Adipose Tissue Uses in Peripheral Nerve Surgery

Currently, many different techniques exist for the surgical repair of peripheral nerves. The degree of injury dictates the repair and, depending on the defect or injury of the peripheral nerve, plastic surgeons can perform nerve repairs, grafts, and transfers. All the previously listed techniques are routinely performed in human patients, but a novel addition to these peripheral nerve surgeries involves concomitant fat grafting to the repair site at the time of surgery. Fat grafting provides adipose-derived stem cells to the injury site. Though fat grafting is performed as an adjunct to some peripheral nerve surgeries, there is no clear evidence as to which procedures have improved outcomes resultant from concomitant fat grafting. This review explores the evidence presented in various animal studies regarding outcomes of fat grafting at the time of various types of peripheral nerve surgery.

O Internato de Formação Especializada em Neurocirurgia: Qual o Atual Panorama Nacional?

Introduction: In Portugal, the number of neurosurgery residents has been rising steadily. However, there are no robust studies assessing the level of satisfaction and quality of the current training programs. The aim of this study was to describe and quantify the level of satisfaction about Neurosurgery residency in 2019, in Portugal.Material and Methods: Quantitative observational cross-sectional study based on an original questionnaire about the level of satisfaction of neurosurgical training in Portugal in 2019, sent electronically to residents and young consultants between October and December 2019.Results: A total of 37 responses were obtained from physicians aged around 29.0 (± 4.0) years old, of which 78.4% were men and 54.1% from centers in the center/south of the country/islands. Overall, 51.4% of the answers came from first three years’ residents. As for the theoretical training, there was dissatisfaction with the morbidity and mortality meetings (59.5%), existence of sessions/anatomical lab (89.2%), participation in medical education (64.9%) and in research (64.9%). As for practical training, there was dissatisfaction only towards outpatient clinics (56.8%). There is a tendency for the first surgery to occur in the first month of residency and, in ascending order, firstly a cranial trauma surgery (5.09 ± 4.59 months), then for cerebrospinal fluid diseases (5.95 ± 4.3 months), peripheral nerves (6.0 ± 7.0 months), craniotomy (6.59 ± 3.88 months) and lumbar spine diseases (11.41 ± 1.5 months). Pediatric surgery was the last type of surgery to begin (19.36 ± 20.0 months). There seems to be a generalized satisfaction with the annual (59.5%) but not with thefinal examination (37.8%).Conclusion: This study has succeed at being a better description of the Portuguese neurosurgical centers and of the level of satisfaction about neurosurgical training in Portugal.

Cervical and Spinal Plexiform Neurofibroma: A Case Report

Plexiform neurofibroma is a rare benign tumor of the peripheral nerves at the expense of perineural connective cells. It is pathognomonic of neurofibromatosis type 1 (NF1 or Von Recklinghausen disease). MRI is of great help in the diagnosis of this pathology. Anatomopathological confirmation is sometimes necessary, especially in the absence of a context suggestive of NF1. We report the observation of an oung boy with a cervical plexiform neurofibroma revealing a neurofibromatosis Type 1

Painful unilateral gynecomastia with identification of the cause of the pain: A case report

A 69-year-old man presented with a one-month history of a painful mass in the right breast. Pathologic evaluation of the excision of the mass revealed a proliferation of both glandular and stromal elements consistent with gynecomastia. In addition, histologic examination revealed peripheral nerves in the deep portion of the specimen were entrapped in the proliferative changes associated with gynecomastia. It is proposed that the expansile proliferation led to compressive pressure on the nerves and caused the pain associated with gynecomastia.

Study of clinical profile and outcome of patients with acute non-traumatic paraparesis

Background: The following study is about the clinical profile and outcome of patients with acute non traumatic paraparesis. It includes the aetiology, clinical presentation and the outcome of various cases of acute non traumatic paraparesis. Paraplegia or paraparesis could be defined as loss of function of both legs as a result of disease or injury of the spinal cord, spinal roots, peripheral nerves or myopathies. Acute non-traumatic paraparesis is a neurological emergency. Reversible causes of acute paraplegia can be treated successfully if diagnosed early.Methods: The observational study was done in the department of general medicine at D. Y. Patil Hospital, Navi Mumbai with sample size of 75 patients over 1 year.Results: With early diagnosis prognosis of acute non traumatic paraparesis can be improved which was evaluated over period of 3 months.Conclusions: Acute non-traumatic paraparesis is a neurological emergency. Reversible causes of acute paraplegia can be treated successfully if diagnosed early. It is important to diagnose and classify all cases into compressive and non-compressive lesions based on presenting symptoms because the management of the two differs.

Peripheral Nerve Stimulation: The Evolution in Pain Medicine

Peripheral nerve stimulation (PNS) involves the application of electrical stimulation near the proximity of peripheral nerves. Although the mechanism of action remains unknown, PNS likely modulates both the central and peripheral nervous systems to provide analgesia for a wide variety of pain disorders involving the head, extremities, and trunk. Historically, PNS was not utilized widely due to underwhelming results from earlier studies. However, significant innovations in device technologies, including improved implantation techniques, hardware miniaturization, and externalized pulse generators, have led to the resurgence of PNS in the field of pain medicine. This editorial briefly reviews the evolution of PNS in the field of pain medicine and highlights areas for future investigation.

Primitive neuroectodermal tumor of ulnar nerve: A rare case

Primitive neuroectodermal tumor (PNET) is a highly aggressive tumor and mostly develops in children and young adults. PNETs of peripheral nerves are uncommon. Ulnar nerve, in particular, is an extremely peculiar origin for PNET and to the best of our knowledge only few well-documented cases have been yet reported.