scholarly journals Complex Diagnosis in Surgical Treatment of Peripheral Nerves Injuries of the Extremities

2016 ◽  
pp. 62-66
Author(s):  
V. G. Ninel’ ◽  
Sh. M. Aitemirov ◽  
G. A. Korshunova ◽  
I. A. Norkin
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Nerve Trunk ◽  
Treatment Results

The purpose of the work was to evaluate the role and potentialities of complex diagnosis in surgical treatment of peripheral nerve trunk injuries of the extremities. Complex examination including electroneuromyography, ultrasonography and contrast neurography was performed in 109 patients with injuries of peripheral nerves of the extremities. Examination results enabled to elaborate the algorithm of diagnosis and differential surgical treatment tactics for surgical treatment of peripheral nerves injuries. Management of patients in accordance with proposed algorithm allowed to improve surgical treatment results significantly - by 21%.

scholarly journals Complex Diagnosis in Surgical Treatment of Peripheral Nerves Injuries of the Extremities

2016 ◽  
Vol 23 (1) ◽  
pp. 62-66
Author(s):  
V. G Ninel’ ◽  
Sh. M. Aitemirov ◽  
G. A Korshunova ◽  
I. A Norkin
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Nerve Trunk ◽  
Treatment Results

The purpose of the work was to evaluate the role and potentialities of complex diagnosis in surgical treatment of peripheral nerve trunk injuries of the extremities. Complex examination including electroneuromyography, ultrasonography and contrast neurography was performed in 109 patients with injuries of peripheral nerves of the extremities. Examination results enabled to elaborate the algorithm of diagnosis and differential surgical treatment tactics for surgical treatment of peripheral nerves injuries. Management of patients in accordance with proposed algorithm allowed to improve surgical treatment results significantly - by 21%.

Exogenous opioids influence the microcirculation of injured peripheral nerves

1997 ◽  
Vol 272 (1) ◽  
pp. H76-H82
Author(s):  
L. Schaafsma ◽  
H. Sun ◽  
D. Zochodne
Keyword(s):  
Blood Flow ◽  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Nerve Trunk ◽  
Local Blood Flow ◽  
Vasa Nervorum ◽  
Perfusion Flow ◽  
Sciatic Nerves ◽  
Microelectrode Measurements ◽  
Hydrogen Clearance

Local microvessels of peripheral nerve trunks (vasa nervorum) dilate following capsaicin-induced inflammation or local nerve trunk injury. In previous work, we observed that morphine blocked capsaicin-induced dilation of vasa nervorum presumably through the action of local opioid receptors. In the present work, we studied injury-related hyperemia of the rat sciatic vasa nervorum using laser Doppler and hydrogen clearance microelectrode measurements of local perfusion. Systemic morphine reversed hyperemia by vasoconstricting both extrinsic and intrinsic microvessels supplying 48-h-old “neuroma” preparations or crush zones of peripheral nerve trunks. Morphine did not constrict microvessels of contralateral uninjured or sham exposed but uninjured sciatic nerves. In contrast to the injured nerves, contralateral uninjured nerves exposed to morphine frequently had a rise in local perfusion, indicating vasodilation. The vasoconstrictive actions of morphine were blocked by pretreatment with naloxone and were not mimicked by saline injections alone. Systemic doses of selective opioid agonists to mu-, kappa-, and delta-receptors also selectively constricted microvessels of injured nerves. Local blood flow in older experimental neuromas at 7 days had partial sensitivity to morphine, whereas at 14 days perfusion flow was not influenced by morphine. Exogenous opioids dampen early but not later inflammatory microvasodilation and could have important influences on the nerve regenerative milieu.

scholarly journals Rehabilitation of extremity war injuries with lesion of peripheral nerves in "PRAXIS" Centre for Physical Medicine and Rehabilitation, Sarajevo

2003 ◽  
Vol 3 (3) ◽  
pp. 37-40
Author(s):  
Džemal Pecar ◽  
Mediha Karić ◽  
Husein Kulenović ◽  
Izet Masić ◽  
Emina Kiseljaković
Keyword(s):  
Surgical Treatment ◽  
Peripheral Nerves ◽  
Physical Medicine ◽  
Treatment Results ◽  
Surgical Interventions ◽  
War Injuries ◽  
Close Cooperation ◽  
Plexus Lesion ◽  
Significant Lesion ◽  
Better Than

Polytrauma with significant lesion of peripheral nerves is a specific war injury. It is also one of the most delicate problems in rehabilitation treatment because it requires a close cooperation with surgeon and timely surgical interventions. Based on our experience, the best results in the treatment of injured persons with lesion of peripheralnerves have been accomplished after the surgical treatment. Results in the neurolysis were better than those accomplished in neurorrhaphy. Total of 436 patients with lesion of peripheral nerves were recorded and 56 patients with plexus lesion. Out of this number, 78 patients (about 15%) had surgical treatment (41 neurorrhaphy and 37 neurolysis). Due to lack of adequate ENMG diagnostics, the objective valorisation of treatment outcome was not possible.

