RESUMO
Traumatic brain injury (TBI) is often accompanied by additional trauma that can be obscured by cognitive dysfunction or multiple injuries in the same region of the body. This report describes the case of an unhelmeted motorcycle rider who collided with a telephone pole. He sustained a diffuse subarachnoid hemorrhage, bilateral subdural hematomas (right frontal and left temporal), diffuse axonal injury in the subcortical and periventricular white matter, and a left tibial fracture. After medical and surgical stabilization, he was transferred to a subacute rehabilitation facility and then to a rehabilitation center. He was evaluated for pain and limited range of motion in his right shoulder, where both a rotator cuff tear and a brachial plexopathy were diagnosed. This report discusses concomitant injuries that occur with TBI, and the management of rotator cuff tears and brachial plexopathy.
Assuntos
Neuropatias do Plexo Braquial/diagnóstico , Lesões Encefálicas/complicações , Lesões do Manguito Rotador , Neuropatias do Plexo Braquial/complicações , Neuropatias do Plexo Braquial/reabilitação , Humanos , Masculino , Pessoa de Meia-Idade , Debilidade Muscular/etiologiaRESUMO
OBJECTIVE: To evaluate the efficacy of carbidopa L-dopa (Sinemet) in reducing left spatial neglect after stroke. DESIGN: Case series. SETTING: Inpatient neurorehabilitation unit in a regional rehabilitation center. PARTICIPANTS: A convenience sample of 4 women with right brain strokes and left neglect. INTERVENTION: A trial of carbidopa L-dopa to treat left neglect, if indicated by selected subtests of the Behavioral Inattention Test (BIT). MAIN OUTCOME MEASURES: Baseline and posttreatment evaluation with the modified BIT and the FIM instrument. RESULTS: Three of 4 subjects had significant improvements in their modified BIT scores (8%, 12%, 27%, respectively) and their functional status on the FIM. CONCLUSION: With further study, carbidopa L-dopa may be shown to reduce unilateral spatial neglect and thereby improve rehabilitation outcomes.
Assuntos
Carbidopa/uso terapêutico , Dopaminérgicos/uso terapêutico , Levodopa/uso terapêutico , Transtornos da Percepção/tratamento farmacológico , Transtornos da Percepção/etiologia , Acidente Vascular Cerebral/complicações , Atividades Cotidianas , Idoso , Carbidopa/metabolismo , Carbidopa/farmacologia , Dopaminérgicos/metabolismo , Dopaminérgicos/farmacologia , Feminino , Avaliação Geriátrica , Humanos , Levodopa/metabolismo , Levodopa/farmacologia , Transtornos da Percepção/classificação , Transtornos da Percepção/diagnóstico , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Laryngeal stenosis secondary to blunt laryngeal trauma is mostly localized at the supraglottic and glottic levels. The epiglottis is ideally suited to reconstruct the defect after excision of supraglottic and glottic scar tissue and anterior thyroid cartilage. It is the conclusion of the authors that epiglottic reconstruction is an effective procedure for repair of laryngeal stenosis at the supracricoid level. Two case reports are given.