The Nerve最新文献

{"title":"Effects of Antiplatelet Agents on Cerebral Vasospasm and Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage Patients Treated with Coil Embolization","authors":"Ki Dong Baek, Jae Hoon Kim, H. Kang, In-Suk Bae, C. Jwa","doi":"10.21129/nerve.2022.00206","DOIUrl":"https://doi.org/10.21129/nerve.2022.00206","url":null,"abstract":"Objective: This study aimed to investigate the role of antiplatelet agents (APAs) in preventing cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (SAH) patients treated with coil embolization. Methods: We reviewced data from 131 consecutive patients who underwent coil embolization following aneurysmal SAH from January 2011 to May 2021. We finally recruited 108 patients and analyzed the occurrence of CVS and DCI, as well as the modified Rankin Scale (mRS) score at discharge according to the use of APA (APA group [n=32] vs. non-APA group [n=76]). Results: The baseline characteristics, except patient age, were not significantly different between the APA and the non-APA groups. DCI (p=0.846), transcranial Doppler ultrasonographic vasospasm (p=0.449), angiographic vasospasm (p=0.176), and mRS scores at discharge (p=0.194) were also not significantly different between the groups. Newly developed cerebral infarction was significantly more frequent in the APA group (p=0.027). Conclusion: APA use did not reduce the occurrence of CVS and DCI in aneurysmal SAH patients treated with coil embolization, indicating that the effect of APAs on clinical outcomes may be trivial compared with other risk factors.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131252480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association of Acute Myocardial Infarction with Pyogenic Spondylitis in Korea: A Nationwide Longitudinal Cohort Study","authors":"Sol Kim, Hakyung Kim, Jimin Kim, Woojun Kim, J. Hong, Jung-Keun Lee, S. Sheen, I. Han, Seil Sohn","doi":"10.21129/nerve.2022.00115","DOIUrl":"https://doi.org/10.21129/nerve.2022.00115","url":null,"abstract":"Objective: The goal of this nationally matched longitudinal study was to investigate the relationship between acute myocardial infarction (AMI) and pyogenic spondylitis (PS) in Korea. Methods: We collected patient data from the National Health Insurance Service Health Screening cohort from January 1, 2004 to December 31, 2015. PS was classified using the In-ternational Classification of Diseases codes M46.2 (osteomyelitis), M46.8 (inflammatory spon-dylopathy), M49.2 (enterobacterial spondylitis), and M49.3 (enterobacterial spondylitis) (spon-dylopathy in other infectious and parasitic diseases). The PS group had a total of 628 patients. The control group included 3,140 people. Utilizing the Kaplan-Meier technique, the groups’ AMI rates were estimated. A Cox proportional-hazards regression analysis was used to com-pute the hazard ratio for AMI. Results: After controlling for age and sex, the hazard ratio for AMI in the PS group was 2.241 (95% confidence interval [CI], 1.112–4.516). The adjusted hazard ratio in the PS group was 2.138 after controlling for demographics and concomitant medical conditions (95% CI, 1.056– 4.318). In a subgroup analysis, the AMI percentages were substantially greater in the PS group in women over 65, those with diabetes, and in non-hypertension and non-dyslipidemia sub-groups. Conclusion: This nationwide longitudinal study found that PS patients had an elevated risk of AMI.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121906511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Extracranial Meningioma Mimicking Musculoskeletal Malignancy: A Case Report","authors":"S. Han, Won Hee Lee","doi":"10.21129/nerve.2022.00108","DOIUrl":"https://doi.org/10.21129/nerve.2022.00108","url":null,"abstract":"covering of the brain or spinal cord. It is essentially an extracranial tumor and can mimic musculoskeletal malignancies. A 74-year-old woman presented with a mass on the right fronto-temporal scalp that had been present for 2 years. Magnetic resonance imaging revealed osteolysis in the right frontal, temporal, and sphenoid bone and involvement of the right temporalis muscle, mimicking a musculoskeletal malignancy. The mass was resected, and the confirmed histological diagnosis was primary extracranial meningothelial meningioma (World Health Organization grade I). The patient was discharged without complications, and no evidence of tumor recurrence was apparent 48 months after surgery. This case supports complete surgical excision without adjuvant therapy as the modality of choice for PEM since meningioma is radioresistant and recurrence is very rare after adequate surgical resection.