Surgery performed by a multidisciplinary team minimizes risks. Despite the high number of complications published in the literature, the results found in this study were excellent with regards to improving kyphosis angle, as well as facilitating rehabilitation and daily care of children.
ResumoObjetivo Analisar 78 casos de lesão de plexo braquial operados, submetidos à técnica de Oberlin entre 2003 e 2012. Possíveis complicações desta técnica foram analisadas, sobretudo possíveis prejuízos motores ou hipoestesia na mão. Método Foi realizada análise retrospectiva de prontuários de pacientes com lesões do plexo braquial com níveis de lesão C5-C6 e C5-C6-C7. Foram analisados casos que haviam sido submetidos ao procedimento de Oberlin associado ou não a outros procedimentos concomitantes do plexo braquial entre 2003 e 2012. O seguimento pós-operatório mínimo foi de 1 ano. Além do exame clínico, foram usados para o diagnóstico e localização da lesão nervosa a eletroneuromiografia e a ressonância nuclear magnética de plexo braquial. Resultados Foram obtidos 78 casos operados que preenchiam os critérios de inclusão. Alterações neurológicas pós-operatórias foram observadas em 18 pacientes, sendo, em sua grande maioria, transitórias. Hipoestesia na face ulnar da mão foi observada em sete casos; dores neuropáticas, em cinco; alodinia, em quatro; e perda motora na mão, em dois casos. Conclusão Considerando os resultados da nossa casuística, concluímos que as sequelas no território do nervo doador são poucas diante do benefício que a técnica de Oberlin pode trazer à recuperação da flexão do cotovelo nas lesões do plexo braquial.
AbstractObjective To analyze 78 cases of brachial plexus injury operated undergoing Oberlin technique between 2003 and 2012. This study looked at as the possible complications of this technique, especially possible engine damage or hypoesthesia in hand. Method A retrospective analysis of medical records of patients with brachial plexus injuries with injury levels C5-C6 and C5-C6-C7 was performed. Cases were analyzed
Background: Spontaneous spinal epidural hematomas are a rare cause of spinal cord compression in children. These are typically isolated events and could be associated to hemophilia. Symptoms typically include a sudden onset of back pain followed by neurologic deterioration including weakness, numbness, and incontinence. Recurrent spontaneous spinal epidural hematomas have been reported only in two instances in adults. There has been one report of recurrent spontaneous spinal epidural hematomas involving a child. Methods: This case report details the case of a 9year-old female with recurrent spontaneous spinal epidural hematomas who presented with one episode of lower extremity paresis and 2 years after first episode developed a recurrence hematoma causing cervical pain without motor deficit. The patient was operated and had a good outcome. Conclusion: Clinical signs such as severe pain and neurological worsening may represent a new episode of bleeding and should be promptly evaluated and if necessary operated again.
Spinal cord tumors are a rare neoplasm of the central nervous system (CNS). The occurrence of metastases is related to poor prognosis. The authors analyzed one series of metastasis cases and their associated mortality. METHODS: Clinical characteristics were studied in six patients with intramedullary tumors with metastases in a series of 71 surgical cases. RESULTS: Five patients had ependymomas of which two were WHO grade III. The patient with astrocytoma had a grade II histopathological classification. Two patients required shunts for hydrocephalus. The survival curve showed a higher mortality than the general group of patients with no metastases in the CNS (p<0.0001). CONCLUSION: Mortality is elevated in patients with metastasis and greater than in patients with only primary lesions. The ependymomas, regardless of their degree of anaplasia, are more likely to cause metastasis than spinal cord astrocytomas.
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