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At least 703 records · Page 39Linked to original sources
PubMed2000

A simple method of identifying the spinal accessory nerve.

The spinal accessory nerve (nerve XI) constitutes a unique and readily encountered hazard in cutaneous and subcutaneous surgery of the head and neck. Presented is a simple method of using pinprick hyperaesthesia to accurately identify the course of this nerve. Delineating this nerve prior to performing surgery in the lateral neck and shoulder region is crucial to avoid the potentially disastrous complication of severing this nerve.

Accessory Nerve↗
PubMed1987

Genetic linkage of von Recklinghausen neurofibromatosis to the nerve growth factor receptor gene.

von Recklinghausen neurofibromatosis (VRNF) is one of the most common inherited disorders affecting the human nervous system. VRNF is transmitted as an autosomal dominant defect with high penetrance but variable expressivity. The disorder is characterized clinically by hyperpigmented patches of skin (café au lait macules, axillary freckles) and by multiple tumors of peripheral nerve, spinal nerve roots, and brain (neurofibromas, optic gliomas). These tumors can cause disfigurement, paralysis, blindness, and death. We have determined the chromosomal location of the VRNF gene by genetic linkage analysis using DNA markers. The VRNF gene is genetically linked to the locus encoding nerve growth factor receptor, located on the long arm of chromosome 17 in the region 17q12----17q22. However, crossovers with the VRNF locus suggest that a mutation in the nerve growth factor receptor gene itself is unlikely to be the fundamental defect responsible for the VRNF phenotype.

Chromosome Mapping↗
PubMed2006

Spine disorder case studies.

Spine and limb pain related to degenerative, wear-and-tear changes of the disks, joints, and soft tissues of the spine (spondylosis) is exceedingly common. Identical spine and limb pain can be caused by fracture, tumor, or infection. Patients who have a history of significant trauma, signs or symptoms of systemic disease, neurologic impairment, and profound pain require further evaluation, and some may require surgical intervention to decompress the spinal nerves, spinal cord, or cauda equina or to stabilize adjacent spinal segments. The discovery of red flags in the history or on examination can identify patients who should have imaging and possibly surgical intervention. Neurologic assessment is required to determine which patients could benefit from surgery. The natural history for most acute spondylotic conditions is favorable. Treatment for acute and chronic spine-related pain syndromes is available.

Adult↗
PubMed2001

A comparison of the SF-36 and Nottingham Health Profile in patients with chronic neuropathic pain.

The aim of this study was to evaluate and compare the psychometric properties of two generic health-related quality of life (HRQoL) instruments, the Short Form Health Survey (SF-36) and the Nottingham Health Profile (NHP) in a group of patients with chronic peripheral neuropathic pain (PNP). The sample consisted of 126 adults (56 men and 70 women) with PNP following a lesion of a peripheral nerve, spinal nerve or nerve root or patients with post-herpetic neuralgia. The battery of tests included visual analogue scales (VASs) for pain assessment and global rating of health and verbal rating scales of pain and other symptoms, as well as patient descriptors. The SF-36 had higher internal consistency reliability coefficients (alpha=0.79, range 0.70-0.90) than the NHP (alpha=0.68, range 0.49-0.79). Correlations between comparable dimensions of the two instruments were significant (range from -0.79 for the physical and mental dimensions to -0.29 for the social dimension) indicating a moderate degree of convergent validity. The study population had significantly worse scores on all dimensions of the two instruments when compared with the general population. Subjects with high VAS scores for pain on movement and those with low global health ratings had poorer scores on the both instruments. Overall, the SF-36 performed somewhat better on psychometric testing than did the NHP. However, the NHP contains dimensions such as sleep and more pain items which might be of particular importance in the PNP population. Since the instruments are short, both could be retained for continued testing in outcome studies of this population.

Adult↗
PubMed1986

Cranial nerve deficits due to amyloidosis associated with plasma cell dyscrasia.

Cranial nerve dysfunction is exceedingly rare in amyloidosis. Cranial nerve deficits have been described in the very rare form of familial amyloidosis in which there appears to be an autosomal dominant pattern of inheritance. By contrast, they are virtually unreported in the two common forms of amyloidosis, that is, secondary amyloidosis (AA), usually associated with a chronic inflammatory lesion, and primary amyloidosis (AL), resulting from light-chain immunoglobulins of plasma cell dyscrasias. Although neurologic involvement in these forms of amyloidosis has been reported in the peripheral nerves, spinal nerve roots, and autonomic ganglia, the absence of reports of cranial nerve lesions is remarkable. We report the case of a woman with multiple bilateral cranial nerve deficits involving the left trigeminal, left facial, right abducens, and hypoglossal nerves. She had nonfamilial amyloidosis associated with a plasma cell dyscrasia of the IgG kappa type with increased production of light-chain immunoglobulins. The rarity of cranial nerve involvement in this clinical setting is highlighted by three previous studies, each of which reported involvement of only a single nerve (either the facial or olfactory nerve). Since aging has been correlated with congophilic changes in the brain, the explanation for the sparing of cranial nerves can be only speculative.

