• Title/Summary/Keyword: Neurologic deficits

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A case of Discospondylitis in a Dog (개에서 Discospondylitis의 진단과 치료 일례)

  • 김주민;송상범;황철용;윤정희;윤화영;한홍율
    • Journal of Veterinary Clinics
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    • v.19 no.4
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    • pp.436-439
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    • 2002
  • Discospondylitis is an infection of an intervertebral disk with concurrent osteomyelitis of contiguous vertebrae. Clinical signs are variable and include pain, fever, anorexia, weight loss, depression, stilted gait and paresis or paralysis. A seven-year-old, intact female Yurkshire terrier dog was refered to the Vfterinary Medicine Teaching Hospital of Seoul National University because of intermitent pain of unknown cause for 2 weeks. On physical examination, pain was evident when spines were manipulated, especially thoracolumbar junction part. No neurologic deficits were deteced in the general neurologic test. Spinal radiography demonstrated the bony lysis of the vertebral end plates and sclerosis of the $T_{12-13}$ vertebral body. Based on the results of examinations, the dog was diagnosed as discospondylitis and recoverd following antibiotic therapy.

The Effect of Conservative Therapy on Thoracolumbar Intervertebral Disc Disease on 15 dogs (소형견 15예의 흉요추추간판질환에 대한 보존치료)

  • 한현정;정순욱;김준영;정만복;김지선
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.52-58
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    • 2003
  • Fifteen dogs with clinical signs of paraparesis, paraplegia and urinary dysfunction were referred to Veterinary Medical leaching Hospital, College of Veterinary Medicine, Konkuk University. According to physical and neurologic examination, survey radiograph and myelography, these patients were diagnosed as thoracolumbar intervertebral disc disease. All of them were treated with medical (prednisolone or carprofen, antibiotics), acupuncture (Ji Zhong, Bai Hui, Zhong Shu, Pang Guang Shu, Zu San Li, Huan Tiao) and physical therapy (hydrotherapy, thermotherapy, massage, manipulation, swimming). Of twelve patients were recovered of neurologic deficits within 21 days after the onset of treatment. However, three dogs were not resolved, which were found to have other spinal cord disease concomitantly. All of patients showed normal urination after treatment. Until 21 months after treatment, there were no recurrence in twelve patients. This study indicated that the conservative therapy could be effectively managed in paraparesis or paraplegia and urinary dysfunction which caused by intervertebral disc disease.

Diamox-enhanced Brain SPECT in Cerebrovascular Diseases (뇌혈관질환에서 다이아목스부하 뇌 단일광자방출 전산화단층촬영)

  • Choi, Yun-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.85-90
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    • 2007
  • Acute event in cerebrovascular disease is the second most common cause of death in Korea following cancer, and it can also cause serious neurologic deficits. Understanding of perfusion status is important for clinical applications in management of patients with cerebrovascular diseases, and then the attacks of ischemic neurologic symptoms and the risk of acute events can be reduced. Therefore, the normal vascular anatomy of brain, various clinical applications of acetazolamide-enhanced brain perfusion SPECT, including meaning and role of assessment of vascular reserve in carotid stenosis before procedure, in pediatric Moyamoya disease before and after operation, in prediction of development of hyperperfusion syndrome before procedure, and in prediction of vasospasm and of prognosis in subarachnoid hemorrahge were reviewed in this paper.

Intradural Lumbar Disc Herniation

  • Lee, Hui-Keun;Hong, Soon-Ki;Whang, Kum;Kim, Hun-Ju
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.314-316
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    • 2006
  • Intradural lumbar disc herniation[ILDH] is a rare pathology. The pathogenesis of ILDH is not known with certainty. Adhesions between the ventral wall of the dura and the posterior longitudinal ligament[PLL] could act as a preconditioning factor. Diagnosis of ILDH is difficult and seldom suspected preoperatively. Prompt surgery is necessary because the neurologic prognosis appears to be closely related to preoperative duration of neurologic symptoms. Despite preoperatively significant neurological deficits, the prognosis following surgery is relatively good. We report on case of ILDH at L3/4 with differential diagnoses, and the possible pathogenic factors are discussed.

A Case Report of Large Schwannoma Arising in Sciatic Nerve (좌골신경에서 발생한 거대 신경초종의 치험례)

  • Park, Ji Hun;Yang, Ho Jik;Kim, Jong Hwan;Jeong, Tae Kwang;Lee, Hye Kyung
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.799-802
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    • 2009
  • Purpose: Schwannoma is one of common neoplasm in the central and peripheral nervous systems. However, schwannoma of sciatic nerve is rare, especially large schwannoma arising in sciatic nerve is extremely rare. This is a report of our experience with large schwannoma arising in sciatic nerve with minimal neurologic symptoms. Methods: A 65 - year - old man presented with palpable mass in middle portion of posterior thigh. No definitive neurologic deficits were detected on physical examinations. CT and sonography showed well - defined mass with large dimension. The mass was excised and confirmed histologically as a schwannoma. In postoperative period, NCS and EMG were followed. Results: The patient complained of difficulty in dorsiflexion of ipsilateral ankle joint postoperatively. NCS and EMG obtained immediately and showed sciatic neuropathy. After 2 months postoperatively, NCS and EMG were followed and abnormal findings of previous NCS and EMG were not found. Dorsiflexion of ankle joint was improved to normal range of motion. Conclusion: We report a rare case of large schwannoma arising in sciatic nerve with no definitive neurologic symptoms.