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128188425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-Dimensional Printed Mesh-Cage Replacement for a Metastatic Spinal Tumor and a Vertebral Compression Fracture: A Report of Two Cases","authors":"Jin-Gun Rim, H. Jang, K. Kim, Jeong-Yoon Park, D. Chin, Keun-Su Kim, Yong-Eun Cho, Seung-Kwan Ryu","doi":"10.21129/nerve.2022.00122","DOIUrl":"https://doi.org/10.21129/nerve.2022.00122","url":null,"abstract":"Harms mesh cages are commonly used in the treatment of metastatic spinal tumors by spondylectomy with cage insertion and posterior screw fixation. These cages are even useful for the surgical reconstruction of spinal deformities with mesh-cage replacement after vertebral column resection (VCR). Mesh cages can be customized by 3-dimensional (3D) printing based on the angle between the endplates for the requisite weight-bearing capacity and fit. This study reports two cases wherein a 75-year-old man and a 63-year-old woman were treated with reconstructive spondylectomy and mesh-cage replacement, followed by posterior screw fixation. The 75-year-old man was initially diagnosed with an L4 metastatic non–small cell lung carcinoma accompanied by a pathologic fracture and severe paralysis. The 63-year-old woman had slipped 13 years before and sustained a T11-L1 compression fracture that was ag-gravated 6 months before this admission, with back pain and numbness in both soles. Herein, we describe the treatment approach with instrumentation using a customized 3D-printed mesh cage after total spondylectomy for the metastatic spinal tumor and after VCR for deformity repair surgery in the respective cases. Our application of a 3D-printed mesh cage in surgery for a metastatic tumor is the first report of such treatment in Korea. Although the use of customized 3D-printed cages for a metastatic spinal tumor and a severe compression fracture was effective, challenges remain regarding fitting, manufacturing time, and costs.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"189 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134347291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double Fascicular Nerve Transfer to Restore Elbow Flexion Following Neuralgic Amyotrophy: A Case Report","authors":"K. Chung, Jinseo Yang, Yong-Roew Cho, S. Kang, H. Choi, Jinpyeong Jeon","doi":"10.21129/nerve.2022.00080","DOIUrl":"https://doi.org/10.21129/nerve.2022.00080","url":null,"abstract":"who was diagnosed with neuralgic amyotrophy (NA) 2 years previously. We aimed to investigate the short-term outcomes and feasibility of DFNT applied to non-traumat-ic neuropathy. A 63-year-old, right-handed man presented to us with persistent right elbow flexion weakness 24 months after receiving the diagnosis of NA. On examination, biceps strength was 0/5, and shoulder abduction strength was 3/5. Magnetic resonance neurography demonstrated muscle atrophy in the upper trunk. DFNT was considered to restore elbow flexion. The donor and recipient fascicles were then coapted (flexor digitorum superficialis to biceps brachii, flexor carpi ulnaris to brachialis). Postoperatively, paresthesia was reported in the area of ulnar innervation, and the patient complained of hand clumsiness. From postoperative day 10 onward, biceps muscle contracture was identified and on the 14th day, grade 3 elbow flexion strength was observed. We suggest that DFNT may be a safe and effective method to restore elbow flexion in patients with NA.