectrum of indications expanded. At present SNS has been applied in more than 1300 patients with fecal incontinence limited. PMID:15771288

Matzel, K E; Stadelmaier, U; Besendörfer, M

2004-01-01

385

Femoral nerve dysfunction  

MedlinePLUS

Felice, KJ. Focal neuropathies of the femoral, obturator, lateral femoral cutaneous and other nerves of the thigh and pelvis. In: Bromberg MB, Smith GA, eds. Handbook of Peripheral Neuropathy. Boca Raton, Fl: Taylor and Francis; 2005:chap ...

386

[Physiology of the injured peripheral nerve].  

PubMed

Peripheral nerve injuries are frequent and generate significant deficits. Their treatment sometimes leads to functional recovery but is mostly incomplete or unpredictable, despite the regular use of sophisticated repair techniques. The clinician must clearly understand the peripheral nervous system's responses to injury, which reveal surprising degenerating and spontaneous regenerating abilities. This potential recovery is a peripheral nervous system specificity and follows a relatively complex process. Peripheral neurons depend on glial cell structure and metabolism, inducing a global and dynamic response of the whole axon environment, even in cases of focal lesion, modulated by the initial type and mechanism of injury. Today's progress remains insufficient to improve functional prognosis significantly, but a better understanding of peripheral nerve regenerating processes has opened the door to new medical and surgical advances. PMID:19232649

Delmotte, A; Rigoard, S; Buffenoir, K; Wager, M; Giot, J-P; Robert, R; Lapierre, F; Rigoard, P

2009-03-01

387

[Facial nerve and petrous bone cholesteatoma].  

PubMed

The diagnosis and treatment of petrous bone cholesteatoma is a challenge to aural surgeons. Seven patients with extensive petrous bone cholesteatomas which invaded the labyrinth and fallopian canal are presented. These cholesteatomas originated as secondary to acquired lesions. The cases were evaluated according to the clinical features, the intraoperative findings, the radiological findings, and the surgical approaches. In this series, six patients presented with facial paralysis associated with profound or total deafness. The transtemporal lateral approach was used in all the cases. Acute facial nerve palsy or facial nerve pareses progressing to palsy in patients with chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma. PMID:8031580

Li, Z

1993-01-01

388

Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow  

Microsoft Academic Search

Because of a lack of biomechanical studies of lateral elbow ligament reconstruction in the literature, the initial stability afforded by 3 different techniques of lateral ulnar collateral ligament reconstruction was evaluated in 8 cadaveric elbows. The arm was mounted in a testing apparatus, and passive flexion was performed with the arm in varus and valgus orientations. A pivot shift test

Graham J. W King; Cynthia E Dunning; Zane D. S Zarzour; Stuart D Patterson; James A Johnson

2002-01-01

389

Hirschsprung's disease associated with congenital heart malformation, broad big toes, and ulnar polydactyly in sibs: a case for fetoscopy  

Microsoft Academic Search

Successful fetoscopy using a 9 mm laparoscope was carried out on an 18-week pregnancy of a healthy woman who had had two previous male infants with bilateral double big toes, bilateral ulnar supernumerary digits associated with short segment Hirschsprung's disease, and ventricular septal defect of the heart, a syndrome apparently not previously described. The fetus was found to be normal,

K M Laurence; R Prosser; I Rocker; J F Pearson; C Richard

1975-01-01

390

A Comparative Analysis of Sonographic Interpretation of Peripheral Nerves in the Anterior Compartment of the Forearm Between an Experienced and Novice Interpreter  

PubMed Central

Purpose: This article describes a pilot study that compares the ability of a novice interpreter and an experienced interpreter to interpret ultrasound images of peripheral nerves in the anterior compartment of the forearm. Methods: Twenty subjects between 18 and 50 years of age were included. A student was taken through tutorials in which she was guided through identification of the peripheral nerves of the anterior forearm. After the tutorials, the experienced interpreter traced the subjects' ulnar nerve and artery neurovascular bundle proximally in the anterior compartment of the forearm until just before it separated into the artery and nerve. Here the distance between the median and ulnar nerve was measured by the investigators. The Bland and Altman design and paired t tests were used to compare the agreement between the results of the two investigators. Results: The Bland and Altman analysis reveals that the difference between two sets of measurements (experienced investigator vs. student) is calculated to be 0.08 mm ± 0.22 mm for the left arm and 0.16 mm ± 0.43 mm for the right arm. A paired t test revealed that there is no significant difference in the measurements obtained by the two investigators (left arm: p = .12; right arm: p = .10). These results suggest that the measurements of the two investigators may be interchangeable. Conclusions: This pilot study shows that after tutorials combining dissection and sonographic interpretation, the ability of a novice interpreter to identify ultrasonographic images of peripheral nerves in the anterior compartment of the forearm is comparable to that of an experienced interpreter

Hung, Laurie Y.; Lucaciu, Octavian C.; Soave, David M.

2012-01-01

391

Lower cranial nerves.  

