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

We have encountered a case of superior mediastinal neurinoma which grows through the intercostal space and advances into the erector spinal muscles. Neurinoma which shows such a growth pattern is rare. MRI is useful in making preoperative evaluation. For operation, non-open chest extrapleural extirpation was successfully performed by the supraclavicular and posterior approach. This type of operation has the following advantages: surgical stress is less; postsurgical pain is mild, etc.
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PMID:[Superior posterior mediastinal neurinoma with extrathoracic extension]. 160 90

Painful shoulder conditions are common primary care problems. Providers should learn the topographical landmarks about the shoulder and understand shoulder mechanics. A careful clinical evaluation will usually provide a likely diagnosis. In unclear cases with marked pain, weakness, and reduced mobility, or with a suspected rotator cuff tear or rupture, arthrography or MRI will usually establish a diagnosis. Therapy of bursitis/tendinitis consists of a steroid injection into the inflamed subacromial area or a 14-day trial of an NSAID. Therapy of bicipital tendinitis, largely empiric because definitive studies are unavailable for any specific treatment, includes judicious peritendinous steroid injections and avoiding aggravating activities. In the management of patients with suspected tendon tears or rupture, primary care practitioners can confirm the diagnosis by ordering MRI or arthrography before referring these patients to an orthopedist for definitive surgical therapy. Optimal management of adhesive capsulitis remains unclear, but an intraarticular steroid injection appears beneficial at least in temporarily diminishing pain. Pendular motion exercising is also an integral part of therapy. Deleterious effects of peribursal or intraarticular steroid infiltration appear minimal; but injections into the tendon or frequent, repetitive injections are contraindicated. Each shoulder condition has a variable course, depending on the structure(s) and extent of involvement.
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PMID:Painful shoulder syndromes: diagnosis and management. 844 Oct 74

The postoperative mucocele of the maxillary sinus typically occurs after 11-15 years after the initial Caldwell-Luc operation with the complaints of swollen and painful cheek. Typical signs and symptoms will be divided into two groups, the one which is associated with expansive lesions and the other with pains along the various branches of the maxillary nerve. In the clinical set-ups, cases with the similar signs and symptoms, and yet lacking definite mucoceles, are often encountered. The present treatise will compare 86 definite cases and 27 simulating cases as to the history, signs and symptoms, various modalities of imaging (CT & MRI), and the possible causes leading to simulating cases. The age at onset, gender, affected side, and period after the initial sinus surgery all showed no differences between the two, i.e., definite and simulating cases. Among signs and symptoms, the definite case showed more of swelling-related matters whereas the simulating case more of pain-related except toothache. The past history of surgeries for the mucoceles on the similar sides to the present lesion is more often seen in the simulating case (64.3%) than in the definite case (18.3%). The findings by imagings in the simulating cases are as follows; obliterated sinus (25.0%), healthy, aerated postop. cavity (35.7%), postop. cavity with mucosal thickening (32.1%), and cyst-like aerated cavity (7.1%). The possible causes leading to the simulating cases are as follows; causes unknown (39.3%), recurrent infection in the postop. cavity (28.6%), dental origin (10.7%), atypical neuralgia (10.7%) and the case shortly after the proceeding sinus surgery (within 12 months, 10.7%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[On the postoperative mucocele of the maxillary sinus and its simulating cases. A clinical treatise]. 161 6

A Japanese woman, aged 42, was admitted because of paroxysmal attacks consisting of paresthesia of the left face, tremor in the right hand, epigastric pain and urinary incontinence. A year prior to the admission, she noticed some difficulty in writing, dysarthria and unsteadiness of walking. These symptoms had been persistent since then. At the end of March, 1991, these symptoms rapidly worsened, and she fell down frequently. She also experienced pain behind both eyes, numbness in her left fingers and toe, urinary frequency and the above-mentioned attacks. Neurological examination disclosed bilateral internuclear ophthalmoplegia and upbeating nystagmus on upward gaze, titubation in the head, scanning speech, dysmetria in all limbs, exaggerated reflexes in jaw and both legs, bilateral extensor plantar reflexes and ankle clonus. SEP showed delayed cortical response with stimulation of the median nerves bilaterally and of the right posterior tibial nerve. P40 was absent with the left posterior tibial nerve stimulation. VEP was normal. T2-weighted image of MRI showed multiple high intensity areas located around the third ventricle, crus cerebri and the right upper part of the pons. The diagnosis of multiple sclerosis was made. Each paroxysmal attack started with numbness in the left face and burning sensation in the neck. Almost simultaneously tremor in the right hand began. The surface EMG showed the rhythmic contractions in the dorsal hand muscles and wrist extensors at a frequency of 6-7 Hz, and sometimes it revealed synchronized contractions of finger flexors and the dorsal hand muscles. A few seconds later she felt painful sensation in the epigastric region, and the tremor gradually increased in its intensity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of multiple sclerosis with paroxysmal attacks of facial paresthesia, unilateral hand tremor, epigastric pain and urinary incontinence]. 162 36

