ABSTRACT
Objectives: This study retrospectively investigated the prevalence and clinical features of trephine syndrome, which is a late complication of craniectom, in patients who underwent craniectomy decompression. Methods: Trephine syndrome was defined as an increase of ≥2 points in the functional independent measure (FIM) score at 7 days after cranioplasty compared with that 3 days before cranioplasty. Patients who underwent craniectomy at Kawasaki Medical School Hospital between January 1, 2010, and March 15, 2020, were included in the study. Results: During the observation period, 102 patients underwent craniectomy decompression; 71 of them later underwent cranioplasty. In total, 12 and 59 patients were assigned to the trephine and non-trephine syndrome groups, respectively. The patients in the trephine syndrome group were significantly younger than those in the non-trephine syndrome group (P<0.05). The mean durations±standard deviations (in days) from craniectomy decompression to cranioplasty were 57.1±38.9 and 83.6±69.3 for the trephine and non-trephine syndrome groups, respectively (P<0.05). Improvements in the FIM motor scores were greater than the improvements in the cognitive scores for all but one case (P<0.05). The frequency with which patients experienced exacerbation (worsened consciousness and sudden anisocoria) after hospitalization was significantly higher in the trephine syndrome group than in the non-trephine syndrome group (P<0.05). Conclusions: Performing cranioplasty as early as possible in young patients may lead to functional improvement. In the trephine syndrome group, the improvement in motor FIM score was greater than that of the cognitive score. Moreover, post-hospitalization exacerbation was more frequent in the trephine syndrome group.
ABSTRACT
Arai N, Yoshimura M, Yamamoto S, Abe H, Hanayama K. Effectiveness of simple body image evaluation and manipulation for chronic pain: A case report. Jpn J Compr Rehabil Sci 2021; 12: 15-18. Introduction: We report a case in which chronic pain was successfully relieved using a new simple body image evaluation and body image manipulation based on the evaluation results. Case: The patient, a man in his 60s, accidentally sustained a left ulnar trunk fracture and left hand degloving injury at work. Occupational therapy for approximately 2 years could not completely relieve pain in the ring finger (allodynia), causing difficulty in changing clothes and driving a car. Images of the left and right ring fingers were compared and manipulated using bandages to make the two images similar. Allodynia was reduced (visual analog scale 10 cm â 3.6 cm), and the ability to change clothes and drive a car improved. Discussion: The bandage presumably changed the tactile and visual information inputs of size, weight, length, thickness, and thickness and reconstructed the perceptual-motor loop.
ABSTRACT
The purpose of this study was to confirm that the arytenoid regions dynamically adduct and extend upward toward the epiglottis during laryngeal elevation. While 14 healthy volunteers aged 19-32 years old swallowed 5 ml of white soft yogurt in one gulp without chewing, the movement of the arytenoid regions was observed for videoendoscopic evaluation of swallowing (VE). Each moving image was stored simultaneously on videotape. A cross-sectional area surrounded by the epiglottis and the bilateral arytenoid regions (S) and the length of a straight line passing through the anterior borders of the left and right arytenoid regions (L) were measured. The relative area of the entrance in the laryngeal vestibule was calculated as [S/L (2)] before the swallowing reflex (resting condition), just before laryngeal closure, and just after laryngeal closure. [S/L (2)] was smaller just before epiglottal descent than at the resting condition, and became smallest just after the epiglottis started to ascend. The mean area narrowed to 37.9% of the resting area just after laryngeal closure and in the most extreme case to 8.7% of the resting area. It was demonstrated that the arytenoid regions adducted and extended up toward the epiglottis during laryngeal elevation. The technique used to measure the cross-sectional area of the entrance in the laryngeal vestibule employing VE was an effective analytical procedure.
