Percutaneous Full-Endoscopic C2 Ganglionectomy for the Treatment of Intractable Occipital Neuralgia: Technical Note

2021 ◽  
Author(s):  
Yong Yu ◽  
Ye Jiang ◽  
Fulin Xu ◽  
Yuhang Mao ◽  
Lutao Yuan ◽  
...  
Keyword(s):  
Technical Note ◽  
Careful Examination ◽  
Cerebrospinal Fluid Leakage ◽  
Occipital Neuralgia ◽  
Continuous Irrigation ◽  
Endoscopic Spine Surgery ◽  
Constant Pain ◽  
Radiofrequency Therapy ◽  
History Of ◽  
Paraspinous Muscle

ABSTRACT BACKGROUND The C-2 dorsal root ganglionectomy procedure can provide effective treatment for intractable occipital neuralgia (ON). However, the traditional microsurgery of C2 ganglionectomy needs a wide incision and significant paraspinous muscle dissection for adequate visualization. The indications of endoscopic spine surgery are ever expanding, with the development of endoscopic armamentaria and technological innovations. OBJECTIVE To validate the feasibility of the approach and describe several operative nuances based on the authors’ experience. In this paper, the authors describe a patient with intractable ON who was successfully treated with a percutaneous full-endoscopic C2 ganglionectomy. METHODS We describe the case of an 83-yr-old female with a 2-yr history of left ON who did not respond to a series of treatments, including physical therapy, drug therapy, injection therapy, and radiofrequency therapy. After careful examination, we performed a percutaneous, full-endoscopic left C2 ganglionectomy. RESULTS The patient was successfully treated with a percutaneous full-endoscopic ganglionectomy. Afterwards, her intractable and constant pain was relieved. There was no cerebrospinal fluid leakage, incision infection, neck deformity, or other complications. CONCLUSION C2 ganglionectomy can be accomplished successfully using a full-endoscopic uniportal surgical technique under continuous irrigation, which has the advantages of excellent illumination and visualization, reduced surgery-related trauma, and reduced bleeding.

scholarly journals Candida Chorioamnionitis in Mothers with Gestational Diabetes Mellitus: A Report of Two Cases

2021 ◽  
Vol 18 (14) ◽  
pp. 7450
Author(s):  
Elia Shazniza Shaaya ◽  
Siti Atiqah Abdul Halim ◽  
Ka Wen Leong ◽  
Kevin Boon Ping Ku ◽  
Pei Shan Lim ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Umbilical Cord ◽  
Neonatal Death ◽  
Periodic Acid ◽  
Careful Examination ◽  
Periodic Acid Schiff ◽  
History Of ◽  
Methenamine Silver

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.

The history of a “primary source”: The making of Tûghî's chronicle on the regicide of Osman II

2009 ◽  
Vol 72 (1) ◽  
pp. 41-62
Author(s):  
Baki Tezcan
Keyword(s):  
Seventeenth Century ◽  
Primary Source ◽  
Collective Responsibility ◽  
Careful Examination ◽  
Political Sophistication ◽  
History Of ◽  
Initial Attitude ◽  
Historical Developments ◽  
The Military ◽  
The Way

AbstractA short chronicle by a former janissary called Tûghî on the regicide of the Ottoman Sultan Osman II in 1622 had a definitive impact on seventeenth-century Ottoman historiography in terms of the way in which this regicide was recounted. This study examines the formation of Tûghî's chronicle and shows how within the course of the year following the regicide, Tûghî's initial attitude, which recognized the collective responsibility of the military caste (kul) in the murder of Osman, evolved into a claim of their innocence. The chronicle of Tûghî is extant in successive editions of his own. A careful examination of these editions makes it possible to follow the evolution of Tûghî's narrative on the regicide in response to the historical developments in its immediate aftermath and thus witness both the evolution of a “primary source” and the gradual political sophistication of a janissary.

scholarly journals A rare case of cavernous hemangioma accompanied with diffuse hepatic hemangiomatosis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuji Ota ◽  
Toshiya Kamiyama ◽  
Takuya Kato ◽  
Takayuki Hanamoto ◽  
Kunihiro Hirose ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Cavernous Hemangioma ◽  
Contraceptive Use ◽  
Careful Examination ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Adjacent Area ◽  
Oral Contraceptive Use ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Abstract Background Hepatic cavernous hemangioma (CH) is the most common hepatic benign tumor. Most cases are solitary, asymptomatic, and found incidentally. In symptomatic cases with rapidly growing tumors and coagulopathy, surgical treatment is considered. In rare cases, diffuse hepatic hemangiomatosis (DHH) is reported as a comorbidity. The etiology of DHH is unknown. Case presentation A 29-year-old female patient had a history of endometriosis treated with oral contraceptives. Hepatic CH was incidentally detected in the segment IVa of the liver according to the Couinaud classification. Follow-up computed tomography (CT) and ultrasound sonography showed the growth of the lesion and formation of multiple new lesions near the first. Enhanced CT and magnetic resonance imaging (MRI) revealed that the new lesions were different from CH. Although oral contraceptives were stopped, all lesions grew in size. Malignancy and possibility of rupture of these tumors were considered due to the clinical course, and we opted for surgical removal of the tumors. Left liver lobectomy and cholecystectomy were performed. Surgical findings were small red spot spreading and a mass in segment IV of the liver. Pathological examination revealed a circumscribed sponge-like tumor with diffuse irregular extension to the adjacent area. Both of the lesions consisted of blood-filled dilated vascular spaces lined by flat endothelium without atypia. The diagnosis was hepatic CH with DHH. The patient was discharged on postoperative day 12 uneventfully. Conclusion We report the successful resection of CH with DHH. The case findings suggest a relationship between oral contraceptive use and enlargement of CH and DHH. Although DHH has been poorly understood, a few previously published cases reported DHH occurrence in patients using oral contraceptives. In such cases, the decision to perform surgical resection should be made after careful examination.

