• Title/Summary/Keyword: The Paraplegia

Search Result 140, Processing Time 0.026 seconds

Acquired Chiari Malformation

  • Song, Sang-Woo;Chung, Chun-Kee
    • Journal of Korean Neurosurgical Society
    • /
    • v.40 no.1
    • /
    • pp.38-39
    • /
    • 2006
  • Perioperative lumbar drainage of cerebrospinal fluid is commonly used in neurosurgical practice. However, the relationship between lumbar drainage and acquired Chiari malformation is not well established. The authors present an unusual case of paraplegia as a result of acquired Chiari malformation after lumbar drainage. Acquired Chiari malformation can induce compression of cervicomedullary junction and syrinx formation. Foramen magnum decompression is recommended for the solution of such problems.

The Risk Factors and Outcomes of Acute Kidney Injury after Thoracic Endovascular Aortic Repair

  • Jeon, Yun-Ho;Bae, Chi-Hoon
    • Journal of Chest Surgery
    • /
    • v.49 no.1
    • /
    • pp.15-21
    • /
    • 2016
  • Background: We aimed to evaluate the incidence, predictive factors, and impact of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR). Methods: A total of 53 patients who underwent 57 TEVAR operations between 2008 and 2015 were reviewed for the incidence of AKI as defined by the RIFLE (risk, injury, failure, loss, and end-stage kidney disease risk) consensus criteria. The estimated glomerular filtration rate was determined in the perioperative period. Comorbidities and postoperative outcomes were retrospectively reviewed. Results: Underlying aortic pathologies included 21 degenerative aortic aneurysms, 20 blunt traumatic aortic injuries, six type B aortic dissections, five type B intramural hematomas, three endoleaks and two miscellaneous diseases. The mean age of the patients was $61.2{\pm}17.5years$ (range, 15 to 85 years). AKI was identified in 13 (22.8%) of 57 patients. There was an association of preoperative stroke and postoperative paraparesis and paraplegia with AKI. The average intensive care unit (ICU) stay in patients with AKI was significantly longer than in patients without AKI (5.3 vs. 12.7 days, p=0.017). The 30-day mortality rate in patients with AKI was significantly higher than patients without AKI (23.1% vs. 4.5%, p=0.038); however, AKI did not impact long-term survival. Conclusion: Preoperative stroke and postoperative paraparesis and paraplegia were identified as predictors for AKI. Patients with AKI experienced longer average ICU stays and greater 30-day mortality than those without AKI. Perioperative identification of high-risk patients, as well as nephroprotective strategies to reduce the incidence of AKI, should be considered as important aspects of a successful TEVAR procedure.

A Case of Canine Ectopic Parasitism of Heartworm in the Systemic Circulation (개에서 발생한 전신 순환계의 심장사상충 이소기생 증례)

  • Jang, Hyo-Mi;Lee, Hee-Chun;Jung, Dong-In
    • Journal of Veterinary Clinics
    • /
    • v.32 no.4
    • /
    • pp.347-351
    • /
    • 2015
  • A 3-year-old intact female Dachshund was referred due to paraplegia and cool extremities. History taking, physical examination, neurological examination, and blood profiling studies were evaluated to determine the diagnosis. Based on abdominal ultrasound and echocardiograph, features suggestive of adult heartworm were detected in aberrant places. The result of enzyme-linked immunosorbent assay (ELISA) testing with a commercial heartworm antigen kit was positive. The dog fell into a comatose state, and the client requested the dog be euthanized. On post-mortem examination, the patient was diagnosed with ectopic parasitism of heartworm in the left side of heart, aorta, aorta abdominalis, and iliac arteries, a circumstance that induced systemic thromboembolism. This case report describes the clinical, diagnostic imaging, and necropsy findings of canine ectopic parasitism of heartworm.