Six patients had isolated hemiataxia and ipsilateral sensory loss, as a manifestation of thalamic infarction in the thalamogeniculate territory. Acute hemiataxia-hypesthesia was not found in 1075 other patients from the Lausanne Stroke Registry who were admitted during the same period. Stroke onset was progressive in five patients and immediately complete in one. Five patients had an objective sensory loss. In two patients this affected light touch, pain and temperature sense, and in another three light touch, pain temperature, position and vibration sense. One patient had a purely subjective sensory disturbance. The sensory deficit cleared or was clearing although the ataxia persisted in all patients. On lesion mapping on CT or MRI, all patients had involvement of the lateral part of the thalamus (ventral posterior nucleus and ventral lateral nucleus). The presumed causes of stroke were cardioembolism in one patient, posterior cerebral artery occlusion in one patient and meningovascular syphilis in one patient, hypertensive small vessel disease in two patients, and undetermined in one patient. Hemiataxia-hypesthesia is a new stroke syndrome involving the perforating branches to the lateral thalamus, but in which small vessel disease may not be the leading cause.
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PMID:Hemiataxia-hypesthesia: a thalamic stroke syndrome. 164 Feb 35

Surgical treatments for intervertebral disc disease are useful for animals with gradually progressive, severely acute, or recurrent lesions. Surgical patients require a diligent neuroradiographic evaluation to confirm location and severity of the discopathy and rule out conditions unrelated to disc disease. Although controversial, some surgeons advocate fenestration for recurrent pain or mild ataxia associated with a noncompressive lesion. Decompressive procedures are recommended for treatment and prognostication of compressive disc-associated myelopathy. Foraminotomy is reserved for patients with lateralizing extrusions confirmed with myelography or newer imaging modalities (CT, MRI). Future treatments for animals may include chemonucleolysis or various discectomy procedures currently performed in humans with symptomatic disc disease.
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PMID:Surgical treatments for intervertebral disc disease. 164 23

A 21-year-old woman is reported with aplastic anaemia, who presented with pain in the leg. Rapid loss of sciatic nerve function followed. MRI showed irregular streaks of low intensity in the muscles of the pelvic region. A diagnosis of sciatic neuritis as initial symptom of clostridial myonecrosis was made.
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PMID:Sciatic neuritis as initial symptom of spontaneous clostridial myonecrosis. 165 97

The assessment of cervical injuries in medical expertises can be difficult, because there are sometimes little objective clinical symptoms and radiological signs though the patients pretend to suffer from multiple complaints. A series of 40 neurosurgical expertises has been evaluated: 19 patients (47.5%) had clinical signs of cervical myelopathy, 13 patients (32.5%) had clear radicular syndromes, 7 patients (17.5%) suffered from local cervical syndromes. Clinical symptoms can be objectified by radiological methods, such as MRI, which occasionally can directly show lesions of the cervical cord or the brain stem. Sometimes even in patients with severe neurological deficits there are little radiological alterations. Local pain syndromes were assessed at a reduction in earning capacity of about 20%, radicular syndromes at 20 to 30%, minor grades of myelopathy at 30 to 40% respectively disability, and severe grades of myelopathy at up to 100% resp. incapacity of gainful employment. In our opinion adequate assessment of cervical cord injuries should predominantly base on clinical neurological findings, secondarily on radiological findings.
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PMID:[Criteria for expert assessment of the injured cervical spine from the neurosurgical viewpoint]. 167 21

Reported is a case of a bone metastasis of a hepatocellular carcinoma (HCC). A 61-year-old man with an unresectable HCC, which had been detected on spontaneous rupture, complained of a severe neck pain and numbness of both arms. A roentgenogram of the cervix showed destruction in the spinous process of the third cervical vertebra, and an MRI revealed a vertebral tumor compressing the spinal cord. Thus, the tumor was surgically removed. A pathological examination of the tumor revealed it to have the characteristic features on an HCC. One month after its removal, however, an iliac bone metastasis that was causing pain was found, and, again, an excision of the new tumor was performed. Pain symptoms disappeared after these operations. Treatment of an HCC bone metastasis is palliative, however, it is beneficial in maintaining the quality of the patient's remaining life.
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PMID:[A bone metastasis of hepatocellular carcinoma]. 169 2

We report a case of an extragonadal germ cell tumor in the retrovesical region. The patient complained of a perineal and micturition pain. Urethrography, CT and MRI showed a retrovesical tumor protruding into the bladder. Alfa-fetoprotein was increased to 12,170 ng/ml. Bilateral testes did not contain any palpable mass by careful palpation. No tumor was detected by ultrasonography, either. Clinically, he was diagnosed as having a retrovesical extragonadal germ cell tumor associated with paraaortic lymph-nodes and bilateral pulmonary metastases. Although he was treated by combination chemotherapy (PVB and VAB-6 regimen) and irradiation, he died of carcinomatosis about 6 months after the admission. There was no evidence of tumor in bilateral testes on autopsy. This case was a second case of extragonadal germ cell tumor originating from the retrovesical lesion in the literature.
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PMID:[A case of retrovesical embryonal cell carcinoma]. 171 80


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