Persistent cough associated with osteophyte formation and vagus nerve impingement following cervical spinal surgery

2013 ◽  
Vol 19 (2) ◽  
pp. 167-169 ◽  
Author(s):  
Kadir Serkan Orhan ◽  
Şenol Acar ◽  
Murat Ulusan ◽  
Aydın Aydoseli ◽  
Yahya Güldiken

Persistent cough due to irritation of the vagus nerve by osteophytes resulting from cervical spinal surgery is a very rare condition. The authors report the case of a 49-year-old woman who presented with a persistent cough subsequent to cervical spinal surgery. One year after the initial operation, the patient underwent surgery to free the larynx from the prevertebral fascia and cut the pharyngeal plexus, but her symptoms persisted. In order to control the cough, she used a soft cervical collar with padding inserted in the left side so that the larynx would be pushed to the right, a solution she discovered on her own. Without the collar, she coughed uncontrollably. A CT scan was performed and showed an osteophyte that had developed at the level of the prosthesis. Based on these findings, the authors hypothesized that the cough was caused by vagus nerve irritation due to the osteophyte. The osteophyte was resected and the vagus nerve was moved to a position anterior to the carotid artery and was isolated by means of an autogenous tensor fascia lata graft. The patient's symptom disappeared immediately after the surgery. At the most recent follow-up visit, 18 months after surgery, the patient was symptom free and was pursuing regular daily activities without using a cervical collar.

1992 ◽  
Vol 50 (3) ◽  
pp. 383-386 ◽  
Author(s):  
Osvaldo J. M. Nascimento ◽  
Marcos R. G. de Freitas ◽  
Myrian D. Hahn ◽  
Abelardo Q. C. Araújo

Calf enlargement following sciatica is a rare condition. It is reported the case of a 28-year-old woman who complained of repeated episodes of lower back pain radiating into the left buttock and foot. One year after the beginning of her symptoms, she noticed enlargement of her left calf. X-ray studies disclosed L5-S1 disk degeneration. EMG showed muscle denervation with normal motor conduction velocity. Open biopsies of the gastrocnemius muscles were performed. The left gastrocnemius muscle showed hypertrophic type 2 fibers in comparison with the right gastrocnemius. Electron microscopy showed mildly increased number of mitochondria in these fibers. A satisfactory explanation for denervation hypertrophy has yet to be provided.


2018 ◽  
Author(s):  
Ye Zhang ◽  
Ravi Thomas ◽  
Cong Wang ◽  
Xiangyu Shi

Abstract Background: Spherophakia is a rare condition and compared to its occurrence with familial and systemic disorders, isolated spherophakia is even more uncommon. This rare case of isolated spherophakia will raise the alertness of physicians when dealing with a high myopia patient with shallow anterior chamber and relatively normal fundus. Case presentation: We report a case of a 17-year-old male who experienced painless decrease of vision in both eyes (OU) for 11 years, with progression of visual impairment and occasional ocular pain for one year. Examination revealed high myopia, increased intraocular pressures (IOP, 28 mmHg in the right eye (OD) and 33 mmHg in the left (OS)), shallow central anterior chambers, lenses of a spherical shape with superior subluxation, occludable angles without peripheral anterior synechiae, and healthy optic discs OU. A diagnosis of bilateral isolated spherophakia, lens subluxation, high myopia and secondary angle closure (AC) was made. Pars plana lensectomy with anterior vitrectomy and scleral suturing of an intraocular lens was performed. On postoperative follow-up at 19 days OD and 63 days OS, the visual acuity was 6/6 and the IOP was normal without any medication OU. Conclusions: A presentation with high myopia, shallow anterior chamber with a normal retina should alert the clinician to the possibility of spherophakia, as compared to high myopia caused by elongated axial length. Surgery should be considered in cases of spherophakia with AC where the IOP cannot be controlled by noninvasive means.


2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Moscatelli ◽  
G Trocchio ◽  
N Stagnaro ◽  
A Siboldi ◽  
M Derchi ◽  
...  

