scholarly journals Management of intractable chronic cough during awake craniotomy: illustrative case

2021 ◽  
Vol 2 (25) ◽  
Keyword(s):  
Clinical Condition ◽  
Chronic Cough ◽  
Treatment Approach ◽  
Positive Outcome ◽  
Awake Craniotomy ◽  
Illustrative Case ◽  
Anaplastic Ependymoma ◽  
Speech Language Pathologist ◽  
Appropriate Treatment ◽  
Eloquent Cortex

BACKGROUND Chronic cough is a common but challenging clinical condition that can adversely affect the safety of awake surgical endeavors such as awake craniotomy (AC). This case lesson highlighted a patient with severe refractory chronic cough undergoing AC for resection of a recurrent left frontal, insula, anterior temporal anaplastic ependymoma of the eloquent cortex. OBSERVATIONS The patient was successfully managed using a multifaceted medical treatment regimen combined with preoperative and intraoperative cough suppression therapy with a speech-language pathologist. The patient coughed only once intraoperatively and had a positive outcome. LESSONS Chronic cough is often multifactorial and requires a multifaceted treatment approach. Despite this challenge, select patients can successfully be navigated through AC with appropriate treatment for their condition. A review of neurogenic cough and modern treatments, which were used in this patient and would be helpful to neurologists or neurosurgeons, are also discussed.

scholarly journals Awake craniotomy for glioblastoma in COVID-19–positive patients and delivering the standard of care: illustrative case

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Reinier Alvarez ◽  
Rupesh Kotecha ◽  
Michael W. McDermott ◽  
Vitaly Siomin
Keyword(s):  
Standard Of Care ◽  
Awake Craniotomy ◽  
Illustrative Case ◽  
Speech Mapping ◽  
Viral Particles ◽  
Positive Treatment ◽  
Frontal Operculum ◽  
Eloquent Cortex ◽  
Poor Outcomes ◽  
Novel Coronavirus

BACKGROUND Providing the standard of care to patients with glioblastoma (GBM) during the novel coronavirus of 2019 (COVID-19) pandemic is a challenge, particularly if a patient tests positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Further difficulties occur in eloquent cortex tumors because awake speech mapping can theoretically aerosolize viral particles and expose staff. Moreover, microscopic neurosurgery has become difficult because the use of airborne-level personal protective equipment (PPE) crowds the space between the surgeon and the eyepiece. However, delivering substandard care will inevitably lead to disease progression and poor outcomes. OBSERVATIONS A 60-year-old man with a left insular and frontal operculum GBM was found to be COVID-19 positive. Treatment was postponed pending a negative SARS-CoV-2 result, but in the interim, he developed intratumoral hemorrhage with progressive expressive aphasia. Because the tumor was causing dominant hemisphere language symptomatology, an awake craniotomy was the recommended surgical approach. With the use of airborne-level PPE and a surgical drape to protect the surgeon from the direction of potential aerosolization, near-total gross resection was achieved. LESSONS Delaying the treatment of patients with GBM who test positive for COVID-19 will lead to further neurological deterioration. Optimal and timely treatment such as awake speech mapping for COVID-19–positive patients with GBM can be provided safely.

The Collaborative Medical and Behavioral Management of Chronic Cough

2009 ◽  
Vol 19 (2) ◽  
pp. 49-57
Author(s):  
Brian E. Petty ◽  
Seth H. Dailey
Keyword(s):  
Medical Care ◽  
Chronic Cough ◽  
Therapeutic Management ◽  
Ambulatory Setting ◽  
Behavioral Management ◽  
Speech Language Pathologists ◽  
Speech Language Pathologist ◽  
The Many ◽  
Frequent Reason

Abstract Chronic cough is the most frequent reason cited by patients for seeking medical care in an ambulatory setting and may account for 10% to 38% of a pulmonologist's practice. Because chronic cough can be caused by or correlated with a wide array of disorders and behaviors, the diagnosis of etiologic factors and determination of appropriate therapeutic management in these cases can prove to be daunting for the physician and speech-language pathologist alike. This article will describe the phenomenon of chronic cough, discuss the many etiologic factors to consider, and review some of the more common ways in which speech-language pathologists and physicians collaborate to treat this challenging condition.

