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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute compartment syndrome is a rare orthopedic emergency caused by orthopedic, vascular, iatrogenic, or soft tissue injury that elevates the pressure within a closed fascial space. Untreated acute compartment syndrome leads to ischemia of the muscles and nerves within the compartment with a resultant loss of motor and sensory function, death of skeletal muscle, and subsequent contracture and deformity. This article presents a case of compartment syndrome in a 33-year-old man following a peroneus longus muscle tear. The patient underwent emergent fasciotomy and decompression of the lateral compartment, and a hematoma located at the musculotendonous junction of the peroneus longus was evacuated. The patient was placed in a posterior splint with the ankle at 90 degrees and elevated. Postoperatively, the patient reported complete resolution of pain, numbness, and tingling. The patient underwent delayed skin closure on the second postoperative day and subsequently had an uneventful recovery. By 4 months postoperatively, he had resumed full activity. Knowledge of the signs and symptoms of compartment syndrome and a high index of suspicion is paramount as this injury can occur after a seemingly innocuous injury such as an ankle inversion injury.
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PMID:Acute isolated lateral leg compartment syndrome following a peroneus longus muscle tear. 1929 37

Fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic sistemic disease of unknown etiology, primarily affecting muscular arteries of intermediate size. It has been most commonly observed in the renal, carotid, and intracerebral arteries, although it has been reported in other arterial beds. However, being an uncommon disease in general, the manifestation of FMD in the upper extremities is exceedingly rare. The authors report the case of a 69 years old female admitted with ischemia of the right hand, secondary to fibromuscular dysplasia of the midbrachial artery. The patient presented to vascular surgery clinic with a 4 month history of numbness, pain, and coolness of her right hand, with a small necrotic lesion on her right index finger. Peripheral pulses were barely palpable, and doppler-derived brachial and radial systolic pressures suggested midbrachial artery stenosis. Arteriography showed a normal arch and normal innominate, subclavian, and axillary arteries. The midbrachial artery was markedly abnormal and had alternating areas of stenosis and aneurysm formation - "string-of-beads" appearance. The patient underwent surgical excision of the abnormal right brachial artery, and reconstruction was accomplished with a reversed saphenous vein graft. Distal pulses were restored postoperatively. Pathologic examination confirmed the diagnosis of fibromuscular dysplasia. A review of the literature on the topic was made.
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PMID:[Fibromuscular dysplasia of the brachial artery, an unusual cause of upper extremities ischemia. A case report and review of the literature]. 1930 84

A 68-year-old man presented with sudden onset of left hemiparesis, diplopia and numbness of the left side of the body and was admitted to our hospital. MRI of the brain revealed no abnormality. However, neurological examination on admission strongly suggested ischemia of the brainstem. Under anticoagulation therapy his symptoms gradually disappeared by the fourth hospital day. He had a past history of bouts of unconsciousness caused by right rotation of the head. Dynamic plain roentgenograms of the cervical spine showed spondylotic changes and lateral osteophyte formation at C5/6 without instability. Computed tomography (CT)-angiography demonstrated narrowing of the right vertebral artery due to compression of the lateral osteophyte at C5/6. Vertebral angiography revealed complete occlusion of the right vertebral artery induced by right rotation of the head. The artery-to-artery embolism caused by repeated occlusion of the right vertebral artery due to the neck motion was suggested as the mechanism of ischemic attack in this patient. Osteophytectomy at C5/6 via the anterior approach successfully treated dynamic occlusion of the right vertebral artery. Occlusion of the vertebral artery at C1/2 by the head rotation is well known as Bow-Hunter's syndrome. However, dynamic occlusion due to spondylotic changes at C5/6 is rare. In case of ischemic attack of the posterior circulation with lateral osteophyte formation of the cervical spine, dynamic occlusion mechanisms of the vertebral artery at the lower cervical level should be considered.
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PMID:[Cerebral ischemia originating from rotational vertebral artery occlusion caused by C5/6 spondylotic changes: a case report]. 1966 39