Amyloidosis↗
PubMed1986

Spontaneous neoplastic and non-neoplastic lesions in aging Donryu rats.

Spontaneous neoplastic and non-neoplastic lesions in 95 male and 96 female Donryu rats which were observed up to 120 weeks of age, were examined. The incidence of spontaneous tumors was 73.7% in males and 88.5% in females. In males, the most frequent tumors were pituitary adenomas, followed by pheochromocytomas and insulinomas. In females, uterine adenocarcinomas, mammary fibroadenomas and pituitary adenomas were the most common. Other tumors with relatively high incidences in both sexes included cortical adenomas of the adrenal gland, histiocytic sarcomas of the hematopoietic organs and granular cell tumors of the brain. Various tumors were also found in many other organs and/or tissues, although their incidences were low. The organ distribution and incidences of spontaneous tumors observed in Donryu rats were different from those in other strains of rats such as the ACI, Wistar, F344 or Sprague-Dawley strains. The main non-neoplastic lesions were observed in the lung, cervical lymph nodes and kidney of both sexes. In addition, lesions were also observed in the urinary bladder, prostate and peripheral nerves (spinal nerve roots and peripheral nerves) and/or femoralis muscle of males. Histologically, the most characteristic lesion was radiculoneuropathy with degeneration of the peripheral nerves.

Aging↗
PubMed1997

Experimental study on donor nerves for brachial plexus injury: comparison between the spinal accessory nerve and the intercostal nerve.

The spinal accessory nerve and intercostal nerves are widely used as donor nerves for neurotization in patients with brachial plexus injuries. However, the characteristic differences in reinnervation by the spinal accessory and intercostal nerves have not been investigated. The purpose of this study is to compare the resulting contractile properties of the biceps muscles following nerve-crossing procedures of spinal accessory nerve and intercostal nerves to the musculocutaneous nerves. In 10 beagle dogs, the spinal accessory nerve was used to reinnervate the left biceps muscle, and the second and third intercostal nerves were used to reinnervate the right biceps muscle. After 10 months, the reinnervated muscles were studied by measuring their force of contraction as well as by histochemical methods. Biceps muscles reinnervated by spinal accessory nerves (A transfers) acquired the properties of fast, fatigable muscles, whereas those reinnervated by intercostal nerves (IC transfers) acquired the properties of slow, fatigue-resistant muscles. Furthermore, histochemical studies showed that type II fibers were predominant in A transfers, whereas type I fibers were predominant in IC transfers. This study clearly demonstrates the differences between the spinal accessory nerve and intercostal nerves as donor nerves. This may lead us to select appropriate donor nerves for nerve-crossing procedures and free-muscle transfer depending on the desired functions to be reconstructed.

Accessory Nerve↗
PubMed1997

Ultrastructural changes in the nerve fiber population of anastomosed vagal and spinal accessory nerves in the sheep.

BACKGROUND: The ultrastructure of the vagal and spinal accessory nerves was studied 1) in normal sheep and 2) in sheep in which an experimental crossed-nerve anastomosis had been made by sectioning the supranodose vagal and spinal accessory nerves, then suturing the distal end of the vagal nerve to the distal end of the spinal accessory nerve, and allowing time for regeneration to occur. This study was carried out in order to analyze the modifications liable to occur when this technique is used and to specify the origin and the nature of the fibers that colonize the spinal accessory nerve. METHODS: The study was performed in 4- to 5-month-old-sheep. After the surgical procedure, the animals were housed indoors during 1 year until their sacrifice by fixative perfusion. Then, nerve samples were dissected out, processed for electron microscopy, examined, and systematically photographed. After printing, the diameters of the nerve fibers were determined. RESULTS: In sheep, the ratios of nonmyelinated to myelinated fibers (NF/MF) in the infranodose and supranodose vagal nerve and accessory spinal nerve were 1.21, 1.67, and 3.21, respectively. In both parts of the vagal nerve, the myelinated fibers had a unimodal diameter distribution around a peak of 4 microns; whereas, in the spinal accessory nerve, they were distributed bimodally, and 53% had values of 15-18 microns. After making the above anastomosis, the centrifugal vagal fibers degenerated, and the NF/MF ratios increased in the centripetal infranodose vagal nerve, in the reinnervating supranodose vagal nerve, and in the reinnervated spinal accessory nerve (approximately 1.87, 1.72, and 6.04, respectively). In all of these nerves, the myelinated fibers had a unimodal distribution with a peak at 4 microns, as in the vagal nerve of normal sheep. CONCLUSIONS: These results reveal the large part taken by the nonmyelinated fibers in the nerve fiber population of the vagal nerve and support the vagal origin of the fibers reinnervating the spinal accessory nerve.

Accessory Nerve↗
PubMed2002

Nerve transfer for treatment of brachial plexus injury: comparison study between the transfer of partial median and ulnar nerves and that of phrenic and spinal accessary nerves.

