• Title/Summary/Keyword: 압박 신경병증

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Ultrasonographic Examination of Compression Neuropathy in the Upper Extremity (상지의 압박성 신경병증의 초음파 검사)

  • Chung, Yang-Guk;Kim, Bae-Gyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.64-72
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    • 2008
  • Compression neuropathy around elbow and wrist are one of the common disturbing problems in the upper extremity. The understanding of normal nerve architectures and pathophysiologic changes in compression neuropathy is important to interpret the ultrasonographic images correctly. Compression neuropathies have characteristic ultrasonographic imaging features of flattened nerve at compression and hypoechoic swollen nerve with loss of fascicular patterns at proximal segments. Dynamic ultrasonographic imagings on motion can show dymanic subluxation of ulnar nerve and medial head of triceps muscle over the medial epicondyle in snapping triceps syndrome. Dynamic compression of median nerve also can be visualized in pronator teres syndrome by dynamic imaging studies. A quantitative measures of cross sectional area or compression ratio can be helpful to diagnose compression neuropathies, such as carpal tunnel syndrome or cubital tunnel syndrome. With the clinical features and electeophysiologic studies, the untrasonographic imagings are useful tool for evaluation of the compression neuropathies in the upper extremities.

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Compressive Neuropathy in Upper Extremity (상지의 압박 신경병증)

  • Park, Jong Woong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.2 no.2
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    • pp.99-106
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    • 2009
  • Compressive neuropathy in the upper extremity can be clinically diagnosed by careful history taking, physical examination of the involved nerve. Electrodiagnosis for the suspected nerve informs severity of compression of the involved nerve and indicates specific site of the lesion. In the early stage of the disease, non-operative treatment generally cures the symptom, however, if the conservative treatment fails, confirmation of the exact site of the lesion should be preceded before the operation. Recently, ultrasonography, as a supportive tool for the diagnosis of compressive neuropathy has increasing popularity for its ability to find space occupying lesion, anatomical change of the nerve, and the pathologic change in the nerve itself. For the successful treatment of the compressive neuropathy, these various diagnostic tools have to be introduced in the orthopaedic clinic.

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Compression Neuropathy (압박성 신경병증)

  • Kim, Byung-Sung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.128-133
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    • 2008
  • Nerve compression is caused by external force or internal pathology, which symptom develops along nerve distribution. There are median, ulnar and radial nerve compression neuropathies below elbow. Carpal tunnel syndrome at the flexor retinaculum is most common among all the entrapment neuropathies. Other causes of median nerve neuropathy include Struther's ligament, biceps aponeurosis, pronator teres, FDS aponeurosis and aberrant muscles, which induce pronator syndrome or anterior interosseous nerve syndrome. Ulnar nerve can be compressed at the elbow by arcade of Struther, medial epicondylar groove, FCU two heads, which develops cubital tunnel syndrome, at the wrist by ganglion, fracture of hamate hook and vascular problem, which develops Guyon's canal syndrome. Radial tunnel syndrome is caused by supinator muscle, which compresses its deep branch. Treatment is conservative at initial stage like NSAID, night splint or steroid injection. If symptom persists, operative treatment should be considered after electrodiagnostic or imaging studies.

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Correlation between Neurodynamic Tests for Patients with Sciatic Radiculopathy (볼기신경 뿌리병증 환자에 대한 신경동역학적 검사간의 상관관계)

  • Kim, Seung-Joon
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.4
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    • pp.415-424
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    • 2011
  • 연구목적 : 본 연구는 볼기신경 뿌리병증 환자에 대하여 역학적 스트레스인 압박과 긴장을 가하여 환자의 증상을 나타내 신경동역학적 검사간의 상관관계를 수행하였다. 연구방법 : 신경동역학검사인 하지직거상검사, 수정된 활시위검사, 슬럼프검사에 앞서 방사선과 전문의에 의해 자기공명영상 판독을 실시하여 허리원반 이탈로 진단받은 다리쪽으로 방사통을 호소하는 21명의 환자가 참여 하였다. 수집된 자료는 질적변수에 따른 빈도와 비율은 교차분석표로 작성하였고, 신경동역학적 검사간의 상관관계를 검정하기 위해 피어슨의 카이스퀘어(Pearson's chi-square)을 시행하였다. 연구결과 : 허리 자기공명영상 결과, 증상에 대한 두 검사 간 교차표를 작성하여 하지직거상검사와 수정된 활 시위검사, 하지직거상검사와 슬럼프검사는 유의한 상관관계는 없었지만(p>.05) 수정된 활시위검사와 슬럼프검사는 통계적으로 유의한 상관관계(p<.05)가 제시되었다. 결론 : 볼기신경 뿌리병증 환자에 대한 신경동역학검사인 수정된 활시위검사와 슬럼프검사가 통계적으로 유의한 상관관계를 나타내는 증거를 제공하였다. 신경동역학 검사는 신경계에 역학적 스트레스 즉, 긴장, 활주, 또는 압박 자극을 주어 신경기능이상 환자에 대해 적절한 검사를 제시하였다.

