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Biomedical subjects

A Catz

Publications and source records attributed to A Catz.

At least 37 records · Page 2Linked to original sources
PubMed1999

The treatment dilemma in post-traumatic syringomyelia.

PURPOSE: The aim of the present study was to compare the functional effect of conservative and surgical treatment in post-traumatic syringomyelia. METHOD: The files of 10 male patients treated for posttraumatic syringomyelia were retrospectively reviewed from 1986 to 1996. RESULTS: The spinal lesion was complete in five patients and incomplete in five. All patients underwent rehabilitation, five of them following surgery. The operative procedures included drainage by syringosubarachnoid shunting (four patients) and decompressive laminectomy (one patient). Rehabilitation alone improved the functional status in all five patients so treated. After surgery, function deteriorated in four of the five operated patients, and rehabilitation failed to restore the preoperative functional status in any of them. CONCLUSION: In view of the results it is suggested that patients with post-traumatic syringomyelia undergo rehabilitation with very close clinical and magnetic resonance imaging follow-up.

Adolescent↗
PubMed1999

Feasibility study of a novel approach to sore prevention in patients with spinal cord lesions: the computerized dynamic control Matrix 200 system.

OBJECTIVE: To evaluate the feasibility of a computerized mattress system based on a novel concept in sore prevention: continuous monitoring and adjustment of the interface pressure in small segments of contact between the skin and the supporting surface. DESIGN: A preliminary observational study. SETTING: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. SUBJECTS: Twelve patients with spinal cord lesions. INTERVENTIONS: Patients were examined for signs of impending sores after lying on the mattress for up to 4 successive hours. The pressure within each of the mattress's air cells was continuously measured and adjusted. RESULTS: No evidence of redness or excessive perspiration was found in any of the areas considered to be high risk for bed sores. Maximal interface pressure was 22-30 mm Hg in most of the examinations. Most of the patients felt comfortable on the mattress and the staff adapted easily to its operation. CONCLUSIONS: The system is apparently safe, and at least as efficient as other existing means for preventing sores. In addition, it may allow for increased intervals between bed positionings. We conclude that this approach of pressure control has the potential to improve bed sore prevention in a rehabilitation hospital setting.

Adult↗
PubMed1997

The role of external sphincterotomy for patients with a spinal cord lesion.

For the last three decades external sphincterotomy has been well accepted as a treatment for bladder outlet obstruction in patients with a spinal cord lesions. Recently, however, its value has been brought into question. To assess the current place of this procedure in the treatment of the neuropathic bladder of spinal origin, we studied the outcomes of sphincterotomy in 32 patients. Post-voiding residual urine volume decreased after surgery in 27 patients (84%), considerably in 22 (69%) of them. Clinical infection resolved in 14 out of 19 patients (74%), hydronephrosis disappeared in two out of three (66%), and vesicourethral reflux improved in three out of five (60%) and was cured in two (40%). Six of the patients (19%) were freed from catheterization, but two patients (6%) lost partial continence. Sphincterotomy is an important tool in the treatment of spinal patients with bladder outlet obstruction and should be considered when the proper indications exist.

Adult↗
PubMed1997

SCIM--spinal cord independence measure: a new disability scale for patients with spinal cord lesions.

The Spinal Cord Independence Measure (SCIM) is a new disability scale developed specifically for patients with spinal cord lesions in order to make the functional assessments of patients with paraplegia or tetraplegia more sensitive to changes. The SCIM includes the following areas of function: self-care (subscore (0-20), respiration and sphincter management (0-40) and mobility (0-40). Each area is scored according to its proportional weight in these patients' general activity. The final score ranges from 0 to 100. This study was performed to evaluate the reliability of the SCIM and its sensitivity to functional changes in spinal cord lesion patients compared with the Functional Independence Measure (FIM). Thirty patients were included. Scores were recorded one week after admission and thereafter every month during hospitalization. Each area of function was assessed by a pair of staff members from the relevant discipline. The comparison of scores between each pair of rates revealed a remarkable consistency (r = 0.91-0.99; P < 0.0001; slope approximately 1; constant approximately 0). The total SCIM score (mean = 51, SD = 21) was lower than the total FIM score (mean = 87, SD = 23) owing to the difference in scale range structure and the relatively high cognitive scores of our patients; however, a relationship was noted between the scores of both scales (r = 0.85, P < 0.01). The SCIM was more sensitive than the FIM to changes in function of spinal cord lesion patients: the SCIM detected all the functional changes detected by the FIM total scoring, but the FIM missed 26% of the changes detected by the SCIM total scoring. The mean difference between consecutive scores was higher for the SCIM (P < 0.01). We conclude that the SCIM is a reliable disability scale and is more sensitive to changes in function in spinal cord lesion patients than the FIM. The SCIM when administered by a multidisciplinary team, may be a useful instrument for assessing changes in everyday performance in patients with spinal cord lesion.

