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

A case algodystrophy of the hip during pregnancy is reported and the literature is reviewed. Mostly symptoms manifest in the last trimenon and sometimes in the postpartum period. Typically only the left hip is involved. The symptomatology shows usually three periods: During a first phase there is a sudden onset of symptoms, while in the second phase symptoms remain stable and after birth the pain disappears in a short time. For diagnosis the clinical signs, radiology, radionuclide scans and MRI are helpful. Therapeutically physiokinesitheraphy and analgesics are recommended.
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PMID:[Sudeck's syndrome of the hip in pregnancy. A case report and review of the literature]. 172 Sep 11

Cervical somatosensory evoked potentials (SEPs) recorded using forehead and anterior cervical reference montages were compared in 6 patients whose MRI showed a cervical syrinx. All patients presented with a segmental loss of pain and temperature sensation in upper limbs, but no clinical evidence of dorsal column system dysfunction. Cervical SEPs recorded using the forehead reference montage were normal in all cases, while the N13 potential recorded using an anterior cervical reference was reduced, or absent, in 11 median nerve SEPs out of 12. This discrepancy results from persisting scalp P13-P14 far-field potentials, which were picked up by the forehead, but not by the anterior cervical, reference. It is concluded that the forehead reference montage is inadequate for assessing selectively the spinal N13 potential and should be abandoned for cervical SEP recording.
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PMID:Inadequacy of the forehead reference montage for detecting abnormalities of the spinal N13 SEP in cervical cord lesions. 172 72

The Gamma Knife is currently the only radiosurgical device which has been used in functional neurosurgery. This mode of utilization is possible because the instrument can make lesions in normal brains with a volume as small as 50 mm3. The experience of functional radiosurgery accumulated at the Karolinska Institute over 21 years is reviewed, and the possible implications of the new developments in imaging techniques for the future of functional radiosurgery are considered. The review covers gamma thalamotomy for pain and tremor, radiosurgery for trigeminal neuralgia, gamma capsulotomy for severe anxiety and obsessive-compulsive neurosis, and Gamma Knife surgery for focal epilepsy. The important role of stereotactic MRI localization in functional radiosurgery is pointed out, and a preliminary report of the recent experience with stereotactic magnetoencephalography combined with stereotactic MRI for physiological and anatomic target localization is given. It is concluded that functional radiosurgery should only be performed with radiation of very small volumes of brain, as the very high doses required would be devastating if delivered to even small volumes.
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PMID:Functional neurosurgery--a future for the gamma knife? 172 60

Since November 1988, 28 patients with lumbar L5 radiculopathy refractory to conservative care and with a radiologically verified central or mediolateral disc herniation at the level of L4/L5 had had a percutaneous discectomy. Radiological verification consisted of spinal CT +/- myelography, +/- myelo-CT, +/- MRI. A short-term follow-up analysis of at least 2 months taking the clinical and functional status as well as the professional reintegration into account revealed a 64.3% (18/28 patients) satisfactory outcome and a 32.1% (10/28 patients) failure rate. Of the latter 28.6% (8/28 patients) required further open surgery. One patient whose pain had only partially in regressed was shown at open operation to have a sequestered cranial prolapse as revealed by spinal CT after the percutaneous procedure. There were no major complications. One patient developed a sequestered extraforaminal herniation through the nucleotomy canal three weeks after the procedure. One patient bled for 2 minutes. There were no major vessel injuries. One patient reported local muscular pain, and enhanced nerve root pain after introduction of the trocar sleeve.
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PMID:Lumbar percutaneous discectomy. Initial experience in 28 cases. 174 70

The authors report two cases of intradural metastasis: a man with bronchopulmonary cancer suffering from left L5 sciatic pain and a woman with breast cancer whose examination shows motor weakness of both legs. CT was negative in the first case. Gadolinium injection on T1 sequence shows in the first case small nodular lesions along the roots of cauda equina and in the second case linear enhancements around the spine, at different levels. These aspects are the most frequently reported. MRI is an innocuous and the most sensitive technic for such lesions. An early diagnosis improves the functional prognosis. Despite of radiotherapy and chemotherapy, vital prognosis remains bad because of widespread of the intradural lesions and their frequent association with cerebral metastasis.
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PMID:[Intradural metastases of visceral cancers. MRI aspects. Apropos of 2 cases]. 175 63

