Pub Date : 2023-10-11DOI: 10.21129/nerve.2023.00332
Seung-Hoon Ji, Sung-Kyun Hwang
Objective The mechanisms underlying the formation and rupture of intracranial aneurysms in young adults remain a matter of debate. This study aimed to evaluate the clinical characteristics of young adult patients with aneurysmal subarachnoid hemorrhage (SAH) treated with endovascular or clipping techniques at a single center. Methods Seventeen young adult patients (age, 18-40 years; 7 men and 10 women; mean age, 35.7 years) with aneurysmal SAH were treated at our hospital using an endovascular or clip ligation approach between February 2018 and March 2023. The clinical outcomes, complications, and patient characteristics were evaluated. The mean follow-up duration was 13 months (range, 0-44 months). Results The male-to-female ratio was 0.7 (7 vs. 10 patients), and the most common location of aneurysm was the internal carotid artery (7 patients, 41.2%). Two patients (11.8%) presented with a history of hypertension, and six (35.3%) with smoking. The overall favorable outcome rate was 64.7% (Glasgow Outcome Scale [GOS] 4 and 5), while unfavorable outcomes occurred in 35.3% of patients (GOS 1, 2, and 3). None of the patients rebounded after clipping or endovascular treatment. Two (14.3%) patients treated with coil embolization (14 patients) showed an interval change in the residual neck (recanalization). Conclusion Our results suggest that young adults with ruptured intracranial aneurysms exhibit different characteristics. However, well-controlled investigations using larger prospective studies are warranted to further clarify the clinical characteristics of these patients, including the mechanisms of aneurysm formation and rupture. Key words: Endovascular procedures; Clip; Intracranial aneurysm; Young adult
{"title":"Aneurysmal Subarachnoid Hemorrhage in Young Adult Patients: Single Center Reports","authors":"Seung-Hoon Ji, Sung-Kyun Hwang","doi":"10.21129/nerve.2023.00332","DOIUrl":"https://doi.org/10.21129/nerve.2023.00332","url":null,"abstract":"Objective The mechanisms underlying the formation and rupture of intracranial aneurysms in young adults remain a matter of debate. This study aimed to evaluate the clinical characteristics of young adult patients with aneurysmal subarachnoid hemorrhage (SAH) treated with endovascular or clipping techniques at a single center. Methods Seventeen young adult patients (age, 18-40 years; 7 men and 10 women; mean age, 35.7 years) with aneurysmal SAH were treated at our hospital using an endovascular or clip ligation approach between February 2018 and March 2023. The clinical outcomes, complications, and patient characteristics were evaluated. The mean follow-up duration was 13 months (range, 0-44 months). Results The male-to-female ratio was 0.7 (7 vs. 10 patients), and the most common location of aneurysm was the internal carotid artery (7 patients, 41.2%). Two patients (11.8%) presented with a history of hypertension, and six (35.3%) with smoking. The overall favorable outcome rate was 64.7% (Glasgow Outcome Scale [GOS] 4 and 5), while unfavorable outcomes occurred in 35.3% of patients (GOS 1, 2, and 3). None of the patients rebounded after clipping or endovascular treatment. Two (14.3%) patients treated with coil embolization (14 patients) showed an interval change in the residual neck (recanalization). Conclusion Our results suggest that young adults with ruptured intracranial aneurysms exhibit different characteristics. However, well-controlled investigations using larger prospective studies are warranted to further clarify the clinical characteristics of these patients, including the mechanisms of aneurysm formation and rupture. Key words: Endovascular procedures; Clip; Intracranial aneurysm; Young adult","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136059371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-30DOI: 10.21129/nerve.2022.00199
Dong Wook Kim, Byeong Ho Oh, Jong Beom Lee
Thoracic outlet syndrome (TOS) is a constellation of symptoms caused by the compression of neurovascular structures at the superior aperture of the thorax, properly referred to as the thoracic inlet. However, there is no consistent clinical presentation or definition. Based on a comprehensive literature review, this article presents the etiology, epidemiology, and clinical diagnostics of TOS, as well as the possibilities and outcomes of surgical treatment. The diagnosis and treatment are contentious, and some even question the existence of TOS. Its symptoms are often confused with those of distal compression neuropathies or cervical radiculopathies. The various surgical approaches for this syndrome are evaluated according to their ability to facilitate wide exposure, their potential morbidity, and their beneficial results. Most patients suffering from any form of TOS can benefit from surgical treatment. The duration of symptoms, socioeconomic factors and most notably, a stringent diagnostic workup and an adequate operative approach are important.
