Biomedical subjects

A Nabhan

Publications and source records attributed to A Nabhan.

15 recordsLinked to original sources

PubMed2007

[Cubital tunnel syndrome--simple nerve decompression or decompression with subcutaneous anterior transposition?].

The purpose of this prospective, randomised and controlled study was to evaluate which kind of operative technique for treatment of cubital tunnel syndrome is favourable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/either neurological deficits with clinically and electrographically proven cubital tunnel syndrome. 32 patients underwent nerve decompression without transposition, whereas 34 underwent subcutaneous transposition of the nerve. Follow-up examinations evaluating pain, motor and sensory deficits as well as motor nerve conduction velocities were performed three, nine and 24 months postoperatively. Irrespectively of operative procedures (simple decompression vs. subcutaneous anterior transposition) there were no significant differences between the outcomes of the two groups at either postoperative follow-up examination (p > 0.05).

Aged↗

PubMed2006

Disc replacement using Pro-Disc C versus fusion: a prospective randomised and controlled radiographic and clinical study.

Anterior cervical discectomy and fusion (ACDF) may be considered to be the gold standard for treatment of symptomatic degenerative disc disease within the cervical spine. However, fusion of the segment may result in progressive degeneration of the adjacent segments. Therefore, dynamic stabilization procedures have been introduced. Among these, artificial disc replacement by disc prosthesis seems to be promising. However, to be so, segmental motion must be preserved. This, again, is very difficult to judge and has not yet been proven. The aim of the current study was to first analyse the segmental motion following artificial disc replacement using a disc prosthesis. A second aim was to compare both segmental motion as well as clinical result to the current gold standard (ACDF). This is a prospective controlled study. Twenty-five patients with cervical disc herniation were enrolled and assigned to either study group (receiving a disc prosthesis) or control group (receiving ACDF, using a cage with bone graft and an anterior plate.) Radiostereometric analysis was used to quantify intervertebral motion immediately as well as 3, 6, 12 and 24 weeks postoperatively. Further, clinical results were judged using visual analogue scale and neuro-examination. Cervical spine segmental motion decreased over time in the presence of disc prosthesis or ACDF. However, the loss of segmental motion is significantly higher in the ACDF group, when looked at 3, 6, 12 and 24 weeks after surgery. We observed significant pain reduction in neck and arm postoperatively, without significant difference between both groups (P > 0.05). Cervical spine disc prosthesis preserves cervical spine segmental motion within the first 6 months after surgery. The clinical results are the same when compared to the early results following ACDF.

Adult↗

PubMed2006

[Anatomy of the cerebellopontine angle].

The cerebellopontine angle (CPA) is an anatomically complex region of the brain. In this article we describe the anatomy of the CPA cisterns, of the internal auditory canal, the topography of the cerebellum and brainstem, and the neurovascular structures of this area.

Brain Stem↗

PubMed2006

[Spondylitis/spondylodiscitis].

Spondylitis is an inflammation of the vertebral body. If the infection is manifested in the vertebral motor segment it is called spondylodiscitis, which can be divided into specific and nonspecific forms. It is clinically impressive that at the beginning of the disease, the patients who are quite often immunosuppressed suffer from localized, especially nocturnally exacerbated backache. The initial diagnostic work-up generally consists of clinical history, examination, laboratory tests, and (especially advanced) imaging findings. Although computed tomography still remains the most frequently used advanced imaging technique, magnetic resonance imaging is the golden standard for the diagnosis of spondylitis and spondylodiscitis.

Back Pain↗

PubMed2006

[Differential diagnosis of back pain].

Back pain is one of the most frequent clinical pictures encountered in a physician's practice. It can pose a great burden on the individual and in addition have a multifactorial origin. It can be caused by intervertebral discs, vertebral joints, nerve roots, ligaments, sacroiliac joints, or a combination of the above. Back pain, as a symptom of a systemic disease, can also be a warning signal of grave disorders such as malignancies or in the event of aortic aneurysm. The well-considered choice of appropriate diagnostic procedures and suitable treatment requires a thorough knowledge of this multifactorial clinical picture.

Back Pain↗

PubMed2006

[Postoperative syndrome after spine surgery].

Postoperative syndrome after spine surgery, i.e., symptoms or syndromes caused by complications or procedure-related consequences, is gaining more and more importance. Due to great improvements concerning imaging and operative techniques (microsurgery, instrumentation) the total number of spinal surgeries as well as their related complications are increasing. Procedure-related postoperative complications including neurological deficit syndromes can occur acutely or at a later date. Concerning imaging techniques for postoperative evaluation after spinal surgery there are several modalities available. Their indications depend on complex factors including initial pathology the surgery was performed for, kind of surgical technique (surgical approach, instrumentation), anatomy of the patient as well as the time between onset of symptoms and surgery. In cases of ambiguous findings, the combination of different imaging techniques can be instrumental.

