Radiographic and Clinical Outcomes of the Shoulder in Long-Term Follow-Up of Brachial Plexus Birth Injury

2020 ◽  
Vol 45 (12) ◽  
pp. 1115-1122
Author(s):  
Kristen Ploetze ◽  
Charles Goldfarb ◽  
Summer Roberts ◽  
Lindley Wall
Keyword(s):  
Brachial Plexus ◽  
Clinical Outcomes ◽  
Birth Injury ◽  
Long Term Follow Up ◽  
Brachial Plexus Birth Injury

Treatment of Refractory Pain after Brachial Plexus Avulsion with Dorsal Root Entry Zone Lesions

Neurosurgery ◽  
2001 ◽  
Vol 48 (6) ◽  
pp. 1269-1277 ◽  
Author(s):  
Madjid Samii ◽  
Steffani Bear-Henney ◽  
Wolf Lüdemann ◽  
Marcos Tatagiba ◽  
Ulrike Blömer
Keyword(s):  
Brachial Plexus ◽  
Dorsal Root ◽  
Intractable Pain ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Root Entry Zone ◽  
Long Term Follow Up ◽  
Cervical Root

Abstract OBJECTIVE Significant numbers of patients experience intractable pain after brachial plexus root avulsions. Medications and surgical procedures such as amputation of the limb are often not successful in pain treatment. METHODS Forty-seven patients with intractable pain after traumatic cervical root avulsions were treated with dorsal root entry zone coagulation between 1980 and 1998. The dorsal root entry zone coagulation procedure was performed 4 months to 12 years after the trauma, and patients were monitored for up to 18 years (average follow-up period, 14 yr). RESULTS Immediately after surgery, 75% of patients experienced significant pain reduction; this value was reduced to 63% during long-term follow-up monitoring. Nine patients experienced major complications, including subdural hematomas (n = 2) and motor weakness of the lower limb (n = 7). Improved coagulation electrodes with thermistors that could produce smaller and more-accurate lesion sizes, which were introduced in 1989, significantly reduced the number of complications. CONCLUSION Central deafferentation pain that persists and becomes intractable among patients with traumatic cervical root avulsions has been difficult to treat in the past. Long-term follow-up monitoring of patients who underwent the dorsal root entry zone coagulation procedure in the cervical cord indicated that long-lasting satisfactory relief is possible for the majority of individuals, with acceptable morbidity rates.

scholarly journals Balloon-expandable stents for treatment of symptomatic middle cerebral artery stenosis: Clinical outcomes during long-term follow-up

2018 ◽  
Vol 24 (6) ◽  
pp. 666-673 ◽  
Author(s):  
Sung Hyun Baik ◽  
Hyo Sung Kwak ◽  
Gyung Ho Chung ◽  
Seung Bae Hwang
Keyword(s):  
Middle Cerebral Artery ◽  
Clinical Outcomes ◽  
Cerebral Artery ◽  
Reperfusion Therapy ◽  
Stent Insertion ◽  
Recurrence Rates ◽  
Long Term Follow Up ◽  
Ischemic Events

Background Insertion of a balloon-expandable stent (BES) in patients with symptomatic intracranial atherosclerosis is a treatment option for reperfusion therapy. In this study, we retrospectively reviewed clinical outcomes during long-term follow-up after insertion of balloon-expandable stents in patients with symptomatic middle cerebral artery (MCA) stenosis. Methods Institutional review board approval was obtained for retrospective review of patient data. Thirty-four patients (15 men, 19 women; median age, 67.5 years) with symptomatic MCA stenosis underwent balloon-expandable stent insertion between June 2008 and December 2010. Patient records were reviewed for angiographic findings and clinical outcomes during long-term follow-up. Results Of these patients, 22 presented with acute ischemic stroke with underlying MCA atherosclerosis and had good clinical outcomes (modified Rankin Scale score (mRS): 0–2) after reperfusion therapy. Indications for stenting for the remaining 12 patients were recurrent transient ischemic attacks (TIAs) refractory to medical therapy and MCA stenosis greater than 70%. During the poststenting follow-up period, which ranged from 61 to 108 months (median, 67.5 months), a TIA occurred in five patients. Of these five patients, one experienced a complete reocclusion of the MCA stent, and three had symptomatic restenosis. The remaining 29 patients did not experience any further ischemic events or restenosis during the follow-up period. Conclusions In our study, treatment with balloon-expandable stents in patients with symptomatic MCA stenosis resulted in low recurrence rates for both ischemic events and restenosis during long-term follow-up.

Long-Term Outcomes of Brachial Plexus Reconstruction with Sural Nerve Autograft for Brachial Plexus Birth Injury

2019 ◽  
Vol 143 (5) ◽  
pp. 1017e-1026e ◽  
Author(s):  
M. Claire Manske ◽  
Andrea S. Bauer ◽  
Vincent R. Hentz ◽  
Michelle A. James
Keyword(s):  
Brachial Plexus ◽  
Sural Nerve ◽  
Birth Injury ◽  
Long Term Outcomes ◽  
Nerve Autograft ◽  
Brachial Plexus Birth Injury

scholarly journals Structural integrity of rotator cuff at 16 years following repair: good long-term outcomes despite recurrent tears

2017 ◽  
Vol 11 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Robert S. J. Elliott ◽  
Yi-Jia Lim ◽  
Jennifer Coghlan ◽  
John Troupis ◽  
Simon Bell
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Structural Integrity ◽  
Case Series ◽  
Simple Shoulder Test ◽  
Supraspinatus Tear ◽  
Long Term Follow Up

Background There are few studies reporting long-term rotator cuff integrity following repair. The present study reports a case series of surgically repaired supraspinatus tendons followed up with clinical outcomes and ultrasound imaging after an average of 16 years. Methods The prospectively studied clinical outcomes at short-, medium- and long-term follow-up in 27 shoulders in 25 patients treated with arthroscopic subacromial decompression and mini-open rotator cuff repair have been reported previously. The functional outcomes scores recorded were the University of California Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) measures. These patients then underwent an ultrasound scan with respect to the long-term assessment of the shoulder and the integrity of the repair. Results A recurrent tear was noted in 37% of patients at 16.25 years after surgery, of which 50% were small. Two patients required repeat surgery. Patients had a mean UCLA score of 30, an ASES score of 91.3 and a SST score of 9.5 with a 85% level of satisfaction with surgery. Patients with a recurrent tear had outcome scores equivalent to those with an intact cuff with no significant pain. No independent risk factors were identified as predictors for recurrent tear. Conclusions Patients showed sustained benefit and satisfaction at long-term follow-up despite a 37% recurrence of full-thickness supraspinatus tear.

Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms

2014 ◽  
Vol 121 (5) ◽  
pp. 1093-1101 ◽  
Author(s):  
Christopher R. Durst ◽  
Robert M. Starke ◽  
John R. Gaughen ◽  
Scott Geraghty ◽  
K. Derek Kreitel ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Technical Success ◽  
Parent Vessel ◽  
Technical Success Rate ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
Coil Migration

Object The endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique. Methods The authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported. Results The technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0–2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%. Conclusions The dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.

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