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Query: UMLS:C0007859 (neck pain)
 3,931 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Therapeutic local anaesthesia, although a seemingly simple procedure, requires informed consent by the patient as well as proper indication and careful execution. Four cases selected from a medico-legal experience illustrate some severe complications. Nausea, dyspnoea and respiratory arrest (anaphylactic shock) occurred in a 34-year-old woman shortly after injection of 0.5% Bupivacaine into the paravertebral musculature for the treatment of acute neck pain. She had to be hospitalized for 18 days, at times requiring mechanical ventilation. Three other patients (women aged 40, 43 and 52 years, respectively) developed a pneumothorax after supposedly intramuscular injection of a local anaesthetic. They were hospitalized for 7 to 12 days for treatment by drainage. Anatomical variations were excluded by ultrasound in the 40- and 43-year-old patients. These case reports demonstrate that doctors performing such procedures do not always possess the necessary anatomical knowledge, and the possible occurrence of complications is underestimated.
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PMID:[Negligence of the physician's duty to care during "therapeutic local anesthesia"]. 182 69

Most cases of spinal epidural abscesses occur in a midthoracic or lower lumbar location. Cervical spinal epidural abscess is distinctly rare, and its prognosis is not favorable due to respiratory problems. We report a case of cervical spinal epidural abscess. A 77-year-old male was admitted because of tetraparesis and dyspnea. Two months before admission, he had been treated by femoro-femoral bypass for arteriosclerosis obliterans , and he had suffered from postoperative wound infection one month later. He had noticed neck pain two days before admission, followed by a numbness and motor weakness in both hands. Neurological examination showed flaccid tetraplegy with an absence of DTRs, paralysis of intercostal muscles, loss of sensation below the C4 dermatome, and bladder dysfunction. A spinal CT scan revealed a mass lesion in the anterior epidural space from C2 to C6, which displaced the spinal cord posteriorly. A myelogram showed complete blockage of contrast medium at the level of C7-T1. He was treated by emergency laminectomy of C3 to C6 with evacuation of the epidural abscess. Culture showed staphylococcus aureus, for which appropriate antibiotics were administered. In spite of such an intensive treatment, the patient showed poor neurological improvement and died 42 days after operation.
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PMID:[Cervical spinal epidural abscess: case report]. 235 79

A 67-yr-old woman was admitted with dyspnoea, chest and neck pain and swelling of both supraclavicular fossae and the neck. Chest X-ray showed bilateral pleural effusions. Thoracocentesis yielded a milky fluid with a high triglyceride level. Four previously published cases had similar clinical manifestations. The pathophysiology is discussed.
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PMID:Spontaneous bilateral chylothorax: uniform features of a rare condition. 322 88

We retrospectively reviewed all patients with a final diagnosis of spontaneous thoracic aortic dissection treated at Linkou Chang Gung Memorial Hospital between January 1989 and December 1994. There were a total of 109 patients with a mean age of 55 +/- 11 years ranging from 19 to 88 years. The male-to-female ratio was 2 to 1 (73 to 36). There was a predilection to present during the colder months, with 69% seen between September 1 and February 28 and only 31% during the warmer half of the year. In most patients, hypertension (85%) was the major predisposing factor with another 7% having Marfan syndrome. The remaining 8% had no obvious underlying disease except for one patient who had an atrial septum defect. Presenting chief complaints in order of frequency included: anterior chest pain 58.7% (64/109), back pain 19.2% (21/109), abdominal pain 10.1% (11/109), consciousness change 3.7% (4/109), neck pain 2.7% (3/109), paraparesis 2.7% (3/109), dyspnea 1.8% (2/109), and hemoptysis 0.9% (1/109). The diagnostic breakdown revealed 46% to be type A (50/109) and 54% type B (59/109). A total of 26 (24%) patients died in hospital (16% were type A and 8% were type B). (Type A included all proximal dissections and those distal dissections that extend retrograde to involve the arch and ascending aorta; Type B refers to the other distal dissections without proximal extension; proposed by Daily et al.) Thoracic aortic dissection remains an important concern in patients with a history of hypertension. Patients seem particularly susceptible during cold weather months. The average age of our patients was only 55 years and 24% of them died during hospitalization. Earlier identification and more aggressive antihypertensive treatment is required.
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PMID:Aortic dissection in Taiwan. 855 68

Spontaneous pneumomediastinum, or Hamman's syndrome, is a rare condition which may present with the symptoms of chest pain, dyspnoea, dysphagia, or neck pain. The signs of subcutaneous emphysema and Hamman's crunch (the presence of a crepitance sound that varies with the heartbeat on auscultation of the precordium) are usually present. A case of this syndrome occurring in an elderly patient with none of the recognised risk factors is presented.
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PMID:Spontaneous pneumomediastinum. 931 40