Back Pain↗

PubMed2006

[Imaging of extradural spinal lesions].

There is a wide variety of spinal extradural tumors. In addition to real neoplasms, degenerative diseases, congenital abnormalities and inflammatory disorders can be causes of extradural masses. Due to the bony boundary of the spinal canal, both benign as well as malignant masses can cause progressive neurological deficits including paraplegia. Most of the spinal tumors are benign (hemangioma of the vertebral body, degenerative diseases). In younger patients congenital abnormalities and primary tumors of the spine have to be considered, whereas in adults the list of differential diagnoses should include secondary malignancies such as metastases and lymphomas as well as metabolic disorders such as osteoporotic vertebral compression fracture and Paget's disease. Cross-sectional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) of the spine often help to make a specific diagnosis of extradural spinal lesions and represent important tools for tumor staging and preoperative evaluation.

Diagnosis, Differential↗

PubMed2006

[Differential diagnosis of non-neoplastic space-occupying lesions of the spinal cord].

This overview addresses the topic of non-neoplastic intraspinal space-occupying lesions. Knowledge of these entities is essential to distinguish them from tumorous processes. A selection of clinically relevant differential diagnoses is presented which pertain to inflammatory, vascular, and degenerative diseases. In addition, special clinical findings, the radiological procedure, and therapeutic possibilities are outlined.

Angiography↗

PubMed2005

[Function of the facial nerve after operative treatment of acoustic neurinomas. Influence of intraoperative monitoring].

The aim of this study was to evaluate the influence of intraoperative monitoring on the function of the facial nerve after surgical treatment of acoustic neurinomas, classified according to the grading system of Stennert. One hundred thirty patients were divided into two groups. The first group underwent surgery without intraoperative facial monitoring; the second group included intraoperative facial monitoring. Concerning degree of paresis, preoperatively there was no statistically significant difference between the two groups (group 1: 0.77+/-1.5; group 2: 0.4+/-1.2). Despite structural preservation of the facial nerve, postoperative deterioration of its function was observed which consecutively improved postoperatively. Postoperatively, the mean degree of paresis increased to 4.4+/-3.0 in group 1 and 2.4+/-2.3 in group 2. For better understanding of the role of intraoperative monitoring, we investigated the outcome of patients with acoustic neurinomas who underwent surgery over the following 6 months postoperatively. At that time, function improved by 4.1+/-3.2 (group 1) and 2.0+/-2.3 (group 2). We could show that intraoperative monitoring of the facial nerve was a significant factor for better postoperative function in patients undergoing microsurgical excision of neurinomas (P=0.001) .

Facial Nerve↗

PubMed2005

[Spinal syndrome triggered by a lumbar spinal av malformation. A case report].

We report the case of a 64-year-old male suffering from long-term claudicatio spinalis who underwent surgery in an orthopedic outpatient ward for posterior lumbar interbody fusion and bony decompression due to spinal stenosis. Postoperatively, the clinical symptoms, consisting of difficulties with walking and stocking-like dysesthesia of both lower extremities, did not improve. Due to persistent complaints, spinal MRI was performed which revealed myelomalacia and moreover was indicative of dural arteriovenous (AV) malformation at the L2-3 spinal level, which was verified as a type Ia AV fistula (according to Spetzler) by digital subtraction angiography (DSA). After microsurgical treatment of the AV fistula, clinical symptoms improved and control DSA could demonstrate complete disconnection of the fistula without any signs of recanalization. This case demonstrates that neurological deficits of patients suffering from degenerative spinal disorders can generally be considered as caused by more common spinal disease such as lumbar stenosis. Since vascular malformations may also cause neurological deficits and even mimic symptoms of spinal stenosis, it is important to consider these entities in diagnostic evaluation.

Arteriovenous Malformations↗

PubMed2005

[Skull base tumors].

Modern imaging techniques have great importance in the diagnosis and therapy of skull-base pathologies. Many of these lesions, especially in relation to their specific location, can be evaluated using CT and MR imaging. Tumors commonly found in the anterior skull base include carcinoma, rhabdomyosarcoma, esthesioneuroblastoma and meningioma. In the central cranial fossa, nasopharyngeal carcinoma, metastases, meningioma, pituitary adenoma and neurinoma have to be considered. The most common neoplasms of the posterior skull base, including the CP angle, are neurinoma, meningioma, nasopharyngeal carcinoma, chordoma and paraganglioma. One major task of imaging is the evaluation of the exact tumor extent as well as its relationship to the neighboring neurovascular structures. The purpose of this review is to recapitulate the most important anatomical landmarks of the skull base. The typical imaging findings of the most common tumors involving the skull base are also presented.