scholarly journals Metastasis of Ewing Sarcoma to the Pancreas: Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Hyma Polimera ◽  
Prashanth Moku ◽  
Shady Piedra Abusharar ◽  
Monali Vasekar ◽  
Jayakrishna Chintanaboina
Keyword(s):  
Ewing Sarcoma ◽  
Rare Case ◽  
Bone Cancer ◽  
Positive Outcome ◽  
Tumor Burden ◽  
Response To Treatment ◽  
Effective Management ◽  
Review Of The Literature ◽  
Appropriate Treatment ◽  
Prompt Diagnosis

Ewing sarcoma (ES) is a highly aggressive malignant bone cancer. ES is part of the Ewing sarcoma family of tumors (ESFT), which express characteristic t(11;22) translocation as well as higher levels of CD99. Given that metastasis and tumor burden are significant prognostic factors in patient’s response to treatment, prompt diagnosis is needed to effectively treat ESFT patients. However, the challenges in classifying and characterizing ESFT complicate effective management and treatment of ES. In this report, we present a rare case of ES metastasis to the pancreas. Upon review of the literature, we found 39 cases of ESFT involving the pancreas, but only 3 were metastatic to the pancreas while the remaining cases of ESFT primarily originated from the pancreas. Given the rarity of such metastasis, the positive outcome in our patient’s case may explain the importance of prompt diagnosis in order to initiate appropriate treatment.

Approach to Radiculopathy

2021 ◽  
Vol 41 (06) ◽  
pp. 760-770
Author(s):  
Rafid Mustafa ◽  
Narayan R. Kissoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Treatment Approach ◽  
Treatment Plan ◽  
Treatment Options ◽  
Accurate Diagnosis ◽  
Clinical Approach ◽  
Low Back ◽  
Appropriate Treatment ◽  
Neurology Clinic

AbstractLow back pain and neck pain, often with associated radiculopathy, are two of the most common reasons for referral to the outpatient neurology clinic. A thorough clinical evaluation remains paramount in establishing an accurate diagnosis and subsequently an appropriate treatment plan. In this article, we review anatomic considerations for spondylotic radiculopathy; outline the clinical approach for the evaluation of these patients, including discussion of electrodiagnostic and imaging modalities; and address treatment options based on a stratified treatment approach.

Gastroesophageal Junction Tumors Does Location Determine Treatment?

2017 ◽  
Author(s):  
Emily L. Siegel ◽  
Miguel Burch
Keyword(s):  
Study Design ◽  
Clinical Case ◽  
Classification Scheme ◽  
Treatment Approach ◽  
Gastroesophageal Junction ◽  
Design Study ◽  
Appropriate Treatment ◽  
Study Intervention ◽  
Landmark Study

This chapter summarizes a landmark study in treatment of gastroesophageal (GE) junction tumors. Should an anatomically based classification scheme of GE tumors define the appropriate treatment approach for these tumors? Starting with that question, it describes the basis of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving possible gastrectomy and esophagectomy.

scholarly journals Using cortical function mapping by awake craniotomy dealing with the patient with recurrent glioma in the eloquent cortex

2020 ◽  
Author(s):  
Ying-Ching Li ◽  
Hsiao-Yean Chiu ◽  
Kuo-Chen Wei ◽  
Ya-Jui Lin ◽  
Ko-Ting Chen ◽  
...  
Keyword(s):  
Awake Craniotomy ◽  
Recurrent Glioma ◽  
Cortical Function ◽  
Eloquent Cortex ◽  
Function Mapping

Implementing DBT: selecting, training and supervising a team

2010 ◽  
Vol 3 (2) ◽  
pp. 71-79 ◽  
Author(s):  
Michaela A. Swales
Keyword(s):  
Clinical Guideline ◽  
Treatment Approach ◽  
Borderline Personality ◽  
Behaviour Therapy ◽  
Training And Supervision ◽  
Appropriate Treatment ◽  
Cognitive Behavioural ◽  
Behavioural Therapies ◽  
And Training ◽  
Nice Clinical Guideline