Abstract Introduction Tricuspid valve duplication is an extremely rare condition and in most of the cases it is associated with other congenital cardiac malformations. Because of its rarity, the clinical presentation and the management are not defined yet. Clinical Case We report the case of an 18 y/o caucasian male, who was admitted to our Hospital in February 2018 for rapid atrial flutter not responsive to medical therapy (propanolol and digossin). He had a pre-natal diagnose of ventricular septum defect (VSD) and tricuspid straddling. At 1 year of age he underwent pulmonary artery bandage and one year later VSD closure was performed. Blood test showed sub-clinic hypothyroidism, probably related to previous amiodaron therapy. A transthoracic echocardiogram was obtained. The right atrium (RA) was severely dilated and the atrial septum dislocated towards left ventricle (LV); two right atrioventricular valves (tricuspid valves) were detected: the ‘true’ tricuspid opening was inside the right ventricle, and an ‘accessory‘ opening was located inside the LV and severely regurgitant into the RA; the mitral valve was morphologically and functionally normal; both ventricles were dilated with preserved systolic function; systolic pulmonary artery pressure was not detectable. A Cardiac Magnetic Resonance clearly delineated the anomaly. Atrial flutter radio frequency transcatheter ablation was succesfully performed before corrective surgery. The regurgitant accessory tricuspid orifice was closed with an heterologous pericardial patch and a right reduction atrioplasty was also done. The post-operative course was uneventful and only a mild paraseptal tricuspid jet with LV to RA shunt was present at post op echocardiography. After one year follow-up the patient remained asymptomatic, without arrhythmia recurrence. Conclusion DOTV is an extremely rare condition that could be responsible of severe tricuspid regurgitation. At the moment, there are not sufficient data to establish the correct timing for surgical intervention. In our case, the presence of severe tricuspid regurgitation, right atrium dilatation, biventricular overload and atrial flutter guided the clinical management and suggested surgical correction. Abstract P189 Figure.


2021 ◽  
Vol 15 (1) ◽  
pp. 79-82
Author(s):  
Mohammad Abusamak ◽  
Hamzeh M. Alrawashdeh

Introduction: Papillophlebitis is a rare condition that has a high probability of misdiagnosis due to its puzzling resemblance to common conditions, especially Central Retinal Vein Occlusion (CRVO) and papillitis. Methods: We present an interesting case of a 30-year-old healthy woman with mild CRVO in the right eye associated with ocular pain on upgaze, visual field defect, dyschromatopsia, and desaturation of red color along with initially normal visual acuity, nondetectable relative afferent pupillary defect, and normal foveal reflex. She underwent a subdermal etonogestrel implant (progestin) by a gynecologist two months before presentation. Following the removal of the progestin implant by her gynecologist, we started the patient on intravenous methylprednisolone (500mg daily for 3 days). Results: This combination of incomplete features of CRVO and papillitis guide us to the diagnosis of atypical papillophlebitis. The fundi showed a typical appearance of angioid streaks. The association between papillophlebitis and angioid streaks was unclear. After a thorough review of the literature, no correlation was found, indicating that angioid streak is only an incidental finding. Conclusion: The patient’s condition improved with systemic steroid administration, and complete visual recovery was noted after one year, despite the presence of macular ischemia and nerve fiber layer atrophic changes on Optical Coherence Tomography (OCT) and OCT angiography.


2013 ◽  
Vol 7 (1) ◽  
pp. 75-77 ◽  
Author(s):  
V De Luna ◽  
V Potenza ◽  
L Garro ◽  
P Farsetti ◽  
R Caterini

Trigger finger is a rare condition in children. In this paper, we report on a 2-year-old boy with multiple congenital bilateral trigger digits. The patient had no history of perinatal trauma, viral or bacterial infections, or metabolic disorders. The patient was treated with physiotherapy for one year. At the one-year follow-up, the boy presented with six trigger fingers (3 on the right hand, 3 on the left hand). Neither thumb was involved. The six trigger fingers were treated surgically: first, the right-hand trigger fingers and, six months later, those of the left hand. After each operation, a 4-week brace in extension was applied to the operated hand. The symptoms were completely resolved after surgical treatment. Many authors have recommended surgical release for the treatment of trigger finger in children; empirical treatment with physiotherapy may be an option when symptoms present or appear at an older age.