OBJECTIVE: To compare the effect of using partial median and ulnar nerves for treatment of C(5-6) or C(5-7) avulsion of the brachial plexus with that of using phrenic and spinal accessary nerves. METHODS: The patients were divided into 2 groups randomly according to different surgical procedures. Twelve cases were involved in the first group. The phrenic nerve was transferred to the musculocutaneous nerve or through a sural nerve graft, and the spinal accessary nerve was to the suprascapular nerve. Eleven cases were classified into the second group. A part of the fascicles of median nerve was transferred to be coapted with the motor fascicle of musculocutaneous nerve and a part of fascicles of ulnar nerve was transferred to the axillary nerve. The cases were followed up from 1 to 3 years and the clinical outcome was compared between the two groups. RESULTS: There were 2 cases (16.6%) who got the recovery of M4 strength of biceps muscle in the first group but 7 cases (63.6%) in the second group, and the difference was statistically significant (P<0.025). However, it was not statistically different in the recovery of shoulder function between the two groups. CONCLUSIONS: Partial median and ulnar nerve transfer, phrenic and spinal accessary nerve transfer were all effective for the reconstruction of elbow or shoulder function in brachial plexus injury, but the neurotization using a part of median nerve could obtain more powerful biceps muscle strength than that of phrenic nerve transfer procedure.

Adolescent↗
PubMed1988

Stretch-induced spinal accessory nerve palsy.

Left spinal accessory nerve palsy occurred in a young man when he quickly turned his head to the right while his shoulders were pulled down by heavy hand-held objects. Electrophysiologic studies demonstrated partial axonotmesis of the spinal accessory nerve branches innervating the sternocleidomastoid and upper and middle trapezius and complete axonotmesis of spinal accessory branches to the lower trapezius. There was a separate, although functionally minor, cervical plexus innervation of the lower trapezius.

Accessory Nerve Injuries↗
PubMedDate not supplied

Benign solitary nerve sheath tumors of the spinal accessory nerve in the posterior triangle of the neck. Report of two cases.

A case of solitary schwannoma and one of solitary neurofibroma originating from the spinal accessory nerve in the posterior triangle of the neck are described. Location of such neoplasms in this region is exceptional. The authors emphasize the importance of accurately enucleating the mass; when it is impossible to preserve the continuity of the neural pathway, nerve repair should be considered.

Accessory Nerve↗
PubMed2001

Meningeal carcinomatosis in patients with breast cancer: report of 8 patients.

BACKGROUND: Meningeal carcinomatosis (MC) is an uncommon but aggressive complication of advanced breast cancer with a recently increasing incidence. Although the prognosis is extremely poor for MC patients, early diagnosis and appropriate treatment are important. SUBJECTS AND METHODS: We reviewed 8 cases of MC from breast cancer at Kyoto University Hospital from 1990 to 1999. The median age was 51.5 years. All patients had widespread systemic metastases when diagnosed with MC. clinical symptoms were categorized into 3 groups: cranial nerve symptoms, spinal nerve symptoms, and other symptoms. Imaging studies were positive for MC in only 4 patients. Initial CSF cytology studies were positive in 4 patients, and repeated CSF cytology yielded positive results in the remaining 4 patients. Thus the median interval between the onset of any clinical symptom of MC and the initiation of treatment was 22.5 days (range 7 to 120 days ). All patients received whole brain radiotherapy (WBRT). Four patients were given intrathecal chemotherapy and/or intrathecal immunotherapy in addition to WBRT. RESULTS: Improvement of cranial nerve symptoms, spinal nerve symptoms, and other symptoms were observed in 3/5, 1/3, and 5/7 patients, respectively. Patients with cranial nerve symptoms who started WBRT within 29 days of the onset of the symptoms showed at least partial recovery whereas patients who started WBRT later showed no recovery. The median survival was 123 days (53 to 310 days). MC was the direct cause of death in 1 of 8 patients. CONCLUSION: When MC is clinically suspected, neither a negative imaging study nor a single negative CSF cytology can rule out MC. Prompt initiation of WBRT with or without intrathecal chemotherapy may be important for recovery from cranial nerve symptoms.

Adult↗
PubMed2001

[Angiotensin II in rostral ventrolateral medulla mediates amino acids release from spinally projecting nerve terminals in the spinal cord].

Microdialysis in the intermediolateral column (IML) was employed to examine amino acids release induced by angiotensin II (ANG II) applied into the rostral ventrolateral medulla (RVLM). Microinjection of ANG II (100 pmol, n = 11) into the RVLM significantly increased (P < 0.01) the release of aspartate (from 4.75 +/- 1.01 to 8.90 +/- 2.28 pmol/20 microliters) and glutamate (from 18.99 +/- 8.64 to 73.88 +/- 29.26 pmol/20 microliters) in the spinal cord. The increase of glutamate release was significantly attenuated (P < 0.05) by pretreatment with losartan (10 nmol, n = 8) at the same RVLM site. Immunofluorescence double labeling combined with confocal microscopic observation demonstrated that 62%-91% of the glutamatergic neurons in the RVLM were double-labeled with AT1 receptors, supporting the view that ANG II-induced glutamate release in the spinal cord may arise from the AT1 receptor-containing glutamatergic spinally projecting neurons in the RVLM.

Angiotensin II↗