AbstractNICE Clinical Guideline no. 78 recently identified Dialectical Behaviour Therapy (DBT) as an appropriate treatment approach for the effective treatment of suicidal behaviours in the context of borderline personality disorder. Uniquely among the cognitive behavioural therapies DBT is a team-based treatment. This paper focuses on the task of selecting and training a team before considering issues in the training and supervision of therapists learning this approach.

scholarly journals Fishing-Injury-Related Flexor Tenosynovitis of the Hand: A Case Report and Review

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Danny A. Young-Afat ◽  
Deniz Dayicioglu ◽  
John C. Oeltjen ◽  
Audene P. Garrison
Keyword(s):  
Infectious Disease ◽  
Case Report ◽  
Empiric Antibiotic Therapy ◽  
Illustrative Case ◽  
Soft Tissue Infections ◽  
Severe Damage ◽  
Appropriate Treatment ◽  
Empiric Antibiotic ◽  
Infectious Disease Specialists ◽  
Flexor Tenosynovitis

Hand infections occurring after fishing and other marine-related activities may involve uncommon bacteria that are not susceptible to the conventional or empiric antibiotic therapy used to treat soft tissue infections. Therefore appropriate treatment is often delayed and could lead to severe hand damage. An illustrative case of fishing-related injury leading to complicated tenosynovitis and horseshoe abscess caused byMycobacterium marinumand its treatment course is outlined. Laceration of the skin during boating is fairly common. Because of the rarity of some of the bacteria, referrals to the appropriate specialist including hand surgeons and infectious disease specialists should occur in early stages.M. marinuminfections should always be considered in injuries related to seawater and fishing as this may lead to early appropriate treatment and prevent severe damage.

scholarly journals Immunology and Immunopathology of COVID-19: Precision Medicine and Individualized Treatment Approach are Decisive Factors

2021 ◽  
Vol 3 (2) ◽  
pp. 73-74
Author(s):  
Tooba Ghazanfari ◽  
Keyword(s):  
Cohort Study ◽  
Precision Medicine ◽  
Treatment Approach ◽  
Individualized Treatment ◽  
Research Center ◽  
Multicenter Cohort Study ◽  
Treatment Protocols ◽  
Multicenter Cohort ◽  
Appropriate Treatment ◽  
Underlying Mechanisms

As I noted in my previous editorial, It is necessary to examine the immunological aspects of COVID-19. Thus, in order to identify the underlying mechanisms, design appropriate treatment protocols, and effective vaccination, we started to conduct a multicenter cohort study entitled “Iran-Cohort Study of COVID-19 Immunology and Immunopathology”. This comprehensive multicenter cohort study is underway at Immunoregulation Research Center, Shahed University, Tehran, Iran.

Parapharyngeal Ganglioneuroma with Neurofibromatosis: An Unusual Presentation

2011 ◽  
Vol 120 (12) ◽  
pp. 769-774 ◽  
Author(s):  
Parul Sinha ◽  
Suresh C. Sharma ◽  
Shipra Agarwal ◽  
Siddhartha Datta Gupta
Keyword(s):  
Unusual Case ◽  
Benign Tumor ◽  
Parapharyngeal Space ◽  
Treatment Approach ◽  
Hypertensive Crisis ◽  
Neurogenic Tumors ◽  
Appropriate Treatment ◽  
Rare Benign Tumor ◽  
Hypertensive Crises ◽  
Biochemical Features

Objectives: Ganglioneuroma is a rare benign tumor of the sympathetic nervous system that is seldom localized to the head and neck. Rarer still are cases of functional ganglioneuroma with catecholamine production. We report an unusual case of a large parapharyngeal space ganglioneuroma in a patient with neurofibromatosis that caused an intraoperative hypertensive crisis in the absence of a neuroblastomatous component — Hitherto an undocumented complication. Methods: We present a case of functional parapharyngeal ganglioneuroma and review the clinicopathologic and biochemical features of these rare tumors. Results: Fewer than 40 anecdotal cases of parapharyngeal ganglioneuromas have been reported, and there is a lack of ade quate literature on the biology and appropriate treatment approach of these tumors. Conclusions: Our case illustrates the importance of vigilant preoperative precautions in the management of neurogenic tumors, particularly ganglioneuromas. These usually nonfunctional tumors can result in sudden intraoperative and postoperative hypertensive crises even in the absence of any preoperative autonomic symptoms.

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