2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
A. Gungor ◽  
N. Gokkaya ◽  
A. Bilen ◽  
H. Bilen ◽  
E. M. Akbas ◽  
...  

Pituitary insufficiency secondary to internal carotid artery (ICA) aneurysm is a very rare condition. Its prevalence is reported as 0.17% (Heshmati et al., 2001). We present a case of pituitary insufficiency and hyperprolactinemia secondary to suprasellar giant intracranial aneurysm. A 71-year-old man was admitted to our clinic with symptoms of hypopituitarism, hyperprolactinemia, and visual field defect. His pituitary MRI and cerebral angiography revealed a giant saccular aneurysm filling suprasellar cistern arising from the ophthalmic segment of the right ICA. Endovascular treatment was performed on the patient to decrease the mass effect of aneurysm and improve the hypophysis dysfunction. After treatment, his one-year follow-up showed the persistence of hypophysis insufficiency, decrease of prolactin (PRL) level, and normal visual field. An intracranial aneurysm can mimic the appearance and behavior of a pituitary adenoma. Intracranial aneurysms should be taken into consideration in the situation of hypopituitarism and hyperprolactinemia. It is important to distinguish them because their treatment approach is different from the others.


2017 ◽  
Vol 4 (6) ◽  
pp. 2081
Author(s):  
Chisel Bhatia ◽  
Satish Dalal ◽  
Vundavalli Sattibabu ◽  
Jagat P. Beniwal

Vascular malformation of the parotid gland is an extremely rare condition with very few reported cases in the literature. Here we report a case of a 55 years old, female who presented with the complaint of swelling in the right parotid region for one year. Imaging revealed a vascular malformation involving the superficial lobe of the right parotid gland. Superficial Parotidectomy was done and histopathology was consistent with the diagnosis of vascular malformation of the parotid.


2019 ◽  
Vol 65 (5) ◽  
pp. 756-759
Author(s):  
Mikhail Postolov ◽  
Nadezhda Kovalenko ◽  
K. Babina ◽  
Stanislav Panin ◽  
Yelena Levchenko ◽  
...  

Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by expression of both mela-nocytic and smooth muscle markers. Only 10 primary malignant lung PEComas have been reported up to date. We report a 59-year-old male who presented with a lung neoplasm, found during the routine X-ray examination. Preoperative CT-scan revealed the 3,5-cm-sized mass, located at the border of the upper, middle and lower lobes of the right lung. Patient underwent a thoracotomy, resection of the upper, middle and lower lobes of the right lung accompanied with mediastinal lymphadenectomy. After surgery, chylothorax was revealed. Conservative treatment was unsuccessful, so we performed laparoscopic clipping of the thoracic lymph duct. Patient was dismissed from hospital on the 10-th day after the second operation in good condition. In this report, we intend to increase the limited knowledge relating to natural history and optimal treatment of such a rare condition as a primary malignant lung PEComa.


2021 ◽  
pp. 1-4
Author(s):  
Baher M. Hanna ◽  
Wesam E. El-Mozy ◽  
Sonia A. El-Saiedi

Abstract Isolated sub-pulmonary membrane is a rare condition, the origin of which has been debatable. Transcatheter treatment of pulmonary valve atresia with intact interventricular septum by radiofrequency perforation and balloon dilatation to restore biventricular circulation is gaining more popularity, with improving results over time. We report in our experience of 79 cases in 10 years the development of a sub-pulmonary membrane in 4 cases: causing significant obstruction requiring surgical excision in one case that revealed a fibrous membrane on pathology; causing mild right ventricular outflow tract obstruction in another and not yet causing obstruction in 2. On cardiac MRI, the right ventricular outflow tract and the right ventricular outflow tract/pulmonary atresia angle showed no morphological abnormalities.


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