scholarly journals Ultra-Early Cord Decompression in the Emergency Setting and its Impact on Outcome

2021 ◽  
Vol 7 (1) ◽  
pp. 9-13
Author(s):  
Ali Ahmadvand ◽  
◽  
Mohammad J. Behzadnia ◽  
Amin Jahanbakhshi ◽  
Mohammad R. Zarei ◽  
...  
Keyword(s):  
Excellent Result ◽  
Spinal Fractures ◽  
Complete Recovery ◽  
Cervical Cord ◽  
Optimal Time ◽  
Emergency Setting ◽  
Traumatic Injuries ◽  
Cord Injury ◽  
Medical Facilities ◽  
History Of

Background Traumatic cervical are injuries are very common due to high motility of cervical spine and its vulnerability to traumatic injuries. Optimal time for stabilizing the patients with traumatic spinal fractures remains controversial. It is almost due to different outcomes in various studies and the lack of consensus about it. Here we explain an ultra–early cord decompression that led to complete recovery of a patient with severe cervical cord injury. Case Presentation The patient was a 27-year-old gymnast woman with a recent history of spinal cord injury caused by high jumping with head back and neck hyperextension presented within 2-hours of trauma. As a critical case and lack of advanced radiologic equipment, only cervical spinal radiographs were used for decision-making within the first 3 hours of injury to save the patient’s cord function by surgical decompression. Conclusion Many studies have proposed different intervention times for achieving the optimal result; however, we present an ultra-early surgery (within 3-hours of injury), conducted in a context of limited medical facilities. This case revealed an excellent result after 12-months follow-up.

scholarly journals A Nearly Lethal Screw: An Unusual Cause of Recurrent Bradycardia and Asystole Episodes after Fixation of the Cervical Spine

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Amit Frenkel ◽  
Yair Binyamin ◽  
Evgeni Brotfain ◽  
Leonid Koyfman ◽  
Aviel Roy-Shapira ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spine Injury ◽  
Cervical Cord ◽  
Unstable Fracture ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Fixation Screw ◽  
Direct Pressure ◽  
History Of ◽  
High Cervical

We present a case of a 51-year-old man who was injured in a bicycle accident. His main injury was an unstable fracture of the cervical and thoracic vertebral column. Several hours after his arrival to the hospital the patient underwent open reduction and internal fixation (ORIF) of the cervical and thoracic spine. The patient was hospitalized in our critical care unit for 99 days. During this time patient had several episodes of severe bradycardia and asystole; some were short with spontaneous return to sinus and some required pharmacological treatment and even Cardiopulmonary Resuscitation (CPR). Initially, these episodes were attributed to the high cervical spine injury, but, later on, CT scan suggested that a fixation screw abutted on the esophagus and activated the vagus nerve by direct pressure. After repositioning of the cervical fixation, the bradycardia and asystole episodes were no longer observed and the patient was released to a rehabilitation ward. This case is presented in order to alert practitioners to the possibility that, after operative fixation of cervical spine injuries, recurrent episodes of bradyarrhythmia can be caused by incorrect placement of the fixation screws and might be confused with the natural history of the high cervical cord injury.

scholarly journals Ossified longitudinal ligament causing same level cord contusion in a case of Klippel-Feil syndrome

2021 ◽  
pp. 114-116
Author(s):  
Amit Agrawal
Keyword(s):  
Cervical Vertebrae ◽  
Cervical Cord ◽  
Congenital Fusion ◽  
Cord Injury ◽  
History Of ◽  
Traumatic Episode ◽  
A Minor ◽  
Cervical Cord Injury

Klippel-Feil syndrome (KFS) is a congenital fusion of two or more cervical vertebrae due to faulty segmentation of the vertebral axis during gestation. (1-5) These patients present with a constellation of manifes­tations and are typically prone to cervical cord injury after a minor fall or a major traumatic episode. (2, 5-8) 34 years old gentlemen, a plumber by profession presented with a history of slipped and fall about two stairs height while he was working. 

Paralysis from an ear infection: a severe case of otitis externa leading to acute complete cervical cord syndrome

2021 ◽  
Vol 14 (12) ◽  
pp. e245594
Author(s):  
Rachael Collins ◽  
George Lafford ◽  
Laura Parry
Keyword(s):  
Otitis Externa ◽  
Severe Case ◽  
Complete Recovery ◽  
Cervical Cord ◽  
Team Approach ◽  
Neck Stiffness ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Red Flag

We report a case of a generally fit and well 54-year-old man who presented with a 2-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and fever on the background of a 7-week history of otitis externa (OE). His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately, he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life threatening condition. It emphasises the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multidisciplinary team approach when managing complex complications of OE.

Hazardous complications of animate foreign bodies in otology practice

2015 ◽  
Vol 129 (6) ◽  
pp. 540-543 ◽  
Author(s):  
K Sikka ◽  
R Agrawal ◽  
K Devraja ◽  
J V Lodha ◽  
A Thakar
Keyword(s):  
Foreign Bodies ◽  
Sinus Thrombosis ◽  
Complete Recovery ◽  
Sigmoid Sinus ◽  
Emergency Setting ◽  
Delayed Presentation ◽  
Cavernous Sinus Thrombosis ◽  
Orbital Apex ◽  
Orbital Apex Syndrome ◽  
History Of

AbstractBackground:Animate foreign bodies in the ear are frequent occurrences in otology practice. Such foreign bodies may lead to hazardous complications.Method:This paper describes a retrospective study of six patients with a recent history of an insect in the ear who presented with various complications following intervention received elsewhere.Results:An insect was retrieved from the external auditory canal in four cases and from the antrum in two cases. The patients presented with progressive otological complications: two patients who presented with orbital apex syndrome and cavernous sinus thrombosis succumbed to the disease; three patients suffered sensorineural hearing loss; and two patients had persistent facial palsy. One patient with sigmoid sinus thrombosis, who presented early, experienced complete recovery.Conclusion:Insects in the ear can lead to hazardous complications. Animate foreign bodies should preferably be managed by a trained otologist, even in an emergency setting. Patients with delayed presentation and complications have a guarded prognosis.