Cerebellopontine Angle↗

PubMed2005

Simple decompression or subcutaneous anterior transposition of the ulnar nerve for cubital tunnel syndrome.

The purpose of this prospective randomised study was to evaluate which operative technique for treatment of cubital tunnel syndrome is preferable: subcutaneous anterior transposition or nerve decompression without transposition. This study included 66 patients suffering from pain and/or neurological deficits with clinically and electromyographically proven cubital tunnel syndrome. Thirty-two patients underwent nerve decompression without transposition and 34 underwent subcutaneous transposition of the nerve. Follow-up examinations evaluating pain, motor and sensory deficits as well as motor nerve conduction velocities, were performed 3 and 9 months postoperatively. There were no significant differences between the outcomes of the two groups at either postoperative follow-up examination. We recommend simple decompression of the nerve in cases without deformity of the elbow, as this is the less invasive operative procedure.

Cubital Tunnel Syndrome↗

PubMed2002

[Atypical symptoms in carpal tunnel syndrome - treatment and results].

PURPOSE: Additionally to the typical carpal tunnel symptoms, the patients of this study had atypical complaints. Other reasons for these symptoms than those caused by the compression of the median nerve could be excluded using medical examination or imaging techniques. Purpose of this study was to investigate whether decompression of the median nerve may reduce or even abolish the atypical complaints. METHOD: For this prospective study 378 patients with carpal tunnel syndrome were clinically and electroneurographically examined, which was performed before and after (3 months) they underwent surgical decompression of the median nerve. RESULTS: 70 patients (19 % of all patients) with carpal tunnel symptoms suffered from additional atypical symptoms such as cardiac pain, ipsilateral headache as well as neck and shoulder pain. The diagnosis of carpal tunnel syndrome was made using clinical and electroneurographical examination. Carpal tunnel symptoms of all patients disappeared completely after surgery. Respectively, 61 % of those patients with preoperative atypical complaints did also fully recover. CONCLUSION: This study shows that patients with carpal tunnel syndrome may also suffer from atypical complaints. These symptoms have been shown to be associated with the compression of the median nerve. They may be caused by spinal synaptic interaction between sensory and sympathetic/parasympathetic neuronal pathways by somatically-induced reflex responses.

Adult↗

PubMed1995

The prevalence of congenital malformations at birth in Ain Shams University Maternity Hospital Cairo, Egypt, 1994.

The prevalence of congenital malformations among births (live and still birth) at Ain-Shams Maternity Hospital was examined. Fifty five malformation cases were found among the whole births examined (1157 births) over the 9-month study period, this yields a prevalence rate of 4.75%, a rate similar to the worldwide prevalence rate. Elevated rate of neural tube defects was observed (13.8/1000) followed by limb deformities (12.1/1000). Case control study was also conducted to evaluate the different risk factors. The increased rate among cases can be explained by potential exposure at father employment, drug intake during pregnancy and history of fever using multivariant logistic analysis.

Birth Rate↗

PubMedDate not supplied

[Operative treatment of symptomatic nerve root cysts].

AIM OF THE STUDY: Nerve root cysts are often asymptomatic and show a predilective manifestation for the lumbo-sacral spine. Depending on their size and the anatomic relationship to the nerve roots they may cause symptoms such as pain or even neurological deficits. From the therapeutical point of view, different moldalities of intervention are controversially discussed because the clinical importance of this entity is still unclear. There are curative as well as symptomatic therapeutic options. The curative therapy includes surgical excision of the cyst and duraplasty whereas the symptomatic therapy is limited to drainage of the cyst. The purpose of this study was to evaluate the role of surgical excision of the cyst with duraplasty using microsurgical techniques. METHOD: This study included 13 patients who suffered from pain and neurological deficits with myelographically and MRI proven sacral nerve root cysts. All patients underwent surgery for cyst excision plus duraplasty. RESULTS: Clinical symptoms such as pain and sensory deficits significantly improved in all patients postoperatively. 85 % of the patients showed a full recovery from the previously existing radicular pain and motoric as well as sensory deficits. All patients reported a significant improvement of their preoperative loss in muscle strength. CONCLUSION: Surgical excision combined with duraplasty using microsurgical techniques has proven to be the method of choice in the treatment of symptomatic sacral nerve root cysts.

Adolescent↗