PubMed

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

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

2014-02-01

392

Retrograde axonal transport of /sup 125/I-nerve growth factor in rat ileal mesenteric nerves. Effect of streptozocin diabetes  

SciTech Connect

The retrograde axonal transport of intravenously (i.v.) administered /sup 125/I-nerve growth factor (/sup 125/I-NGF) was examined in mesenteric nerves innervating the small bowel of rats with streptozocin (STZ) diabetes using methods described in detail in the companion article. The accumulation of /sup 125/I-NGF distal to a ligature on the ileal mesenteric nerves of diabetic animals was 30-40% less than in control animals. The inhibition of accumulation of /sup 125/I-NGF in diabetic animals was greater at a ligature tied 2 h after i.v. administration than at a ligature tied after 14 h, which suggests that the diabetic animals may have a lag in initiation of NGF transport in the terminal axon or retardation of transport at some site along the axon. The /sup 125/I-NGF transport defect was observed as early as 3 days after the induction of diabetes, a time before the development of structural axonal lesions, and did not worsen at later times when dystrophic axonopathy is present. Both the ileal mesenteric nerves, which eventually develop dystrophic axonopathy in experimental diabetes, and the jejunal mesenteric nerves, which never develop comparable structural alterations, showed similar /sup 125/I-NGF transport deficits, suggesting that the existence of the transport abnormality does not predict the eventual development of dystrophic axonal lesions. Autoradiographic localization of /sup 125/I-NGF in the ileal mesenteric nerves of animals that had been diabetic for 11-13 mo demonstrated decreased amounts of /sup 125/I-NGF in transit in unligated paravascular nerve fascicles. There was, however, no evidence for focal retardation of transported /sup 125/I-NGF at the sites of dystrophic axonal lesions.

Schmidt, R.E.; Plurad, S.B.; Saffitz, J.E.; Grabau, G.G.; Yip, H.K.

1985-12-01

393

Successful delayed reconstruction of common peroneal neuroma-in-continuity using sural nerve graft.  

PubMed

Injuries of the common peroneal nerve (CPN) are frequent and associated with poor motor outcomes. So far, the opinion is held, that nerve reconstruction is reasonable and indicated up to 6 months after injury. We describe successful sural nerve interposition grafting in a patient with neuroma-in-continuity formation of the CPN, presenting with foot drop, 13 months after injury. Due to this positive result, we think nerve grafting in neuroma-in-continuity lesions of the CPN should be contemplated in patients with foot drop even more than one year after injury. PMID:23180561

Reichl, Heike; Ensat, Florian; Dellon, A Lee; Wechselberger, Gottfried

2013-02-01

394

A new system for continuous recurrent laryngeal nerve monitoring.  

PubMed

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

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

2007-01-01

395

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

PubMed

Vaccine-associated paralytic poliomyelitis is a serious concern while using the live attenuated oral polio vaccine for the eradication of poliomyelitis. The bonnet monkey model of poliovirus central nervous system (CNS) infection following experimental inoculation into the ulnar nerve allows the comparative study of wild-type and attenuated poliovirus invasiveness. Dosages >/=10(4) TCID(50) of Mahoney strain of poliovirus type 1 [PV1(M)] result in paralysis. In contrast, even with 10(7) TCID(50) of Sabin attenuated strain of poliovirus type 1 (LSc/2ab), no paralysis occurs, but virus spreads into the CNS where viral RNA is found in spinal cord neurons. While wild-type PV1(M) viral RNA replicates in neurons (and possibly in glial cells) and in cells around vessel walls, which may be mononuclear or endothelial cells, attenuated viral RNA is detected only in neurons. Systemic viraemia and gastrointestinal virus shedding occurs only in PV1(M)-infected animals. While a systemic serologic response is detected in both groups of animals, cerebrospinal fluid antibodies are detected only in animals infected with PV1(M). Both the PV1(M) and LSc/2ab strains spread to the cervical spinal cord and then to the lumbar spinal cord following ulnar nerve inoculation. Neuronophagia and neuronal loss are only seen in PV1(M)-infected monkeys in whom clinical paralysis is observed. Infection with LSc/2ab does not result in neuronophagia, neuronal loss or clinical paralysis. Spread of attenuated poliovirus in spinal cord neurons without causing paralysis following inoculation into the ulnar nerve is an important finding. PMID:11369876

Ponnuraj, E M; John, T J; Levin, M J; Simoes, E A

2001-06-01

396

Late irradiation-induced lesions of the lumbosacral plexus.  

PubMed

Lumbosacral plexus lesions developed in two women 8 and 14 years, respectively, after operation and irradiation for carcinoma of the uterus. In both patients, a left femoral nerve lesion was the presenting sign. The irradiation dose was about 5,000 rad on both sides in patient 1 and 8,400 rad on the affected side in patient 2. Both patients had low-frequency periodic discharges in the EMG. PMID:6306507

Aho, K; Sainio, K

1983-07-01

397

PK (‘peripheral benzodiazepine’) – binding sites in the CNS indicate early and discrete brain lesions: microautoradiographic detection of [3H]PK 11195 binding to activated microglia  

Microsoft Academic Search

The isoquinoline PK 11195 has been suggested as a marker of glial pathology in the lesioned brain. The aim of the present study is to clarify the precise cellular location of its binding site in the central nervous system. Here, we report that in the facial nucleus after facial nerve axotomy–a lesion causing a retrograde neuronal reaction without nerve cell

R. B Banati; R Myers; G. W Kreutzberg

1997-01-01

398

Nerve conduction and ATP concentrations in sciatic-tibial and medial plantar nerves of hens given phenyl saligenin phosphate.  

