• Title/Summary/Keyword: Motor weakness

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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.

Neuromyelitis Optica Mimicking Intramedullary Tumor

  • Oh, Si-Hyuck;Yoon, Kyeong-Wook;Kim, Young-Jin;Lee, Sang-Koo
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.316-319
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    • 2013
  • Neuromyelitis optica (NMO) is considered to be a rarer autoimmune disease than multiple sclerosis. It is very difficult to make a diagnosis of MNO for doctors who are not familiar with its clinical features and diagnostic criteria. We report a case of a young female patient who had been suffering motor weakness and radiating pain in both upper extremities. Cervical MRI showed tumorous lesion in spinal cord and performed surgery to remove lesion. We could not find a tumor mass in operation field and final diagnosis was NMO. NMO must be included in the differential diagnosis of lesions to rescue the patient from invasive surgical interventions. More specific diagnostic tools may be necessary for early diagnosis and proper treatment.

Acute Cervical Spinal Subdural Hematoma Not Related to Head Injury

  • Kim, Hee-Yul;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.467-469
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    • 2010
  • We report an extremely rare case of traumatic cervical spinal subdural hematoma not related to intracranial injury. There has been no report on traumatic cervical spinal subdrual hematoma not related to intracranial injury. A 27-year-old female patient was admitted to our emergency room due to severe neck pain and right arm motor weakness after car collision. On admission, she presented with complete monoplegia and hypoesthesia of right arm. Magnetic resonance imaging (MRI) revealed subdural hematoma compressing spinal cord. Lumbar cerebrospinal fluid (CSF) analysis revealed 210,000 red blood cells/$mm^3$. She was managed conservatively by administrations of steroid pulse therapy and CSF drainage. Her muscle power of right arm improved to a Grade III 16 days after admission. Follow-up MRI taken 16th days after admission revealed almost complete resolution of the hematoma. Here, the authors report a traumatic cervical spinal SDH not associated with intracranial injury.

Exacerbation of spasticity in ipsilateral shoulder after right brachial plexus block in a patient with right hemiplegia

  • Park, Sang-Jin;Baek, Jong-Yoon
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.22-25
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    • 2015
  • Spasticity is a common impairment in patients with central nervous system disease. Clinical observation has demonstrated that spasticity can be aggravated by various factors such as emotional state as well as noxious stimuli. A 51-year-old male patient was scheduled for arteriovenous fistula surgery. He had right hemiplegia including motor weakness and spasticity. It was decided that the surgery would be performed under an axillary brachial plexus block (BPB). He appeared nervous when blockade was terminated. The spasticity of the right shoulder increased after ipsilateral BPB. However, when we administered sedative drugs and performed interscalene BPB 2 days later, spasticity did not occur. Exacerbation of spasticity might be evoked by an anxious emotional state. Thus, it seems to be good to consider removing of anxiety and using an appropriate approach when it is tried to perform nerve blocks in individuals with spasticity.

Clinical Experience of Takayasu`s Arteritis (Takayasu씨 동맥염의 임상적 고찰)

  • 이계영
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1492-1496
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    • 1992
  • Takayasu`s arteritis is a nonspecific inflammatory vascular disease of unknown origin. It most often cuases stenosis of the aorta or its branch arteries with ischemic changes in the organs supplied, but the vessels inside these organs are not directly involved. From 1983 to 1991, we performed operation on 6 patients with Takayasu`s arteritis. There were 6 female patients ranging in age from 17 years to 36 years. Symptoms included headache, dizzness, visual disturbance, and motor weakness or pain of arm. In 5 cases, bypass graft arised from ascening aorta[ventral aorta] were done, and in one, stenotic segments of left subclavian and vertebral arteries were resected an graft interposition done. Follow-up has been 62.4$\pm$34.8 months[ranging from 11 to 113 months], results of each patient were exellent, except one postoperative death.