A 57 year-old Japanese male was seen with the chief complaints of left parotid gland swelling, pain, trismus. At the initial visit, a subcutaneous mass, measuring 50 x 70mm, was seen in the left parotid region. The mass was moderately tender and the consistency was soft anteriorly and elastic firm posteriorly. The mobility was restricted with no change in the skin covering the mass. The saliva from the left parotid gland was normal in colour and contents. Various imaging modalities were done preoperatively including CT, MRI, ultrasonography and aspiration biopsy under the ultrasonographic guide. None was thus conclusive for the differential diagnosis and our tentative diagnosis was a cystic lesion in the parotid gland. A partial parotidectomy was performed under general anesthesia and the cystic lesion, measuring 20mm in diameter, was found in the deep lobe. The cyst showed no connection to the external ear canal, and tracts and fistulae were absent. Histopathological report lead to the definite diagnosis of lymphoepithelial cyst. A mild and incomplete facial palsy on the left had been noted for more than 10 years and this, however, improved after the surgery.
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PMID:[A case report of lymphoepithelial cyst in the parotid gland]. 175 41

We report a case of left pseudothalamic cortical syndrome associated with asymbolia for pain in a right-handed male patient. The responsible lesion, detected at both CT and MRI, was infarction of the superficial territory of the middle cerebral artery, restricted to the posterior insula, the superior aspect of T1, the parietal operculum and the supramarginal gyrus. The ascending parietal gyrus and the thalamus were spared. This case, together with data from the literature, suggest that the somatosensory area II was responsible for the pseudothalamic syndrome. This interpretation is concordant with the hypothesis that S II plays the principal role in passive somatosensory discrimination, whereas S I plays the principal role in active discrimination implying stimulus exploration. The location of lesions that were responsible for asymbolia for pain is discussed. This case and those reported by Berthier et al. (1988), provide arguments in favour of Geschwind's hypothesis which attributes asymbolia for pain to sensory-limbic disconnection due to damage of the insula.
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PMID:[Left pseudothalamic cortical syndrome and pain asymbolia]. 176 57

Spinal epidural hematoma is a rare clinical entity, and the literature provides reports of 29 cases so far in Japan. A case of spinal epidural hematoma associated with idiopathic thrombocytopenic purpura diagnosed by CT scan and MRI is reported in detail with references to the literature. A 56-year-old female was admitted to our hospital on April 22, 1990, because of sudden onset of nuchal pain and right hemiparesis. Her consciousness was alert, but the deep tendon reflex was depressed, and pathological reflex such as Babinski's reflex was positive on the right side. Nuchal stiffness was observed. CT scan of the head revealed no abnormality, but the scan of cervical area showed an abnormal high density area in the right posterior region of the spinal cord at C2 - 3 level. MRI also revealed a low intensity area in the same region both in T1 and T2 weighted images. On admission, the platelet count was 10,000/microliters, and the bone marrow aspirate showed abundant megakaryocytes. The patient was diagnosed as having spinal epidural hematoma associated with idiopathic thrombocytopenic purpura. The patient was initially treated with a corticosteroid and a hyperosmotic agent. About 15 hours after the onset, her motor function began improving. Conservative therapy was continued, and she could walk 2 weeks after the onset. Spinal epidural hematoma is an uncommon disease commencing with back and radicular pain, paraplegia and rectovesical insufficiency. Early diagnosis and surgical decompression is generally imperative, although an exceptional remission without operation such as was observed in this case may occur.
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PMID:[A case of spinal epidural hematoma associated with idiopathic thrombocytopenic purpura]. 176 46

The authors present 71 cases of malunion or old traumatic lesions. They result from an unadapted initial surgical or functional treatment. The pain symptoms are in the form of vertebral pain or nerve root pain, often associated with signs of neurological deficit. The authors emphasize the stability or instability of the lesion in order to assess its reducibility. The radiographic exploration (dynamic views, MRI, CT, medullary arteriography) would serve as a guide for the treatment strategy. The authors do not report any case of permanent postoperative neurological aggravation. Three surgical options are analyzed (anterior approach, posterior approach and "three-stage" surgery). An enlarged posterior approach enables treatment and reduction of all malunions, except if a medullary feeder artery is present on the site of the lesion. The pain symptoms improve in 87% of all cases. The authors do not report any permanent postoperative neurological aggravation.
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PMID:[Old traumatic lesions of the dorsal and lumbar spine]. 177 52

Five patients with intraarticular synovial ganglia of the knee were treated by arthroscopic surgery. These synovial cysts were found in the intercondylar fossa and appeared to originate from the cruciate ligaments. In 3 patients the ganglia were the only pathologic finding, solely responsible for the pain and functional impairment. In the other 2 patients the ganglia were accompanied by other intraarticular lesions. The diagnostic procedure (radiography, arthrography, CT, MRI, arthroscopy), confirmed the validity of CT scan and MRI in detection, differential diagnosis, and location of the ganglia in all cases. Arthroscopy enabled us to directly observe, biopsy, and remove the ganglia, resulting in immediate disappearance of symptoms and no relapse after a minimum follow-up of 20 months.
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PMID:Synovial ganglia of the central pivot of the knee. 178 42


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