PubMed

To assess the relationship of nerve conduction and adenosine triphosphate (ATP) status in organophosphorus-induced delayed neuropathy (OPIDN), we evaluated both in adult hen peripheral nerves following exposure to a single 2.5 mg/kg dose of phenyl saligenin phosphate (PSP). ATP concentrations were determined at days 2, 4, 7, and 14 post-dosing, from five segments (n = 5 per group) representing the entire length of the sciatic-tibial and medial plantar nerve. Initial effects of PSP dosing were seen in the most distal segment at day 2, when a transient ATP concentration increase (388 +/- 79 pmol/ml/mg versus control value of 215 +/- 23, P < 0.05) was noted. Subsequently, ATP concentration in this distal segment returned to normal. In the most proximal nerve segment, ATP concentrations were decreased on day 7, and further decreased on day 14 post-dosing (P < 0.05). Changes in ATP concentration and nerve conduction velocity begin at post-dosing day 2, and were found prior to development of clinical neuropathy and axonopathic lesions. These results suggest that alterations in sciatic-tibial and medial plantar nerve conduction associated with sciatic-tibial and medial plantar nerve ATP concentration are early events in the development of OPIDN. PMID:11307855

Massicotte, C; Barber, D S; Jortner, B S; Ehrich, M

2001-02-01

399

[Damage to cranial and peripheral nerves following patency restoration of the internal carotid artery].  

PubMed

The aim of the study was an assessment of the incidence of injury to cranial and peripheral nerves as complication of patency restoration of the internal carotid artery, and analysis of the effect of peripheral nerve injury on the results of carotid patency restoration. From Oct 1987 to Sept 1999 543 procedures were carried out for restoration of patency of the internal carotid artery. After the operation hypoglossus nerve injury was found in 7 cases (1.4%), vagus injury in 9 (1.8%). Signs of exclusively recurrent laryngeal nerve damage were found in 6 cases (1.2%). Glossopharyngeus nerve was damaged in 2 cases (0.4%), transient phrenic nerve palsy as a result of conduction anaesthesia was noted in 2 cases (0.4%). Damage to the transverse cervical nerve was found in 96 cases (60%). In 2 patients (1.2%) lower position of mouth angle was due to section of the mandibular ramus of the facial nerve. In another 2 cases skin sensation disturbances were a consequence of lesion of the auricularis magnus nerve and always they coexisted with signs of transverse cervical nerve damage. In conclusion: damage to the cranial nerves during operation for carotid patency restoration are frequent but mostly they are not connected with any health risks and often they regress spontaneously. PMID:11732265

Myrcha, P; Ciostek, P; Szopi?ski, P; Noszczyk, W

2001-01-01

400

Correlation Analysis of Histomorphometry and Motor Neurography in the Median Nerve Rat Model  

PubMed Central

Objective: Standard methods to evaluate the functional regeneration after injury of the rat median nerve are insufficient to identify any further differences of axonal nerve regeneration after restitution of motor recovery is completed. An important complementary method for assessing such differences is a histomorphometric analysis of the distal to lesion nerve fibers. Recently, an electrophysiological method has been proposed as a sensitive method to examine the quality of axonal nerve regeneration. Methods: A linear regression analysis has been performed to correlate histomorphometric and neurographic data originating from 31 rats subjected to neurotmesis and immediate reconstruction of their right median nerve. Results: A significant linear correlation between the velocity of neuromuscular conduction and the total number of nerve fibers (P = .037) as well as between the amplitude of compound muscle action potential and the total number of nerve fibers (P = .026) has been identified. Interestingly, a significant correlation between the velocity of neuromuscular conduction and the square root of the cross-sectional area of the nerve could be found (P = .008). This corresponds to a linear correlation between the velocity of neuromuscular conduction and the radius of the nerve. Conclusion: These results contribute in a better interpretation of morphological predictors of nerve regeneration and verify the previously described electrophysiological assessment in the median nerve rat model as a valid method.

Manoli, Theodora; Werdin, Frank; Gruessinger, Hannes; Sinis, Nektarios; Schiefer, Jennifer Lynn; Jaminet, Patrick; Geuna, Stefano; Schaller, Hans-Eberhard

2014-01-01

401

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.

Bartel, Dianna L.

2013-01-01

402

Bilateral congenital third cranial nerve palsy.  

