Perineural fibrosis

2009 ◽  
pp. 145-147
Author(s):  
L GILES
Keyword(s):  
Perineural Fibrosis

Histology and Histomorphometric Analysis of the Normal and Atrophic Heel Fat Pad

1995 ◽  
Vol 16 (5) ◽  
pp. 254-258 ◽  
Author(s):  
William R. Buschmann ◽  
Melvin H. Jahss ◽  
Frederick Kummer ◽  
Panna Desai ◽  
Russell O. Gee ◽  
...  
Keyword(s):  
Lipid Droplets ◽  
Light And Electron Microscopy ◽  
Subcutaneous Fat ◽  
Staining Technique ◽  
Elastic Fibers ◽  
Elastic Tissue ◽  
Histomorphometric Analysis ◽  
Fat Pad ◽  
Perineural Fibrosis ◽  
Fat Pads

Light and electron microscopy was used for a histologic examination of normal heel fat pads and atrophic heel fat pads from patients with peripheral neuropathies. Histomorphometric analysis revealed an average 30% smaller mean cell area and 16% smaller mean cell diameters in the atrophic pads compared with the normal heel fat pads. Septal walls in the atrophic fat pads were often fragmented and approximately 75% wider than normal. Perineural fibrosis was also found in the atrophic heel fat pads. The Verhoeff elastic staining technique was used to determine the relative percentage of collagen to elastic tissue within the septae. No significant differences were noted between the normal and atrophic heels. The ultrastructure of the adipocytes from the normal and atrophic heel pads was similar to those found in abdominal subcutaneous fat. Lipid droplets of variable size and density within the center of the adipocyte were surrounded by a thin border of cytoplasm. The interphase between adipocytes contained fine collagen and elastic fibers.

Comparison between optical coherence tomography imaging and histological sections of peripheral nerves

2019 ◽  
pp. 1-8
Author(s):  
Anne E. Carolus ◽  
Jens Möller ◽  
Martin R. Hofmann ◽  
Johannes A. P. van de Nes ◽  
Hubert Welp ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Peripheral Nerves ◽  
Imaging Technique ◽  
Structural Features ◽  
Weighted Averaging ◽  
Optical Coherence ◽  
Myelinated Axons ◽  
Averaging Filter ◽  
Perineural Fibrosis

OBJECTIVEOptical coherence tomography (OCT) is an imaging technique that uses the light-backscattering properties of different tissue types to generate an image. In an earlier feasibility study the authors showed that it can be applied to visualize human peripheral nerves. As a follow-up, this paper focuses on the interpretation of the images obtained.METHODSTen different short peripheral nerve specimens were retained following surgery. In a first step they were examined by OCT during, or directly after, surgery. In a second step the nerve specimens were subjected to histological examination. Various steps of image processing were applied to the OCT raw data acquired. The improved OCT images were compared with the sections stained by H & E. The authors assigned the structures in the images to the various nerve components including perineurium, fascicles, and intrafascicular microstructures.RESULTSThe results show that OCT is able to resolve the myelinated axons. A weighted averaging filter helps in identifying the borders of structural features and reduces artifacts at the same time. Tissue-remodeling processes due to injury (perineural fibrosis or neuroma) led to more homogeneous light backscattering. Anterograde axonal degeneration due to sharp injury led to a loss of visible axons and to an increase of light-backscattering tissue as well. However, the depth of light penetration is too small to allow generation of a complete picture of the nerve.CONCLUSIONSOCT is the first in vivo imaging technique that is able to resolve a nerve’s structures down to the level of myelinated axons. It can yield information about focal and segmental pathologies.

Post-discectomy perineural fibrosis: Comparison of conventional versus microsurgical techniques

Microsurgery ◽  
1992 ◽  
Vol 13 (4) ◽  
pp. 192-194 ◽  
Author(s):  
Alexandros S. Touliatos ◽  
Panayotis N. Soucacos ◽  
Alexandros E. Beris
Keyword(s):  
Microsurgical Techniques ◽  
Perineural Fibrosis

scholarly journals Percutaneous Needle Electrolysis Reverses Neurographic Signs of Nerve Entrapment by Induced Fibrosis in Mice

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
R. Margalef ◽  
F. Valera-Garrido ◽  
F. Minaya-Muñoz ◽  
M. Bosque ◽  
N. Ortiz ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Compound Muscle Action Potential ◽  
Nerve Entrapment ◽  
Galvanic Current ◽  
Nerve Entrapments ◽  
Muscle Action Potential ◽  
Vascular Compromise ◽  
Tunnel Syndrome ◽  
Fibrous Reaction ◽  
Perineural Fibrosis

Nerve entrapments such as carpal tunnel syndrome are the most common mononeuropathies. The lesional mechanism includes a scarring reaction that causes a vascular compromise. The most effective treatment is surgery, which consists of removing the scarred area, thus reverting the vascular impairment. In the present study, a more conservative therapeutic approach has been undertaken to release the nerve by means of galvanic current (GC) applied with a needle: percutaneous needle electrolysis (PNE). For this purpose, a mouse model of sciatic nerve entrapment has been created using albumin coagulated by glutaraldehyde (albumin 35% and glutaraldehyde 2% volume applied, 10 μl). After two weeks, a fibrous reaction was obtained which entrapped the nerve to the extent of causing atrophy of the leg musculature (14.7%, P < 0.05 compared to the control leg). Ultrasound imaging confirmed that the model’s image was compatible with that of nerve entrapment in patients. To quantify the degree of entrapment, nerve conduction recordings were made. The amplitude (peak-to-peak) of the compound muscle action potential (CMAPs) decreased by 32.2% ( P < 0.05 ), and the proximal latency increases by 17.7% ( P < 0.05 , in both cases). In order to release the sciatic nerve, PNE was applied (1.5 mA for 3 seconds and 3 repetitions; 1.5/3/3) by means of a solid needle in the immediacy of perineural fibrosis before and 5 minutes after the application of GC, and the proximal latency shows a decrease of 16% ( P < 0.05 ). The recovery of CMAPs amplitude was about 48.7% ( P < 0.05 ). Three weeks later, the CMAPs amplitude was almost completely recovered (94.64%). Therefore, with the application of GC by means of a solid needle, the sciatic nerve was definitively released from its fibrous entrapment.