Botulinum Toxin Therapy in a Patient with HHH Syndrome with Gait Disturbance: A Case Report

  • Kim, Dong-Hyun;Choi, Yoon-Hee
    • Journal of The Korean Society of Integrative Medicine
    • /
    • v.9 no.2
    • /
    • pp.105-108
    • /
    • 2021
  • Background : Hyperornithinemia-hyperammonemia-homocitrullinuria (HHH) syndrome is a rare, autosomal recessive metabolic disorder which is caused by genetic mutations that disrupt the urea cycle. It is characterized by variable clinical presentation and the age of onset. Patients may present with gait disturbance and progressive paraplegia and muscle tightness in the lower extremities. The use of botulinum toxin in metabolic disease has rarely been discussed. We describe a case of a 14-year-old-boy with HHH syndrome, who presented with a several - month history of gait disturbance and lower extremity weakness. Case presentation : A 14-year old male had a history of recurrent upper respiratory tract infections, occasional vomiting, loss of appetite, and general weakness, all of which started since he was 10 months old. He was diagnosed with HHH syndrome at one year of age. At the age of 14, he was referred for the assessment and treatment of his gait disturbance and aggravated weakness of the lower extremities. Brain MRI, electrodiagnostic study and blood test were performed to exclude any lesions related to neurologic dysfunction. Botulinum toxin type A were injected into muscles of adductor longus, adductor magnus, lateral and medial hamstring, and lateral and medial gastrocnemius muscle heads under needle electromyography guidance to reduce lower limb spasticity. Intensive physical therapy including gait training and stretching exercise of adductor and calf muscles were also provided. After intensive physical therapy and botulinum toxin injection to reduce lower limb spasticity, he was able to ambulate for 20 meters independently without any walking aids. There were no adverse events after the injection. Conclusion : Botulinum toxin injection is a safe and effective therapy for patients with HHH syndrome who suffer from gait disturbance.

Clinical Study on the Case of Patient with Multiple Myeloma (다발성 골수종으로 진단된 환자 1례에 대한 증례 보고)

  • Lee, Yun-Kyu;Park, Seo-Young;Ko, Kyoung-Mo;Lee, Yoon-Kyoung;Kim, Jae-Su;Lee, Kyung-Min;Lee, Bong-Hyo;Jung, Tae-Young;Lim, Seong-Chul
    • Journal of Acupuncture Research
    • /
    • v.25 no.1
    • /
    • pp.233-245
    • /
    • 2008
  • Multiple Myeloma is malignant tumor that malignant proliferous plasma cell to originate from bone marrow invades bone multiply. Objectives : Therapy for Multiple Myeloma includes chemotherapy, radiation therapy and self-stem cell transplantation, but it has no effect for a majority of Multiple Myeloma patients. So we diagnosed it as Wei symptom, oliguria, or dysuria(遺尿) in Oriental medicine, and treated it using the Oriental medical system. Methods : The patient was treated using acupuncture, electroacupuncture, herbal acupuncture treatment, moxibustion, physical treatment and western medicine. We observed 12 kinds of symptoms in the patient when admitted to the hospital. Results : 1. Paraplegia, urination desire, voluntary urination, and other symptoms improved except for a period of complication. 2. Defecation desire, sensory disturbance of the body and lower extremities, self-made changes, maintenance of body posture, and other symptoms improved during admitting days. 3. Voluntary defecation, pains of the neck and lower extremities, and other symptoms had irregular changes during admitting days. Conclusions : This study demonstrates the necessity of having more clinical study about Mutiple Myeloma.

  • PDF

Intracranial Dissemination from Spinal Cord Anaplastic Astrocytoma

  • Jeong, Seong-Man;Chung, Yong-Gu;Lee, Jang-Bo;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
    • /
    • v.47 no.1
    • /
    • pp.68-70
    • /
    • 2010
  • We report a case of intracranial dissemination developing approximately 4 months after partial removal of a spinal cord anplastic astrocytoma in a 22-year-old male. He presented with paraplegia on initial admission at a local hospital. Spinal magnetic resonance (MR) images disclosed multiple intramedullary lesions at the T3-11. The tumor was partially removed. The final histologic diagnosis was anaplastic astrocytoma. Four months after the operation, he was admitted with the symptoms of headache and deterioration of consciousness. MR images showed enhanced lesions in the anterior horn of the left lateral ventricle, and septum pellucidum. He underwent computed tomography-guided stereotactic biopsy and histological appearance was consistent with anaplastic astrocytoma. The clinical course indicates that the tumor originated in the spinal cord and extended into the subarachnoid space, first the spinal canal and later intracranial.