Neurol Neurochir Pol
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The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. ⋯ Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.
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Chronic pelvic pain is a syndrome of chronic non-malignant pain of multifactorial pathophysiology. Perineal, anal and coccygeal pain can be a form of failed-back surgery syndrome or complex regional pain syndrome. Apart from conservative treatment interventional methods are useful in this condition as neurolytic blocks or non-destructive neuromodulation procedures. Peripheral nerve, spinal cord stimulation or sacral stimulation can be applied. ⋯ Sacral roots stimulation is a non-destructive and minimally invasive neuromodulation method in the treatment of chronic pelvic pain. It can be effective even in the long-term observation but special care is advised to secure aseptic conditions in the implantation and to prevent the infection which leads to removal of the stimulating system.
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Neurol Neurochir Pol · Jan 2015
Case ReportsThe role of ultrasound in the diagnosis of temporal arteritis.
Temporal arteritis (TA), also known as giant cell arteritis, is a chronic vasculitis of medium and large-sized blood vessels, in particular the main cervical branches of the aorta, with particular affinity to the temporal arteries and eye-supplying arteries. Temporal artery biopsy is still a gold standard for diagnosis, however in recent years colour duplex ultrasound examination has been proposed as a useful diagnostic screening tool in cases of TA suspicion. We report three cases of TA in which the ultrasonographical examination of the temporal arteries had a decisive role in the diagnosis.
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Neurol Neurochir Pol · Jan 2015
Case ReportsEmergency microsurgical embolectomy in acute ischemic stroke with diffusion-negative MRI.
Although diffusion-weighted imaging (DWI) is highly sensitive and specific for the detection of acute ischemic injury, there are increasing reports that it may fail to demonstrate an acute stroke. Here, we present a case involving an acute ischemic stroke with a false-negative DWI in a 64-year-old woman who had undergone an emergency microsurgical embolectomy for an occluded middle cerebral artery (MCA). Although the endovascular mechanical embolectomy failed in treating the occluded MCA, we were able to successfully treat our patient with the second treatment option of a microsurgical embolectomy. Microsurgical embolectomy might be the treatment of choice, especially if the mechanical catheter is expected to not be able to access the target artery due to tortuous vascular structures.
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Neurol Neurochir Pol · Jan 2015
Comparative Study5% lidocaine medicated plasters vs. sympathetic nerve blocks as a part of multimodal treatment strategy for the management of postherpetic neuralgia: a retrospective, consecutive, case-series study.
5% lidocaine medicated plasters (5% LMP) have been appointed as a first-line treatment for post-herpetic neuralgia (PHN), while formerly used sympathetic nerve blocks (SNBs) were recently denied their clinical efficacy. The aim of this study was to compare the results of PHN management with the use of SNBs and 5% LMP as a first-line treatment. ⋯ It may be concluded that SNBs may still be considered useful in PHN management, as it appears that in some cases this mode of treatment may offer some advantages over 5% LMP.