Neurophysiological investigation of injuries sustained in sport

2013 ◽  
Author(s):  
Gerard Mullins ◽  
Julian Ray
Keyword(s):  
Peripheral Nerves ◽  
Occupational Injury ◽  
Competitive Sports ◽  
Nerve Injuries ◽  
Physiological Demands

The continued growth of recreational and competitive sports has been accompanied by an increased incidence of nerve injuries that have been traditionally associated with other types of occupational injury (Krivickas and Wilbourn 1998). Peripheral nerves are susceptible to injury in the athlete because of excessive physiological demands (...

Advances in reconstructive options of nerve injuries in the hand

2012 ◽  
Vol 153 (45) ◽  
pp. 1767-1778 ◽  
Author(s):  
Vilmos Bíró
Keyword(s):  
Peripheral Nerves ◽  
Common Property ◽  
Review Of Literature ◽  
Nerve Injuries ◽  
Important Data ◽  
The Past ◽  
Reconstructive Operations ◽  
Detailed List ◽  
High Level ◽  
Reconstructive Techniques

The author summarizes the most important data about the development of reconstructive techniques of nerve injuries in the hand based on literature references and the author’s own experience in the past decades. A new bulk of knowledge turned into a common property related to the micro- and macroanatomic structure of peripheral nerves, the process of nerve regeneration, and the technical conditions of nerve reconstructive operations. This knowledge is a prerequisite for hand surgeons to perform their nerve reconstructive operations on a contemporary high level with an optimal result. After a critical review of literature data, the author reports his own experience and sketches the coming possible roads. A detailed list of references is also provided for those who are interested in the field. Orv. Hetil., 2012, 153, 1767–1778.

Sonographic examination of peripheral nerve injuries at the hands of children

2014 ◽  
Vol 5 (3) ◽  
pp. 64-66
Author(s):  
Marina Nikolayevna Romanova ◽  
Nikolay Grigoryevich Zhila ◽  
Yelena Vladimirovna Sinelnikova
Keyword(s):  
Early Detection ◽  
Peripheral Nerve ◽  
Patient Outcomes ◽  
Ultrasound Imaging ◽  
Peripheral Nerves ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Sonographic Examination ◽  
Extent Of Damage ◽  
Improve Patient

Ultrasound imaging of peripheral nerves can accurately determine the level of damage, and also to assess the extent of damage to the structure of the nerve fiber. Early detection of the type of damage can significantly improve patient outcomes.

Thermographic presentation of cutaneous sensory and vasomotor activity in the injured peripheral nerve

1985 ◽  
Vol 62 (5) ◽  
pp. 711-715 ◽  
Author(s):  
Kathleen L. Brelsford ◽  
Sumio Uematsu
Keyword(s):  
Elevated Temperature ◽  
Peripheral Nerve ◽  
Local Anesthesia ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Content Type ◽  
Vasomotor Activity ◽  
Fine Print

✓ Impaired function of cutaneous segments of monkey peripheral nerves experimentally blocked by lidocaine anesthesia was clearly visualized by means of elevated temperature measurements obtained on computerized color telethermography. Mean temperature elevations in the segments of anesthetized primate nerves were 2.40°C at the ulnar segment 17 minutes after nerve block, and 1.20°C at the peroneal nerve at 20 minutes. The vasomotor activity of specific nerves, recorded after local anesthesia and displayed by color telethermographic imaging, corresponded to the distribution of sensory segments identified by more cumbersome means. Telethermography is therefore shown to be a useful tool, both qualitatively and quantitatively, in mapping cutaneous distribution of peripheral nerves and for evaluation of peripheral nerve injuries.

scholarly journals Microsurgery of peripheral nerve injuries: Analysis of twenty-five year experiences

2003 ◽  
Vol 50 (1) ◽  
pp. 7-14
Author(s):  
Miroslav Samardzic
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Peripheral Nerves ◽  
The Other ◽  
Surgical Results ◽  
Operating Microscope ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Microsurgical Technique ◽  
Factors Influencing

Microsurgical procedures on injured peripheral nerves have been performed in Institute of neurosurgery in Belgrade for twenty-five years. During this period 1284 procedures, including 1029 on peripheral nerves, and 255 on brachial plexus were done. In this paper we analyze surgical results of individual procedures and the other factors influencing the outcome. Despite advances caused by introduction of the operating microscope, there are numerous controversies mainly in microsurgical technique that are discussed.