Canaletto implant in revision surgery for carpal tunnel syndrome: 21 case series

2011 ◽  
Vol 37 (7) ◽  
pp. 682-689 ◽  
Author(s):  
A. Bilasy ◽  
S. Facca ◽  
S. Gouzou ◽  
P. A. Liverneaux
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Case Series ◽  
Invasive Technique ◽  
Carpal Tunnel Surgery ◽  
Tunnel Syndrome ◽  
Quick Dash ◽  
Perineural Fibrosis

Revision carpal tunnel surgery varies from 0.3% to 19%. It involves a delayed neurolysis and prevention of perineural fibrosis. Despite numerous available procedures, the results remain mediocre. The aim of this study is to evaluate the results of the Canaletto implant in this indication. Our series includes 20 patients (1 bilateral affection) reoperated for carpal tunnel between October 2008 and December 2009. After the first operation, the symptom-free period was 112 weeks, on average. The average incision was 27 mm. After neurolysis, the Canaletto implant was placed in contact with the nerve. Immediate postoperative mobilization was commenced. Sensory (pain, DN4, and hypoesthesia), motor (Jamar, muscle wasting), and functional (disabilities of the arm, should, and hand; DASH) criteria were evaluated. Nerve conduction velocity (NCV) of the median nerve was measured. Average follow up was 12.1 months. All measurements were improved after insertion of the Canaletto implant: pain (6.45–3.68), DN4 (4.29–3.48), Quick DASH (55.30–34.96), Jamar (66.11–84.76), NCV (29.79–39.06 m/s), hypoesthesia (76.2–23.8%), wasting (42.9–23.8%). Nevertheless, four patients did not improve, and pain was the same or worse in six cases. Our results show that in recurrent carpal tunnel syndrome, Canaletto implant insertion gives results at least as good as other techniques, with the added advantage of a smaller access incision, a rapid, less invasive technique, and the eliminated morbidity of raising a flap to cover the median nerve.

scholarly journals Surgical Options for Recalcitrant Carpal Tunnel Syndrome with Perineural Fibrosis

Hand ◽  
2012 ◽  
Vol 7 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Joshua M. Abzug ◽  
Sidney M. Jacoby ◽  
A. Lee Osterman
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Surgical Options ◽  
Tunnel Syndrome ◽  
Perineural Fibrosis

Ultrasound of the Brachial Plexus

2018 ◽  
Vol 22 (03) ◽  
pp. 323-333 ◽  
Author(s):  
James Griffith
Keyword(s):  
Brachial Plexus ◽  
Soft Tissues ◽  
High Spatial Resolution ◽  
Nerve Sheath Tumor ◽  
Common Variants ◽  
Ultrasound Technique ◽  
Neuralgic Amyotrophy ◽  
Inflammatory Neuropathies ◽  
The Common ◽  
Perineural Fibrosis

AbstractExamination of the brachial plexus with ultrasound is efficient because it allows many parts of the brachial plexus as well as the surrounding soft tissues to be assessed with high spatial resolution. The key to performing good ultrasound of the brachial plexus is being familiar with the anatomy and the common variants. That makes it possible to concentrate solely on the ultrasound appearances free of simultaneously wondering about the anatomy. Ultrasound of the brachial plexus is particularly good for assessing nerve sheath tumor, perineural fibrosis, metastases, some inflammatory neuropathies, neuralgic amyotrophy, and posttraumatic sequalae. It is limited in the assessment of thoracic outlet syndrome and in the acute/subacute trauma setting. This review addresses the anatomy, ultrasound technique, as well as pathology of the brachial plexus from the cervical foramina to the axilla.

High-resolution ultrasound in the diagnosis of failed carpal tunnel decompression: a study of 35 cases

2022 ◽  
pp. 175319342110686
Author(s):  
Enrico Carità ◽  
A. Donadelli ◽  
M. Laterza ◽  
P. Perazzini ◽  
S. Tamburin ◽  
...  
Keyword(s):  
High Resolution ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Giant Cell Tumour ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Ultrasound Findings ◽  
Cause Of Failure ◽  
Perineural Fibrosis ◽  
Median Nerve Injury

We used high-resolution ultrasound to examine 35 median nerves (35 patients) with failed carpal tunnel decompression to identify the cause of failure. The carpal tunnel was examined before revision surgery, and the results were correlated with surgical findings. The cross-sectional area was measured, and nerve morphology was analysed at the sites of compression. We found persistent median nerve compression in 30 out of 35 patients. In 20 patients, the compression was caused by a residual transverse carpal ligament, in four by perineural fibrosis, in five by both of these causes and in one by tenosynovitis. In four patients, evidence of median nerve injury with an epineural/fascicular lesion was detected; and in one, no abnormalities were found. Surgical findings were consistent with the ultrasound findings except in one patient where tenosynovitis was associated with a giant cell tumour, which was missed by ultrasound. High-resolution ultrasound can provide helpful information in preoperative diagnosis of failed carpal tunnel decompression with good correlation between the ultrasound and surgical findings. Level of evidence: IV

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