• Title/Summary/Keyword: Motor deficits

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Cervical Disc Herniation as a Cause of Brown-S$\acute{e}$quard Syndrome

  • Choi, Kyeong-Bo;Lee, Choon-Dae;Chung, Dai-Jin;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.505-510
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    • 2009
  • The possible causes of Brown-S$\acute{e}$quard Syndrome (BSS) have been frequently observed with spinal trauma and extramedullary spinal tumors, but the cervical disc herniation to cause BSS is rare. The authors present five cases of patients who were diagnosed with BSS resulting from cervical disc herniation, and the results of the literature in view of their distinctive symptoms and clinical outcomes. Postoperatively, the patients showed complete or almost complete recovery from their motor and sensory deficits. On the basis of our cases, it is important to diagnose it early by cervical magnetic resonance imaging, especially in the absence of the typical symptoms of cervical disc herniation or other obvious etiology of extremity numbness. Immediate surgical treatment is also essential for a favorable functional neurological recovery.

Tactile and Proprioceptive Discriminative Sensory Dysfunction After Unilateral Stroke (뇌졸중 환자의 촉각 및 위치 식별감각 이상에 관한 연구)

  • 최스미
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.138-147
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    • 1996
  • Although sensory deficits caused by stroke have been occasionally reported, dysfunctions of discriminative sensation have seldom been studied in patients with strokes. With the use of specifically designed methods, discriminative sensations including texture discrimination and position sense were tested in 67 patients with acute unilateral stroke. Thirty-two age and sex-matched healthy subjects were used as controls. Impaired discriminative sensation was common in patients with unilateral stroke (detected in 57 out of the 67 patients) regardless of the lesion location except for patients with lateral medullary stroke. Proprioceptive discriminative sensation remained intact in all except for three out of 25 patients who were initially diagnosed as having pure motor stroke on the bases of conventional sensory tests. However, tactile discriminative sensation remained intact in only 17 out of 25 patients. Discriminative sensory disturbances are common in patients with unilateral stroke even in those with intact sensory function on routine examination. The subtle disturbances of this sensation may explain, at least in part, the clumsiness of the patients that is not readily explained by conventional neurological tests.

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A Schwannoma Originating from Median Nerve at Proximal Forearm Caused Ulnar Nerve Symptom by Compression

  • Yoo, Jeong Hyun;Kim, Joon Yub;Kim, Hyoung Soo;Kim, Joo Hak;Sung, Ki Hyuk;Song, Sang Hun;Kwak, Ho Il
    • Archives of Reconstructive Microsurgery
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    • v.23 no.2
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    • pp.86-88
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    • 2014
  • A schwannoma is a benign soft tissue tumor arising from the nerve sheath of a Schwann cell. Clinically, a schwannoma is an asymptomatic mass rarely causing neurologic deficits. However, it can cause discomfort as well as motor and sensory disturbances by compressing the nerve of its origin. The authors encountered a huge schwannoma arising from the median nerve at the proximal forearm, which caused symptoms mainly in the ulnar nerve. The tingling sensation along the ulnar nerve disappeared completely after enucleation of the schwannoma originating from the median nerve.

A Case Report of "Spinal Cord Apoplexy" Elicited by Metastatic Intramedullary Thyroid Carcinoma

  • Choi, In-Jae;Chang, Jae-Chil;Kim, Dong-Won;Choi, Gun
    • Journal of Korean Neurosurgical Society
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    • v.51 no.4
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    • pp.230-232
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    • 2012
  • A 31-year-old man presented with acute onset of paraplegia. The patient's history was significant for thyroid carcinoma that had been treated 2 years earlier by thyroidectomy. A magnetic resonance imaging scan showed an enhancing intramedullary lesion at T7-8. Patient underwent surgical treatment and a tumor with hematoma was resected via posterior midline myelotomy. Postoperatively, the patient's motor weakness was improved to grade 3. The lesion showed typical histologic features consistent with papillary thyroid carcinoma. Early diagnosis and microsurgical resection can result in improvement in neurological deficits and quality of life of patients with an ISCM.

Severe Symptomatic Vasospasm following Intraventricular Hemorrhage from Arteriovenous Fistula

  • Park, Beom-Seok;Won, Yu-Sam;Choi, Chun-Sik;Kim, Byung-Moom
    • Journal of Korean Neurosurgical Society
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    • v.45 no.5
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    • pp.300-302
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    • 2009
  • The authors present a rare case of severe vasospasm following the rupture of arteriovenous fistula. On initial CT scan, hematoma in the corpus callosum and left inferior frontal region with surrounding cerebromalacia and all ventricles without apparent subarachnoid hemorrhage were seen. Angiograms showed arterivenous fistula but did not show cerebral vasospasm. Thirteen days after admission the neurological state of patient suddenly deteriorated and bilateral motor weaknesses developed. Following angiograms revealed severe narrowing on the supraclinoid portion of bilateral internal carotid arteries, bilateral anterior cerebral arteries and bilateral middle cerebral arteries. Transluminal angioplasty and intra-arterial papaverine infusion were performed. The patient remained stable with moderate neurologic deficits.

