Nature of the Nerve Lesion caused by a Pneumatic Tourniquet

Ochoa, José L.; Danta, G; Fowler, Thomas J.; Gilliatt, R. W.

doi:10.1038/233265a0

Cited by 151 publications

(65 citation statements)

References 4 publications

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“…Furthermore, this was dissimilar to that found in animal models of acute nerve compression (Ochoa et al 1971(Ochoa et al , 1972 and during pure deformation of nerve (Fern & Harrison, 1991).…”

Section: Relevance For Clinical Compression Disorderscontrasting

confidence: 51%

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The contribution of ischaemia and deformation to the conduction block generated by compression of the cat sciatic nerve

Fern

Harrison²

1994

Experimental Physiology

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SUMMARYThe pattern of conduction block induced in cat peripheral nerve by compression has been investigated electrophysiologically by recording unitary action potentials. A degree of compression, associated with chronic compression disorders in man, was applied to the cat sciatic nerve and resulted in a conduction block typified by early failure of the slow conducting myelinated axons. By contrast, a greater degree of compression, a degree more likely to result in acute compression lesions, produced a different pattern of effect, inducing early conduction failure in the fast conducting myelinated axons. These results are related to earlier studies which have shown that nerve deformation during compression has a differential action upon fast myelinated axons, while nerve ischaemia has a differential action upon slow myelinated axons.

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Section: Relevance For Clinical Compression Disorderscontrasting

confidence: 51%

“…Thus, during relatively severe compression, the nodes of Ranvier of myelinated fibres become displaced away from the compressed region (Ochoa et al 1971(Ochoa et al , 1972. Deformation of nerve structure has also been found in chronically compressed nerve (Fullerton & Gilliatt, 1967a,b;Anderson et al 1970).…”

Section: Introductionmentioning

confidence: 99%

The contribution of ischaemia and deformation to the conduction block generated by compression of the cat sciatic nerve

Fern

Harrison²

1994

Experimental Physiology

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“…[7][8][9] In animal models, experimental compression caused selective damage to large myelinated fibers with preservation of the small myelinated and unmyelinated fibers, similar to our patients. Also reported is demyelination and axonal degeneration under the areas of compression with axonal degeneration in the segment distal to compression as seen in several of our patients.…”

mentioning

confidence: 69%

Chronic meralgia paresthetica and neurectomy

et al. 2014

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Objective: To understand the pathologic and clinical correlates of patients with chronic meralgia paresthetica (MP) undergoing lateral femoral cutaneous nerve (LFCN) neurectomy.Methods: A retrospective cohort approach was utilized to identify 7 patients undergoing LFCN neurectomy for intractable pain. Control autopsied LFCN was obtained. Clinical, radiologic, and electrophysiologic features were reviewed.Results: In identified cases, preoperative symptoms included severe lateral thigh pain and numbness. The duration of symptoms prior to surgery ranged from 2 to 15 years. Body mass index (BMI) varied from 20 kg/m 2 to 44.8 kg/m 2 (normal-morbidly obese), with 6 out of 7 patients being obese. No patients were diabetic. Focal nerve indentation at the inguinal ligament was seen intraoperatively and on gross pathology in 4 of 7 cases. Multifocal fiber loss, selective loss of large myelinated fibers, thinly myelinated profiles, regenerating nerve clusters, perineurial thickening, and subperineurial edema were seen. None of these features were observed in control nerve. Morphometric analysis confirmed loss of large myelinated fibers with small and intermediate size fiber predominance. Five patients had varying degrees of intraneural and epineurial inflammation. Six of 7 reported improved pain after neurectomy, sometimes dramatic. Meralgia paresthetica (MP) has been found to be relatively common, with an incidence of 32.6-43 per 100,000 patient-years.1,2 The incidence is greatest in older persons (55-64 years) with elevated body mass index (BMI), which supports the theory that mechanical compression plays a role.1 However, a strong association between diabetes and MP was also found, which was not explained by the increase in BMI alone, suggesting that diabetes may be an independent risk factor for MP. Specifically considered in the lateral femoral cutaneous nerve (LFCN), pathologic mechanisms of MP are (1) compression at the inguinal ligament from obesity; (2) injury susceptibility related to elevated blood sugars; or (3) an inflammatory or autoimmune mechanism as occurs in diabetic and nondiabetic lumbosacral plexitis, which commonly affects the femoral nerve.

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“…Tais lesões podem ser causadas por isquemia ou pressão direta sobre o nervo (5) . O maior risco de seu aparecimento pode estar também relacionado ao sexo e idade do paciente, mas principalmente ao tempo de uso do garrote (6) .…”

Section: Discussionunclassified