RESUMEN
BACKGROUND: This study aimed to evaluate the structural changes of temporomandibular joint immediately after condylar fractures with magnetic resonance imaging (MRI). METHOD: We evaluated 34 subjects of condylar fractures with MRI. The position, shape, and signal intensity of the condyle, disc, and retrodiscal tissue were analyzed with MR images. RESULTS: Immediately after trauma, the disc was displaced with the fractured segment in almost all cases. And, the changes of signal intensity at the retrodiscal tissue were found but less related to the degree of fracture displacement. And, the high signals were observed almost at all fractured joint spaces and even at some contralateral joints. CONCLUSIONS: The displaced disc as well as the increased signal intensity of the joint space, condylar head, and retrodiscal tissue demands more attention to prevent the possible sequela of joint.
Asunto(s)
Cabeza , Articulaciones , Imagen por Resonancia Magnética , Cóndilo Mandibular , Fracturas Mandibulares , Métodos , Articulación TemporomandibularRESUMEN
This report describes the successful treatment of spontaneous intracranial hypotension (SIH) with multiple cerebrospinal fluid (CSF) leaks using 10 applications of epidural blood patches (EBP). A forty year old female who suffered with a postural headache was diagnosed as having SIH. On the cisternography, multiple CSF leaks were noted at the thoracic and lumbar area. Her headache was not improved with conservative treatments such as bed rest, hydration and NSAIDS. So, she underwent treatment with EBPs. After 10 applications of site-directed EBPs, her headache was resolved gradually and completely without any complications.
Asunto(s)
Femenino , Humanos , Antiinflamatorios no Esteroideos , Reposo en Cama , Parche de Sangre Epidural , Líquido Cefalorraquídeo , Cefalea , Hipotensión IntracranealRESUMEN
Essential hyperhidrosis is a socially disabling and emotionally embarrassing condition. Localized excessive sweating in the sacrococcygeal region is a rare form of focal hyperhidrosis. Although numerous treatment options exist, including botulinum toxin and sympathetic neurolysis, there has been no generally accepted form of treatment. The following cases describe the successful reduction of excessive sweating in the sacrococcygeal region, without side effects, after local applications of topical glycopyrrolate and the use of fast drying clothes.
Asunto(s)
Toxinas Botulínicas , Glicopirrolato , Hiperhidrosis , Región Sacrococcígea , Sudor , SudoraciónRESUMEN
BACKGROUND: Although lidocaine seems to be one of the most suitable spinal anesthetics for ambulatory surgery, the safety of lidocaine for spinal anesthesia has been called into question by report of transient neurologic toxicity. So diluted bupivacaine with opioids or adrenergic receptor agonist can replace spinal lidocaine, but delayed awakening, pruritis, intraoperative weak motor block are unsolved problems. This study explored the possibility of solving the unmerited problem to mix bupivacaine and plain lidocaine in spinal anesthesia for transurethral surgery. METHODS: Fifty patients presented for transurethral resection of bladder or prostate. The duration was expected to less one hour. All patients were randomized to two groups receiving the following spinal anesthetics: Group I (7.5 mg bupivacaine), 1.5 ml of 0.5% spinal bupivacaine in 8% dextrose + 0.6 ml saline; Group II (7.5 mg bupivacaine + 6 mg lidocaine), 1.5 ml of 0.5% spinal bupivacaine in 8% dextrose + 0.6 ml 1% plain lidocaine. The sensory and motor block level were checked via pinprick test and modified Bromage score. RESULTS: The highest level of sensory block was not different in group I and group II [median (range): T8 (T5-T9) vs. T8 (T5-T10)]. Onset time to peak block was similar in both groups (11+/-2 vs. 11+/-4 min). Time to two-segment regression (49+/-10 vs. 42+/-10 min; P < 0.05), L1 regression (139+/-27 vs. 113+/-24 min; P < 0.01), S2 regression (200+/-41 vs. 158+/-38 min; P < 0.01) were significantly reduced in group II. No clinical evidence of transient neurologic toxicity was found. Modified Bromage score to evaluate for motor block was not different at the same sensory block level. CONCLUSIONS: Bupivacaine and lidocaine mixture as spinal anesthetics provided the combination of adequate depth of anesthesia and rapid recovery.