Clinical Outcomes of the Surgical Excision of the Ganglion Cyst Causing Compressive Neuropathy - A Review of Twelve Collected Cases - (압박 신경병증을 일으킨 결절종의 수술적 절제의 임상적 결과)

  • Jung, Sung-Taek;Cho, Seong-Beom;Moon, Eun-Sun;Lee, Jae-Joon;Kim, Ki-Hyeoung;Yang, Hyun-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.63-70
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    • 2006
  • Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

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Lateral plantar nerve entrapment combined with a chronic plantar fasciitis in a basketball player -A case report- (농구선수에서 발생한 만성 족저근막염이 동반된 외측 족저 신경 압박증 -증례 보고-)

  • Lee, Kyung-Tai;Kim, Jun-Beom;Young, Ki-Won;Kim, Jin-Su;Park, Young-Uk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.2
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    • pp.121-124
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    • 2010
  • In athletes, repetitive low-energy impacts in plantar lesion lead often to tendinitis, stress fracture, or overuse syndrome. The major cause of heel pain in athletes is plantar fasciitis. And it is most often attributable to repetitive low energy impact, but the vast majority patients with heel pain achieve symptomatic relief with conservative treatment and return to full activities. Not commonly, Nerve entrapment may be occurred from repetitive low energy trauma in athletes, and is not as easily diagnosed. The authors observed a basketball player who complained of chronic heel pain that do not respond to conservative treatment, he had the lesions both plantar fasciitis and lateral plantar nerve entrapment. The authors described an unusual mechanism of entrapment of the lateral plantar nerve combined with a chronic plantar fasciitis in a basketball player and reported with review of literature.

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Review of Diabetic Neuropathy (당뇨병성 신경병증에 대한 고찰)

  • Bae Sung-Soo;Baek Su-Jeong;Kim Jong-Youl
    • The Journal of Korean Physical Therapy
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    • v.11 no.3
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    • pp.151-158
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    • 1999
  • Neuropathy is a common and often debilitating complication of diabetes, Diabetic peripheral neuropathy(DN) includes a variety of different disorders that affect the peripheral nervous system. The most common type of DN is the predominantly sensory distal polyneuropathy. Typically, symptoms begin in the foot and proximally during the course of the discease, reflecting the fact that longer fibres are involved earlier that shorter ones. Reviewed the pathogenesis, the diagnosis of DN, the gait pattern and the excercise, the treatment of pain in DN patient.

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Treatment of Cervical Perineural Cyst by the Transforaminal Epidural Steroid Injection (경추간공 경막외 스테로이드 주사를 통한 경추부 신경초 낭종의 치료)

  • Hwang, Jae-Kwang;Choi, Shin Woo;Kim, Chung-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.183-187
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    • 2020
  • Perineural cysts are usually discovered incidentally; only approximately one percent of such cysts are symptomatic. Symptomatic cervical perineural cysts, of which only five case reports have been found in the literature, are extremely rare and there is no consensus regarding treatment. When a cervical perineural cyst is discovered in a patient with cervical radiculopathy without the cause of other apparent compression, the cyst can be considered as a possible cause of cervical radiculopathy. In such cases, non-surgical conservative treatment can be considered before any surgical intervention. We reported the successful treatment of case of a 40-year-old woman with a symptomatic cervical perineural cyst by oral steroids and transforaminal epidural steroid injection.

Microscopic Decompression of Digital Nerve Surrounded by Hemangioma: A Case Report (미세수술을 통하여 수지신경을 압박하는 혈관종을 성공적으로 제거한 증례 보고)

  • Ko, Jun Gul;Kim, Jun Hyeok;Rha, Eun Young;Lee, Jun Yong;Yoo, Gyeol;Baek, Sang Oon
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.301-305
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    • 2018
  • Hemangiomas are benign neoplasms of endothelial cells origin, rarely found in hand region. Authors report a 62-year-old female with capillary hemangioma of right index finger causing a neuropathic symptom via nerve compression. A space-occupying vascular lesion surrounding the radial digital nerve was revealed in magnetic resonance imaging (MRI), which was removed under microscopic assist. The digital nerve was decompressed consequently. The mass was firmly attached to both the digital nerve and digital artery, requiring a meticulous microscopic dissection to preserve the nerve and artery. Compression neuropathy caused by space-occupying lesions is rare and its diagnosis is often difficult. A microscopic surgical approach can be used to successfully relieve neuropathic pain after proper diagnosis established by diagnostic tools such as MRI as in this case.

Carpal Tunnel Syndrome with Recurrent Motor Branch Entrapment: A Case Report (수근관 증후군에 동반된 운동 반회 신경 가지의 포착: 증례보고)

  • Kwon, Young Woo;Choi, In Cheul;Kwon, Hee-Kyu;Park, Jong Woong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.267-270
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    • 2018
  • Recurrent motor branch entrapment syndrome is a compressive mononeuropathy of recurrent motor branch of median nerve. It is a rare condition as a cause of thenar muscle wasting and may have different pathogenesis. If such an anatomical variation is the cause, there is a possibility that thenar muscle atrophy remains if only the transcarpal ligament release is performed. We report a 25-year-old male patient with carpal tunnel syndrome with thenar muscle wasting 1 month ago.