• Title/Summary/Keyword: Neurologic examination

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REPORT OF THE MANAGEMENT OF GUNSHOT WOUNDS TO THE LEFT FACE (산탄총에 의한 좌측 안면부 손상 환자의 치험례 (증례보고))

  • Kim, Il-Kyu;Lee, Sang-Sun;Oh, Sung-Sup;Choi, Jin-Ho;Kim, Hyung-Don;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.224-227
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    • 2000
  • Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

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Acute Myelopathy Caused by a Cervical Synovial Cyst

  • Kim, Dong Shin;Yang, Jin Seo;Cho, Yong Jun;Kang, Suk Hyung
    • Journal of Korean Neurosurgical Society
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    • v.56 no.1
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    • pp.55-57
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    • 2014
  • Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level. These symptoms developed after manual stretching 3 days prior. Computed tomography scanning and magnetic resonance imaging revealed a 1-cm, small multilocular cystic lesion in the spinal canal with cord compression at the C7-T1 level. We performed a left partial laminectomy of C7 and T1 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient's symptoms resolved after surgery. We describe a case of acute myelopathy caused by a cervical synovial cyst that was treated by surgical excision. Although cervical synovial cysts are often associated with degenerative facet joints, clinicians should be aware of the possibility that these cysts can cause acute neurologic symptoms.

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

  • Yu, Hyun Jeong;Park, Chan Jin;Yim, Kyoung Hoon
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.129-135
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    • 2016
  • Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

Motor Peripheral Neuropathy Involved Bilateral Lower Extremities Following Acute Carbon Monoxide Poisoning: A Case Report (급성 일산화탄소 중독 환자에서 발생한 양하지 말초 운동신경병증 1례)

  • Choi, Jae-Hyung;Lim, Hoon
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.46-49
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    • 2015
  • Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

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Phenobarbital and zonisamide treatment of a cat with epilepsy of unknown cause

  • Lee, Ki-Ho;Park, Jun-Seok;Kim, Jung-Kook;Seo, Kyoung-Won;Song, Kun-Ho
    • Korean Journal of Veterinary Service
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    • v.40 no.2
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    • pp.143-147
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    • 2017
  • A Korean domestic short hair (1-year-old, male) presented with 2 to 3 weeks of seizures, aggressive behavior, vomiting, anorexia, and lethargy. The frequency of seizure had gradually increased from once a week to once every 3 hours. Physical and neurologic examination, diagnostic screening tests, including complete blood count (CBC), serum chemistry, electrolyte, coagulation test, X-ray, ultrasonography, and urinalysis were performed. Feline Leukemia Virus (FeLV), Feline Immunodeficiency Virus (FIV) and Toxoplasma spp. All tested negative, but the Feline Corona Virus (FCoV) kit revealed a positive result. To determine the exact diagnosis, magnetic resonance imaging (MRI) was performed but yielded no specific findings. The patient was then diagnosed with idiopathic epilepsy and treatment of phenobarbital was initiated. A month's treatment with phenobarbital proved ineffective as symptoms worsened. Zonisamide was then selected as an additional anticonvulsant. After adding zonisamide, symptoms improved, and seizures abated for 15 months. This is the first case report in South Korea describing the use of phenobarbital and zonisamide in the treatment of a cat with idiopathic epilepsy.

Difference of Physical Symptoms, PWI and JCQ according to Sasang Constitutions for Industrial Workers (사업장 근로자의 사상체질별 건강관련 신체증상, 사회심리적 스트레스, 직무 스트레스 요인과의 차이)

  • Cha, Nam-Hyun;Kim, Jeong-Ah;Lee, Ki-Nam;Wang, Myoung-Ja
    • Research in Community and Public Health Nursing
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    • v.16 no.4
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    • pp.508-516
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    • 2005
  • Purpose: This study was conducted to analyze industrial workers' stresses from physical symptoms, PWI, JCQ and tasks in classification of Sasang constitutions. Method: Data were collected from industrial workers in J Province from May 2003 to June 2003. Questionnaires were distributed and collected on the day of their physical examination. Collected data were analysed through $x^2-test$. Result: Health-related characteristics showed that most of smokers and drinkers were Taeumins and this result was statistically significant. Physical symptoms related to constitutions indicated that GI and neurologic symptoms are significantly more frequent in Soeumin. The percentage of subjects with moderate risk was high in order of Soyangin, Taeumin and Soeumin while the percentage of subjects with high risk was high in order of Soeumin, Taeumin and Soyangin. Conclusion: Through this study, Lee Jae Ma's theory was be confirmed compatible with disease characteristics. However, research with more various subjects and variables needs to be made.