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115841475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Subdural Hygroma Due to Injury of an Ommaya Reservoir: A Case Report","authors":"Seung Bin Sung, Young Deok Kim, H. Jeong","doi":"10.21129/nerve.2022.00129","DOIUrl":"https://doi.org/10.21129/nerve.2022.00129","url":null,"abstract":"68-year-old the emergency department after a passerby found him lying on the road with a bicycle. He had been diagnosed with neurolymphomatosis in and had an Ommaya reservoir targeted to the right lateral ventricle via the right Kocher’s point for chemotherapy. His initial mental status was stuporous. Brain computed tomography (CT) showed multiple traumatic injuries. Seven days after admission, bilateral subdural hygroma (SDG) developed. We performed CT cisternography. The contrast was directly injected into the Ommaya reservoir and CT images were obtained. On cisternography, contrast leakage points were identified from the Ommaya reservoir. The patient underwent surgery for Ommaya reservoir removal and occlusion of the permanent tract of the Ommaya reservoir. This case shows a rare etiology of traumatic SDG and demonstrates the usefulness of CT cisternography to determine cerebrospinal fluid leakage from an implant.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134422361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Cranioplasty vs. Staged Cranioplasty for Reconstruction of Bilateral Craniectomy","authors":"Young-Min Park, James Y. Shin, Young Il Kim, B. Son, J. Sung, Young-Joo Kim, S. Yang","doi":"10.21129/nerve.2022.00101","DOIUrl":"https://doi.org/10.21129/nerve.2022.00101","url":null,"abstract":"Objective: Cranioplasty (CP) following decompressive craniectomy (DC) is of low complexity surgically. However, even this “simple” procedure may have a high complication rate, especial-ly for the reconstruction of bilateral craniectomy compared to the reconstruction of unilateral craniectomy. This study aimed to assess and compare the rate of complications between simultaneous and staged CP for the reconstruction of bilateral craniectomy. Methods: All patients who underwent CP at our institution following DC for stroke or traumatic brain injury between 2008 and 2017 were reviewed. A total of 139 patients were iden-tified, of whom 17 underwent bilateral CP. Simultaneous and staged CP was performed in 6 and 11 patients, respectively. The median time from craniectomy until CP was 94 days (range, 25-220 days). In patients with staged CP, the interval between the first CP and the second CP was 15 days (range, 6-43 days). The overall rate of complications, such as postoperative bleed-ing, seizures, postoperative infection, and hydrocephalus, was 16%. Results: There were no statistically significant differences in outcome variables between simultaneous CP and staged CP for the reconstruction of bilateral craniectomy, except for estimated blood loss. The estimated blood loss was lower in patients who underwent staged CP than in those who underwent simultaneous CP. The length of hospital stay was naturally longer when staged CP was performed. Conclusion: No significant differences were found in outcome variables between simultaneous and staged CP for the reconstruction of bilateral craniectomy, except for estimated blood loss and the length of hospital stay. Therefore, simultaneous CP might be more beneficial for economic reasons than staged CP.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126272861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid Regrowth of Atypical Teratoid Rhabdoid Tumor after Gross Total Resection in Adult: Case Report","authors":"Jun Mo Kim, Gwang Yoon Choi, K. Choi, H. Choi","doi":"10.21129/nerve.2022.00094","DOIUrl":"https://doi.org/10.21129/nerve.2022.00094","url":null,"abstract":"Atypical teratoid/rhabdoid tumors (AT/RTs) are rare embryonal tumors. Herein, we present an unusual case of an AT/RT showing rapid regrowth to more than its original size approximately 1 month after gross total resection (GTR). A 22-year-old man presented with a severe headache. On magnetic resonance imaging (MRI), a tumor was found in the left cerebellopontine angle (2.8 × 3.7 × 3.7 cm; 38.3 cm 3 ). GTR was performed, and biopsy confirmed AT/RT. On day 38 after surgery, a follow-up MRI due to abrupt mental deterioration to coma was performed, showing that the tumor had regrown to be even larger than its original size (3.6 × 3.5 × 5.3 cm; 66.78 cm 3 ). After 1 month, the patient died. The median survival of AT/RT patients who undergo GTR is 20 months. In our case, the patient died much earlier than the previously reported overall survival duration after GTR. Therefore, physicians should always be wary of the possibility of rapid regrowth of AT/RTs when establishing the treatment plan.