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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ten cases of painful ophthalmoplegia are reported. In all cases pain marked the onset of the disease; the condition was mostly unilateral. Recurrence and dramatic response to steroid therapy were more constant features than angiographic findings which may be completely normal. CAT permitted us to eliminate a tumor of the cavernous sinus in 7 cases, but in one case, which was operated, an aggravation followed surgery. Despite complete investigations of all patients, some questions remain unanswered. Is it an inflammatory or an allergic inflammatory process? (And the presence of antinuclear factor in an only case does not permit it to respond.) Why is the process confined to the superior orbital fissure? Mathew and Chandy tried to find a similarity between this syndrome and Bell's palsy although the 2 syndromes have not been shown to coexist. Is the Tolosa-Hunt syndrome comparable to the pseudotumor of the orbit? Although the dura mater is inserted on the border of the sphenoidal cleft, some patients may altern the 2 syndromes.
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PMID:Tolosa-Hunt syndrome. 73 3

The CAT shows the site, extension and evolution of cerebral ischemic lesions, and implies no risk or pain for the patient. Cerebral ischemic lesions appear as dark, hypodense areas on the brain section planes and are well differentiated from the white hyperdense areas of hemorrhagic lesions. In the territory of the middle cerebral artery the symptomatology is well related to the extension of the lesions, but not to their site when they are 'limited'. At present the CAT is essential for the treatment of cerebral ischemic lesions.
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PMID:Computerized axial tomography (CAT) in cerebral ischemia. 75 38

Review of 7 patients with idiopathic retroperitoneal fibrosis (IRF), treated with a combination of corticosteroids (6-methyl-prednisolone) and endourological procedures. The presentation symptom was lumbar pain in all 7 cases. Mean creatinine (Cr) levels were 5.4 mg/dl, with mean erythrocyte sedimentation rate (ESR) of 114. Three (43%) patients were positive to rheumatoid factor (RF) and had raised IgG. Definite diagnosis was achieved in all cases by CAT, including puncture biopsy in 1; all 7 (100%) cases were bilateral. With an average follow-up of 3 years, clinical evolution is satisfactory in all 7 cases. Mean control Cr is 1.2 mg/dl and mean ESR 19. CAT showed disappearance of fibrotic plaque in all cases. One patient relapsed when maintenance therapy was discontinued but responded again to a new therapy course. No steroid therapy-related complications were seen. The association of conservative steroid therapy and endourological procedures is a very low morbidity, sensible alternative in the management of benign retroperitoneal fibrosis where CAT and MNR are the primary diagnostic techniques.
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PMID:[Idiopathic retroperitoneal fibrosis: combined steroid and endourologic treatment]. 159 69

CAT scan of the costovertebral joints has been performed in 17 patients with ankylosing spondylitis, all suffering from lower thoracic pain. Fourteen of them (82%) showed abnormal findings, including erosions and sclerosis, more pronounced in the vertebral side of the joint, and joint widening. Bony proliferation arising from the vertebral side in the anterior margin of the joint was also seen. One patient showed at the D12 level anterior bony bridges, similar to the vertebral syndesmophytes. Fusion was noted in five patients (including the three with longest disease duration) and represents the end result of the inflammatory process. These changes provide an anatomical basis for the understanding of the thoracic pain in AS patients.
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PMID:Costovertebral joint changes in ankylosing spondylitis with thoracic pain. 159 5

Case report of a pubertal female patient with clinical signs of hypogastric pain initiated with the menarche, dysmenorrhoea and a palpable pelvic mass. The suspected clinical signs, ultrasound scans, urographies and CAT, confirmed the existence of an uterovaginal duplicity with right hematocolpos due to imperforate septum and pool of menstrual blood, as well as ipsilateral renal agenesis. The vagina examination and resection of the septum under sedation solved the case.
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PMID:[Uterovaginal duplication with right hematocolpos caused by imperforate septum and ipsilateral renal agenesia: report of a case diagnosed using non-invasive methods]. 179 96

A study is presented of the effect of a new native calcium antagonist foridon on the course of the disease central and peripheral hemodynamics, fatty metabolism, lipid peroxidation intensity, activity of ceruloplasmin and catalase, iron and chromium saturation of transferrin, content of cyclic nucleotides in thrombocytes, the state of cellular immunity and the number of circulating immune complex in 30 patients with advancing and stable exertion stenocardia (control--30 analogous patients treated by phynoptin and corinfar). It was established that foridon produced a positive effect on the intensity of the pain syndrome, hemodynamics, degree of lipid peroxidation, content of cyclic nucleotides and immune status of stenocardia patients.
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PMID:[The efficacy of foridon in treating stenocardia patients]. 180 58