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Evaluation of Mental Status in High-Risk Neonates using Infants Coma Scale (고위험신생아의 의식수준 사정을 위한 Infants Coma Scale의 개발과 적용)

  • Ahn, Young-Mee;Sohn, Min;Lee, Sang-Mi
    • Journal of Korean Academy of Nursing
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    • v.40 no.4
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    • pp.561-570
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    • 2010
  • Purpose: This was a cross sectional descriptive study to introduce the Infants Coma Scale (ICS), describe mental status of high risk infants using ICS and explore the relationships between ICS and clinical variables in infants hospitalized in a neonatal intensive care unit of a university hospital in Korea. Methods: After ICS was developed and tested by the authors, a research nurse evaluated the mental status of the infants using the English version of ICS and obtained clinical information on the infants from their medical records. Results: Data from 88 infants were analyzed. About 60% were male, 90% were preterm births, and 40% had pathologic abnormalities. Their mean gestational age was 32.4 (${\pm}3.50$) weeks and the mean birth weight was 1,842 (${\pm}728.6$) grams. The Cronbach's alpha for the ICS was .78. There was a statistically significant positive correlation between ICS total score and five clinical variables including gestational age, birth weight, 1 and 5 min Apgar scores and respiration status. Conclusion: Mental status is an important parameter in nursing assessment. ICS is a valid and reliable instrument, which clinicians can easily use to evaluate the mental status of high risk infants.

Two Cases of Disc Internal Disruption Syndrome (추간판 내부 파열 증후군(Internal disc disruption) 2례)

  • Lee, Jong-Hyeung;Ahn, Myun-Whan;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • v.8 no.1
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    • pp.238-245
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    • 1991
  • The disc internal disruption syndrome is not well known to us, but the following hypothesis is widely accepted in clinical practice. The disc internal disruption syndrome may develop intractable back pain with aggrevated of pain, loss of spinal motion with any physical exercise, leg pain, loss of energy, marked weight loss, and profound depression. The patient with this syndrome will be found to have normal plain roentgenograms, myelograms, CT scans, results of blood examination and neurologic findings. For these reasons, this syndrome was frequently diagnosed by abnormal discographic findings. We had experience with two cases of disc internal disruption syndrome with clinical, roentgenographic and discographic evaluations. Thus We present these cases with a brief review of the concerned literature.

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Clinical Evaluation of Bromovincamine for Cerebral Stroke (뇌졸중 환자에서의 Brovincamine의 임상효과)

  • 김준석;서홍석;오동주;임도선
    • YAKHAK HOEJI
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    • v.37 no.1
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    • pp.84-88
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    • 1993
  • Brovincamine is a selective cerebral vasodilator that was apparently produced via a slow calcium blockade. Brovincamine has been shown to increase ATP production and glucose and oxygen consumption in brain, improving energy metabolism. Also brovincamine inhibited platelet aggregation induced by ADP and collagen in vivo and in vitro via an increase of cAMP concentration, promoting therapeutic effects on cerebral circulatory disorders. So we investigated and represented the clinical effects and safety of brovincamine in patients with cerebral stroke. Thirty patients of cerebral stroke that was older than 2 months, who were 22 cases of cerebral infarction, 6 of cerebral embolism that originated from carebral infarction, 6 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral embolism that originated from cardiac diseases, and 2 of cerebral hemorrhage, were administered of 20 mg of oral brovincamine three times daily for 8 weeks. Improvement rates of each symptom after 8 week administration were 30.8% for subjective symptoms, 76% for psychiatric symptoms and 65.6% for neurologic symptoms. In final global improvement rates, much improvement was 10%, improvement was 23.3% slight improvement is 36.7%, and no change was 30%. So global improvement rate including slight improvement was 70%. As for side effects, there were 3 cases of mild gastrointestinal symptoms, but there were no other subjective side effects and significant fluctuation in laboratory examination. Conclusively throughout the present study, brovincamine is judged to be well tolerated and effective in patients with cerebral stroke.

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The Effect of Animal Physiotherapy on Balance and Walking in Dog with Sciatic Nerve Injury and Degenerative Joint Disease, Case Report

  • Lee, Shinho;Cha, Yuri
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.279-284
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    • 2022
  • Objective: This study was conducted to confirm the effect of physiotherapy on the balance and walking in dog with sciatic nerve injury and degenerative arthritis of stifle joints. Design: Single case study Methods: The dog walked abnormally for six months and was administrated in S animal hospital. The dog's right hindlimb was operated for cranial cruciate ligament repair and the dog had been taking a nonsteroidal anti-inflammatory analgesic before being refered. There was severe degenerated osteoarthritis in the right hindlimb. During stance and walking, the right hindlimb was often shown partial weight bearing. The dog's left hindlimb was shown plantigrade stance and walking. The radiograph was shown an intact calcaneal tendon in the left hindlimb. In the neurologic examination, sciatic nerve injury in the left hindlimb was confirmed. The dog was treated using muscle strengthening, proprioceptive exercise, underwater treadmill and Laser therapy two, or three times a week for 3 months. At the 10th and 17th treatment, it was evaluated through stance and gait analyzer system to measure dog's balance and walking. Results: 3 months following physiotherapy, the dog's balance was improved in center of pressure(COP). And peak vertical force(PVF), vertical impulse(VI) was increased in right hindlimb and double stance was decreased. Conclusions: Physiotherapy may have improved the prognosis in this dog with severe osteoarthritis and sciatic nerve injury. This study suggested that animal physiotherapy is a valuable way to improve balance and walking.