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At least 145 records · Page 8Linked to original sources
PubMed1997

Radiologic imaging of the carpal tunnel.

Compression neuropathy of the median nerve (carpal tunnel syndrome) is the most common nerve compression syndrome of the extremities. Although the disease is usually diagnosed on the basis of clinical examination and nerve conduction studies, radiologic imaging plays an important role in equivocal cases and especially in the assessment of recurrent or unrelieved symptoms after surgical carpal tunnel release. While plain radiographs and computed tomography are of limited diagnostic value except for the evaluation of osseous carpal stenosis and soft tissue calcifications, high-resolution sonography and magnetic resonance imaging allow for direct visualization of the compressed median nerve and the other soft tissue structures of the carpal tunnel. Due to its excellent contrast resolution, magnetic resonance imaging is superior in detecting mild degrees of median nerve compression and in identifying potential causes of carpal tunnel syndrome, such as tenovaginitis of the flexor tendons or space-occupying lesions. However, the low cost and time requirement favor the use of sonography as the initial imaging study in evaluating the carpal tunnel.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[A case of osteopoikilosis combined with dermal changes and compression syndromes of peripheral nerves].

In the case of combination of osteopoikilosis with dermal alterations we wanted to know if the hereby discussed general mesenchymal lesions are the cause of the additional entrapment syndromes of peripheral nerves present in our case. For this purpose we recorded the pressure at the distal median and ulnar nerves within and out of the entrapment location. The results of the pressure recording of not point to a primary nerve lesion by a elevated pressure susceptibility or a pressure elevation at the peripheral nerve out of a defined entrapment location e.g. by an increase of connective tissue. Because of a hypertrophic scar formation in this case it should be paid attention to the wound healing of all patients with osteopoikilosis. The histologically verified nevoid mesenchymal alterations of the connective tissue found in this case, are to be delineated from the disseminated lenticular dermatofibrosis of the Buschke-Ollendorff syndrome.

Bone and Bones↗
PubMedDate not supplied

Internal neurolysis.

One hundred seventy-eight patients diagnosed with a lower extremity nerve compression syndrome were treated conservatively using orthopedic, medical, and physical therapy modalities. Eighty-two per cent of these patients improved and recovered, and required no further care. Eighteen per cent of these patients did not recover or experience significant improvement in their sensory or motor loss. This chronic group was treated by internal neurolysis. Ninety-five per cent of this chronic group treated by internal neurolysis improved. Only 5% did not have significant prolonged relief or improvement and eventually required excision of a sensory peripheral nerve. Internal neurolysis may not be indicated in those patients who suffer from transient sensory paresthesias; conservative care and/or an external peripheral nerve decompression may suffice. Internal neurolysis is indicated in those patients who have constant sensory aberations or motor loss from a chronic peripheral nerve compression syndrome or any other nerve lesion that has not responded well to conservative care or to an external nerve decompression procedure. Internal neurolysis, in addition to conservative care regimes presented here, has been found to be effective in reversing heretofore thought to be irreversible pain syndromes in the lower extremity even when significant atrophy has already occurred.

Foot Diseases↗
PubMed1981

[Carpal tunnel syndrome in infants].

We have observed and operated on 5 children at the age of 15 months to 6 years for carpal tunnel syndrome. 4 children, all belonging to the same family had bilateral median nerve compression syndrome. These 4 children also suffered from bilateral tenosynovitis, and a mild form of mucopoolysaccharidosis (M. Scheie) was diagnosed. The symptoms in all 5 children were uncharacteristic and initially difficult to associate with nerve compression at first. Numbness and dysaesthesia in the thumb, index and middle finger, the most frequent signs in adult patients, were missing. In these children, the observation of general manual clumsiness, unusual patterns of grasping, sudden change in playing habits with avoidance of manual activity led to the suspicion of a median nerve compression syndrome. In all children decompression of the median nerve resulted in normalization or marked improvement of hand function.

Carpal Tunnel Syndrome↗
PubMed1994

Intercondylar fractures of the distal humerus: routine anterior subcutaneous transposition of the ulnar nerve in a posterior operative approach.

Intercondylar fractures of the distal humerus in adults are rare and notoriously difficult to treat. The goals of open reduction are to preserve the articular surface and restore elbow function. We treated 20 patients by open reduction with dual-plate internal fixation and routine anterior subcutaneous transposition of the ulnar nerve. The follow-up period ranged from 15 to 35 months. The fractures were classified according to Muller's system. The results were evaluated using the Cassebaum rating system and subjective functional status. Excellent or good results were achieved in 15 elbows (75%), two had a fair result, and three, poor. A clearer understanding of fracture patterns, rigid dual-plate internal fixation, and early rehabilitation are needed to improve the results from this vexing injury. We recommended routine ulnar nerve anterior subcutaneous transposition using a posterior approach. Compared with published reports, our preliminary results demonstrated no postoperative ulnar nerve compression syndrome at follow-up. Routine anterior subcutaneous transposition of the ulnar nerve to avoid the postoperative ulnar nerve compression syndrome is required.

