RESUMO
COVID-19 pandemic has led to a change in the way we manage acute medical illnesses. This pandemic had a negative impact on stroke care worldwide. The World Stroke Organization (WSO) has raised concerns due to the lack of available care and compromised acute stroke services globally. The numbers of thrombolysis and thrombectomy therapies are declining. As well as, the rates and door-to treatment times for thrombolysis and thrombectomy therapies are increasing. The stroke units are being reallocated to serve COVID-19 patients, and stroke teams are being redeployed to COVID-19 centers. Covid 19 confirmed cases and deaths are rising day by day. This pandemic clearly threatened and threatening all stroke care achievements regionally. Managing stroke patients during this pandemic is even more challenging at our region. The Middle East and North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) is the main stroke organization regionally. MENA-SINO urges the need to developing new strategies and recommendations for stroke care during this pandemic. This will require multiple channels of interventions and create a protective code stroke with fast triaging path. Developing and expanding the tele-stroke programs are urgently required. There is an urgent need for enhancing collaboration and cooperation between stroke expertise regionally and internationally. Integrating such measures will inevitably lead to an improvement and upgrading of the services to a satisfactory level.
Assuntos
Infecções por Coronavirus/terapia , Prestação Integrada de Cuidados de Saúde/normas , Pneumonia Viral/terapia , Acidente Vascular Cerebral/terapia , Trombectomia/normas , Terapia Trombolítica/normas , África do Norte/epidemiologia , COVID-19 , Consenso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Oriente Médio/epidemiologia , Pandemias , Segurança do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Padrões de Prática Médica/normas , Distância Psicológica , Quarentena , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Telemedicina/normas , Fatores de Tempo , Resultado do Tratamento , Triagem/normasRESUMO
Neck pain from cervical spinal disease is a common problem with significant disability, and chiropractic manipulation has emerged as one of the leading forms of alternative treatment for such spinal symptoms. However, more experience with these forms of treatment has revealed associated complications that are far from benign. Complications range from mild symptoms, such as local neck tenderness or stiffness, to more severe injuries involving the spinal cord, peripheral nerve roots, and arteries within the neck. Phrenic nerve injury causing diaphragmatic palsy is a rare complication of cervical chiropractic manipulation. We report a case of bilateral diaphragmatic paralysis in a healthy gentleman who underwent cervical manipulation. Physicians must be aware of this complication and should be cautious when recommending spinal manipulation for the treatment of neck pain, especially in the presence of preexisting degenerative disease of the cervical spine.