RESUMO
Buckling of the posterior longitudinal ligament with compression against the thecal sac was the cause of persistent positional back pain after chemonucleolysis. Computed tomography in the supine and prone positions was helpful in making the diagnosis, and the cause was confirmed at laminectomy.
Assuntos
Quimiólise do Disco Intervertebral/efeitos adversos , Ligamentos , Síndromes de Compressão Nervosa/etiologia , Adulto , Doenças Ósseas/etiologia , Humanos , Laminectomia , Ligamentos/patologia , Masculino , Mielografia , Síndromes de Compressão Nervosa/diagnóstico por imagem , Síndromes de Compressão Nervosa/cirurgia , Tomografia Computadorizada por Raios XRESUMO
A medical student developed a progressive mesencephalic lesion found to be cystic in nature by computed tomographic (CT) scanning. Stereotactic aspiration of a pontomesencephalic hematoma was carried out twice, and the patient recovered. Angiography and CT scanning demonstrated a vascular lesion compatible with a venous angioma.
Assuntos
Tronco Encefálico , Hemorragia Cerebral/cirurgia , Hematoma/cirurgia , Técnicas Estereotáxicas , Sucção , Adulto , Biópsia por Agulha , Hemorragia Cerebral/diagnóstico por imagem , Hematoma/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
A helpful clinical sign of ruptured cervical disc is pain relief upon arm abduction. When the disease process is spondylosis with foraminal stenosis, changing arm position does not relieve pain. Anatomical considerations are discussed.
Assuntos
Braço/inervação , Vértebras Cervicais/fisiopatologia , Deslocamento do Disco Intervertebral/fisiopatologia , Adulto , Idoso , Vértebras Cervicais/cirurgia , Feminino , Humanos , Deslocamento do Disco Intervertebral/cirurgia , Laminectomia , Masculino , Síndromes de Compressão Nervosa/fisiopatologia , Raízes Nervosas Espinhais/fisiopatologiaRESUMO
The medical literature relating to spontaneous cervical epidural hematoma has been reviewed, and two new cases have been added. In total, 43 cases have been analyzed in detail, and the authors present some new hypotheses as to the pathophysiology of this disorder.
Assuntos
Hematoma Epidural Craniano/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico por imagem , Idoso , Feminino , Hematoma Epidural Craniano/patologia , Humanos , Radiografia , Medula Espinal/irrigação sanguínea , Doenças da Medula Espinal/patologiaRESUMO
Two patients with posttraumatic osteolytic skull lesions are presented and discussed. One was operated on, and pathological examination confirmed an inflammatory reactive process within the bone lesion.
Assuntos
Traumatismos Craniocerebrais/complicações , Osteólise/etiologia , Crânio , Adolescente , Doenças Ósseas/etiologia , Criança , Feminino , Humanos , Masculino , Osteólise/diagnóstico por imagem , Osteólise/patologia , Crânio/cirurgia , Tomografia Computadorizada por Raios X , CicatrizaçãoRESUMO
Four infants underwent craniectomy for craniosynostosis and subsequently developed an expanding cranial defect with herniation of brain. All four had an unrepaired laceration of the dura. The pathophysiology of this entity and of the growing fracture of childhood are discussed, and a unified interpretation of the consequences of unrepaired dural defects is proposed.
Assuntos
Lesões Encefálicas/fisiopatologia , Encefalocele/fisiopatologia , Crânio/cirurgia , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Lesões Encefálicas/etiologia , Craniossinostoses/cirurgia , Dura-Máter/lesões , Encefalocele/etiologia , Humanos , Lactente , MasculinoRESUMO
One hundred fifty patients underwent spinal surgery for radiculopathy; of these, 120 underwent lumbar surgery and 30 had cervical operations. All of the surgeries were performed to alleviate symptoms due to disc herniation, spondylosis, or both. During the surgical procedures continuous intraoperative electromyograph recordings were taken from the muscle corresponding to the involved nerve root. In baseline recordings taken in the operating room 10 minutes before lumbar surgery, electrical discharge or firing was recorded from the muscle in 18% (22 of 120 patients) of the cases. Once the nerve was decompressed, muscle firing ceased. Electrical discharges were produced with regularity on nerve root retraction. This study concludes that continuous electromyograph monitoring can be accomplished easily and yields valuable information that indicates when the nerve root is adequately decompressed or when undue retraction is exerted on the root.
Assuntos
Eletromiografia , Monitorização Intraoperatória , Coluna Vertebral/cirurgia , Idoso , Feminino , Humanos , Deslocamento do Disco Intervertebral/complicações , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/cirurgia , Valor Preditivo dos Testes , Raízes Nervosas Espinhais , Osteofitose Vertebral/complicaçõesRESUMO
This is the report of two children who had prominent arachnoid granulations that were mistaken clinically for dermoid cysts. These lesions appeared in the midline, primarily posteriorly. During surgery, the lesions extended through the dura connected by a stalk. A pathologic examination confirmed the lesions to be arachnoid granulations.
Assuntos
Aracnoide-Máter/patologia , Cisto Dermoide/diagnóstico , Couro Cabeludo , Neoplasias Cutâneas/diagnóstico , Encefalopatias/diagnóstico , Encefalopatias/patologia , Criança , Diagnóstico Diferencial , Feminino , Humanos , LactenteRESUMO
Until 1986, the only issues in women's health which received direct attention were those related to childbearing. At that time the National Institutes of Health made inclusion of women in research a criteria for funding. Since then, the knowledge base to guide disease prevention and treatment of women has grown dramatically. Unfortunately, the incorporation of these data into clinical practice has been much slower. The purpose of this needs assessment was to establish a comprehensive data base on which future programming decisions could be based. Areas of interest identified by health care providers included stress reduction, breast health, prevention of heart disease, and osteoporosis. Other topics that emerged were menopause and reproduction issues, cancer prevention, domestic violence, substance abuse, nutrition, and weight control. These data suggest topics for future programming.
Assuntos
Pessoal de Saúde/educação , Avaliação das Necessidades/organização & administração , Equipe de Assistência ao Paciente , Saúde da Mulher , Atitude do Pessoal de Saúde , Currículo , Avaliação Educacional , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Humanos , Pesquisa em Educação em Enfermagem , Pennsylvania , Saúde da População Rural , Inquéritos e QuestionáriosAssuntos
Atitude do Pessoal de Saúde , Educação Continuada em Enfermagem/organização & administração , Avaliação das Necessidades/organização & administração , Recursos Humanos de Enfermagem/educação , Recursos Humanos de Enfermagem/psicologia , Competência Profissional/normas , Saúde da População Rural , Apoio Social , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Enfermeiros Administradores/psicologia , Pesquisa em Educação em Enfermagem , Cultura Organizacional , Pennsylvania , Inquéritos e Questionários , Fatores de Tempo , Apoio ao Desenvolvimento de Recursos Humanos , ViagemRESUMO
Transneuronal degeneration of retinal ganglion cells was directly demonstrated in a patient who had unilateral removal of the striate cortex forty years prior to necropsy. For comparison, another case is presented showing anterograde transneuronal atrophy forty years after enucleation of one eye.