Individual mechanisms underlying peripheral nerve damage when exposed to metallic mercury

2020 ◽  
Vol 60 (12) ◽  
pp. 918-924
Author(s):  
Dina V. Rusanova ◽  
Oleg L. Lakhman ◽  
Galina M. Bodienkova ◽  
Irina V. Kudaeva ◽  
Natalya G. Kuptsova
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Blood Circulation ◽  
The State ◽  
Contact Period ◽  
Peripheral Nerve Damage ◽  
Demyelinating Disorders ◽  
Peripheral Blood Circulation ◽  
Antibodies To Dna

Introduction. There is a lack of knowledge of the pathophysiological mechanisms that form peripheral nerve disorders in mercury lesions of professional origin. The study aims to reveal the mechanisms underlying peripheral nerve damage in the long-term post-contact period of chronic mercury intoxication (CMI). Materials and methods. Fifty-one people had the diagnosis of a long-term period of CMI. The post-contact period was 8.5±2.6 years. The authors compared the results with a control group of 26 healthy men who had no contact with toxic substances. Stimulating electroneuromyography was performed. We studied the body systems that could contribute to the formation of disorders in the peripheral nerves. Changes in peripheral hemodynamics were studied using reovasography. The content of autoantibodies, neuron-specific enolase, serotonin, histamine, catecholamines (epinephrine, dopamine), metanephrine, and neurotrophin-3 was reviewed. The content of ceruloplasmin, secondary products of lipid peroxidation processes, reduced glutathione, the activity of superoxide dismutase and the content of nitric oxide levels were determined. Results. The study established pathogenetic structural links of peripheral nerve disorders. The autoimmune process's role was to increase the range of antibodies to the MAG protein and increase the level of antibodies to DNA. Violations of elastic-tonic properties of peripheral vessels could be associated with the functional state of motor axons. The increased content of neurotransmitters is related to the state of peripheral blood circulation; the most pronounced changes were on the legs, which could contribute to the occurrence and maintenance of vasoconstriction. The role of oxidative stress in the formation of demyelinating disorders in patients' peripheral nerves in the long-term period of CRI is possible. Conclusion. Neuroimmunological processes has an essential role in the development of peripheral nerve demyelination was shown, which consists in an increase in the content of antibodies to the MAG protein expressed on Schwann cells of peripheral nerves and in an increase in the level of antibodies to DNA involved in the formation of demyelinating changes when exposed to metallic mercury. The revealed pathological changes in the state of the peripheral blood circulation, characterized by a violation of the vessels' elastic-tonic properties, leading to demyelination of motor axons in patients in the long-term period of CMI. The increased content of neurotransmitters in the examined is of great importance in the state of peripheral circulation. Pronounced changes in blood circulation are established on the lower extremities, which may be associated with the predominance of α-adrenergic receptors in the arterial bed and may contribute to the occurrence and maintenance of vasoconstriction in the legs. The relationship between changes in indicators of oxidative stress, consisting of a decrease in the value of superoxide dismutase and reduced glutathione, and the formation of demyelinating disorders of peripheral nerves in patients in the long-term period of CMI has been proved.

scholarly journals Experimental Methods to Simulate and Evaluate Postsurgical Peripheral Nerve Scarring

2021 ◽  
Vol 10 (8) ◽  
pp. 1613
Author(s):  
Alessandro Crosio ◽  
Giulia Ronchi ◽  
Benedetta Elena Fornasari ◽  
Simonetta Odella ◽  
Stefania Raimondo ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Experimental Methods ◽  
Scar Tissue ◽  
Experimental Models ◽  
Tissue Formation ◽  
Surgical Interventions ◽  
Pubmed Database ◽  
Different Types ◽  
Scar Tissue Formation

As a consequence of trauma or surgical interventions on peripheral nerves, scar tissue can form, interfering with the capacity of the nerve to regenerate properly. Scar tissue may also lead to traction neuropathies, with functional dysfunction and pain for the patient. The search for effective antiadhesion products to prevent scar tissue formation has, therefore, become an important clinical challenge. In this review, we perform extensive research on the PubMed database, retrieving experimental papers on the prevention of peripheral nerve scarring. Different parameters have been considered and discussed, including the animal and nerve models used and the experimental methods employed to simulate and evaluate scar formation. An overview of the different types of antiadhesion devices and strategies investigated in experimental models is also provided. To successfully evaluate the efficacy of new antiscarring agents, it is necessary to have reliable animal models mimicking the complications of peripheral nerve scarring and also standard and quantitative parameters to evaluate perineural scars. So far, there are no standardized methods used in experimental research, and it is, therefore, difficult to compare the results of the different antiadhesion devices.

