RESUMEN
Sixty-six patients with ulnar nerve entrapment at the elbow underwent neurolysis and the application of a Silastic envelope in an attempt to prevent postoperative scarring and recurrence of symptoms. All patients were evaluated pre- and postoperatively using a numerical scoring system that included clinical, motor, and sensory evaluation as well as nerve conduction studies. The Silastic material was well tolerated in the 70 cases. The overall 66% score improvement was more closely related to clinical relief (64%) than to improvement in motor conduction velocities (45%). Our 10-year experience indicates that ulnar neurolysis with Silastic envelope interposition is a safe surgical method of treatment for ulnar nerve entrapment at the elbow.
Asunto(s)
Síndromes de Compresión Nerviosa/cirugía , Nervio Cubital/cirugía , Adulto , Anciano , Codo/cirugía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Síndromes de Compresión Nerviosa/fisiopatología , Conducción Nerviosa , Complicaciones Posoperatorias/prevención & control , Recurrencia , Estudios Retrospectivos , Elastómeros de SiliconaRESUMEN
A case is reported in which a chronic subdural hematoma caused recurrent episodes of neurologic dysfunction that simulated transient ischemic attacks. Possible pathophysiological mechanisms are: a subdural hematoma could cause local ischemia or focal epileptic discharges; a cerebral mass could cause cortical depression by mechanical stimulation; regional cerebral edema could cause vascular displacement and ischemia; or small repeated hemorrhages could cause transient neurologic deficits. Computer assisted tomography of the head is recommended in the differentiation of the two conditions.