PubMed

We describe a patient in whom bilateral congenital third cranial nerve palsy was diagnosed at 2 weeks of age. The ptosis was treated at 3 weeks with bilateral eyelid suspension surgery, and surgical repair of the exotropia was done at 4 months. To our knowledge this is the fourth reported case of this condition. It was probably caused by a single lesion involving the oculomotor and possibly the trochlear nuclei in the brain stem. Magnetic resonance imaging scans supported this hypothesis and suggested other central nervous system anomalies. PMID:2713752

Flanders, M; Watters, G; Draper, J; O'Gorman, A

1989-02-01

403

Cranial Nerves III, IV, and VI  

PubMed Central

Motor activity affecting the direction of gaze, the position of the eyelids, and the size of the pupils are served by cranial nerves III, IV, and VI. Unusual oculomotor activity is often encountered in psychiatric patients and can be quite informative. Evaluation techniques include casual observation and simple tests that require no equipment in addition to the sophisticated methods used in specialty clinics and research labs. This article reviews pupil size, extraocular movements, nystagmus, lid retraction, lid lag, and ptosis. Beyond screening for diseases and localizing lesions, these tests yield useful information about the individual’s higher cortical function, extrapyramidal motor functioning, and toxic/pharmacologic state.

Sanders, Richard D.

2009-01-01

404

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

405

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.

Masciadri, N.; Ferranti, C.

2011-01-01

406

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.

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

2010-01-01

407

Optic nerve glioma: an update.  

PubMed

Optic nerve glioma is the most common optic nerve tumour. However, it has an unpredictable natural history. The treatment of optic nerve gliomas has changed considerably over the past few years. Chemotherapy and radiation therapy can now stabilize and in some cases improve the vision of patients with optic nerve gliomas. The treatment of optic nerve glioma requires a multi-disciplinary approach where all treatment options may have to be implemented in a highly individualized manner. The aim of this review article is to present current diagnostic and treatment protocols for optic nerve glioma. PMID:24736941

Nair, Akshay Gopinathan; Pathak, Rima S; Iyer, Veena R; Gandhi, Rashmin A

2014-08-01

408

Injection nerve palsy  

PubMed Central

Objective: To study the clinical profile and outcome of surgery for injection nerve palsies. Materials and Methods: This is a retrospective study of patients with INP who were treated at our institute during May 2000 to May 2009. Clinical, electroneuromyography (ENMG), and operative findings were noted. Intraoperative nerve action potential monitoring was not used in any case. Outcome of patients who were followed was reviewed. Results: INP comprised 92 (11%) of 837 nerve injury patients. Seventy one patients were children less than 16 years. The nerves involved were sciatic in 80 patients, radial in 8, and others in four. Fifty seven patients had power, grade 0/5. ENMG studies revealed absent compound muscle action potential in 64 and absent sensory nerve action potential in 67 patients. Thirty nine (42.3%) of 92 patients underwent surgery. The mean duration since injury in these patients was 5.2 months (3 months to 11 months). All underwent neurolysis. Only 18 patients who underwent surgery had a follow up of more than 3 months. Ten (55.5%) patients had good or fair outcome after surgery. Except for grade of motor deficit prior to surgery, none of the variables were found to significantly affect the outcome. Conclusion: The outcome of INP is generally good and many patients recover spontaneously. The outcome of surgery is dependent on preoperative motor power.

Kakati, Arindhom; Bhat, Dhananjaya; Devi, Bhagavathula Indira; Shukla, Dhaval

2013-01-01

409

Wrist pain, distal radial physeal injury, and ulnar variance in the young gymnast.  

PubMed

In gymnastics, the wrist joint is subjected to repetitive loading in a weightbearing fashion. In this setting, chronic wrist pain is quite common. Because gymnasts ordinarily enter the sport at very young ages and train for several years before skeletal maturity is attained, the growth plates of the wrist are at risk for injury. In addition, imaging studies have identified evidence of injury to the distal radial physis and the development of positive ulnar variance. Recent studies provide more information on the relationships between these findings, as well as factors that may predispose some gymnasts to wrist pain. This article provides a comprehensive review of these issues and offers suggestions for management, preventive measures, and future research. PMID:16493174

DiFiori, John P; Caine, Dennis J; Malina, Robert M

2006-05-01

410

[Anatomic bases of surgical approaches to the nerves of the lower limb: tips for young surgeons].  

PubMed

For trainee surgeons, the surgical approaches of the lower limb's peripheral nerves remain partially or completely unknown, but traumatic nerve lesions are rather frequent at this level and nerve tumors require intervention. Young surgeons will also have to treat spasticity and perform selective neurotomies, which can provide dramatic improvement of the functional status of properly selected patients. Excellent knowledge of anatomy is the key point to successful surgery. For each nerve approach, the key points on the morphological data of the nerve and its surroundings are given, as are the typical indications for this surgery and certain particularities related to patient installation in the operating room. The surgical approach section details the incision, the nerve exposure and the technical pitfalls. PMID:19800088

Rigoard, P; Buffenoir-Billet, K; Giot, J-P; d'Houtaud, S; Delmotte, A; Lapierre, F

2009-10-01

411

Wallerian degeneration demonstrated by magnetic resonance: spectroscopic measurements on peripheral nerve. [Rats  

SciTech Connect

Wallerian degeneration of rat sciatic nerves was induced by nerve section. Fifteen days later the degenerated nerves were compared with the intact contralteral nerves from the same animal. Histological sections showed the changes typical of wallerian degeneration: axonal degeneration and secondary demyelination. The freshly dissected nerves were analyzed by magnetic resonance (MR) spectroscopy at 10 MHz, and the water content was determined by dehydration. In the degenerated nerves there was a marked prolongation of both T1 and T2 relaxation times, accompanied by an increase of water content. These results suggest that it should be possible to detect wallerian degeneration in MR images; this will have an important impact on neuropathological diagnosis of central and peripheral nervous system lesions.

