• Title/Summary/Keyword: Neurologic Complications

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First Results of the Single Heartstring Aortotomy for Multiple Off-Pump Vein Grafts: A Case Series

  • Santos, Rafael Freire dos;Niclauss, Lars
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.403-407
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    • 2020
  • To validate the technique of the single Heartstring aortotomy for multiple off-pump venous bypass grafts (described in 2015), the results of a 38-month follow-up study of 18 patients, including high-risk patients, are presented. No early deaths or cardiac or cerebral complications occurred. During the follow-up period, 2 patients died of non-cardiac causes, and 3 developed coronary ischemia. Ischemia occurred due to late graft occlusion in 2 patients, both of whom had normal postoperative courses and correct graft flow. The presence of acute symptoms 24 months after surgery in these patients indicated that technical graft failure was unlikely. This safe technique combines the advantages of simple and reproducible revascularization, the off-pump approach, and minimal aortic manipulation.

Spinal Epidural Hematoma Occuring after Bloody Tap during Epidural Catheter for Cancer Pain Control -A case report- (암성통증치료를 위한 경막외카테테르 거치술중 혈성천자로 발생한 경막외혈종 -증례 보고-)

  • Woo, Sung-Chang;Cha, Dong-Suk;Kang, Keon;Kim, Young-Ki
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.160-164
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    • 1998
  • We report a case of epidural hematoma occuring after bloody tap during epi-dural catheter for cancer pain control in thrombocytopenic patient. Two hours after epidurl puncture, patient experienced severe back pain and numbness of both legs. Following day, patient complained of motor paralysis and urinary difficulty. Diagnosis utilizing magnetic reasonance imaging, showed epidural hematoma extending from $T_{11}$ to $T_{12}$. Thrombocytopenia prevented surgical intervention. Therefore we restored conservative therapy with packed red cell, platelet concentration, steroid and hemostatic, which provided complete neurologic recovery, spontaneously over several days without surgical intervention.

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Paradoxical Transtentorial Herniation Caused by Lumbar Puncture after Decompressive Craniectomy

  • Jung, Heyun-Jin;Kim, Dong-Min;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.51 no.2
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    • pp.102-104
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    • 2012
  • Although decompressive craniectomy is an effective treatment for various situations of increased intracranial pressure, it may be accompanied by several complications. Paradoxical herniation is known as a rare complication of lumbar puncture in patients with decompressive craniectomy. A 38-year-old man underwent decompressive craniectomy for severe brain swelling. He remained neurologically stable for five weeks, but then showed mental deterioration right after a lumbar puncture which was performed to rule out meningitis. A brain computed tomographic scan revealed a marked midline shift. The patient responded to the Trendelenburg position and intravenous fluids, and he achieved full neurologic recovery after successive cranioplasty. The authors discuss the possible mechanism of this rare case with a review of the literature.

Superior Hypogastric Plexus Blocks for Malignant Pelvic Pain (상 하복신경총 차단을 이용한 골반내 통증관리)

  • Kang, Sung-Hee
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.108-112
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    • 1992
  • Pain from pelvic cancer is very difficult to manage because it's vague ness and bilateral nature. Furthermore, nerve blocks in this area are dangerous because sensory afferent nerves from pelvic viscera are adjacent to nerves that regulate bowel and bladder control, and motor nerve of lower extremities'. Bilateral lumbar sympathectomy has been used for malignant pelvic pain with little risk of neurologic complication. However it is not a specific block for pelvic visceral pain, because the lumbar sympathetic chain does not innervate pelvic viscera in a direct manner. Therefore the potentials of lumbar sympathectomy for pelvic visceral pain are attributed to caudad diffusion of neurolytic agents to the smperior hypogastric plexus. I have experienced 3 cases of superior hypogastric plexus neurolysis per se without any significant complications.

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Ventricular Arrhythmia Following Aconitine-Ingestion - 2 Case Reports - (초오 성분이 포함된 화풍단 복용 후 발생한 심실 부정맥 2례)

  • Kim, Mi-Ran
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.2
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    • pp.180-186
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    • 2006
  • The various species of aconitum contain diterpene (C-20) and norditerpene (C-19) forms of the natural alkaloid aconitine that cause neurologic, gastrointestinal, cardiovascular symptoms. In chinese medicine, these plants has been used as drugs to treat pain, dyspepsia, cerebrovascular disease, and so on. Because the therapeutic window is narrow, poisoning may occur from unintentional exposure, with a variety of toxic effects such as arrhythmia, hypotension, paresthesia, paralysis, nausea, vomiting, and abdominal pain. Aconitine-containing folk remedies are widely used in Korea. We encountered two cases of ventricular arrhythmia in patients who ingested tablets, known as 'Wha-Pung-Dan' made with aconitine extracts and were subsequently admitted to the ED. A 42 year-old man who took 35 tablets presented with ventricualr tarchycardia, and 40 year-old woman who took 40 tablets showed premature ventricular contractions. Both patients were discharged normally without any complications after three days.