Cold sensation and numbness have been reported as post-stroke sensory sequelae attributable to distal axonopathy, which is caused by chronic ischemia of diseased limbs resulting from dysfunction of vasomotor regulatory systems. Keishibukuryogan is a traditional herbal medicine used to treat symptoms of peripheral ischemia such as cold extremities. This study investigated clinical improvement and skin temperature in peripheral ischemia patients to determine the efficacy of keishibukuryogan in alleviating post-stroke cold sensation and numbness. Twenty-two stroke patients with cold sensation and/or numbness were enrolled in this study. Subjective cold sensation and numbness, evaluated using the visual analogue scale, were found in 21 and 31 limbs, respectively. The skin temperature of diseased and healthy limbs was recorded. We observed all patients for 4 weeks and 17 patients for 8 weeks after administration of keishibukuryogan. The skin temperature of diseased limbs was significantly higher than baseline at 4 weeks and 8 weeks, whereas that of healthy limbs did not change significantly. Cold sensation and numbness were significantly improved at 4 weeks and 8 weeks compared to baseline. Keishibukuryogan administration resulted in warming of diseased limbs and improved cold sensation and numbness, probably by increasing peripheral blood flow.
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PMID:Efficacy of keishibukuryogan, a traditional Japanese herbal medicine, in treating cold sensation and numbness after stroke: clinical improvement and skin temperature normalization in 22 stroke patients. 2009 17

Subclavian steal syndrome (SSS) is caused by hypoplasia of a vertebral artery or stenosis or occlusion of the subclavian artery or the brachiocephalic artery with subsequent retrograde filling of the subclavian artery via the contralateral vertebral artery. Symptoms of SSS are due to vertbrobasilar insufficiency or ischemia of the ipsilateral upper extremity, and they may include dizziness, syncope, ataxia, arm claudication, hand numbness or a decrease in brachial blood pressure on the affected side. However, most SSS cases are asymptomatic and they are classified as subclavian steal phenomenon (SSP). Atherosclerosis is the common cause of SSS, and Takayasu arteritis, neurofibromatosis, trauma, embolization, congenital vascular anomalies and surgical interruption of the subclavian artery can be identified among the other causes. We describe a rare case of hypervascular thyroid nodule presenting with features of SSP. The patient was hospitalized with acute cerebral infarction due to middle cerebral artery (MCA) severe stenosis. The patient had conservative therapy in the acute stage, and underwent STA-MCA anastomosis for MCA stenosis in the chronic stage. SSS was asymptomatic although there was laterality in blood pressure in the patient's bilateral upper limbs. Thyroid tumor was regarded as benign by radiological findings, laboratory data, and physical examination. If SSS becomes symptomatic, removal of the thyroid tumor may be indicated.
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PMID:[Subclavian steal phenomenon associated with hypervascular thyroid tumor]. 2052 19

Complications after endovascular repair of thoracic aortic pathologies may be devastating. We report the case of endovascular treatment of late in-stent-graft dissection after thoracic endovascular aneurysm repair (TEVAR). A 25-year-old man was admitted to our hospital 2 years after endovascular treatment of posttraumatic aortic pseudoaneurysm using stent-graft implantation with an acute sudden onset of ischemia in both legs with absent femoral pulses, numbness, and renal functions deterioration. Multidetector computed tomography (MDCT) angiography showed an intimal flap in the distal part of the stent-graft with critical stenosis of the residual lumen. The patient was successfully treated with stent-graft implantation by way of percutaneous approach while under local anesthesia. The risk of this late complication after TEVAR should be considered during follow-up, especially in young patients with increased physical activity. Endovascular treatment can be the method of choice for these patients.
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PMID:Endovascular treatment of late in-stent-graft dissection after thoracic endovascular aneurysm repair. 2119 89