Jolesz, F.A.; Polak, J.F.; Ruenzel, P.W.; Adams, D.F.

1984-07-01

412

The role of microsurgery in nerve repair and nerve grafting.  

PubMed

Advances in the field of microsurgery have improved the results after peripheral nerve surgery and have extended the types of nerve repair that can be accomplished. Innovative techniques using microsurgical dissection, such as nerve transfers and end-to-side repairs are direct consequences of these advances. PMID:17478254

Dvali, Linda; Mackinnon, Susan

2007-02-01

413

Gene profiling during development and after a peripheral nerve traumatism reveals genes specifically induced by injury in dorsal root ganglia  

Microsoft Academic Search

In order to shed light on transcriptional networks involved in adult peripheral nerve repair program, we propose for the first time an organization of the transcriptional dynamics of the mouse dorsal root ganglia (DRG) following a sciatic nerve lesion. This was done by a non-hierarchical bioinformatical clustering of four Serial Analysis of Gene Expression libraries performed on DRG at embryonic

Ilana Méchaly; Steeve Bourane; David Piquemal; Mohammed Al-Jumaily; Stéphanie Ventéo; Sylvie Puech; Frédérique Scamps; Jean Valmier; Patrick Carroll

2006-01-01

414

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

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

1990-01-01

415

The pathophysiology of compression injuries of the peripheral facial nerve.  

PubMed

The buccolabial branches of guniea pig facial nerves were crushed to produce axonotmesis, Wallerian degeneration, and demyelination. The lesions were followed from 1 to 8 weeks by transmission electron microscopy, electrophysiological tests, and cytochemical staining methods for Na+ channels. The first week demonstrated the classic degenerative neural changes. At 2 weeks the axoplasmic side of the demyelinated axolemma demonstrated diffuse staining for Na+ channels at a distance of 1 micrometer. At 4 weeks multiple condensed areas of dense staining were noted along the demyelinated axolemma. These staining areas resemble in character and length a normal node of Ranvier and denote new Na+ channels. The internodal distance is shorter than for the normal facial nerve. At 6 weeks a thin layer of myelin covered the nerve fibers. At 8 weeks half of the nerves were normal sized and the myelin sheath was normal in width. Following nerve crushing, electrical activity is present for 24-48 hours in the axonotmetic distal stump. Then the axon becomes unresponsive to electrical stimulation. There is gradual resumption of electrical activity between 5 and 14 days. Normal conduction resumes by 8 weeks. This study provides ultrastructural and cytochemical evidence for nerve fiber reorganization, axolemmal plasticity and sodium channel production and redistribution following Wallerian degeneration and demyelination in axonotmesis. Resumption of electrical neural excitability is achieved by an increase in the density of sodium channels and reduction in the internodal distance as a means for impedence matching. Reduction of the cross sectional diameter of the regenerating axon facilitates electrical conduction. PMID:7132527

Ge, X X; Spector, G J; Carr, C

1982-10-01

416

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

NASA Astrophysics Data System (ADS)

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

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

2011-03-01

417

Use of Ultrasound in Detection and Treatment of Nerve Compromise in a Case of Humeral Lengthening  

PubMed Central

The development of iatrogenic nerve lesions during and following limb lengthening procedures present a challenge to orthopedic surgeons. Early treatment of nerve damage is critical in salvaging full function of the nerve. Precise location of damage, however, must be determined in order to appropriately administer treatment. We report a patient with a short humerus caused by a growth arrest undergoing a 7-cm lengthening who developed a neurapraxic injury of the radial nerve. Nerve compromise was noted 1 month into the lengthening program. Nerve conduction studies and electromyography could not be used to determine the precise site of injury. Likewise, magnetic resonance imaging and computed tomography were contraindicated and inconclusive, respectively, due to the presence of a metallic external fixation device. High-resolution ultrasonography (US) findings, however, correlated with our clinical examination of the patient's radial nerve function and permitted identification of the precise site of nerve involvement. Treatment was administered by removing a causative half-pin. Several days following treatment, nerve function returned to normal. There are a limited number of articles in the literature regarding nerve injuries associated with limb lengthening and their corrective treatments. The outcome of this case underscores the usefulness of US over various other diagnostic techniques under certain circumstances.

Fryman, Craig; Bigman, Daniel; Adler, Ronald

2010-01-01

418

Bilateral Optic Nerve Meningioma  

Microsoft Academic Search

A case of bilateral optic nerve meningioma is reported. The onset of the clinical symptoms, at age 27, resembled unilateral optic neuritis with papilledema, leading to bilateral amaurosis with optic atrophy 4 years later. Skull X-ray revealed a ‘blistering’ type of bone reaction. In the carotid angiogram, the ophthalmic artery appeared quite enlarged and displaced. The CT scan showed a

H. Liaño; C. Garcia-Alix; M. Lousa; M. Marquez; L. Nombela; J. de Miguel

1982-01-01

419

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

420

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

421

Vertebral rim lesions in the dorsolumbar spine.  

