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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Single photon emission computed tomography with N-isopropyl-p-[I-123]iodoamphetamine was performed in 13 cases of craniosynostosis before and after surgery. Of 13 cases, 8 cases (62%) showed focal low perfusion area on preoperative study. Four of seven cases (57%) with brachycephaly showed low perfusion areas in either of frontal lobes, occipital lobes, and cerebellum. Besides, two patients with scaphocephaly and one with plagiocephaly showed low perfusion area in unilateral cerebral hemisphere. Two Crouzon disease cases showed no focal low perfusion area, but an Apert disease showed low perfusion areas in both frontal lobes, cerebellum, as well as left occipital lobe. Corresponding CT and MRI showed no focal abnormality in any of these cases. These low perfusion areas were diminished or disappeared after surgical treatment in 6 cases (75%). We concluded that the I-123-IMP-SPECT is considered to be a useful index for the evaluation of functional recovery after surgery in cases with craniosynostosis.
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PMID:[Study by I-123-IMP-SPECT before and after surgery for craniosynostosis]. 229 Feb 12

A case of facial nerve neurilemmoma within the temporal bone is reported. The patient is a 47-year-old female complaining of 10 years' history of left facial palsy. CT and MRI examinations showed an enlarged mass of the tympanic cavity protruding into the petrous bone, mastoid cavity and external auditory meatus. An open biopsy of the tumor at the external auditory meatus revealed neurilemmoma. The tumor was totally removed by a retroauricular approach. Five months after surgery, both the cross nerve graft using the peroneal nerve and the temporal muscle transfer, method modified by Johnson were performed for the functional recovery of facial palsy.
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PMID:[Neurilemmoma of intra-temporal facial nerve:case report]. 748 74

We studied Wallerian degeneration of the cortico-descending tract in the cerebral peduncle following a supratentorial cerebrovascular lesion by MRI. A total of 57 patients with palsy following a supratentorial cerebrovascular lesion were prospectively studied. Wallerian degeneration was detected as a high signal intensity (HSI) in 37 patients between 70 days and 100 days after the onset, but not detected in the remaining 27 patients. Patient with an HSI in all area of the cerebral peduncle had a large lesion involving the hemisphere. Patient with an HSI at the center of the cerebral peduncle had a lesion confined to the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. Patient with an HSI at the lateral side of the cerebral peduncle had a lesion of parietal lobe or temporal lobe which spares the corticospinal tract originating from the paracentral gyrus, precentral gyrus, corona radiata or posterior limb of the internal capsule. These findings suggest that an HSI at the center of the cerebral peduncle may reveal Wallerian degeneration of the corticospinal tract, and an HSI at the lateral side of the cerebral peduncle may show Wallerian degeneration of the corticopontine tract. The functional recovery of paresis was poor in all patients with an HSI at the center of the cerebral peduncle, while it was good in all patients without an HSI in that region.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Wallerian degeneration of the cortico-descending tract in the cerebral peduncle following a supratentorial cerebrovascular lesion detected by MRI--the relationship between Wallerian degeneration at the center of the cerebral peduncle and functional recovery of paresis]. 812 72

A 32-year-old woman experienced subacute onset of weakness in her left leg, urinary retention and difficulty in extending her right middle and third finger. She subsequently suffered episodes of myelopathy, optic neuritis and cerebellar ataxia over a period of several years. Brain MRI showed multiple areas of high signal intensity on T2-weighted images, consistent with multiple sclerosis (MS). However spinal MRI revealed no abnormal findings. In her most recent episode, at age 40 she developed paraparesis. Neurologic examination revealed down beat nystagmus on gazing to the right, horizontal jerk nystagmus gazing to the left, weakness of the right middle and third fingers and paraparesis associated with spasticity of the right leg. Sensory disturbance below C3 and diminished vibration and position sense in both legs were also observed. The patient could not stand or walk, and urinary disturbance was present. Spinal MRI revealed syrinx formation at the level of vertebral bodies C2 to C6. The syrinx within the cervical cord diminished in size after four months, but the patient was unable to walk unaided and had moderate sensory disturbance as before. This finding suggests that the prognosis of MS with syrinx formation following repeated episodes of myelopathy is not always favorable. We believe that functional recovery in MS with syringomyelia is affected by the severity of the demyelination and/or gliosis caused by MS rather than by the presence of the syrinx.
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PMID:[Multiple sclerosis with syringomyelia--case report]. 813 3

Ninety-nine consecutive patients with brachial plexus injuries were operated upon over a period of 8 1/2 years. Among them, 70% sustained traction injuries. The surgical procedures included neurolysis in 35, excision of a lateral neuroma in six and interfascicular sural nerve grafting in 27 patients. In 25 patients, after an exploration, no further surgical procedure was carried out. In four patients, an intercosto-musculocutaneous anastomosis, and in two a trapezius muscle transplant were carried out. Just over two-thirds (68%) of the patients were operated upon 6 months after the injury. Water soluble contrast myelography was performed in 60 patients. These included patients where a root injury had been diagnosed clinically or electrophysiologically. MRI was performed in 14 patients to visualize root avulsions and distal lesions. Operative confirmation of MRI findings were obtained in more than 85% of patients. While an early improvement was seen in patients where only a neurolysis was required, at longer follow-up, gratifying results were recorded even in patients with interfascicular grafts of 6-8 cm length. All 49 patients who came for follow-up and in whom a definitive surgical procedure had been carried out improved. Of these patients, 61% showed near normal or satisfactory functional recovery. The other patients were followed for periods of less than 1.5 years and may show further improvement with time.
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PMID:Surgical treatment of brachial plexus injuries. 826 87

