Intraneural cyst of the peroneal nerve in child

2022 ◽  
Vol 26 (6) ◽  
pp. 63-67
Author(s):  
A. V. Klimkin ◽  
M. R. Mamatkhanov ◽  
N. V. Marchenko ◽  
E. Yu. Gorelik ◽  
M. A. Bedova

This article presents an observation of an intraneural cyst of the peroneal nerve in a 16-year-old boy after a knee injury. Surgical treatment of an intraneural cyst of the peroneal nerve was performed 9 months after the appearance of peroneal nerve neuropathy. One month after the operation, the peroneal muscle strength increased from 2 to 4 points on the MRC scale; positive dynamics after the operation was also noted according to the data of electroneuromyography and ultrasound examination. Children often observed intraneural cyst of the peroneal nerve at the knee (90% of cases among all sites intraneural cysts). For diff erential diagnosis with compression-ischemic neuropathy and nerve cysts, clinical and neurophysiological data should be supplemented by ultrasound and/or MRI examination. Early diagnosis and surgical treatment are critical to the full recovery of motor and sensory function.

1992 ◽  
Vol 50 (3) ◽  
pp. 313-318 ◽  
Author(s):  
Joaquim P. Brasil-Neto

The author reviews the literature on electromyography and nerve conduction velocity studies in leprosy. It is concluded that these studies can be helpful in the early diagnosis of neural involvement, in the elucidation of pathophysiological mechanisms, and in the follow-up of patients under medical and/or surgical treatment.


2013 ◽  
Vol 71 (3) ◽  
pp. 146-152 ◽  
Author(s):  
Guilherme Fregonezi ◽  
Palomma Russelly Saldanha Araújo ◽  
Tathiana Lindemberg Ferreira Macêdo ◽  
Mario Emilio Dourado Junior ◽  
Vanessa Regiane Resqueti ◽  
...  

ObjectiveIt was study the relationship between respiratory muscle strength and forced vital capacity (FVC) in patients with amyotrophic lateral sclerosis (ALS) versus healthy subjects.MethodsPulmonary function and respiratory muscle strength [maximal inspiratory (PImax), maximal expiratory (PEmax) and sniff nasal inspiratory pressure (SNIP)] were assessed in patients with ALS and healthy subjects, matched using cutoffs established in the literature for impaired pulmonary function and respiratory muscle weakness.ResultsTwenty-eight ALS patients and 28 healthy subjects were studied. We found sensitivity and specificity for PImax, PEmax and SNIP of 75/58%, 81/67% and 75/67%. The Receiver Operating Characteristic curve (ROC curve) indicated that the variables PImax, PEmax and SNIP can identify differences in respiratory muscle strength between ALS and healthy individuals at 0.89, 0.9 and 0.82, respectively. A positive correlation was recorded between FVC (%) versus SNIP, PImax and PEmax.ConclusionIn ALS, monitoring respiratory muscle strength assists in early diagnosis of respiratory dysfunction as opposed to the isolated use of FVC.


2017 ◽  
Vol 34 (2) ◽  
pp. 179-188
Author(s):  
Milovan Stojanović ◽  
Marina Deljanin-Ilić ◽  
Aleksa Vuković ◽  
Dejan Petrović

Summary Tetralogy of Fallot is the most common cyanogenic congenital heart defect. The diagnosis is based on clinical signs, ECG examination, ultrasound examination of the heart, additional imaging methods and invasive testing. The therapeutic approach to the patient with tetralogy is complex and based on conservative and radical methods. Patients who have not undergone a radical surgical intervention have a poor prognosis, whereas the prognosis is much better for patients who have been operated. The most common complication of the surgical treatment is the pulmonary valve insufficiency which usually requires reintervention, as was the case with our patient.


2021 ◽  
Vol 49 (9) ◽  
pp. 030006052110434
Author(s):  
Liang Chen ◽  
Wen Zhang ◽  
Zhenguo Qiao

Gastrointestinal bleeding and gallbladder stones are common diseases of the digestive system. However, duodenal necrosis and bleeding caused by gallbladder stone compression is relatively rare. The present report describes a patient with repeated hematemesis and melena that relapsed after several symptomatic treatments. The patient and his family elected surgical treatment. Intraoperative examination revealed necrosis of the duodenal bulb with hemorrhage, which was related to compression of the gallbladder neck. Because the imaging manifestations of this disease lack specificity, early diagnosis is difficult.


