Rare surgical procedures for proximal nerve lesions - a case report.

Peripheral nerve injury can result in serious problems with a severe functional deficit. Solutions of individual cases vary and proper management based on the physician's sound professional experience is fundamental. In case of motor nerve lesions, time is the crucial factor due to the ongoing deterioration of motor end plates. Distal nerve transfers are procedures leading to the reduction of distance between the point of injury and the denervated muscles. The authors describe the case of a young boy with proximal ulnar nerve injury to present the method. Key words: ulnar nerve - nerve transfer - nerve injury.

[Cerebral salt wasting syndrome (CSWS) - rare case from a surgical department]. / Cerebral salt wasting syndrom (CSWS) - nezvyklá kazuistika z chirurgického pracoviste

INTRODUCTION: Cerebral salt wasting syndrome (CSWS) is one of several possible causes of the development of hyponatraemia in patients with severe cranial trauma associated with intracranial bleeding and brain oedema. Other possible causes of post-traumatic hyponatraemia include the syndrome of inappropriate antidiuretic hormone secretion (SIADH). CASE HISTORY: The authors present the case of a twenty-five-year-old polytraumatized female patient who was treated in our department and who was diagnosed with cerebral salt wasting syndrome. CONCLUSION: In patients with severe cranial trauma and subsequent hyponatraemia, CSWS should be considered. It is crucial to distinguish between CSWS and SIADH as wrongly selected treatment can have serious or even fatal impacts for a gravely injured patient.

[Carotid microendarterectomy]. / Karotická mikroendarterektomie.

Atherosclerosis of the internal carotid artery with resulting stenosis, threatens the patients by cerebral ischaemia. Patients with high-grade stenosis, who have a high risk of stroke, gain profit from the surgery. The surgeon's decision is based on the clinical picture and on the degree of stenosis. The degree of the stenosis indicated for surgery was determined by international multicentric randomized studies and such indication represents the evidence-based medicine. Carotid microendarterectomy is performed at neurosurgical departments. The microsurgical technique enables perfect endarterectomy, eliminates patching and reduces risk of embolisation and vessel dissection. Cerebral ischaemia is a complex problem and carotid microendarterectomy is a part of the complex management of stroke.