PubMed Central

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

Hilton, R C; Ball, J

1984-01-01

422

Bone stresses before and after insertion of two commercially available distal ulnar implants using finite element analysis.  

PubMed

Distal ulnar arthroplasty is becoming a popular treatment option for disorders of the distal radioulnar joint; however, few studies have investigated how load transfer in the ulna is altered after insertion of an implant. The purpose of our study was to compare bone stresses before and after insertion of two commercially available cemented distal ulnar implants: an implant with a titanium stem and an implant with a cobalt chrome stem. Appropriately sized implants of both types were inserted into eight previously validated subject-specific finite element models, which were created by using information derived from computed tomography scans. The von Mises stresses were compared at eight different regions pre- and post-implantation. The bone stresses with the titanium stem were consistently closer to the pre-implantation stresses than with the cobalt chrome stem. For the loading situation and parameters investigated, results of these models show that insertion of the E-Centrix® ulnar Head may result in less stress shielding than the SBI uHead™ stem. Future studies are required to investigate other implant design parameters and loading conditions that may affect the predicted amount of stress shielding. PMID:21416502

Austman, Rebecca L; King, Graham J W; Dunning, Cynthia E

2011-09-01

423

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

424

Reproducible mouse sciatic nerve crush and subsequent assessment of regeneration by whole mount muscle analysis.  

PubMed

Regeneration in the peripheral nervous system (PNS) is widely studied both for its relevance to human disease and to understand the robust regenerative response mounted by PNS neurons thereby possibly illuminating the failures of CNS regeneration(1). Sciatic nerve crush (axonotmesis) is one of the most common models of peripheral nerve injury in rodents(2). Crushing interrupts all axons but Schwann cell basal laminae are preserved so that regeneration is optimal(3,4). This allows the investigator to study precisely the ability of a growing axon to interact with both the Schwann cell and basal laminae(4). Rats have generally been the preferred animal models for experimental nerve crush. They are widely available and their lesioned sciatic nerve provides a reasonable approximation of human nerve lesions(5,4). Though smaller in size than rat nerve, the mouse nerve has many similar qualities. Most importantly though, mouse models are increasingly valuable because of the wide availability of transgenic lines now allows for a detailed dissection of the individual molecules critical for nerve regeneration(6, 7). Prior investigators have used multiple methods to produce a nerve crush or injury including simple angled forceps, chilled forceps, hemostatic forceps, vascular clamps, and investigator-designed clamps(8,9,10,11,12). Investigators have also used various methods of marking the injury site including suture, carbon particles and fluorescent beads(13,14,1). We describe our method to obtain a reproducibly complete sciatic nerve crush with accurate and persistent marking of the crush-site using a fine hemostatic forceps and subsequent carbon crush-site marking. As part of our description of the sciatic nerve crush procedure we have also included a relatively simple method of muscle whole mount we use to subsequently quantify regeneration. PMID:22395197

Bauder, Andrew R; Ferguson, Toby A

2012-01-01

425

Reproducible Mouse Sciatic Nerve Crush and Subsequent Assessment of Regeneration by Whole Mount Muscle Analysis  

PubMed Central

Regeneration in the peripheral nervous system (PNS) is widely studied both for its relevance to human disease and to understand the robust regenerative response mounted by PNS neurons thereby possibly illuminating the failures of CNS regeneration1. Sciatic nerve crush (axonotmesis) is one of the most common models of peripheral nerve injury in rodents2. Crushing interrupts all axons but Schwann cell basal laminae are preserved so that regeneration is optimal3,4. This allows the investigator to study precisely the ability of a growing axon to interact with both the Schwann cell and basal laminae4. Rats have generally been the preferred animal models for experimental nerve crush. They are widely available and their lesioned sciatic nerve provides a reasonable approximation of human nerve lesions5,4. Though smaller in size than rat nerve, the mouse nerve has many similar qualities. Most importantly though, mouse models are increasingly valuable because of the wide availability of transgenic lines now allows for a detailed dissection of the individual molecules critical for nerve regeneration6, 7. Prior investigators have used multiple methods to produce a nerve crush or injury including simple angled forceps, chilled forceps, hemostatic forceps, vascular clamps, and investigator-designed clamps8,9,10,11,12. Investigators have also used various methods of marking the injury site including suture, carbon particles and fluorescent beads13,14,1. We describe our method to obtain a reproducibly complete sciatic nerve crush with accurate and persistent marking of the crush-site using a fine hemostatic forceps and subsequent carbon crush-site marking. As part of our description of the sciatic nerve crush procedure we have also included a relatively simple method of muscle whole mount we use to subsequently quantify regeneration.

Bauder, Andrew R.; Ferguson, Toby A.

2012-01-01

426

Bilateral eventration of sciatic nerve.  

