Presse Med
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Case Reports
[The anterior interosseous nerve syndrome. A rare lesion of a median nerve branch in the forearm. A case].
Apparently spontaneous and isolated lesions of the anterior interosseous nerve--a purely motor branch of the median nerve in the forearm--are extremely rare. Their clinical manifestations are fairly stereotyped, consisting of paralysis restricted to the long flexor muscle of the thumb, the deep flexor muscle of the index finger and the quadrate pronator muscle, without sensory disorders. ⋯ The syndrome may caused by traumas of the forearm or may develop spontaneously, although underlying anatomical abnormalities which may act as predisposing factors are not infrequently found in this case. The natural outcome may be favourable, but surgery may be required to release the nerve.
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From October, 1969 to December, 1982, 1117 aortic valve replacements were performed at the Foch Medico-Surgical Centre. Five of these operations (0.4%) were followed, within 6 months to 6 years (mean 37 months), by acute dissection of the whole ascending aorta with a varying degree of extension further down. Such accidents raise problems of aetiology, diagnosis, treatment and possibly prevention. ⋯ Lesions of cystic necrosis of the media were regularly found at histology. In every case during the first operation the surgeon reported that the aorta was dilated or particularly fragile. The question therefore arises as to whether ascending aortas that are fragile and of more than 5 cm in diameter should be systematically replaced.