Clinical Experience and Management of Cervico-Thoracic Epidural Hematoma

  • Ahn, Sang-Soak;Song, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.381-384
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    • 2010
  • Spinal epidural hematoma (SEH) causing acute myelopathy is rare. The usual clinical presentation of a SEH is sudden severe neck or back pain that progresses toward paraparesis or quadriparesis, depending on the level of the lesion. Recent studies have shown that early decompressive surgery is very important for patient's recovery. We experienced five patients of cervico-thoracic epidural hematomas associated with neurologic deficits that were treated successfully with surgical intervention.

Missed Detection of an Occipito-atlanto-axial Instability: A Case Report (초기 발견에 실패한 후두-환추-축추 불안전성 환자: 증례보고)

  • Lee, Shih-Min;Yoon, Kyeong-Wook
    • Journal of Trauma and Injury
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    • v.27 no.1
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    • pp.1-4
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    • 2014
  • Occipito-atlanto-axial subluxation is a type of high cervical injury. Misdiagnosis of this instability might cause several complications, including neurologic deficits. A radiologic evaluation must be performed and specific parameters that imply cervical instability must be confirmed. Full understanding of these parameters may prevent not only delayed diagnosis but also unexpected complication. We report a case of delayed detection of a cervical instability and emphasize the role of proper diagnosis.

The Effect of Moxibustion at Chonjung(CV17, Shanzhong) on Patients with Dysphagia after Stroke (중풍환자(中風患者)의 연하장애(嚥下障碍)에 전중혈 구치료(灸治療)가 미치는 효과(效果))

  • Na, Byong-Jo;Rhee, Jun-Woo;Lee, Cha-Ro;Park, Young-Min;Choi, Chang-Min;Sun, Jong-Joo;Jung, Woo-Sang;Moon, Sang-Kwan;Park, Sung-Wook;Cho, Ki-Ho;Kim, Tae-Hun
    • The Journal of Internal Korean Medicine
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    • v.26 no.2
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    • pp.353-359
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    • 2005
  • Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.

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Comparison of Intraoperative Somatosensory Evoked Potential(SSEP) Monitoring During Aneurysm Surgery : ACA Aneurysms vs MCA Aneurysms (전대뇌동맥과 중대뇌동맥 동맥류 수술시 체성감각유발전위의 모니터링의 비교, 분석)

  • Choi, Kwang Yeong;Kim, Gook Ki;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.281-288
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    • 2001
  • Objectives : The purpose of this study is to evaluate the usefulness of SSEP monitoring during intracranial aneurysm surgery and compare the characteristics of wave change in relation to neurologic changes between ACA aneurysms and MCA aneurysms. Methods : During recent three years(between January 1997 and November 1999), intraoperative SSEP monitoring had been done in 63 operations for intracranial aneurysms. We had monitored the median nerve SSEP during surgery for aneurysms of MCA and the posterior tibial nerve SSEP for aneurysms of ACoA or ACA. A more than 50% reduction of any cortical SEP response was considered to be a significant SEP change, compared to its baseline value before the start of surgery. Changes in the SEPs were categorized as follows : Type IA, no significant amplitude changes without temporary clipping ; Type IB, no significant amplitude changes with temporary clipping ; Type II, significant changes with temporary clipping and complete return to control amplitude ; Type III, significant changes with temporary clipping and incomplete return to control amplitude ; Type IV, significant changes with temporary clipping and more decreased amplitude changes. Results : Among the 63 intraoperative monitoring, there were 37 cases of ACA aneurysms(An), and 26 of MCA An. The temporary proximal arterial occlusion during surgery were performed in 31(83.8%)cases of ACA An, 22(84.6%) of MCA An. Seven of the 31 ACA An(22.6%) and ten of the 22 MCA An(45.5%) had significant changes. The type were as follows : 4 patients with type II and 3 with type III in the ACA An ; 3 patients with type II and 3 with type III and 4 with type IV in the MCA An. In both group type II changes had no new postoperative neurological deficit. All 6 patients with type III had new neurological deficits ; However, One case in the ACA An and two cases in the MCA An. had transient neurologic deficit and improved markedly over the next two months. All 4 type IV changes in the MCA An. had permanant neurologic deficits. Two out of 30 cases(6.7%) in the ACA An. and one out of 16 cases(6.3%) in the MCA An. without significant amplitude change had new neurologic deficit postoperatively. Conclusion : Based on this study, Intraoperative SSEP monitoring during aneurysm surgery would provide useful information for detecting cerebral ischemia. SSEP response during surgery for MCA An. is more sensitive than ACA An. Otherwise, there were no meaningful difference in rate of false negativity.

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Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.