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J Benetin

Publications and source records attributed to J Benetin.

6 recordsLinked to original sources
PubMed2001

Results of peripheral nerve reconstruction by autograft.

OBJECTIVES: This paper presents the results achieved in microtechnique surgeries performed during a 15-year-long period (1985-1999). By performing surgeries on 60 patients, 63 nerves were treated. MATERIAL AND METHODS: In 42 patients with injuries of peripheral nerves of upper extremities, 45 nerves were reconstructed by autografts. 14 patients were subjected to reconstructive surgeries on peripheral nerves of lower extremities. In 4 patients we reconstructed the facial nerve by means of autograft. The analysis of surgical effects has been made in dependence on indicators as follows: period elapsed from injury to surgery, age of patient, nature of injury, length of autograft, location of injury, kind of nerve inflicted. RESULTS: When assessing the results of reconstructive surgeries of peripheral nerves of lower and upper extremities we observed a big difference on the behalf of upper extremities. High efficiency can be seen in tibial nerve surgeries of lower extremities. In general we achieved good results in facial nerve reconstructions. CONCLUSION: The crucial factor that has an impact on the result of surgery is that of the time which elapsed from injury to reconstructive surgery. The factor is especially marked in younger patients. (Tab. 7, Ref. 15.).

Adult↗
PubMed2001

Surgical treatment of injuries of nervus fibularis.

STARTING POINT: In this retrospective study, we present the results of 40 surgeries of 40 patients that within the period of 15 years, i.e. from 1985 to 1999 were provided the treatment of 40 lesions of n. fibularis, historically treated as problematic in terms of successful healing. The work provides the fundamental lines of their surgery treatment. MATERIAL AND METHODS: From the total number of 40, external neurolysis was performed to 20 patients. The remaining 20 patients were provided with reconstruction surgeries of the injured nerves, while 8 surgeries was done by suture of peripheral nerve and 12 surgeries were performed by nerve graft, in cases of complete and persisting neurological deficit and absence of action potential at EMG. The mechanism of lesion included the damages of nerve from elongation, with or without fracture, "sharp" or "blunt" lesions, lesions of shooting, compressions and iatrogenic injuries. If the spontaneous adjustment did not occur within the period of 2-6 months after the lesion, the patients underwent surgery. We performed the analysis of the efficiency of the surgical intervention depending on the following parameters: period of surgery from the lesion, patient's age, nature of lesion, degree of lesion, type of surgery intervention. RESULTS: With 27 of 40 an effective adjustment was achieved preventing the sagging of the foot trace and with 25 of 40 protective sensitivity appeared. After neurolysis with 18 of 20 patients (90%) we achieved effective degree of adjustment in spite of heavy pre-surgical motor deficit. With 8 patients an "end to end" suture was performed and with 6 (75%) the degree of adjustment was 3 or higher. 12 patients requested reconstruction surgeries with the help of nerve grafts, the length of grafts varied from 4 to 20 cm. The grafts were shorter than 5 cm with 2 patients, 1 with cut lesion and 1 patient with iatrogenic lesion. With both patients the function was adjusted to the degree M4. With 1 of 4 patients (25%) with the graft of 6 to 12 cm and with none of 6 with the grafts from 13 to 20 cm the adjustment of the degree 3 or higher was not achieved. In this cases, however, we noticed partial adjustment of trophic and tonus, however at the absence of motor adjustment. CONCLUSION: The pre-surgical and persurgical examinations are indispensable conditions for obtaining optimal results. It is worth of mentioning that surgical treatment proximal lesins of n. fibularis yielded better results than treatment of more distal lesions in the area of knee. (Tab. 5, Ref. 20.)

Adult↗
PubMed2001

Our experience with surgical treatment of ischial nerve injuries.

OUTLINE: This report presents the results of 44 surgical interventions performed on 44 patients during a period of 15 years, from 1985 to 1999. The report presents the basic lines of surgical treatment performed on a total number of 50 peripheral nerves of lower extremities--nervus ischiadicus and its rami. PATIENT GROUP AND METHODS: In the whole group of 44 patients, external neurolysis was performed in 23 individuals on 26 nerves. Remaining 21 patients were treated by reconstruction surgery that included 24 injured nerves. In this subgroup, suture of peripheral nerve was performed in 8 treatments on 9 nerves and neural graft was performed in 13 treatments of 15 nerves in cases of complete and persisting neurological deficit, and in the absence of action potentials as revealed by EMG. Complete or severe motoric defects and the absence of spontaneous recovery during the period of several months were the indications for the treatment. The analysis of the efficiency of surgical treatment was performed with respect to the following parameters: period between the injury and operation, patient's age, character of injury, type of injured nerve, and type of surgical intervention. RESULTS: The best results were obtained in external neurolysis which was applied in traumatic lesions of least severity. The effective degree of recovery M3 was observed in 21 patients (91.3%). With respect to reconstruction surgery, more favourable results were obtained in treatments involving suture (in 6 patients, 75%) than in nerve grafts used for the treatment of the most severe injuries associated with a loss of nerve tissue. In the latter cases, improvement was observed after a delay, and the extent of recovery did not always meet the expectations. The effective degree of recovery was observed in 4 patients (30.8%). Good and excellent results were typical for n. tibialis and they were not dependent on the type of surgical intervention, character and location of the injury, period from the injury or patient's age. CONCLUSION: Our results demonstrate that late and inappropriate treatment of injured peripheral nerves has severe and disturbing consequences for the patient. If a complete treatment of the injured nerve is not possible by the first contact physician, it should be performed as soon as possible by a specialist trained for microneurosurgical techniques of the treatment of peripheral nerves. (Tab. 6, Ref. 11.)

Adult↗
PubMedDate not supplied

Late responses after transcranial magnetic stimulation in stroke.

In addition to early responses after transcranial magnetic stimulation, usually designated as Motor Evoked Potentials (MEP), several late responses have been reported in intervals up to 500 ms following stimulus. Our attention in this work was focused on the response in interval 150-300 ms after stimulus output, which is also designated as S > 150 response. We monitored longitudinally late S > 150 response in group of 19 stroke patient with verified hemispherical ischemic lesion. Our results have shown that the presence of late S > 150 response on the first day after stroke predicts an excellent improvement of clinical deficit and that late S > 150 response is more sensitive to hemispheric lesion than early MEPs. From this point of view, recording of late responses can supplement early MEP recording. Our study demonstrated that supratentorial structures are involved in the origin of the S > 150 response. According to the observation that in some patients a normal early response was present and an S > 150 response was absent on the hemiparetic side, and both responses were present on the unaffected side, we hypothesize that cortical structures play an important role in S > 150 response.

Aged↗
PubMedDate not supplied

Changes of motor evoked potential amplitudes following magnetic stimulation after hyperventilation.

The influence of hyperventilation on amplitudes of motor evoked potentials (MEP) following cortical and root magnetic stimulations was tested in ten healthy volunteers. Hyperventilation significantly increased MEP amplitude following cortical stimulation (p < 0.01) but failed to change MEP amplitude following root stimulation. This finding is compatible with the concept of hyperventilation as a promoter of greater excitability at the level of cortical structures. The provoking method applied during magnetic cortical stimulation might be a useful procedure in studying some functional affections associated with hyperventilation, such as hyperventilation tetany or panic disorder.

Adult↗