scholarly journals Debunking Millar v. Taylor: The History of the Prohibition of Legislative History

2018 ◽  
Vol 41 (1) ◽  
pp. 32-58
Author(s):  
John J Magyar
Keyword(s):  
The United States ◽  
Federal Courts ◽  
State Courts ◽  
Careful Examination ◽  
House Of Commons ◽  
Legislative History ◽  
Secondary Literature ◽  
The Us ◽  
History Of ◽  
The 19Th Century

Abstract The generally accepted belief about the rule prohibiting recourse to legislative history as an aid to statutory interpretation is that it began in the case of Millar v.Taylor in 1769, and it was followed thereafter in England and throughout the United States through to the 20th century. However, all four judges on the panel in Millar v.Taylor considered evidence from the Journal of the House of Commons and changes made to the relevant bill in their opinions. Meanwhile, the case was widely cited for several substantive and procedural matters throughout the 19th century, but it was not cited by a judge as a precedent for the rule against legislative history until 1887. A careful examination of the relevant cases and secondary literature from the 18th and 19th centuries reveals a much more nuanced and complex history to the rule. Its emergence becomes less clear because it is shrouded in judicial silence. Its beginnings must be inferred from a general and often unarticulated principle that lawyers felt free to disregard. Furthermore, the development, refinement, and decline of the rule followed a different timeline in England, the US federal courts and the state courts.

scholarly journals The importance to update the guidelines for the use of genetic testing in noncancer patients in Brazil

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Tirzah Braz Petta Lajus
Keyword(s):  
Genetic Testing ◽  
Private Health Insurance ◽  
Breast Lesion ◽  
Private Insurance ◽  
Technical Note ◽  
Cancer Syndrome ◽  
History Of ◽  
National Regulatory Agency ◽  
Generation Sequencing ◽  
History Of Cancer

The Brazilian National Regulatory Agency for Private Health Insurance and Plans has recently published a technical note defining the criteria for the coverage of genetic testing to diagnose hereditary cancer. In this study we show the case of a patient with a breast lesion and an extensive history of cancer referred to a private service of genetic counseling. The patient met both criteria for hereditary breast and colorectal cancer syndrome screening. Her private insurance denied coverage for genetic testing because she lacks current or previous cancer diagnosis. After she appealed by lawsuit, the court was favorable and the test was performed using next-generation sequencing. A deletion of MLH1 exon 8 was found. We highlight the importance to offer genetic testing using multigene analysis for noncancer patients.

Paroxysmal Stabbing Headache in The Multiple Dermatomes of The Head and Neck: A Variant of Primary Stabbing Headache or Occipital Neuralgia?

Cephalalgia ◽  
2007 ◽  
Vol 27 (10) ◽  
pp. 1101-1108 ◽  
Author(s):  
JH Shin ◽  
HK Song ◽  
JH Lee ◽  
WK Kim ◽  
MK Chu
Keyword(s):  
Medical Center ◽  
Previous History ◽  
Headache Disorder ◽  
Acute Onset ◽  
Occipital Neuralgia ◽  
Cervical Nerve ◽  
Primary Stabbing Headache ◽  
History Of ◽  
Stabbing Headache

A paroxysmal stabbing or icepick-like headache in the multiple nerve dermatomes, especially involving both trigeminal and cervical nerves, has not been fully explained or classified by the International Classification of Headache Disorder, 2nd Edition (ICHD-II). Of patients with acute-onset paroxysmal stabbing headache who had visited the Hallym University Medical Center during the last four years, 28 subjects with a repeated stabbing headache involving multiple dermatomes at the initial presentation or during the course were prospectively enrolled. All patients were neurologically and otologically symptom free. A coincidental involvement of both trigeminal and cervical nerve dermatomes included seven cases. Six cases involved initially the trigeminal and then cervical nerve dermatomes. Five cases showed an involvement of the cervical and then trigeminal nerve dermatomes. The remaining patients involved multiple cervical nerve branches (the lesser occipital, greater occipital and greater auricular). Pain lasted very shortly and a previous history of headache with the same nature was reported in 13 cases. Preceding symptom of an infection and physical and/or mental stress were manifested in seven and six subjects, respectively. All patients showed a self-limited benign course and completely recovered within a few hours to 30 days. Interestingly, a seasonal gradient in occurrence of a stabbing headache was found in this study. A paroxysmal stabbing headache manifested on multiple dermatomes can be explained by the characteristics of pain referral, and may be considered to be a variant of primary stabbing headache or occipital neuralgia.