2020 ◽  
Vol 10 (1) ◽  
pp. 17-24
Author(s):  
Irina I. Borisova ◽  
Anatoliy V. Kagan ◽  
Svetlana A. Karavaeva ◽  
Aleksey N. Kotin

Background. The cystic form of biliary atresia is a rare form of atresia of the biliary tract, which is a relatively favorable variant of the defect and can be diagnosed antenatally. In practice, it is important not only to suspect this diagnosis, but also to differentiate this variant of impaired development of the external bile duct from the cyst of the common bile duct. This is due to the difference in approaches and methods of surgical treatment of choledochal cysts and biliary atresia. Obliteration (atresia) of the bile ducts in the absence of timely surgical intervention quickly leads to the progression of cirrhosis and the development of liver failure. The method of choice in the treatment of AD is Kasai surgery, often palliative in nature, but allowing to delay the time until liver transplantation. The cyst of the common bile duct rarely requires early surgical treatment, and the risk of cirrhosis is significantly lower. Surgical intervention is aimed at removing the cyst and restoring the flow of bile by anastomosing the external bile ducts with the intestines, which is a radical method of treatment and leads to the recovery of the child. External similarity in ultrasound examination of the fetus and newborn baby of the cystic form of biliary atresia of the bile ducts with a cyst of the common bile duct does not always allow differentiation of one defect from another, which can lead to untimely correction of the defect and an unfavorable outcome. Aim. Demonstrate a rare type of biliary atresia. Materials and methods. Between 2001 and 2019, 33 patients with biliary atresia were treated in the Childrens City Multidisciplinary Clinical Specialized Center for High Medical Technologies in St. Petersburg, only two patients had a cystic form. Both children were initially treated as patients with bile duct cyst. Children were operated on at the age of 2 and 3.5 months. The first patient underwent surgery Kasai, the second hepaticoyunoanastomosis. Results. During the observation period (9 years and 4 years), the synthetic function of the liver is normal, and there are currently no indications for transplantation. Conclusion. If a fetus or a newborn with neonatal jaundice is detected during ultrasound examination of a cystic formation in the gates of the liver, it is very important to correctly and quickly make a differential diagnosis between the cystic form of biliary atresia of the biliary tract and the common bile duct cyst.


2021 ◽  
Vol 03 (01) ◽  
pp. 32-34
Author(s):  
Ağaşirin Aydın oğlu Rüstəmov ◽  
◽  
Fatma Fatma Oruc qızı Rəcəbova7............ ◽  

For the diagnosis and differentiation of chronic cholesistoxolangiitis from the diseases of the biliary system, 20 patients used modern instrumental and laboratory methods. In these methods, excision cholesistorentgenography, retrograde cholangiography, high frequency ultrasound examination, and cholesterol in the blood, manometric tonometry. In the objective examination, patients were disturbed by the pain on the right side of the neck, on the right side of the breast and in the right rib. Dyspeptic symptoms such as lower appetite, nausea, vomiting, and meteorism have been discovered. Dietotherapy, spasmolitics, antibiotics, gallbladder and physiotherapy have also been used in the treatment. Thus, based on the results of our examination, it is recommended that they be used in early diagnosis of chronic cholesistoxolangitis. Key words: cholangiocholecystitis, gallbladder, symptoms, clinical, diagnosis


2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Nicole Pini ◽  
Martina Ceccoli ◽  
Patrizia Bergonzini ◽  
Lorenzo Iughetti