Adult↗
PubMed1991

The cranial nerve vascular compression syndrome: I. A review of treatment.

The author reviews current literature on microvascular decompression (MVD) for treatment of hemifacial spasm (HFS) and trigeminal neuralgia (TN), which shows that MVD is an effective treatment for these disorders. Although there are treatments for TN other than MVD that demonstrate a high rate of success, MVD is the only effective long-term treatment for HFS. MVD is also an effective treatment for glossopharyngeal neuralgia (GPN), and recently MVD has been shown to be an effective treatment for particular types of vertigo (disabling positional vertigo, DPV) and certain types of tinnitus.

Cranial Nerve Diseases↗
PubMed1991

The cranial nerve vascular compression syndrome: II. A review of pathophysiology.

The various hypotheses regarding the pathophysiologies of trigeminal neuralgia and hemifacial spasm are reviewed, and the results of recent physiological studies on the pathogenesis of hemifacial spasm are discussed. Evidence is presented that strongly supports the hypothesis that the symptoms and signs of hemifacial spasm are caused by hyperactivity in the facial motonucleus. Some of the contradictions regarding the prevalence of vascular conflicts in the cerebellopontine angle and the symptoms of vascular compression are discussed, and a hypothesis is presented that assumes that a suitable substrate must be present, in addition to vascular compression of the respective cranial nerve root, for the symptoms and signs of a cranial nerve vascular compression disorder to develop. Finally, it is discussed how this hypothesis can explain some of the differences between the disorders that can be cured by microvascular decompression of respective cranial nerves.

Cranial Nerve Diseases↗
PubMed1999

[Peroneal nerve paresis after long-term bed rest in intensive care patients].

Despite careful nursing and physiotherapy, wasting, myopathy and neuropathy are commonly seen in sedated or comatose intensive care patients undergoing long term bedrest. Four cases of peroneal nerve lesion with drop-foot are described in patients with up to eight weeks of immobilisation due to severe infections complicated with multiple organ failure. No other peripheral nerve compression syndromes were found. These isolated nerve lesions could not be related to the metabolic or cerebral status of the patients. To avoid rotation of the hipjoints with secondary muscle contracture the nursing procedure in the ICU had been changed shortly before the incidents of drop-foot were detected. Along with well-known prophylactic anti-compression procedures, sandbags were now placed on the lateral side of the knees. After abandoning this new procedure, peroneal nerve lesions have not been seen.

Adult↗
PubMed1989

[Syndrome of compression of the external saphenous nerve (or the sural nerve)].

The authors describe a new canal syndrome, which they call the "superficial sural aponeurosis canal syndrome" or "sural nerve tunnel syndrome". Mostly seen in sportsmen, it was observed in this case in the context of a myositis ossificans circumscripta of the tendo-muscular junction of the heel. The clinical signs are caused by compression of the sural nerve where it passes through a nonextensible tunnel formed by the fold of the posterior sural aponeurosis. This is distinguished from a loge syndrome; the most typical clinical sign is increased pain in the territory of the sural nerve during plantar flexion of the ankle; in this position reduced sensory conduction velocity is measured. The treatment consists in a section of the fibro-aponeurotic arch.

Female↗
PubMed1993

Relative frequency of nerve conduction abnormalities at carpal tunnel and cubital tunnel in France and the United States: importance of silent neuropathies and role of ulnar neuropathy after unsuccessful carpal tunnel syndrome release.

The two most frequently diagnosed nerve compression syndromes of the upper extremities are carpal tunnel syndrome and cubital tunnel syndrome. In order to determine the relative frequencies of nerve conduction abnormalities at the carpal tunnel and cubital tunnel in France and the United States, we evaluated all patients (nFR = 882 and nUS = 818) who had nerve conduction studies of the upper extremities over a six-yearFR or three-yearUS interval. In both France and the United States, the risk of electrophysiological abnormalities was 2 to 1 for the wrist relative to the elbow. Abnormal median nerves were twice as likely to be symptomatic as were abnormal ulnar nerves (silent ulnar neuropathy). Thus, the clinical risk for carpal tunnel syndrome relative to cubital tunnel syndrome was approximately 4 to 1. In many cases of persistent hand symptoms following carpal tunnel release, the problem may actually be related to an undiagnosed ulnar nerve lesion. Thus, a complete neurophysiological evaluation of the upper extremity necessitates both median and ulnar studies.

Adolescent↗
PubMed1999

Synovial osteochondromatosis at the elbow producing ulnar and median nerve palsy. Case report and review of the literature.

The authors present the case of a 53-year-old woman suffering from synovial osteochondromatosis of her right elbow responsible for ulnar and median nerve entrapment neuropathy. This condition is characterised by the formation of multiple cartilaginous nodules in the metaplastic synovium of otherwise normal joints, bursae or tendon sheaths. Treatment consisted of partial synovectomy, removal of loose bodies and microscopic nerve release. Synovial osteochondromatosis complicated by nerve compression syndromes has been rarely reported, usually with ulnar tunnel syndrome at the elbow. The literature on this subject is reviewed.