{"title":"Thoracic Outlet Syndrome","authors":"Dong Wook Kim, Byeong Ho Oh, Jong Beom Lee","doi":"10.21129/nerve.2022.00199","DOIUrl":"https://doi.org/10.21129/nerve.2022.00199","url":null,"abstract":"Thoracic outlet syndrome (TOS) is a constellation of symptoms caused by the compression of neurovascular structures at the superior aperture of the thorax, properly referred to as the thoracic inlet. However, there is no consistent clinical presentation or definition. Based on a comprehensive literature review, this article presents the etiology, epidemiology, and clinical diagnostics of TOS, as well as the possibilities and outcomes of surgical treatment. The diagnosis and treatment are contentious, and some even question the existence of TOS. Its symptoms are often confused with those of distal compression neuropathies or cervical radiculopathies. The various surgical approaches for this syndrome are evaluated according to their ability to facilitate wide exposure, their potential morbidity, and their beneficial results. Most patients suffering from any form of TOS can benefit from surgical treatment. The duration of symptoms, socioeconomic factors and most notably, a stringent diagnostic workup and an adequate operative approach are important.","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135563916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-25DOI: 10.21129/nerve.2023.00304
Yohan Son, Young-Jin Kim, Sang-koo Lee
{"title":"Anterior Cage Migration during Transforaminal Lumbar Interbody Fusion: A Case Report and Review of the Literature","authors":"Yohan Son, Young-Jin Kim, Sang-koo Lee","doi":"10.21129/nerve.2023.00304","DOIUrl":"https://doi.org/10.21129/nerve.2023.00304","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115537440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-25DOI: 10.21129/nerve.2023.00318
J. Ha, Sangpyung Lee, Jin-Ah Beak, Kyoungsoo Ryou, T. Park, Seonghwan Kim
{"title":"Neurogenic Thoracic Outlet Syndrome Induced by Subclavius Muscle Hypertrophy: A Case Report","authors":"J. Ha, Sangpyung Lee, Jin-Ah Beak, Kyoungsoo Ryou, T. Park, Seonghwan Kim","doi":"10.21129/nerve.2023.00318","DOIUrl":"https://doi.org/10.21129/nerve.2023.00318","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124278231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-25DOI: 10.21129/nerve.2023.00269
Jong Hyeok Lee, S. Sung, Bu Kwang Oh, J. Lee, Chi Hyung Lee, C. Hwang, Sang Weon Lee, G. Song
{"title":"Multiple Spinal Metastases of Anaplastic Meningioma: A Case Report","authors":"Jong Hyeok Lee, S. Sung, Bu Kwang Oh, J. Lee, Chi Hyung Lee, C. Hwang, Sang Weon Lee, G. Song","doi":"10.21129/nerve.2023.00269","DOIUrl":"https://doi.org/10.21129/nerve.2023.00269","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116895789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-24DOI: 10.21129/nerve.2023.00262
Chai Yoon Kim, J. Hur, Jeong Gyun Kim, Jong Won Lee, I. Yun, Hyun Koo Lee
{"title":"Ventriculitis Associated with Invasive Klebsiella Pneumoniae Syndrome: A Case Report","authors":"Chai Yoon Kim, J. Hur, Jeong Gyun Kim, Jong Won Lee, I. Yun, Hyun Koo Lee","doi":"10.21129/nerve.2023.00262","DOIUrl":"https://doi.org/10.21129/nerve.2023.00262","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132103728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-20DOI: 10.21129/nerve.2022.00255
C. De Bonis, B. Chaurasia
{"title":"Lumbar Calcifying Pseudoneoplasm as a Rare Cause of Cauda Equina Syndrome: A Case Report","authors":"C. De Bonis, B. Chaurasia","doi":"10.21129/nerve.2022.00255","DOIUrl":"https://doi.org/10.21129/nerve.2022.00255","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131608906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-20DOI: 10.21129/nerve.2022.00227
Jung‐won Lim, Jin-Hoon Park, H. Shin, Jeong Kyun Joo, Jung Jae Lee
Objective: Approximately 90% of spinal fractures occur at the thoracolumbar (T-L) junction and may be accompanied by neurological symptoms, in which decompression and post-fixation are generally performed. However, decompression surgery can aggravate patients’ symptoms due to adverse incidents, such as developing postoperative hematomas or iatrogenic spinal cord injury. This study compared the surgical and radiographic outcomes of patients with T-L junction burst fractures and neurological deficits who underwent direct or indirect decompression. Methods: We retrospectively reviewed all patients who had undergone posterior surgical treatment for T-L junction burst fractures with neurologic deficits. Patients were classified according to the procedure: indirect decompression (group 1) or spinal decompression through laminectomy and facetectomy (group 2). Clinical results and radiologic findings