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1.
NeuroRehabilitation ; 54(1): 75-90, 2024.
Article in English | MEDLINE | ID: mdl-38251069

ABSTRACT

BACKGROUND: Following a severe acquired brain injury, neuro-orthopaedic disorders are commonplace. While these disorders can impact patients' functional recovery and quality of life, little is known regarding the assessment, management and treatment of neuro-orthopaedic disorders in patients with disorders of consciousness (DoC). OBJECTIVE: To describe neuro-orthopaedic disorders in the context of DoC and provide insights on their management and treatment. METHODS: A review of the literature was conducted focusing on neuro-orthopaedic disorders in patients with prolonged DoC. RESULTS: Few studies have investigated the prevalence of spastic paresis in patients with prolonged DoC, which is extremely high, as well as its correlation with pain. Pilot studies exploring the effects of pharmacological treatments and physical therapy show encouraging results yet have limited efficacy. Other neuro-orthopaedic disorders, such as heterotopic ossification, are still poorly investigated. CONCLUSION: The literature of neuro-orthopaedic disorders in patients with prolonged DoC remains scarce, mainly focusing on spastic paresis. We recommend treating neuro-orthopaedic disorders in their early phases to prevent complications such as pain and improve patients' recovery. Additionally, this approach could enhance patients' ability to behaviourally demonstrate signs of consciousness, especially in the context of covert awareness.


Subject(s)
Consciousness Disorders , Orthopedics , Humans , Consciousness Disorders/diagnosis , Consciousness Disorders/etiology , Consciousness Disorders/therapy , Muscle Spasticity/diagnosis , Muscle Spasticity/etiology , Muscle Spasticity/therapy , Quality of Life , Consciousness , Paresis , Pain , Persistent Vegetative State/rehabilitation
2.
Rev. chil. pediatr ; 74(6): 599-603, nov.-dic. 2003. ilus
Article in Spanish | LILACS | ID: lil-388746

ABSTRACT

Entre las complicaciones posibles de observar en un paciente con un Síndrome nefrótico, deben considerarse los fenómenos trombóticos tanto venosos como arteriales, incluyendo la trombosis de senos venosos cerebrales. Objetivo:Presentar la evolución de un niño que desarrolló una trombosis de seno longitudinal superior asociada a un Síndrome nefrótico, comparando la evolución de nuestro paciente con los 32 casos descritos en la literatura. Caso clínico: Varón de 14 años que ingresó por síndrome nefrótico descompensado y cefalea moderada, asociado a papiledema bilateral, en el cual el scanner cerebral y la angioresonancia mostraron una trombosis de seno longitudinal superior en etapa aguda. El hallazgo más significativo fue un aumento de la presión intracraneana de hasta 44 cm. de agua. El aumento progresivo de los anticuerpos IgM anticardiolipinas determinó una terapia anticoagulante permanente. Discusión:En el síndrome nefrótico un estado de hipercoagubilidad y otros factores como deshidratación o traumatismos menores, pueden causar trombos en diferentes vasos, incluyendo los senos cerebrales. El seno más frecuentemente comprometido es el seno longitudinal superior. La sintomatología puede ser escasa a pesar de una marcada hipertensión endocraneana, motivo por el cual esta condición puede ser subdiagnosticada si no se realiza una búsqueda dirigida.


Subject(s)
Humans , Male , Adolescent , Intracranial Pressure , Nephrotic Syndrome/complications , Sagittal Sinus Thrombosis/complications , Sagittal Sinus Thrombosis/diagnosis , Sagittal Sinus Thrombosis/drug therapy , Anticoagulants , Diagnostic Imaging
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