Compression neuropathies of the forearm: anatomy, clinical features and management

2021 ◽  
pp. 1-10
Author(s):  
Alexander Scarborough ◽  
Robert J MacFarlane ◽  
Michail Klontzas ◽  
Rui Zhou ◽  
Mohammad Waseem
Keyword(s):  
Peripheral Nerve ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Peripheral Nerves ◽  
Clinical Presentation ◽  
Permanent Damage ◽  
Peripheral Nerve Lesions ◽  
Clinical Presentations ◽  
Wide Range ◽  
Prompt Diagnosis

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

ULTRASONIC STUDY IN DIAGNOSTICS OF PERIPHERAL NEUROPATHIES (CASE FROM PRACTICE)

2021 ◽  
pp. 144-146
Author(s):  
Hamanovich A.I. ◽  
◽  
Baida A.G. ◽  
Koyalo L.G. ◽  
Levantsevich V.V. ◽  
...  
Keyword(s):  
Nervous System ◽  
Gold Standard ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Clinical Case ◽  
Clinical Symptoms ◽  
Nerve Trunk ◽  
Peripheral Neuropathies ◽  
Ultrasound Scanning ◽  
Electrophysiological Methods

Electrophysiological methods, such as electromyography and neuromyography, are traditionally recognized as the "gold standard" for detecting pathology of the peripheral nervous system. It should be noted, however, that the information obtained during the above examinations does not give an idea of the state of the surrounding tissues, does not indicate the nature and cause of damage to the nerve trunk, and does not always accurately reflect the localization of changes. At the same time, it is this information that helps to determine the tactics of conservative or surgical treatment of the patient. Ultrasound scanning is quite successfully used in the diagnosis of damage and diseases of the peripheral nerves. The article presents a clinical case of a diagnostic search for a causative disease in a patient with clinical symptoms of neuropathy of the peroneal nerve.

The Validation of Measures of Outcome Following Suture of Divided Peripheral Nerves Supplying the Hand

1990 ◽  
Vol 15 (1) ◽  
pp. 25-34
Author(s):  
D. MARSH
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Sensory Function ◽  
The Other ◽  
Functional Tests ◽  
Nerve Suture ◽  
Classic Paper

Erik Moberg pioneered the idea of validating measures of sensory function following peripheral nerve suture by correlating their results with those of functional tests. However it is important that powerful prior variables (age at suture, time elapsed since suture and delay between injury and suture) be controlled. Failure to do this may result in spurious correlations, as illustrated by analysis of two sets of data, one collected by the author and the other given in the classic paper of Önne (1962).

Physiology of Spinal Cord, Nerve Root and Peripheral Nerve Compression

1956 ◽  
Vol 185 (1) ◽  
pp. 217-229 ◽  
Author(s):  
Samuel Gelfan ◽  
I. M. Tarlov
Keyword(s):  
Spinal Cord ◽  
Peripheral Nerve ◽  
Nerve Root ◽  
Peripheral Nerves ◽  
Compressive Force ◽  
Mechanical Deformation ◽  
Dorsal Column ◽  
Neuronal Structure ◽  
Mechanical Pressure ◽  
Wide Range

The reversible conduction block produced by maintained mechanical pressure around small segments of spinal cord, nerve root or peripheral nerve (dog) is due to mechanical deformation of the neuronal tissue and not to lack of O2. The compressed segment, although ischemic, is not anoxic; O2 from adjacent nonischemic tissue reaches it, presumably by diffusion. The entire pattern of modification of neuronal responses by compression and the postdecompression recovery pattern are distinctly different from the patterns observed during anoxia and recovery from the latter, indicating the difference in mechanisms by which mechanical deformation and O2 lack block conduction. The largest fibers in dorsal columns, roots and peripheral nerves are most susceptible to pressure and the smallest ones are relatively most resistant. Secondary neurons are less vulnerable than the primary afferent ones to light and moderate, but suprasystolic, circumferential spinal cord pressure. All components of the composite spinal cord potential are blocked at about the same time by larger compressive forces. Anoxia, on the other hand, always inactivates secondary neurons before dorsal column fibers and blocks smaller A fibers in peripheral nerves before the larger ones. The latency for complete blocking in each neuronal structure is specific and irreducible in the case of anoxia, whereas in compression it varies over a wide range, depending upon the magnitude of the compressive force.

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