Carpal tunnel syndrome (CTS) is a neurological impairment caused by compression of the median nerve throughout the carpal tunnel, which consequently induces ischemia and mechanical disruption, dysfunctional axonal transport, and epidural blood flow. Most common symptoms include numbness, rather than pain, with a typical night exacerbation, weakness, paresthesia, and loss of sensitive discrimination. In rare cases, such syndrome may present with cutaneous manifestations localized on the distal phalanges of the hands, even without the above mentioned neurological symptoms. We describe a case of a woman who came to our attention complaining of the appearance of recurrent bullous eruptions involving the distal phalanges innervated by the median nerve. She did not report any neurological signs whatsoever. After excluding a bullous disease, we further investigated through additional analysis that revealed a CTS. Hence, physicians should consider CTS as a differential diagnosis when assessing cutaneous lesions of the first three fingers of the hands.
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PMID:Unusual presentation of carpal tunnel syndrome with cutaneous signs: a case report and review of the literature. 2132

We reported a 78-year-old woman who had a sudden-onset episode of vertigo, nausea and vomiting. Half an hour later, she felt right hemiataxia, and then noticed numbness on the entire right side of the face. She did not complain of hearing disorders or sensory disorders of left half body involving face. Pure tone audiogram and auditory brainstem responses were normal. Magnetic resonance imaging showed right hypersignals in the dorsolateral pons and middle cerebellar peduncle, as well as in cerebellum. Magnetic resonance angiography showed occlusion of the right anterior inferior cerebellar artery (AICA). Neuroradiological findings suggested ischemia in the whole territory of the right AICA. This is a case of AICA infarction and clinicians should be aware that sensory defect was only in the ipsilateral face without hearing disorders can be the manifestation of AICA infarction.
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PMID:Isolated hypalgesia in ipsilateral face without hearing disorders: a variant of AICA infarction. 2171 Jan 32

Persistent nerve injuries in context of peripheral nerve blocks are uncommon. Previous surveys and prospectively designed studies have specified neurological dysfunctions in different ways, which may cause the variability of data about incidence; so it has to be reckoned with about 5% after 1 week, 1% after 1 month and 0,01% after 6 months. Amongst the different locations interscalene blocks with their associated surgical procedures seem to have the highest incidence. Establishing the correlation between disabilities and the performed block technique often constitutes difficulties, especially when other reasons like patient positioning techniques, tractions, ischemia and surgery related nerve injuries have to be considered. Dysfunctions manifest as numbness, parasthesia, tingling sensation and/or amyasthenia. Fortunately long-term lesions, caused by nerve blocks are a rarity.
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PMID:[Nerve injuries associated with nerve blocks: clinic and incidence]. 2262 28

Transradial access for cardiac catheterization is now widely accepted among the invasive cardiology community as a safe and viable approach with a markedly reduced incidence of major access-related complications compared with the transfemoral approach. As this access technique is now being used more commonly for cardiac catheterization, it is of paramount importance to be aware of its complications and to understand their prevention and management. Some of the common complications of transradial access include asymptomatic radial artery occlusion, nonocclusive radial artery injury and radial artery spasm. Among these complications, radial artery spasm is still a significant challenge. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of the transradial approach. Early identification of these rare complications and their immediate management is of vital importance. Arteriovenous fistula, minor nerve damage and complex regional pain syndrome are very rare but have been reported. Recently, granulomas have been reported to be associated with the use of a particular brand of hydrophilic sheaths during the procedure. Generally, access-site complications can be minimized by avoiding multiple punctures, selection of smaller sheaths, gentle catheter manipulation, adequate anticoagulation, use of appropriate compression devices and avoiding prolonged high-pressure compression. In addition, careful observation for any ominous signs such as pain, numbness and hematoma formation during and in the immediate postprocedure period is essential in the prevention of catastrophic hand ischemia.
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PMID:Access-site complications and their management during transradial cardiac catheterization. 2265 38


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