Rapid-stretch injury to peripheral nerves: implications from an animal model

2020 ◽  
Vol 133 (5) ◽  
pp. 1537-1547 ◽  
Author(s):  
Mark A. Mahan ◽  
Wesley S. Warner ◽  
Stewart Yeoh ◽  
Alan Light
Keyword(s):  
Animal Model ◽  
Peripheral Nerves ◽  
Temporary Increase ◽  
Nerve Injuries ◽  
Muscle Weight ◽  
Stretch Injury ◽  
Tapered Beam ◽  
Mild Reduction ◽  
Sciatic Functional Index ◽  
Neuroma Formation

OBJECTIVERapid-stretch nerve injuries are among the most devastating lesions to peripheral nerves, yielding unsatisfactory functional outcomes. No animal model has yet been developed that uses only stretch injury for investigation of the pathophysiology of clinical traction injuries. The authors’ objective was to define the behavioral and histopathological recovery after graded rapid-stretch nerve injury.METHODSFour groups of male B6.Cg-Tg(Thy1-YFP)HJrs/J mice were tested: sham injury (n = 11); stretch within elastic limits (elastic group, n = 14); stretch beyond elastic limits but before nerve rupture (inelastic group, n = 14); and stretch-ruptured nerves placed in continuity (rupture group, n = 16). Mice were injured at 8 weeks of age, comparable with human late adolescence. Behavioral outcomes were assessed using the sciatic functional index (SFI), tapered-beam dexterity, Von Frey monofilament testing, and the Hargreaves method. Nerve regeneration outcomes were assessed by wet muscle weight and detailed nerve histology after 48 days.RESULTSPost hoc biomechanical assessment of strain and deformation confirmed that the differences between the elastic and inelastic cohorts were statistically significant. After elastic injury, there was a temporary increase in foot faults on the tapered beam (p < 0.01) and mild reduction in monofilament sensitivity, but no meaningful change in SFI, muscle weight, or nerve histology. For inelastic injuries, there was a profound and maintained decrease in SFI (p < 0.001), but recovery of impairment was observed in tapered-beam and monofilament testing by days 15 and 9, respectively. Histologically, axon counts were reduced (p = 0.04), muscle atrophy was present (p < 0.01), and there was moderate neuroma formation on trichrome and immunofluorescent imaging. Stretch-ruptured nerves healed in continuity but without evidence of regeneration. Substantial and continuous impairment was observed in SFI (p < 0.001), tapered beam (p < 0.01), and monofilament (p < 0.01 until day 48). Axon counts (p < 0.001) and muscle weight (p < 0.0001) were significantly reduced, with little evidence of axonal or myelin regeneration concurrent with neuroma formation on immunofluorescent imaging.CONCLUSIONSThe 3 biomechanical grades of rapid-stretch nerve injuries displayed consistent and distinct behavioral and histopathological outcomes. Stretch within elastic limits resembled neurapraxic injuries, whereas injuries beyond elastic limits demonstrated axonotmesis coupled with impoverished regeneration and recovery. Rupture injuries uniquely failed to regenerate, despite physical continuity of the nerve. This is the first experimental evidence to correlate stretch severity with functional and histological outcomes. Future studies should focus on the pathophysiological mechanisms that reduce regenerative capacity after stretch injury.

Surgical treatment of gunshot injuries of peripheral nerves

1923 ◽  
Vol 19 (5) ◽  
pp. 18-24
Author(s):  
V. L. Bogolyubov
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerves ◽  
World War ◽  
Nerve Injuries ◽  
Gunshot Injuries

The issue of surgical treatment of gunshot injuries of peripheral nerves until the last war seemed to be extremely underdeveloped. Only the experience of the last World War clarified many aspects of this issue, significantly changing the surgeons' views on the treatment of nerve wounds. However, despite this, even at present the issue of surgical treatment of gunshot nerve injuries seems to be far from exhausted and deserves attention in many respects.

Ultrasound of the Peripheral Nerves

2019 ◽  
pp. 382-386
Author(s):  
Carlo Martinoli ◽  
Sonia Airaldi ◽  
Federico Zaottini
Keyword(s):  
Nervous System ◽  
High Resolution ◽  
Soft Tissue ◽  
Peripheral Nerves ◽  
Evidence Base ◽  
Clinical Findings ◽  
Reliable Information ◽  
Technical Expertise ◽  
Nerve Injuries ◽  
Imaging Tool

The most common disorders affecting peripheral nerves that are amenable to US examination are illustrated in Chapter 126, including compressive neuropathies, polyneuropathies, nerve injuries, tumors, and tumorlike lesions. There is an expanding evidence base to support the use of high-resolution US as an imaging tool to evaluate the peripheral nervous system. However, the highly operator-dependent nature and level of technical expertise required to perform an adequate US assessment of peripheral neuropathies means that appropriate training and an in-depth knowledge of anatomy and clinical findings are required. A careful US approach with thorough understanding of soft tissue planes and extensive familiarity with anatomy are prerequisites for obtaining reliable information regarding these types of examinations.