Chondromatosis, Synovial↗
PubMed1987

Synovial chondromatosis presenting with peripheral nerve compression--a report of two cases.

We report two cases of synovial chondromatosis presenting with peripheral nerve compression syndromes involving respectively the median nerve at the wrist and the posterior interosseous nerve at the elbow. Only one previous instance of nerve compression due to this condition has been described, involving the ulnar nerve at the elbow. In one of our cases the disease process was at an early stage in its natural history and in the other at an advanced stage. The occurrence of nerve compression was related to the site rather than the stage of the disease. Full recovery followed local excision with decompression of the peripheral nerve involved.

Aged↗
PubMed1991

[Long-term results after neurolysis and palmar transposition of the ulnar nerve].

We reviewed 41 patients with 43 proximal ulnar nerve compression syndromes. The usual procedure was neurolysis of the ulnar nerve und subcutaneous transposition. The average follow-up period was 5 1/2 years (15 1/4 years to 3 months). The M/F ratio is 2.4:1. Most of the patients are hard manual workers, the dominant arm is most often affected, and 60% have some form of an injury in their history. About half of the patients followed-up have extensive relief of pain, loss of sensibility and weakness of the hand. But only 8 patients feel to have a perfect result. A few do complain of some tenderness in the scar region, some sensibility loss and a Tinel sign along the anterior route of the transposed nerve. Regaining of strength last months or even years. There is a general tendency to better final results in younger patients.

Adolescent↗
PubMed1999

Neurovascular compression syndrome of the eighth cranial nerve. Can the site of compression explain the symptoms?

Considerable skepticism still exists concerning the concept of neurovascular compression (NVC) syndromes of the eighth cranial nerve (8th N). If such syndromes exist, the sites of compression of the nerve must explain the symptoms encountered. We recorded compound action potentials of the cochlear nerve (CCAPs) during neurovascular decompression (NVD) to examine the topography of the three components of the 8th N. The sites of compression of the 8th N in cases of NVC syndrome confirmed at surgery were superimposed on the topography of the CN and vestibular nerve (VN) in order to determine the relationship between the sites of compression and the symptoms. CCAPs were clearly and consistently recorded on the caudal surface of the 8th N along the midline. In patients with vertigo and tinnitus there was vascular compression of the rostroventral (VN) and caudal surface (CN) of the nerve, respectively. In patients with both vertigo and tinnitus, there was compression of both VN and CN. Our findings clearly demonstrate that the symptoms of NVC of the 8th N depend on the part of the nerve that is compressed by blood vessels, and they support the concept of NVC syndrome of the 8th N.

Action Potentials↗
PubMed1979

Syndromes of compression of the median nerve in the proximal forearm (pronator teres syndrome; anterior interosseous nerve syndrome).

Entrapment of the median nerve in the proximal forearm is seen in two forms: the pronator teres syndrome, and the anterior interosseous nerve (or Kiloh-Nevin) syndrome. Both syndromes are rare, and they comprised approximately 1% of the compression syndromes of the upper limb which were treated operatively by the authors. The symptoms, signs, etiologies, and intraoperative findings are discussed. It is pointed out that certain of the clinical features may resemble those of irritation of the median nerve by a supracondylar process or Struthers' ligament. Although both proximal median entrapment syndromes have a favorable prognosis when treated non-operatively, the authors recommend operative treatment in cases in which there is no perceptible improvement following 8 weeks of non-operative treatment, since this is likely to speed and enhance recovery. Nine cases of the pronator teres syndrome (8 treated successfully by operation, 1 failure) and 2 cases of the anterior interosseous nerve syndrome (both fully recovered) are added to the cases reported previously in the literature.

Adult↗
PubMed2004

Hand surgery in organ transplant patients.

PURPOSE: This study presents a series of organ transplant patients who developed problems that affected their upper extremities, related to the organ transplant operation itself, to the patient's underlying systemic disease, to long-term immunosuppression, or to subsequent hand injury after the organ transplant surgery. METHODS: A retrospective chart review of 40 organ transplant patients with upper extremity problems at 3 major organ transplant centers was performed. RESULTS: Six general problems were identified that affected the hand and upper extremity in these transplant patients: inflammatory conditions (16), nerve compression syndromes (18), infections (6), neoplasms (6), vascular problems (4), and trauma (14). Thirty-eight patients had 72 separate hand procedures. No problems were encountered with postoperative infections, and skin and bony healing occurred uneventfully. CONCLUSIONS: Organ transplant patients are prone to developing atypical infections, skin malignancies, ischemia, and various nerve compression syndromes that affect the hand. These patients with upper-extremity problems should be treated in a manner similar to any patient without prior organ transplant.

Bursitis↗