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Международный журнал нейрореабилитации

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Объем 5, Проблема 3 (2018)

Обзорная статья

Review of Persistent Phrenic Nerve Palsy

Andrew T Koogler and Michael Kushelev

Regional anesthesia techniques for orthopedic surgeries have become more frequently utilized for postoperative analgesia. A commonly used technique for shoulder surgery is the interscalene brachial plexus nerve block which involves anesthetizing nerves of the shoulder. Unfortunately, patients can experience a transient phrenic nerve block resulting in dyspnea. Rarely this develops into a persistent phrenic nerve block that can out last the duration of the local anesthetics deposited around the brachial plexus. Patients with a persistent phrenic nerve block can present to neurologists and other specialists with symptoms that appear to have a cardiac or pulmonary etiology requiring prompt diagnosis and management.

Мини-обзор

Breast Cancer with Behç's Disease: A Short Review

Shinsaku Kanazawa and Makoto Kammori*

Various immune-mediated disorders are associated with an increased risk of malignancy. Behçet’s disease (BD) is chronic, relapsing, systemic vasculitis of unknown etiology. It is characterized by recurrent urogenital aphthae and systemic manifestations, including ocular disease, skin lesions, gastrointestinal involvement, mammary manifestations, vascular disease, and arthritis. BD has been associated with malignancy in a few case series and case reports. However, the relationship between Behçet’s disease (BD) and breast cancer remains unclear. Here, we consider the relationship between BD and breast cancer through analysis of the medical literature and a review of our own experience.

История болезни

Acute Disseminated Encephalomyelitis (ADEM): A Diagnosis of Exclusion with Atypical Neuroimaging

Muhammad Fahad Zakir*, Teena Rajput, Fasiha Sohail, Ghania Niazi, R. Annum Rahim, Misbah Patoli and Sumera Nawaz

Acute disseminated encephalomyelitis (ADEM) is characterized by a brief but widespread attack of inflammation in the brain and spinal cord that damages myelin-the protective covering of nerve fibers. Although most often observed as a single episode, relapsing or recurrent forms are also present. The true incidence in Pakistan is still undetermined. ADEM is a diagnosis of exclusion in many cases, and relies on neuroimaging .We present a case of young female having no history of immunization recently with nonspecific symptoms (lower limbs weakness, fever that progress to all four limbs weakness with urine incontinence and aphasia). An atypical MRI finding of extensive abnormal areas in white matter involving frontopaietal and occipital lobes on T2 and FLAIR. ESR, C.T brain and L.P came normal which subsided young stroke and multiple sclerosis hence diagnosis of ADEM was made. She was subsequently treated with high-dose steroids (methylprednisolone) and plasmapheresis with good outcomes.
Комментарий

Helistroke: Neurointerventionalist Helicopter Transport for Interventional Stroke Treatment: A Short Commentary

Ferdinand Hui* and Amgad El Mekabaty

Recent randomized controlled trials have shown the efficacy of endovascular therapy in acute ischemic stroke due to large vessel occlusion. A pooled analysis of these trials has confirmed the known fact that time to intervention is a significant independent factor in good outcome in ischemic stroke. In order to reduce patient transfer time to an endovascular-capable stroke center, we analyzed the workflow in a novel case of helicopter transfer of neurointerventionalist to a stroke patient in a primary stroke center. This proof of concept case demonstrates the feasibility of such a process and offers an additional tool in advancing endovascular therapy in acute ischemic stroke.

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