scholarly journals Falx Cerebelli Meningioma: Technical Note

2014 ◽  
Vol 21 (3) ◽  
pp. 337-340
Author(s):  
Amit Agrawal
Keyword(s):  
Dura Mater ◽  
Rare Case ◽  
Technical Note ◽  
Imaging Findings ◽  
Tentorium Cerebelli ◽  
History Of

Abstract The falx cerebelli is a small sickle-shaped fold of dura mater below the tentorium cerebelli, which projects forward into the posterior cerebellar notch. We report a rare case of 28 year female presented with the history of headache of six months duration off and it increased in severity and frequency over last 15 days. Imaging findings were suggestive of meningiona arising from the falx cerebelli. The lesion could be excised totally and safely.

scholarly journals Pain syndrome patterns and their characteristics in multiple sclerosis patients

2021 ◽  
Vol 27 (1-2) ◽  
pp. 36-45
Author(s):  
M.I. Bozhenko ◽  
Keyword(s):  
Multiple Sclerosis ◽  
Pain Syndrome ◽  
Persistent Pain ◽  
Pain Syndromes ◽  
Constant Pain ◽  
Average Pain ◽  
History Of ◽  
Multiple Sclerosis Patients ◽  
Syndrome Patterns ◽  
Paroxysmal Pain

Aim of the research is to analyze the patterns of pain syndromes and their characteristics in multiple sclerosis patients. Materials and Methods. A total of 104 multiple sclerosis patients complaining of pain during the last month were examined in Lviv Regional Multiple Sclerosis Center. We analyzed medical records, performed general medical and neurological examinations and compiled history of lifestyle, illness and pain. The VAS and PainDetect questionnaires were used to assess the characteristics of pain syndromes. The patients were asked to choose one of the 4 typical patterns of pain, which best described their feelings. Then the analysis of pain syndrome patterns and their characteristics was carried out. Results and Discussions. All 4 typical patterns of pain syndromes were registered in multiple sclerosis patients. However, only 26.92% of the participants experienced an intermittent pain pattern. The rest of patients suffered from patterns characterized by persistent pain. The evaluation of the patterns and their characteristics revealed typical features. The highest intensity of the severest and average pain during the last month was present in the patients suffering from constant pain with distinct attacks: 8.0 [7.0; 9.0] points (p<0.05) and 7.0 [5.0; 8.0] points (p<0.05), respectively. Persistent paroxysmal pain was more common in the multiple sclerosis patients with neuropathic pain (43.8±8.8% vs 20.4±5.8%, p<0.05). Irradiating pain is also characteristic to this pattern in 52.9±8.6% of patients (p<0.05). The head is the most common pain localization in the patients experiencing persistent pain with severe attacks - 82.4±9.2% of cases (p<0.05). Conclusions. Pain is a permanent symptom in a significant number of multiple sclerosis patients. It can have different patterns of progression. However, it has typical characteristics and their understanding will aid in the diagnosis, prognosis and treatment of pain syndromes in multiple sclerosis patients

scholarly journals Cronkhite-Canada Syndrome: A Rare Cause of Chronic Diarrhoea in a Young Man

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Dhrubajyoti Bandyopadhyay ◽  
Adrija Hajra ◽  
Vijayan Ganesan ◽  
Suvrendu Sankar Kar ◽  
Debarati Bhar ◽  
...  
Keyword(s):  
Correct Diagnosis ◽  
Bacterial Overgrowth ◽  
Close Correlation ◽  
Small Intestinal Bacterial Overgrowth ◽  
Clinical Findings ◽  
Careful Examination ◽  
Chronic Diarrhoea ◽  
History Of ◽  
Clostridium Difficile Toxin ◽  
Colon And Rectum

A young Indian man presented with nine-month history of chronic diarrhea, occasionally mixed with blood and intermittent colicky abdominal pain. He also complained of generalized body swelling for the last three months. On examination, he had diffuse hyperpigmentation of the skin and dystrophic nail changes. Upper and lower gastrointestinal endoscopy revealed multiple sessile polyps in the stomach, small bowel, and colon and rectum. Biopsy of polyps showed adenomatous changes with stromal edema and dilated glands. Cronkhite-Canada syndrome (CCS) was diagnosed and treated with glucocorticoids and enteral nutritional supplementation. There was an associated small intestinal bacterial overgrowth (SIBO) and stool was positive for clostridium difficile toxin. After 12 weeks of treatment, the patient achieved remission. Close correlation with clinical findings, including pertinent ectodermal abnormalities, endoscopic studies, and careful examination of biopsies will ensure a timely and correct diagnosis of CCS.

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