Likely pathogenic FIG4 related amyotrophic lateral sclerosis patient who correlated with clinical, imaging and neuropsychological studies

  • Ko, Pan-Woo;Min, Yu-Sun;Park, Jin-Sung
    • Annals of Clinical Neurophysiology
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    • v.22 no.1
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    • pp.33-36
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    • 2020
  • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with numerous causes that include genetic factors. Efforts to reveal the genetics of ALS have identified several candidate genes that are associated with familial and sporadic ALS. Here we report a Korean ALS patient who showed prominent upper motor-neuron-related symptoms with marked brain atrophy and neuropsychological deficits. The findings were highly suggestive of ALS in a patient with a likely pathogenic FIG4 variant.

Lateral Laminectomy in Thoracolumbar Disc Herniated Dogs (흉요추 추간원반탈출증 권에서의 편측 추궁절제술)

  • 엄기동;윤정회
    • Journal of Veterinary Clinics
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    • v.15 no.2
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    • pp.255-262
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    • 1998
  • Lateral laminectomy was performed far spinal decompression in 7 thoracolumbar disc herniated dogs. These dogs showed upper motor neurologic signs including kyphosisi urinary dysfunction, and paraplegia or paralysis in hindlimbs. The lesions were evaluated with myelographic findings and predominated in $T_{12}-T_{13}, T_{13}-L_{1} and L_{1}-L_{2}$ discs. Five dogs which were operated within 48 hours after the onset of paraplegia were recovered from kyphosis and sustained the normal gait and walkings furthermore normal urination and defecation were presented within 3 days of postoperation. One dog was expired with steroid induced intestinal bleeding. The other dog operated on 96 hours after the onset of paraplegia was not recovered from neurologic deficits. Spinal decompression technique was considered to be useful method fur improving neurological problems resulted firom thoracolumbar disc herniation, if dogs are operated on early stage of the onset of paraplegia.

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Optic neuritis and multiple cranial neuropathies in patient with chronic inflammatory demyelinating polyneuropathy

  • Bae, Min-Jeong;Lee, Joonwon;Eun, Jeong Ik;Shin, Kyong Jin
    • Annals of Clinical Neurophysiology
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    • v.24 no.2
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    • pp.59-62
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    • 2022
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic recurrent acquired immune-mediated disease of the peripheral nerves that presents with progressive sensory and motor deficits in all four limbs. Cranial nerve involvement is not as common as in Guillain-Barre syndrome, and central nervous system involvement including optic neuritis has rarely been reported in patients with CIDP. We recently experienced a case with classic CIDP involving bilateral facial and trigeminal nerves, right lower cranial nerves, and the right optic nerve.

Radiological assessment and follow-up of a nonsurgically treated odontoid process fracture after a motor vehicle accident in Egypt: a case report

  • Ahmad Mokhtar Abodahab
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.411-415
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    • 2023
  • An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

Retroperitoneal Extrapleural Approach for Corpectomy of the First Lumbar Vertebra : Technique and Outcome

  • Zidan, Ihab;Khedr, Wael;Fayed, Ahmed Abdelaziz;Farhoud, Ahmed
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.61-70
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    • 2019
  • Objective : Corpectomy of the first lumbar vertebra (L1) for the management of different L1 pathologies can be performed using either an anterior or posterior approach. The aim of this study was to evaluate the usefulness of a retroperitoneal extrapleural approach through the twelfth rib for performing L1 corpectomy. Methods : Thirty consecutive patients underwent L1 corpectomy between 2010 and 2016. The retroperitoneal extrapleural approach through the 12th rib was used in all cases to perform single-stage anterior L1 corpectomy, reconstruction and anterior instrumentation, except for in two recurrent cases in which posterior fixation was added. Visual analogue scale (VAS) was used for pain intensity measurement and ASIA impairment scale for neurological assessment. The mean follow-up period was 14.5 months. Results : The sample included 18 males and 12 females, and the mean age was 40.3 years. Twenty patients (67%) had sensory or motor deficits before the surgery. The pathologies encountered included traumatic fracture in 12 cases, osteoporotic fracture in four cases, tumor in eight cases and spinal infection in the remaining six cases. The surgeries were performed from the left side, except in two cases. There was significant improvement of back pain and radicular pain as recorded by VAS. One patient exhibited postoperative neurological deterioration due to bone graft dislodgement. All patients with deficits at least partially improved after the surgery. During the follow-up, no hardware failures or losses of correction were detected. Conclusion : The retroperitoneal extrapleural approach through the 12th rib is a feasible approach for L1 corpectomy that can combine adequate decompression of the dural sac with effective biomechanical restoration of the compromised anterior loadbearing column. It is associated with less pulmonary complication, no need for chest tube, no abdominal distention and rapid recovery compared with other approaches.