PubMed

During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN), the common peroneal nerve (CPN), and the tibial nerve (TN), either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block. PMID:22049898

Sharma, T; Singla, R K; Lalit, M

2010-01-01

427

The Effect of Drill Trajectory on Proximity to the Posterior Interosseous Nerve During Cortical Button Distal Biceps Repair  

PubMed Central

Purpose The aim of this study was to evaluate the effect that different drill trajectories across the radius have on the proximity of the drill tip to the posterior interosseous nerve (PIN). Methods In 10 cadaveric specimens, we drilled from the bicipital tuberosity across the radius using four different trajectories: 1) aiming across the radius at 90° to the longitudinal axis of the radius, 2) distally at 45°, 3) ulnarly, and 4) radially. We measured the distance between the tip of the drill as it exited the dorsal cortex of the radius and the PIN. Results Aiming 90° across the radius and aiming ulnarly across the radius resulted in a distance of 11.2 ±3.2 (95% CI: 8.9, 13.5) mm and 16.0 ±3.8 (95% CI: 13.3, 18.7) mm, respectively, between the drill tip and the PIN. Aiming the drill 45° distally or aiming radially resulted in a distance of only 2.0 ±2.2 (95% CI: 0.5, 3.6) mm and 4.2 ±2.2 (95% CI: 2.6, 5.8) mm, respectively. The differences were found to be statistically significant. Conclusion Based on the results of this anatomic study, when using the cortical button distal biceps repair technique, we recommend drilling across the radius at 90° to its longitudinal axis and aiming from 0-30 degrees ulnarly, with forearm in full supination. This provides an increased margin of safety to prevent injury to the PIN compared to drilling radially or distally.

Lo, Eddie Y; Li, Chin-Shang; Van den Bogaerde, James M.

2011-01-01

428

Local substitution of GDF-15 improves axonal and sensory recovery after peripheral nerve injury.  

PubMed

The growth/differentiation factor-15, GDF-15, has been found to be secreted by Schwann cells in the lesioned peripheral nervous system. To investigate whether GDF-15 plays a role in peripheral nerve regeneration, we substituted exogenous GDF-15 into 10-mm sciatic nerve gaps in adult rats and compared functional and morphological regeneration to a vehicle control group. Over a period of 11 weeks, multiple functional assessments, including evaluation of pinch reflexes, the Static Sciatic Index and of electrophysiological parameters, were performed. Regenerated nerves were then morphometrically analyzed for the number and quality of regenerated myelinated axons. Substitution of GDF-15 significantly accelerated sensory recovery while the effects on motor recovery were less strong. Although the number of regenerated myelinated axons was significantly reduced after GDF-15 treatment, the regenerated axons displayed advanced maturation corroborating the results of the functional assessments. Our results suggest that GDF-15 is involved in the complex orchestration of peripheral nerve regeneration after lesion. PMID:22955564

Mensching, Leonore; Börger, Ann-Kathrin; Wang, Xialong; Charalambous, Petar; Unsicker, Klaus; Haastert-Talini, Kirsten

2012-11-01

429

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 3cm. 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

430

Management of desmoid-type fibromatosis involving peripheral nerves.  

PubMed

Desmoid-type fibromatosis is an uncommon and aggressive neoplasia, associated with a high rate of recurrence. It is characterized by an infiltrative but benign fibroblastic proliferation occurring within the deep soft tissues. There is no consensus about the treatment of those tumors. We present a surgical series of four cases, involving the brachial plexus (two cases), the median nerve and the medial brachial cutaneous nerve. Except for the last case, they were submitted to multiple surgical procedures and showed repeated recurrences. The diagnosis, the different ways of treatment and the prognosis of these tumoral lesions are discussed. Our results support the indication of radical surgery followed by radiotherapy as probably one of the best ways to treat those controversial lesions. PMID:22836457

Siqueira, Mario G; Tavares, Paulo L; Martins, Roberto S; Heise, Carlos O; Foroni, Luciano H L; Bordalo, Marcelo; Falzoni, Roberto

2012-07-01

431

Echographic correlation of optic nerve sheath size and cerebrospinal fluid pressure.  

PubMed

A 23-year-old obese woman presented with papilledema. Computed tomography showed no intracranial mass lesions and lumbar puncture revealed an increased opening pressure, confirming the diagnosis of pseudo-tumor cerebri. Standardized echography of the optic nerves was performed immediately before and after lumbar puncture. A marked reduction of cerebrospinal fluid pressure correlated with a decrease in the subarachnoid fluid of the optic nerve sheath. PMID:2526162

Galetta, S; Byrne, S F; Smith, J L

1989-06-01

432

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

Microsoft Academic Search

This is a case report of an arthroscopic treatment performed on a patient with piriformis syndrome due to perineural cyst\\u000a on piriformis muscle and sciatic nerve. Confirmation, incision, and drainage of benign cystic lesion on the sciatic nerve\\u000a below the piriformis muscle were performed following the release of the piriformis tendon through the posterior and posteroinferior\\u000a arthroscopic portal. Recurrence of

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

2010-01-01

433

Electrodiagnostic techniques in the evaluation of nerve compressions and injuries in the upper limb.  

PubMed

Nerve conduction studies and the needle examination of muscles (EMG) are valuable aids in the evaluation of acute and chronic focal neuropathies. A careful clinical examination, however, remains the best way to assess patients with these disorders. In an acute and apparently complete nerve lesion, the main drawbacks of electrophysiologic testing are that a full evaluation cannot usually be done before 10 days after the injury, and the differentiation between axonotmesis and neurotmesis cannot be made. PMID:3793766

Stewart, J D

1986-11-01

434

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.