Background and Objective. Grisel’s syndrome is a rare syndrome characterized by nontraumatic rotatory subluxation of the atlantoaxial joint. It usually affects children and typically presents with torticollis after ear, nose, and throat (ENT) surgery or head and neck infections. In the pediatric literature, there is only a small amount of available data; moreover, no systematic review has been previously done with focus on the pediatric population. We report our experience of two cases, and we provide a systematic review on Grisel’s syndrome in children in order to offer a deeper insight about its clinical presentation, its current diagnosis, and principles of treatment. Case Reports and Review. We describe two boys of 9 and 8 years old, who developed atlantoaxial subluxation after adenoidectomy. Considering the early diagnosis, a conservative treatment was chosen, with no recurrence and no sequelae at follow-up. We identified 114 case reports, of which 90 describe children, for a total of 171 pediatric patients. Of the 154 cases in which cause was reported, 59.7% presented a head and neck infection and 35.7% had previous head and neck surgery. There is no sex prevalence (49.7% males versus 50.2% females). Mean delay in diagnosis is 33 days. Eight % of the patients had neurological impairment of the 165 cases which mentioned treatment, 96% underwent a conservative treatment, of whom the 8.8% recurred with the need of surgery. As a whole, 12% underwent surgery as a first- or second-line treatment. 3 6% of the patients whose follow-up was reported developed a sequela, minor limitation of neck movement being the most frequent. Conclusion. Grisel’s syndrome should be suspected in children with painful unresponsive torticollis following ENT procedures or head and neck inflammation. CT scan with 3D reconstruction is the gold standard for diagnosis, allowing the identification of the subluxation and the classification according to the Fielding–Hawkins grading system. Surgical treatment is indicated in case of high-grade instability or failure of conservative treatment. Review of the literature shows how early diagnosis based on clinical and radiological evaluation is crucial in order to avoid surgical treatment and neurologic sequelae.


2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0051
Author(s):  
Arvind Prasad Gupta

Introduction: The Multiligament Knee Injury is a complex knee problem and mostly associated with subluxation or dislocation of knee joint. Failure to diagnose and treat them appropriately can leads to devastating outcome particularly high-grade injury (Schenck Type 3,4 and 5). We favor single stage early surgical treatment of high grade Multiligament knee injury which leads to good functional outcome and return to work. Hypotheses: Single stage early surgical treatment of high grade Multiligament knee injury will leads to good functional outcome with higher IKDC and Lysholm score and helps the patients to in return early to work with higher satisfaction rate. Methods: From June 2013 to January 2020, 42 patients with age from 18 years to 56 years with acute (< 6 weeks) Multiligament knee injury included in surgical treatment. Patients with neurovascular injury were not included in study. From 42 patients, 28 patients was type 3,8 patients was type 4 and 6 patients was type 5 in this study. In all 42 patients, single stage treatment first Intraarticular ligament (anterior cruciate ligament ACL, posterior cruciate ligament PCL or both) reconstruction done by arthroscopic method then Extraarticular ligament (medial collateral ligament MCL, lateral collateral ligament LCL, Posterolateral corner PLC) treated with repair/augmentation/reconstruction depending upon status of ligaments by open method. We used only autograft (hamstring and peroneal longus tendon) of same limb or contralateral limb. Patient evaluation done with IKDC and Lyshlom score both in preoperative and postoperative period. Patient limb was kept in full extention in brace and started with aggressive physiotherapy with passive ROM at 2 weeks in post operative period . Follow up done at 2 weeks then every 6 weeks interval till 6 months then every 3 months interval. Partial weight bearing started at 6 weeks and full weight bearing usually between 10 weeks to 12 weeks. Results: Road traffic accident was the most common cause of Multiligament knee injury. Average follow up was 4 years (range 2 to 6.5 years) .40 % has excellent ,40% has good and 20% has average result. There was a significant improvement in both outcome scores as compared with the preoperative scores. Postoperatively average IKDC was 78 and Lyshlom was 86. Terminal restriction of knee movement was in 19% patients particularly those associated with medial side injury was the major complication in our study. Manipulation under anaesthesia was done in 4 cases and implant removal in 1 case and arthroscopic synovectomy and long term antibiotic in 1 case who develop early infection. Gade 1 posterior laxity and grade 1 varus stress was observed in 10 patints.Recovery after surgery takes 9 to 12 months of rehabilitation prior to returning to full activities. Conclusion: Proper evaluation and full diagnosis is key in Multiligament injury of knee. Failure to treat all injured structure can lead to change in knee kinematics and poorer outcome and increased risk for graft failure.Operative treatment with proper rehabilitation yields good functional and clinical outcome with early return to work and sports activity.


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