scholarly journals Unexpectedly High Block following Epidural Catheter Placement under Direct Vision: A Case Report

2005 ◽  
Vol 33 (1) ◽  
pp. 128-130 ◽  
Author(s):  
A. D'Agapeyeff ◽  
I. J. Crabb
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Epidural Catheter ◽  
Literature Search ◽  
Case Reports ◽  
Direct Vision ◽  
Spinal Decompression ◽  
Epidural Catheter Placement ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

A 72-year-old female underwent elective lumbar spinal decompression. At the end of the procedure an epidural catheter was sited by the surgeon under direct vision. A bolus of levobupivacaine was injected. Shortly after reaching the recovery area, the patient collapsed and required re-intubation and mechanical ventilation. She was extubated five hours later and suffered no adverse sequelae. Having excluded other possible causes of immediate post-operative collapse, a clinical diagnosis of subdural blockade was made. A literature search using Medline has found no other case reports of such a complication following epidural placement under direct vision.

Robotic assistant spinal angiography: a case report and technical considerations

2021 ◽  
Vol 14 (3) ◽  
pp. 1-3
Author(s):  
Satoshi Tateshima ◽  
Hamidreza Saber ◽  
Geoffrey P Colby ◽  
Dieter Enzmann ◽  
Gary Duckwiler
Keyword(s):  
Case Report ◽  
Case Reports ◽  
Spinal Angiography ◽  
Peripheral Vascular ◽  
Robotic Assisted ◽  
Prior Report ◽  
Early Case ◽  
Lumbar Spinal ◽  
Robotic Assistant ◽  
Technical Considerations

Robotic-assisted technology has shown to be promising in coronary and peripheral vascular interventions. Early case reports have also demonstrated its efficacy in neuro-interventions. However, there is no prior report demonstrating use of the robotic-assisted platform for spinal angiography. We report the feasibility of the robotic-assisted thoracic and lumbar spinal angiography.

Capecitabine-induced myopericarditis – A case report and review of literature

2018 ◽  
Vol 25 (4) ◽  
pp. 1006-1010 ◽  
Author(s):  
Sydney Saunders ◽  
Maria Anwar
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Report ◽  
Literature Search ◽  
Case Reports ◽  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Review Of Literature ◽  
Medication Discontinuation ◽  
Laboratory Investigations

Objective To describe a possible case of capecitabine-induced myopericarditis in a patient at the Cardio-Oncology Clinic in Calgary, AB. Design A literature search and adverse drug reaction assessment with the Naranjo tool was conducted. Results A 39-year-old male with recurrent locally advanced rectal adenocarcinoma presented two days after adjuvant treatment with capecitabine and oxaliplatin complaining of intermittent, severe interscapular pain. Based on symptoms, laboratory investigations, and imaging, the patient was diagnosed with acute myopericarditis. Management included aspirin, colchicine, and discontinuing adjuvant chemotherapy. A literature review revealed one case report of capecitabine-induced myopericarditis; however, more data were found regarding the cardiotoxicity of fluorouracil, for which capecitabine is a pro-drug. No case reports were found for oxaliplatin. Conclusion Due to the timeline of capecitabine administration, symptom onset, and improvement upon medication discontinuation, capecitabine is the probable cause of the myopericarditis. Although rare, it is important to consider the possibility of myopericarditis in patients receiving a fluoropyrimidine who present with cardiovascular symptoms.

Subungual Schwannoma, a Rare Entity: A Case Report and Literature Review

2020 ◽  
Vol 25 (04) ◽  
pp. 508-512
Author(s):  
Jason D. Wink ◽  
Olatomide Familusi ◽  
Ines C. Lin
Keyword(s):  
Case Report ◽  
Literature Search ◽  
Glomus Tumor ◽  
Single Case ◽  
Case Reports ◽  
Ring Finger ◽  
Dominant Male ◽  
Rare Entity ◽  
Single Case Report ◽  
Slow Growing

We present a case of a 26-year-old right hand dominant male landscaper with a slow growing right ring finger subungual mass. MRI confirmed a 0.9 × 1.5 × 0.9 cm well circumscribed subungual mass believed to be consistent with a glomus tumor, although size and symptoms were not consistent with that diagnosis. The mass was completely excised and diagnosis of schwannoma was confirmed by H&E histology. A literature search was performed utilizing the term “subungual schwannoma.” Four case reports were found describing this diagnosis in the hand as well as a single case report describing it in the foot. In summary, this is a 26-year-old male who presents with a schwannoma in the unusual subungual location. Although rare, based on our case and the existing literature, subungual schwannomas should be included in the differential diagnosis of a slow growing subungual mass, particularly if symptoms and exam are inconsistent with more common etiologies.