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115104325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Transgluteal Approach for Decompression of Sciatic Nerve Entrapment (Piriformis Syndrome) with Intraoperative Neurophysiology: A Technical Note","authors":"B. Son, Changik Lee","doi":"10.21129/nerve.2022.00087","DOIUrl":"https://doi.org/10.21129/nerve.2022.00087","url":null,"abstract":"in-Although the transgluteal approach splitting the gluteus maximus muscle has been reported as a posterior approach for sciatic nerve entrapment (piriformis syndrome), detailed descrip-tions of the surgical steps and intraoperative findings have not been published. Thus, the objective of this study was to present the transgluteal approach for decompression surgery of sciatic nerve entrapment in the subgluteal space. A method of circumferentially decompressing the sciatic nerve from the surrounding piriformis muscle was devised by decompressing it to the level of the sacrotuberous ligament, which was more proximal than the existing decompression range. Surgical findings are presented step-by-step in the stages of localization, exposure, and decompression of the sciatic nerve during surgery. We also emphasize the importance of intraoperative nerve monitoring to identify the sciatic nerve and its branches and the inferior gluteal nerve during surgery performed under general anesthesia. Our observations of intraoperative electromyographic responses by individual nerve stimulation are summarized and reported.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130299324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiency and Safety of Percutaneous Spinal Biopsy Using Forceps","authors":"Junyeong Jeon, H. Shin, B. Park, J. H. Park, Jung Jae Lee","doi":"10.21129/nerve.2022.00059","DOIUrl":"https://doi.org/10.21129/nerve.2022.00059","url":null,"abstract":"Objective: Percutaneous spinal biopsy is an important tool in the detection and evaluation of patients with metastatic tumors, primary tumors, and infectious spondylitis. It has been reported that in lesions resistant to tissue-tearing, an accurate diagnosis via percutaneous needle biopsy is difficult. A few studies have performed spinal biopsy using forceps, which are mainly used for gastrointestinal endoscopy and transbronchial biopsy. The purpose of this study was to demonstrate the safety and efficiency of performing bone biopsies using forceps. Methods: This multicenter retrospective study included patients who underwent fluorosco-py-guided spinal bone biopsy from July 2013 to November 2020 for suspected spondylitis, tumor metastasis, and primary tumors based on spinal imaging. Data on patients’ demographic characteristics were collected from their electronic medical records. Procedure-related factors such as instrument type, diagnostic yield, procedure time, and the presence of specific lesions (necrotic, sclerosing, or cystic lesions) on preoperative imaging were investigated. Pain at the pathology site was checked using a visual analogue scale before and 1 day after the procedure. We divided the participants into two groups based on the instrument (flyer forceps or biopsy needle) used during the biopsy and analyzed each factor between the two groups. Results: A total of 30 patients (aged 12-81 years) underwent spinal biopsy using a biopsy needle (n=16) or flyer forceps (n=14). Spinal biopsy was performed on 20 patients with metastatic tumors, three with sarcoma, and nine with infections. There were no demographic differences between the two groups, and no difference in pain intensity before and after the procedure was observed between the two groups. The operation time was significantly shorter in the flyer forceps group than in the conventional biopsy needle group (p=0.02). The accuracy of the diagnostic yield of the biopsy was higher in the flyer forceps group (100%) than in the biopsy needle group (75%), and the difference was statistically significant (p=0.04). Conclusion: This study demonstrates the usefulness and safety of bone biopsies performed using flyer forceps. The use of flyer forceps in fluoroscopy-guided biopsy enables the effective collection of sufficient samples in a shorter time than conventional biopsy needles. Further-more, this procedure enabled more accurate diagnoses.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126197210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}