The authors report the results of automated percutaneous diskectomy in the treatment of the herniated disk. During an 18-month period this procedure was used on 39 patients with both evident radicular pathology that had not regressed even after 4-6 weeks of medical and physical therapy as well as clear disk herniation revealed by diagnostic imaging. The level of the herniated disk was L4-L5 in 30 cases. L5-S1 in 7 cases, and L3-L4 in 2 cases. The clinical diagnosis was confirmed by CAT scan in 20 cases, by both CAT scan and x-ray of the spinal region in 14 cases, and by x-ray only in 5 cases. The patients were reviewed 2, 6, and 12 months after surgery. The results were classified according to Watters' criteria based on both the relief of pain and the resumption of everyday work activity. The satisfactory results (excellent and good) totaled 59% at the 6-month follow-up, with no substantial variation at the 1-year follow-up. Hemilaminectomy was performed in 12 cases with unsatisfactory results, confirming the diagnosis of disk herniation in 10 cases (extruded in 9 cases and protruded in 1 case). Diskectomy is a non-invasive, atraumatic method which is indicated for both protruded (non-sequestrated) and subumbilical hernias and allows rapid functional recovery. The rate of success can be increased with more accurate selection of patients based on imaging diagnosis (CAT scan and MRI).
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PMID:[Percutaneous nucleotomy: the indications and limits]. 215 46

New diagnostic tools and alternatives such as CAT-scan, NMRI, discography, functional X-rays, infiltrations and immobilization tests have made spinal instability a more rational diagnosis than it was only a few years ago. Neurological deficit, radicular pain and pseudo-radicular pain may only be an expression of instability and are best treated by stabilizing operations. Laminectomy has few indications and is not a logical procedure, especially if used as decompression of the dural sac in tumor involvement of the spine, which usually comes from the front (vertebral body). Therefore, anterior surgery is indicated rather than so-called posterior decompression. In accordance with osteosynthesis techniques of limb disorders, high stability can be achieved through special implants, on the basis of a better understanding of the biomechanics of implants and the healthy and impaired spine. Short fusion and fixation have therefore become a principle which is the standard of reference for present and future spinal surgery. The spectrum of indications for spinal surgery has vastly increased in the last few years, though exact diagnosis is mandatory for optimal treatment.
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PMID:[Stabilization surgery of the spine]. 218 43

Lumbosacral and associated leg pain and paresthesias arousing patients from a sound sleep, or Vesper's curse, has been previously reported. An increase in right atrial filling pressure reflected in elevated paraspinal venous volumes within the reduced confines of a stenotic lumbar spine has been cited as the cause of this syndrome. Six cases of concomitant nocturnal calf cramps and fasciculations associated with the night pain and paresthesias are reported. In all cases a reduction in cardiopulmonary compliance was noted, with clinical and electromyographic evidence of paraspinal and lower extremity fasciculations increasing at night. Symptoms were relieved by assuming an erect or semi-reclining sleep position. In five of the six reported cases of lumbar spinal stenosis, spondylolisthesis was also present. The motor equivalent of Vesper's curse was evaluated by electromography, evoked potentials, CAT scan, and myelography. The multiple factors involved in the pathomechanics and pathophysiology of lumbar radiculopathy, and spinal stenosis and the role of the paravertebral plexus of veins are reviewed as they relate to the genesis of the restless legs syndrome.
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PMID:Restless legs syndrome associated with diminished cardiopulmonary compliance and lumbar spinal stenosis--a motor concomitant of "Vesper's curse". 233 80

Painful symptomatology in the lower limbs coming on with walking must not systematically be attributed to arteritis of the lower limbs. Among the characteristics which may suggest that this "claudication" is due to a narrowed lumbar canal, is the presence of paresthesia and above all the clear improvement when the patient is seated or adopts a lumbar kyphotic position. It is therefore extremely important to keep in mind the radicular topography of pain and neurological deficit. The congenitally narrow lumbar canals rarely produce problems unless there is further narrowing of the lumbar or radicular canal by a disco-osteophytic projection anteriorly, a posterior articular osteophytic projection posteriorly, thickening of the ligamentum flavum, an abnormal widening of the dural sheath, or excess peridural fat. Among the complementary investigations, CAT scan is useful to analyse the structures involved, but this examination is carried out in decubitus, i.e., without lordosis, while narrowing principally appears on lumbar extension, i.e., in the upright position. Saccoradiculography therefore remains the investigation of choice, performed in the seated and upright position. It can objectively assess the degree of narrowing and analyse the proportion due to the anterior discal or posterior articular component. This investigation should only be requested after failure of medical treatment based above all on analgesics, physiotherapy in lumbar kyphosis, and an abdomino-lumbar corset support. In the event of failure of medical treatment and if the patient is very handicapped, one most often resorts to decompressive surgery, however when narrowing is principally due to a discal projection, one may attempt discolysis with chymopapain.
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PMID:[Radicular claudication with a narrowed lumbar canal]. 252 41


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