Emergent Nerve Injury

2018 ◽  
Author(s):  
Amgad S. Hanna ◽  
Lisa M. Block ◽  
A. Neil Salyapongse
Keyword(s):  
Peripheral Nerves ◽  
Nerve Conduction Studies ◽  
Delayed Presentation ◽  
Sensory Testing ◽  
Nerve Injuries ◽  
Timely Manner ◽  
Optimal Outcomes ◽  
Free Closure ◽  
And Function ◽  
Repair Techniques

Injuries to peripheral nerves must be assessed and treated in a thorough and timely manner to achieve optimal outcomes. Physical examination is the cornerstone in diagnosing acute nerve injuries and includes careful inspection as well as precise motor and sensory testing. Nerve conduction studies and electromyography are often more useful in the setting of delayed presentation. Microsurgical repair techniques differ for clean versus ragged lacerations, and resultant nerve gaps will require a conduit or graft to achieve the necessary tension-free closure. The surgeon and patient should be prepared for a lengthy postoperative course and possible complications as the nerve regenerates and function returns.

scholarly journals MR Imaging of Peripheral Nerves Using Targeted Application of Contrast Agents: An Experimental Proof-of-Concept Study

2020 ◽  
Vol 7 ◽  
Author(s):  
Vlad Tereshenko ◽  
Irena Pashkunova-Martic ◽  
Krisztina Manzano-Szalai ◽  
Joachim Friske ◽  
Konstantin D. Bergmeister ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Contrast Agent ◽  
Contrast Agents ◽  
Peripheral Nerves ◽  
Proof Of Concept ◽  
Peripheral Nerve Injuries ◽  
Radiological Imaging ◽  
Nerve Injuries ◽  
Experimental Proof

Introduction: Current imaging modalities for peripheral nerves display the nerve's structure but not its function. Based on a nerve's capacity for axonal transport, it may be visualized by targeted application of a contrast agent and assessing the distribution through radiological imaging, thus revealing a nerve's continuity. This concept has not been explored, however, may potentially guide the treatment of peripheral nerve injuries. In this experimental proof-of-concept study, we tested imaging through MRI after administering gadolinium-based contrast agents which were then retrogradely transported.Methods: We synthesized MRI contrast agents consisting of paramagnetic agents and various axonal transport facilitators (HSA-DTPA-Gd, chitosan-DTPA-Gd or PLA/HSA-DTPA-Gd). First, we measured their relaxivity values in vitro to assess their radiological suitability. Subsequently, the sciatic nerve of 24 rats was cut and labeled with one of the contrast agents to achieve retrograde distribution along the nerve. One week after surgery, the spinal cords and sciatic nerves were harvested to visualize the distribution of the respective contrast agent using 7T MRI. In vivo MRI measurements were performed using 9.4 T MRI on the 1st, 3rd, and the 7th day after surgery. Following radiological imaging, the concentration of gadolinium in the harvested samples was analyzed using inductively coupled mass spectrometry (ICP-MS).Results: All contrast agents demonstrated high relaxivity values, varying between 12.1 and 116.0 mM−1s−1. HSA-DTPA-Gd and PLA/HSA-DTPA-Gd application resulted in signal enhancement in the vertebral canal and in the sciatic nerve in ex vivo MRI. In vivo measurements revealed significant signal enhancement in the sciatic nerve on the 3rd and 7th day after HSA-DTPA-Gd and chitosan-DTPA-Gd (p &lt; 0.05) application. Chemical evaluation showed high gadolinium concentration in the sciatic nerve for HSA-DTPA-Gd (5.218 ± 0.860 ng/mg) and chitosan-DTPA-Gd (4.291 ± 1.290 ng/mg).Discussion: In this study a novel imaging approach for the evaluation of a peripheral nerve's integrity was implemented. The findings provide radiological and chemical evidence of successful contrast agent uptake along the sciatic nerve and its distribution within the spinal canal in rats. This novel concept may assist in the diagnostic process of peripheral nerve injuries in the future.

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