Assuntos
Coloração Cromossômica , Cromossomos Humanos Par 21/genética , Sequência Conservada/genética , Ordem dos Genes/genética , Mapeamento de Híbridos Radioativos , Suínos/genética , Animais , Peso ao Nascer/genética , Humanos , Escore Lod , Característica Quantitativa Herdável , Homologia de Sequência do Ácido Nucleico , Sitios de Sequências RotuladasRESUMO
One hundred seventy patients with radial nerve disorders were reviewed at the Louisiana State University Medical Center over a 15-year period. Of these, 32 had involvement of the posterior interosseous nerve exclusively. Findings included weak wrist extension with a radial drift, inability to extend the fingers, paralysis of thumb extension, and weak thumb abduction. Causes included entrapment at the arcade of Froshe (14 patients), laceration (6 patients), fracture (6 patients), compression or contusion (3 patients), and loss associated with tumor (3 patients). The ratio of men to women was 2:1, and the right arm was involved twice as often as the left. Preoperative evaluation included physical examination, electrophysiological testing (electromyogram/nerve conduction velocity), and roentgenograms of the elbow and forearm. Of the 30 patients (2 patients had bilateral lesions), 26 underwent operation. In the operative series, all 28 nerves had a function of Grade 3 or more of a possible 5 after 4 years of follow-up. Seventeen had achieved Grade 4/5, and 7 had obtained Grade 5/5. At operation, 23 nerves were found to be in continuity. Fourteen lesions of nerves in continuity were associated with entrapment and, not unexpectedly, transmitted a nerve action potential with slowed conduction and low amplitude across the lesion. Four nerves in continuity that had lesions caused by injury had nerve action potentials and were treated by neurolysis, and another 4 had no nerve action potentials and were treated by graft or suture repair. Five injured nerves were not in continuity. Two could be repaired by end-to-end suture, and 3 required graft repair. A large ganglion cyst involving the posterior interosseous nerve was also resected.
Assuntos
Doenças do Sistema Nervoso Periférico , Nervo Radial , Potenciais de Ação , Traumatismos do Braço/complicações , Feminino , Fixação de Fratura/efeitos adversos , Fraturas Ósseas/complicações , Fraturas Ósseas/cirurgia , Mãos/inervação , Humanos , Masculino , Síndromes de Compressão Nervosa/etiologia , Síndromes de Compressão Nervosa/cirurgia , Condução Nervosa , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/cirurgia , Nervo Radial/lesões , Nervo Radial/fisiopatologia , Nervo Radial/cirurgia , Cisto Sinovial/complicações , PunhoRESUMO
A case of thoracic spinal cord compression caused by intradural extramedullary cyst associated with aspergilloma is presented. The specific diagnosis was extremely difficult and required specialized tissue studies. Clinical suspicion of fungal infection, surgical intervention for spinal cord decompression, and tissue biopsy and relentless diagnostic laboratory studies are particular features of this case.