Evaluation and management of small dural tears in primary lumbar spinal decompression and discectomy surgery

2018 ◽  
Vol 50 ◽  
pp. 177-182 ◽  
Author(s):  
Marcelo Galarza ◽  
Roberto Gazzeri ◽  
Raúl Alfaro ◽  
Pedro de la Rosa ◽  
Cinta Arraez ◽  
...  
Keyword(s):  
Spinal Decompression ◽  
Dural Tears ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

Reliability of postoperative MR imaging in the determination of level and side of lumbar spinal decompression surgery

2016 ◽  
Vol 58 (5) ◽  
pp. 581-585
Author(s):  
Florian Wanivenhaus ◽  
Florian M Buck ◽  
Michael Betz ◽  
Nadja A Farshad-Amacker ◽  
Mazda Farshad
Keyword(s):  
High Reliability ◽  
Surgical Decompression ◽  
Time Interval ◽  
Decompression Surgery ◽  
Mr Images ◽  
Spinal Decompression ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression ◽  
Musculoskeletal Radiologist

Background Magnetic resonance imaging (MRI) is the diagnostic modality of choice in defining soft tissue compromise of the spinal canal. Purpose To evaluate the reliability of postoperative MRI in the determination of level and side of lumbar spinal decompression surgery, investigated by two reviewers, in different levels of training and specialization. Material and Methods Postoperative MR images of 86 patients who underwent spinal decompression (single level, n = 70; multilevel, n = 16; revision decompression, n = 9) were reviewed independently by an experienced musculoskeletal radiologist and a fourth-year orthopedic surgery resident. The level (single or multiple) and side of previous surgical decompression were determined and compared to the surgical notes. We examined factors that may have influenced the reliability, including demographics, type of surgical decompression, use of a drain, and time interval from surgery to MRI. Results Significantly fewer levels were correctly determined by the resident (77/86 cases, 89.5%) compared with the radiologist (84/86 cases, 97.7%) ( P = 0.014). The resident interpreted significantly more MR images incorrectly in cases where a drain was used (n = 8; P < 0.001). Re-decompression cases were interpreted incorrectly significantly more often by both the radiologist (n = 2, P = 0.032) and the resident (n = 4, P = 0.014). Conclusion Determination of the level and side operated on in previous lumbar spinal decompression surgery on MRI has a high reliability, especially when performed by a musculoskeletal radiologist. However, this reliability is decreased in cases involving surgical drainage and same-level revision surgery.

scholarly journals Anatomical Landmarks for Microscopic Bilateral Lumbar Spinal Decompression via Unilateral Laminotomy

2011 ◽  
Vol 25 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Manabu Sasaki ◽  
Masanori Aoki ◽  
Masaaki Fujiwara ◽  
Toshiki Yoshimine
Keyword(s):  
Anatomical Landmarks ◽  
Spinal Decompression ◽  
Lumbar Spinal ◽  
Lumbar Spinal Decompression

scholarly journals P1256 Salvage mitraclip implantation for postmyocardial infarction mitral regurgitation: 2 case reports

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J P Dias Ferreira Reis ◽  
T Mano ◽  
T Mendonca ◽  
G Portugal ◽  
L Ferreira ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Case Report ◽  
Mitral Regurgitation ◽  
Cardiogenic Shock ◽  
Case Reports ◽  
Systolic Dysfunction ◽  
Diabetic Woman ◽  
Regurgitant Volume ◽  
Difficult Weaning

Abstract Introduction Acute mitral regurgitation (MR) secondary to AMI is associated with a poor clinical outcome. The role of MitraClip implantation (MCI) in this population is still not well established. We report two successful cases of salvage MCI in acute ischaemic MR. Case Report 1: A 66-year-old diabetic woman was admitted to our institution due to extensive anterior STEMI with cardiogenic shock. Urgent cardiac catheterization (CC) revealed 100% occlusion of the left anterior descending and critical stenosis of the obtuse marginal artery, with successful PCI of both vessels and implantation of an intra-aortic balloon pump. Early transthoracic echocardiogram (TTE) revealed a dilated left ventricle with severe systolic dysfunction (LVEF – 35%), apical and anterior wall akinesia and functional grade IV MR (EROA - 40mm2 and regurgitant volume - 45mL), that was later confirmed by transesophageal echocardiography (TEE). 48h after AMI, the patient developed an arrhythmic storm requiring multiple shocks and a prolonged period of mechanical ventilation. Due to an extremely slow clinical improvement, with the need for prolonged inotropic support and refractory pulmonary congestion (NYHA IV), she was submitted to MCI, resulting in post-procedural grade I MR (EROA 7mm2 and regurgitant volume 11mL) and a marked clinical and hemodynamic improvement. An ICD for secondary prevention was implanted. At the 3 month follow-up the patient presented in NYHA II functional class without congestive symptoms. Case Report 2: An 82-year old female patient was admitted with an inferior STEMI, with CC documenting severe 3 vessel disease with a calcified occlusion of the right coronary artery, not amenable to PCI, so the patient was submitted to emergent CABG. There was a prolonged period of post-operatory mechanical ventilation with an extremely difficult weaning process, including the need for re-intubation due to acute pulmonary edema. TTE revealed LVEF of 39% with a large inferobasal aneurysm and severe eccentric MR due to tendinous cord rupture. The patient was submitted to MCI with immediate significant improvement of the MR, allowing successful extubation 36 hours after the procedure. In the end of first month of follow-up, the TTE revealed a well-positioned clip with mild-to-moderate MR (EROA – 21.5mm2 and regurgitant volume – 38mL) with the patient being completely asymptomatic. Conclusion Treatment of acute MR following AMI with MCI may be a safe and effective approach in critically ill patients. In our experience, it can lead to a rapid clinical recovery and resolution of cardiogenic shock.

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