were compared between the two groups for 2 years. Results: Among 57 patients who met the inclusion criteria, 29 were categorized into group 1, and 28 were categorized into group 2. Group 1 had a statistically significantly lower Oswestry Disability Index score than group 2 at the final follow-up visit (p=0.03). In group 1, both the T-L junction angle and wedge angle of the injured vertebrae improved significantly, both immediately after surgery (p=0.02 and p=0.01, respectively) and at the final follow-up visit (p=0.01 and p=0.01, respectively). In group 2, the difference between the pelvic incidence and lumbar lordosis was significantly greater than in group 1 at the final follow-up visit (p=0.02). Conclusion: This study confirmed that symptoms could be sufficiently improved with indirect decompression, which should be kept in mind for cases where it is difficult to perform direct decompression,
目的:大约90%的脊柱骨折发生在胸腰椎(T-L)交界处，可能伴有神经系统症状，通常进行减压和后固定。然而,减压手术会加重病人的症状由于不良事件,例如开发术后血肿或医源性脊髓损伤。本研究比较了接受直接或间接减压的T-L连接处爆裂骨折和神经功能缺损患者的手术和影像学结果。方法:我们回顾性分析了所有接受后路手术治疗的T-L连接处爆裂骨折伴神经功能缺损的患者。根据手术方式对患者进行分类:间接减压(1组)或椎板切除术+面切除术脊柱减压(2组)。比较两组2年的临床结果和影像学表现。结果:符合纳入标准的57例患者中，1组29例，2组28例。最后一次随访时，组1的Oswestry残疾指数评分低于组2，差异有统计学意义(p=0.03)。在组1,T-L结角和楔角的受伤的椎骨明显改善,手术后都立即(分别为p = 0.02, p = 0.01),在最后的随访中(分别为p = 0.01, p = 0.01)。2组患者最后随访时盆腔发生率和腰椎前凸的差异显著大于1组(p=0.02)。结论:本研究证实，间接减压可以充分改善症状，对于难以进行直接减压的病例应牢记这一点。
{"title":"Advantages of Posterior Indirect Decompression Surgery in Thoracolumbar Burst Fractures with Neurologic Symptoms","authors":"Jung‐won Lim, Jin-Hoon Park, H. Shin, Jeong Kyun Joo, Jung Jae Lee","doi":"10.21129/nerve.2022.00227","DOIUrl":"https://doi.org/10.21129/nerve.2022.00227","url":null,"abstract":"Objective: Approximately 90% of spinal fractures occur at the thoracolumbar (T-L) junction and may be accompanied by neurological symptoms, in which decompression and post-fixation are generally performed. However, decompression surgery can aggravate patients’ symptoms due to adverse incidents, such as developing postoperative hematomas or iatrogenic spinal cord injury. This study compared the surgical and radiographic outcomes of patients with T-L junction burst fractures and neurological deficits who underwent direct or indirect decompression. Methods: We retrospectively reviewed all patients who had undergone posterior surgical treatment for T-L junction burst fractures with neurologic deficits. Patients were classified according to the procedure: indirect decompression (group 1) or spinal decompression through laminectomy and facetectomy (group 2). Clinical results and radiologic findings were compared between the two groups for 2 years. Results: Among 57 patients who met the inclusion criteria, 29 were categorized into group 1, and 28 were categorized into group 2. Group 1 had a statistically significantly lower Oswestry Disability Index score than group 2 at the final follow-up visit (p=0.03). In group 1, both the T-L junction angle and wedge angle of the injured vertebrae improved significantly, both immediately after surgery (p=0.02 and p=0.01, respectively) and at the final follow-up visit (p=0.01 and p=0.01, respectively). In group 2, the difference between the pelvic incidence and lumbar lordosis was significantly greater than in group 1 at the final follow-up visit (p=0.02). Conclusion: This study confirmed that symptoms could be sufficiently improved with indirect decompression, which should be kept in mind for cases where it is difficult to perform direct decompression,","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"132 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134275818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-19DOI: 10.21129/nerve.2022.00220
Jiyeon Kim, B. Son
{"title":"Paresthesia and Pain in Both Arms when Shampooing One’s Hair: Symptoms of Neurogenic Thoracic Outlet Syndrome","authors":"Jiyeon Kim, B. Son","doi":"10.21129/nerve.2022.00220","DOIUrl":"https://doi.org/10.21129/nerve.2022.00220","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117168514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-19DOI: 10.21129/nerve.2022.00241
Sang Yoon Lee, K. Kim, Jeong-Yoon Park, D. Chin, Keun-Su Kim, Yong-Eun Cho, H. Jang
{"title":"Spontaneous Shrinkage of a Dumbbell-Shaped Schwannoma in the Cervical Spine: A Case Report","authors":"Sang Yoon Lee, K. Kim, Jeong-Yoon Park, D. Chin, Keun-Su Kim, Yong-Eun Cho, H. Jang","doi":"10.21129/nerve.2022.00241","DOIUrl":"https://doi.org/10.21129/nerve.2022.00241","url":null,"abstract":"","PeriodicalId":229172,"journal":{"name":"The Nerve","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131984363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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