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

2013-01-01

435

Congenital toxoplasmosis associated with acquired oculomotor nerve (CN III) palsy.  

PubMed

A nine-week-old Caucasian male presented with right ptosis and right exotropia due to a third cranial nerve palsy. Symmetrical macular lesions and a paramacular hyperpigmented lesion with overlying vitreous cells in the left eye were compatible with congenital toxoplasmosis. Computer tomography demonstrated calcifications in the periventricular and midbrain regions where the oculomotor nerve exits the brainstem. The diagnosis was confirmed by the toxoplasma indirect fluorescent antibody titer greater than 1:2048 for the infant and greater than 1:512 for the mother. Treatment was instituted with pyrimethamine, sulfadiazine and folinic acid. Neurologic sequelae included a right hemiparesis, infantile seizures, and generalized developmental delay. A Mueller's muscle resection (RUL) combined with 9-mm recession of the right lateral rectus and 7-mm resection of the right medial rectus muscles produced minimal ptosis and right exotropia one year later. the child now prefers to fix with the right eye and a vertical nystagmus is evident in the left eye. To our knowledge this is the first reported case of an infant with noncomitant strabismus due to congenital toxoplasma cranial nerve involvement. The finding of an acquired third cranial nerve palsy accompanied by progressive neurologic sequelae warrants consideration of congenital toxoplasmosis. PMID:7175624

Perry, D D; Marritt, J C; Greenwood, R S; Collier, A M; Tennison, M B

1982-01-01

436

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

437

Epidermal nerve fibers  

PubMed Central

Objectives: Our first objective was to explore the value of estimating 95% confidence intervals (CIs) of epidermal nerve fibers (ENFs)/mm for number of sections to be evaluated and for confidently judging normality or abnormality. Our second objective was to introduce a new continuous measure combining nerve conduction and ENFs/mm. Methods: The 95% CI studies were performed on 1, 1–2, 1–3 - - - 1–10 serial skip sections of 3-mm punch biopsies of leg and thigh of 67 healthy subjects and 23 patients with diabetes mellitus. Results: Variability of differences of ENFs/mm counts (and 95% CIs) from evaluation of 1, 1–2, 1–3 - - - 1–9 compared with 1–10 serial skip sections decreased progressively without a break point with increasing numbers of sections evaluated. Estimating 95% CIs as sections are evaluated can be used to judge how many sections are needed for adequate evaluation, i.e., only a few when counts and 95% CIs are well within the range of normality or abnormality and more when values are borderline. Also provided is a methodology to combine results of nerve conduction and ENFs/mm as continuous measures of normality or abnormality. Conclusion: Estimating 95% CIs of ENFs/mm is useful to judge how many sections should be evaluated to confidently declare counts to be normal or abnormal. Also introduced is a continuous measure of both large-fiber (nerve conduction) and small-fiber (ENFs/mm) normal structures/functions spanning the range of normality and abnormality for use in therapeutic trials.

Engelstad, JaNean K.; Taylor, Sean W.; Witt, Lawrence V.; Hoebing, Belinda J.; Herrmann, David N.; Klein, Christopher J.; Johnson, David M.; Davies, Jenny L.; Carter, Rickey E.

2012-01-01

438

The role of nerve allografts and conduits for nerve injuries.  

PubMed

Nerve repair after transection has variable and unpredictable outcomes. In addition to advancements in microvascular surgical techniques, nerve allografts and conduits are available options in peripheral nerve reconstruction. When tensionless nerve repair is not feasible, or in chronic injuries, autografts have been traditionally used. As substitute to autografts, decellularized allografts and conduits have become available. These conduits can reduce donor site morbidity, functional loss at the donor area in cases where autografts are used, and immune reaction from transplants or unprocessed allografts. The development of new biomaterials for use in conduits, as well as use of cytokines, growth factors, and other luminal fillers, may help in the treatment of acute and chronic nerve injuries. The indications and properties of nerve conduits and allografts are detailed in this article. PMID:20670808

Rivlin, Michael; Sheikh, Emran; Isaac, Roman; Beredjiklian, Pedro K

2010-08-01

439

Peripheral nerve injuries due to osteochondromas: analysis of 20 cases and review of the literature.  

PubMed

Object Nerve compressions due to osteochondromas are extremely rare. The aim of this retrospective study was to investigate the mechanisms, diagnostic evaluations, and treatment of nerve lesions due to osteochondromas, and to review the literature. Methods The authors retrospectively reviewed their clinic data archive from 1998 through 2008, and 20 patients who were operated on due to peripheral nerve injuries caused by osseous growth were enrolled in the study. Patients' age, duration of symptoms, localizations, intraoperative findings, and modified British Medical Research Council (MRC) and electromyography data obtained from hospital records were evaluated. The literature on this topic available in PubMed was also reviewed. All 20 patients underwent surgery, which consisted of tumor excision performed by orthopedic surgeons and nerve decompression performed by neurosurgeons. Results There were 17 men and 3 women included in the study, with a mean age of 21 years (range 18-25 years). Three patients had multiple hereditary exostoses, and 17 had a solitary exostosis. All of the patients underwent en bloc resection. The most common lesion si