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Acute Type 1 Aortic Dissection Involving Right Coronary Artery (우관상동맥 침범한 급성 대동맥 박리증 치험 1례)

  • Min, Gyeong-Seok;Lee, Jae-Won;Song, Myeong-Geun
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.188-192
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    • 1995
  • A 50 year old man with acute aortic dissection DeBakey type I, involving right coronary artery and aortic valve, underwent replacement of the ascending aorta and aorto-right coronary bypass grafting. The operative findings showed a large transverse intimal tear was at about 4cm above the aortic valve. The dissection extended out into the proximal right coronary artery. And we found that the right coronary artery originated from the left sinus of Valsalva, run transversally in the aortic wall, with partial rupture. Postoperatively he had no ischemic cardiac symptoms and neurologic complications. He was discharged on postoperative 9th day with good result.

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Epilepsy Surgery of the Cerebral Paragonimiasis

  • Lee, Woo-Jong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.39 no.2
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    • pp.114-119
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    • 2006
  • Objective : The authors investigate appropriate evaluation and surgical methods in treatment of the cerebral paragonimiasis accompanying epilepsy. Methods : Thirteen patients with the cerebral paragonimiasis accompanying epilepsy were included for this study. Preoperative evaluation methods included history taking, skin and serologic tests for Paragonimus westermani, neurologic examinations, computerized tomography, magnetic resonance imaging, amytal test, PET or SPECT, and video-EEG monitoring with depth and subdural grid electrodes. Seizure outcome was evaluated according to Engel's classification. Results : Surgical methods were temporal lobectomy including lesions in six, lesionectomy in five, and temporal lobectomy plus lesionectomy in two. Postoperative neurological complications were not noticed, and seizure outcomes were class I in 12 patients [92%], class II in one [8%]. Conclusion : In patients with a cerebral paragonimiasis accompanying epilepsy, further evaluation methods must be done to define the epileptogenic zone, and complete resection of the epileptogenic zone with different surgical methods should be performed for seizure control.

A Case of Neonate with benign Convulsion without Gastrointestinal Manifestations is Associated with Rotavirus Infection (위장관 증상이 없는 로타바이러스 감염에 동반된 신생아 경련 1례)

  • Kim, Young Jin;So, Kyoung Jin;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.198-201
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    • 2004
  • Rotavirus is a most common etiologic viral agent of pediatric gastroenteritis. Most newborns infected by rotavirus show no specific symptoms, yet, some of neonates can develop serious complications such as intestinal perforation, necrotizing enterocolitis or even death. And rotavirus infection may cause only neurologic manifestation such as seizure without gastrointestinal manifestations in some neonates. We experienced a case of neonatal rotavirus infection with benign convulsion without gastrointestinal manifestations, and report this case with literature review as followings.

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Guillain-barré Syndrome after Multiple Bee Stings (다발성 벌 자상에 의한 길랑 바레 증후군 1례)

  • Jin, Sang-Chan
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.1
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    • pp.57-59
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    • 2018
  • Severe systemic responses including neurologic complications such as myasthenia gravis, myeloradiculopathy, optic neuropathy, parkinsonism, stroke and Guillain-$barr{\acute{e}}$ syndrome can occur after bee stings. This case describes a 78-year-old female who presented with symptoms of acute progressive bilateral symmetrical weakness in both lower legs after multiple bee stings. Nerve conduction study findings were consistent with acute sensorimotor axonal neuropathy and recovered by treatment with intravenous immunoglobulin. This case highlights that bee stings can result in acute onset Guillain-$barr{\acute{e}}$ syndrome, although the pathophysiologies of bee venoms need to be investigated accurately.

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report

  • Paramaswamy, Rathna
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.3
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    • pp.183-187
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    • 2018
  • Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening. Airway management was performed by an awake fiber-optic nasotracheal intubation, where neck movement was avoided with a cervical collar. Vertebral artery injuries may have disastrous consequences, such as basilar territory infarction and death, and should be suspected in patients with head and neck trauma. After mandibular plating, the patient was on cervical collar immobilization for 12 weeks and anti-coagulant therapy.