MRI of the knee was performed in 30 patients who had been submitted to arthroscopically-guided reconstruction of the anterior cruciate ligament from patellar tendon. The autograft structure was investigated and MR results were correlated with clinical findings. Partial/total meniscectomy had been carried out in 21/30 cases. The patients were imaged at various postoperative intervals (3-24 months) by means of an 0.5-T magnet (GE MR Max Plus) in full knee extension and internal rotation. Sagittal and axial T1-weighted images (slice thickness: 3 mm) were combined with real-time reconstruction which better demonstrated the whole graft. T2-weighted coronal images (slice thickness: 5 mm) were also acquired. In each patient the following clinical variables were considered: anterior drawer sign, Lachman test, pivot shift, degree of leg extension, and finally functional recovery. The following MR variables were then considered: structure and alignment of bone tunnels, structure and signal intensity of the graft, degree of synovial inflammation, structure and signal intensity of the posterior cruciate ligament and finally structure of the menisci and/or meniscal residues. Symptoms-MR correlation suggests that the different outcome of surgical reconstruction may depend on the correct alignment of the tibial and femoral bone tunnels and on good meniscal condition. Bone tunnels must be located on the same plane, posterior and parallel to the slope of the intercondylar roof, since angulation causes the latter to impact the graft during knee extension, with inflammation and risk for rupture. As for menisci, tiny residues or total ablation overload tha graft, whose signal increases and whose synovia becomes inflamed. The latter pattern is always distinguished from that of the autograft, whose signal intensity seems not to change in time. In conclusion, MR proved an accurate and non-invasive technique to image this kind of postoperative knee, since metallic artifacts do not reach the joint space.
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PMID:[Reconstruction of the anterior cruciate ligament using the patellar tendon: its magnetic resonance evaluation]. 834 60

We report the case of a 68-year-old patient with a traumatic spinal subdural hematoma. MRI demonstrated an area of abnormal intensity and a black line in the inner part of the intradural space. We anticipate that MRI will help to make one more confident in the preoperative diagnosis of spinal subdural hematoma. The symptoms completely disappeared immediately after the operation. Spinal subdural hematoma requires immediate surgical evacuation. The prognosis for functional recovery is good if the condition is appropriately diagnosed and treated before development of irreversible paralysis. We recommend MRI to make an early diagnosis and early evacuation of spinal subdural hematoma.
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PMID:Spinal subdural hematoma. 883 81

Spinal epidural abscess is an uncommon site of infection, resulting in back pain, fever, weakness and loss of sensibility. These signs should suggest the diagnosis, and quick confirmation by MRI should be performed. Immediate surgical decompression and antibiotherapy is necessary, because this is the base of a possible successful functional recovery. Empiric therapy consisting of high dose of penicillinase-resistant antibiotics is advised because most often an epidural abscess is caused by Staphylococcus aureus. However, because other bacteria can be involved, an aminoglycoside or a cephalosporin should be added to the empiric treatment, until the results of the cultures are known. When diagnosis and therapy are delayed, permanent paralysis and death are common.
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PMID:Epidural abscess: case report and review of the literature. 899 57

Recovery of the cerebral cortex after 10 min of cardiac arrest was studied in rat using noninvasive MRI techniques. The apparent diffusion coefficient (ADC) of brain water was imaged to document reversal of the metabolic impairment. Perfusion-weighted imaging and blood oxygen level dependent (BOLD) imaging were performed to assess functional recovery. To this purpose, rats were anesthetized with alpha-chloralose, and somatosensory cortex was activated by electrical stimulation of the contralateral forepaw. In sham-operated controls, cortical ADC was 862 +/- 10 microm2/s, and stimulation of forepaw led to a focal increase of signal intensity in somatosensory cortex by 71 +/- 22% in perfusion-weighted images and by 6 +/- 1% in BOLD images. One hour after successful resuscitation following 10 min of cardiac arrest, ADC did not differ from control but functional activation was completely suppressed. After 3 hours of reperfusion, functional activity began to reappear but the recovery of the BOLD signal progressed faster than that of the perfusion-weighted signal. The differences in the recovery of ADC, BOLD, and perfusion imaging are related to differences between metabolic and functional recovery on one hand and between blood flow and oxygen extraction on the other. The combination of these MRI methods thus provides detailed qualitative information about the progression of brain recovery after transient circulatory arrest.
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PMID:Recovery of the rodent brain after cardiac arrest: a functional MRI study. 958 10


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