Pneumomediastinum (spontaneous, iatrogenic and traumatic) is a relatively uncommon infrequently reported entity. The most common cause is the rupture of marginal pulmonary alveoli, allowing bubbles of air to dissect along the vascular sheaths and connective tissue planes to the mediastinum. Rupture of the trachea or thoracic traumas are other causes of pneumomediastinum. The most common presenting complaint was retrosternal pain, dyspnea, dysphagia, weakness and neck pain. Physical finding revealed: subcutaneous emphysema extended to face, chest or neck, and Hamman's sign. Chest X-ray was made in all cases and diagnosis was completed with chest CT scan and tracheoscopy. We present our series of 34 PM between January 1.1993 to July 31.1995 and discuss about etiology, diagnosis and treatment of this entity.
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PMID:[Spontaneous and traumatic pneumomediastinum. Analysis of 34 cases]. 941 Dec 92

A 68-year-old male had neck pain and weakness of the left upper extremity after a fall. MRI showed severe cervical canal stenosis and a high signal intensity of the spinal cord on T2-weighted images extending from the medulla oblongata to the C7 level. Neurological examination showed left hemiparesis, bilateral sensory disturbance and a neurogenic bladder. He underwent expansive laminoplasty 5 weeks later. After the operation his neurological deficit improved and 6 weeks later he left the hospital. However, his neurological conditions became worse (quadriparesis) and he was admitted as an emergency 3 weeks later. Although MRI showed decompression of the spinal cord, the area of high signal intensity on T2-weighted images had extended. Quadriparesis was progressive and he died of dyspnea. Autopsy showed the presence of the intramedullary spinal cord tumor (anaplastic astrocytoma; C1-Th4). We could not detect the intramedullary spinal cord tumour on MRI before surgery because of severe canal stenosis and the history of trauma. The high spinal intensity on T2-weighted images was thought to be oedema or myelomalacia. This case illustrates the difficulty of correctly interpreting MRI in patients with severe canal stenosis.
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PMID:Quadriplegia caused by cervical hyperextension injury and intramedullary spinal cord tumour: a case report of autopsy. 981 83

We describe a 42-year-old man with dermatomyositis and interstitial lung disease who presented with anterior neck pain and dyspnoea. Chest radiographs showed subcutaneous emphysema, pneumomediastinum and diffuse reticulonodular infiltration in both lungs. After the administration of high doses of prednisolone, an improvement of pulmonary function and respiratory symptoms was observed but the pneumomediastinum persists 12 months after diagnosis, and without any complication. We review the cases that have been reported thus far of pneumomediastinum associated with dermatomyositis and discuss the possible mechanisms involved. We conclude that pneumomediastinum is not an uncommon complication of dermatomyositis and that its aetiopathogenesis remains very unclear.
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PMID:Persistent pneumomediastinum and dermatomyositis: a case report and review of the literature. 1164 18

We report here a case of severe ovarian hyperstimulation syndrome with massive ascites in a 25-year-old woman with a history of primary infertility after an IVF-ET cycle. At the 9th gestational week she presented with neck pain and dyspnea and duplex Doppler sonographic examination of the neck veins revealed bilateral jugular venous thrombosis. Despite prompt administration of low-molecular weight heparin, pulmonary emboli developed a few days later.
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PMID:Bilateral jugular venous thromboembolism and pulmonary emboli in a patient with severe ovarian hyperstimulation syndrome. 1172 33

Evidence has begun to accumulate that suggests there may be gender differences in the presenting symptoms of acute coronary syndromes (ACS). Identification of gender differences has implications for both health care providers and the general public. Women should be instructed as to the symptoms expected with ACS on the basis of evidence obtained from studies that include both sexes. Twelve studies that identified symptoms of ACS for both women and men were identified through a review of the literature. In several of the studies, which included all types of ACS, women had significantly more back and jaw pain, nausea and/or vomiting, dyspnea, indigestion, and palpitations. In a number of the studies, which solely sampled patients with acute myocardial infarction, women demonstrated more back, jaw, and neck pain; nausea and/or vomiting; dyspnea; palpitations; indigestion; dizziness; fatigue; loss of appetite; and syncope. Men reported more chest pain and diaphoresis in the myocardial infarction sample. Results of these studies showed that women and men experienced the same symptoms with ACS. However, in some studies there were gender differences in the proportion of symptoms. Given the current state of the science, definitive conclusions regarding gender differences in the symptoms of ACS cannot be drawn. Further study is urgently needed to clarify and expand on these findings.
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PMID:Symptoms of acute coronary syndromes: are there gender differences? A review of the literature. 1212 87


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