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Traumatic Cervical Spinal Cord Injury Patient with Jejunal Perforation (외상성 경부 척수 손상 환자에서 동반된 소장 천공 : 증례보고)

  • Go, Seung Je;Yoon, Jeung Seuk;Yun, Jung Ho
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.319-322
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    • 2013
  • A 66 year-old woman had cervical spinal cord injury by an automobile. We performed emergency operation for partial quadriplegia. She recovered from motor weakness gradually, but complained of abdominal distension and mild dyspnea. A physical examination of her abdomen did not have tenderness and rebound tenderness. She underwent a decubitus view of chest X-ray due to aggravated dyspnea at postoperative 4 days. We detected free air gas of abdomen and immediately identified a cause of pneumoperitoneum by abdominal computed tomography. We performed an emergent laparotomy and confirmed a jejunal perforation. After an operation, she recovered well and is under rehabilitation.

Surgical treatment of Takayasu's arteritis : Report of one case (Takayasu씨 동맥염의 수술치험 1예)

  • 조인택
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.489-493
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    • 1986
  • Takayasu`s arteritis is an arteritis of unknown etiology involving larger elastic arteries such as aorta and its branches, pulmonary arteries, and rarely coronary arteries. The late pathologic feature is vascular obstructive change and the resulting clinical manifestations are local ischemic symptoms such as syncope, visual disturbance, claudication of extremities, hypertension, and angina. the disease occurs predominantly in females, with the age of onset between 10 and 30 years. Recently we have experienced one case of Takayasu`s arteritis involving aortic arch and all its major branches. The patient was 36 year-old female and she was admitted because of headache, blurred vision, and easy fatigability and motor weakness of upper extremities. Aortogram revealed total obstruction of both carotid arteries at the site of its origin and partial irregular obstructive change in the innominate artery and both subclavian arteries. Bypass graft surgery using Gore-Tex grafts was performed with successful result.

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Transsacral Neurolytic block for the Relief of Perineal Pain (회음부 동통 완화를 위한 경천추 신경차단)

  • Choe, Huhn;Han, Young-Jin
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.177-180
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    • 1988
  • Transsacral neurolytic block with 2.5ml of phenol in glycerine or bupivacaine was performed in 6 patients with malignant diseases and a patient with sphincter spasm of bladder due to spinal cord injury. Pain relief was satisfactory in all patints except one patient with very low pain threshold. In one patient, second transsacral neurolytic block alone was not sufficient because of widespread pain along distant metastasis of the malignant disease, although the first block was satisfactory. The complications include transient motor weakness(4), voiding difficulty(1), subarachnoid puncture(1), and epidural venous puncture(1), but they were all spontaneously recovered within a sbort period of time and did not give any limitation to the block.

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Pulseless electrical activity during general anesthesia induction in patients with amyotrophic lateral sclerosis

  • You, Tae Min;Kim, Seungoh
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.3
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    • pp.235-240
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    • 2017
  • Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity and is caused by a profound cardiovascular insult (e.g., severe prolonged hypoxia or acidosis, extreme hypovolemia, or flow-restricting pulmonary embolus). Amyotrophic lateral sclerosis (ALS) is a disease that is characterized by progressive degeneration of all levels of the motor nervous system. Damage to the respiratory system and weakness of the muscles may increase the likelihood of an emergency situation occurring in patients with ALS while under general anesthesia. We report a case of PEA during the induction of general anesthesia in a patient with ALS who presented for dental treatment and discuss the causes of PEA and necessary considerations for general anesthesia in patients with ALS.

Neurologic Complication Following Spinal Epidural Anesthesia in a Patient with Spinal Intradural Extramedullary Tumor

  • Kim, Sung-Hoon;Song, Geun-Sung;Son, Dong-Wuk;Lee, Sang-Won
    • Journal of Korean Neurosurgical Society
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    • v.48 no.6
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    • pp.544-546
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    • 2010
  • Paraplegia following spinal epidural anesthesia is extremely rare. Various lesions for neurologic complications have been documented in the literature. We report a 66-year-old female who developed paraplegia after left knee surgery for osteoarthritis under spinal epidural anesthesia. In the recovery room, paraplegia and numbness below T4 vertebra was checked. A magnetic resonance image (MRI) scan showed a spinal thoracic intradural extramedullary (IDEM) tumor. After extirpation of the tumor, the motor weakness improved to the grade of 3/5. If a neurologic deficit following spinal epidural anesthesia does not resolve, a MRI should be performed without delay to accurately diagnose the cause of the deficit and optimal treatment should be rendered for the causative lesion.