scholarly journals Spirituality and Conflict in Healthcare: The History of the Canadian Baptists and Medical Mission in Orissa, 1900–1970

Histories ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 69-84
Author(s):  
Tiasa Basu Roy
Keyword(s):  
Religious Identity ◽  
Well Being ◽  
Word Of God ◽  
Health Issues ◽  
Medical Mission ◽  
The People ◽  
Medical Facilities ◽  
History Of ◽  
Ganjam District ◽  
Positive Results

It was from the middle of the eighteenth century that discussions regarding the strategies taken up by the Protestant missionaries to propagate the Gospel generated the issue of healthcare and medical facilities among people in India. Medical mission, which hitherto was not considered, started to gain importance and reaped positive results in terms of curing individuals and its trustworthiness among tribes residing in the frontier regions. However, this developed a separatist religious identity among the population, which apparently did not appear lethal, but later culminated in the fragmentation and impeachment of solidarity among the adivais (tribal) and vengeance from the Hindu population. This article will show how the Canadian Baptist Mission, with its primary aim of spreading the Kingdom of God among the tribal Savaras in the Ganjam district of Orissa, undertook measures for serving health issues and provided medical facilities to both the caste Oriyas and the tribal Savaras. Although medical activities oriented towards philanthropy and physical well-being, medical mission was not limited to healing illness and caring for all, but also extended to spreading the word of God and influencing the people to embrace Christianity as well, which invited political troubles into the region.

scholarly journals Severe COVID-19 with acute respiratory distress syndrome (ARDS) in a sickle cell disease adult patient: case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marion Teulier ◽  
Alexandre Elabbadi ◽  
Grigorios Gerotziafas ◽  
François Lionnet ◽  
Guillaume Voiriot ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Case Reports ◽  
Cor Pulmonale ◽  
Point Of View ◽  
Nasopharyngeal Swab ◽  
Prevention Policy ◽  
Cord Injury ◽  
History Of ◽  
Pulmonary Arterial ◽  
Venovenous Ecmo

Abstract Background Sickle-cell anaemia is a widespread genetic disease prevalent worldwide among African and African-American populations. The pathogenesis is most often revealed by pulmonary conditions, including acute thoracic syndrome, which is affecting the life expectancy of these populations. The global spread of CoV2-SARS infection with a respiratory tropism, endothelial damages and procoagulant status endangers the SCD population. However, with only a few case reports, consequences of the Covid-19 pandemic on SCD population remain poorly known. Case presentation We report a case of a 33-year-old man with a history of homozygous SS homozygous sickle cell anemia who consulted on March 24, 2020 for febrile dyspnea 11 days after the onset of symptoms. A nasopharyngeal swab was positive for SARS-CoV-2. His respiratory status worsened rapidly in the emergency room and then in ICU leading to severe ARDS requiring intubation, curarization, and venovenous ECMO. Hematologically, severe hemolysis associated with major thrombocytopenia without documented spinal cord injury was noted. Several transfusion exchanges are performed. The evolution was finally slowly favorable and led to discharge from the intensive care unit and then from the hospital. Conclusions This case recalls the importance of an increased prevention policy against COVID-19among the SCD population. In addition, from a therapeutic point of view, it advocates (1) a high preventive anticoagulation from the outset according to the level of D-dimers (2) the use of venovenous ECMO in this particular case, whereas this technique has had rather disappointing results in acute chest syndromes. (3) Unexpectedly, our patient did not develop pulmonary arterial hypertension (PAH) and acute cor pulmonale (ACP), whereas this is a common feature of ARDS during SCD. These last two observations suggest a different pathophysiology of pulmonary disorders in SCD patients in the case of SARS COv2. It could be associated with marked hypoxemia secondary to pulmonary vascular vasodilation.

Benign paroxysmal vertigo of childhood: Long-term outcome

Cephalalgia ◽  
2010 ◽  
Vol 31 (4) ◽  
pp. 439-443 ◽  
Author(s):  
Benjamin Krams ◽  
Bernard Echenne ◽  
Julie Leydet ◽  
François Rivier ◽  
Agathe Roubertie
Keyword(s):  
Patient Outcome ◽  
Complete Recovery ◽  
Homogeneous Condition ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Family Medical History ◽  
History Of ◽  
Attacks Of Vertigo ◽  
Epidemiological Link

Introduction Benign paroxysmal vertigo (BPV) is characterized by recurrent attacks of dizziness in a healthy child. Complete recovery typically takes place during childhood, and an epidemiological link with migraine has been pointed out. Nevertheless, data concerning long-term patient outcome are scarce. Subjects and methods We analyzed the clinical data of 17 patients diagnosed with BPV between 1991 and 2008 in our neuropediatric department; we particularly focused on family medical history and long-term patient outcome by reviewing their medical files and by interviewing the families with a standardized questionnaire administered by phone. Results Thirteen families responded to the questionnaire, performed 1.1 to 24.5 years after onset. Among 10 patients older than 11 years of age, five continue to suffer attacks of vertigo. Median age at recovery was six years. Nine subjects exhibited migraine, including all six aged 15 years or older. There was a first-degree history of migraine in eight out of 13 children. Conclusion BPV may not be a homogeneous condition, as some children have a poorer prognosis than others. The strong link with migraine, already noticed by previous authors, led us to discuss the pathophysiology of this condition.

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