Activities of Daily Living↗
PubMed1994

Saccadic responses in patients with hemispheric stroke.

Saccadic characteristics were examined in 15 patients with unilateral hemispheric stroke. Eye movements were measured by a standard electro-oculogram technique. In patients with cortical infarcts, mean gain values were lower than in the control subjects for eye movements directed away from the infarct (contralateral), but higher for eye movements towards the infarct (ipsilateral) (p < 0.025). We suggest that impairment of efferent neural signals from the affected hemisphere of stroke patients may decrease excitation of the contralateral neural circuits and inhibition of the ipsilateral neural circuits of the brainstem saccade generator.

Adult↗
PubMed1994

The vestibulo-ocular reflex and dysequilibrium after hemispheric stroke.

Patients with hemispheric lesions frequently suffer from equilibrium impairment that may be prolonged and may interfere with rehabilitation. In an effort to clarify whether this phenomenon is related to vestibular dysfunction, we examined the relationship of the horizontal vestibulo-ocular reflex (VOR) with stability in 15 patients with unilateral hemispheric stroke. The study included electro-oculographic recording of the VOR while the patients were rotated in a vestibular chair. Stability was scored in accordance with the patients' ability to maintain equilibrium in six graded positions. The findings demonstrated relationship between VOR gain (eye/head displacement) and equilibrium. It is suggested that the "loss of balance" after stroke may be related to an impairment of the corticovestibular modulation of the vestibular function.

Adult↗
PubMed1993

A new double-purpose device for elbow extension in tetraplegia with paralysis below C5.

A new device for elbow extension, developed as a dynamic orthosis and also as a static splint for a C5 tetraplegic arm, is presented. A patient with tetraplegia, probably related to infection of the central and peripheral nervous system, had a paralysed right triceps muscle, with a very strong corresponding biceps. Extension by force of a posterior stretched rubber ring made the arm useful, while the possibility to lock the elbow hinges of the orthosis at any desired angle enabled static splinting of the elbow to increase the range of motion.

Aged↗
PubMed1993

Late-onset papilledema following spinal injury. Case report.

Papilledema, is a known complication of various spinal pathologies. It has, however, been only infrequently reported following spinal injury, and may be overlooked in these cases. Presented herein is a 27 year old male who suffered thoracic and lumbar spinal injuries. Papilledema following mild increase in intracranial pressure (IICP) developed 3 weeks following trauma, and subsided within 8 weeks. The importance of routine repeat ophthalmoscopic examinations following spinal injury to detect changes characteristic of IICP is emphasized.

Acetazolamide↗
PubMed1993

Vestibulo-ocular reflex suppression following hemispheric stroke.

This study examined vestibular function following hemispheric ischemic strokes, by testing the suppression of the vestibulo-ocular reflex (VOR). Fifteen patients with cortical or subcortical infarcts several months after a unilateral hemispheric stroke were compared with control subjects. The results indicated impairment of VOR suppression in patients with cortical infarcts. It is suggested that cortical infarcts may induce a mild and symmetrical impairment of vestibular activity which may be responsible for mild and transient imbalance in patients who undergo stroke.

Adult↗
PubMed1992

Symptomatic postprandial hypotension in high paraplegia. Case report.

Symptomatic postprandial decrease in blood pressure has been described in patients with various autonomic disorders, but not in patients with spinal injuries. Presented herein is a 31 year old female patient with traumatic complete paraplegia under the T3 level, in whom postprandial hypotension (PPH) was observed. The PPH was preceded by an increase in insulin level and was followed by an acceleration of heart rate. Oral caffeine prevented the hypotension and alleviated the symptoms. It is suggested that the PPH might be manifested as a result of damage to an upper thoracic spinal baroreflex. Clinical investigation of PPH is recommended for patients with high paraplegia.

Adult↗
PubMed1992

Lumbar spine dimensions in paraparetic patients: a 10 year follow up study.

Lumbar spinal AP radiographs of 13 C3-T11 paraparetic patients taken at about a 10 year interval were compared. The height (H) and maximum width (W) of the interapophysolaminar spaces (IALS), the width of the vertebral bodies at their waist (V) and the relationship between them showed minimal change over the follow up period. The difference between the late and early mean IALS height values increased caudally but was statistically significant only below L5. Subjective evaluation of the consecutive x-ray films revealed few new degenerative abnormalities. It is concluded that the normal aging process, which includes horizontal spreading of the lumbar vertebral bodies and narrowing of the lumbar spinal canal, is not accelerated by paraparesis and may even be retarded by relative immobilization.

Adult↗
PubMed1992

Management of pyogenic vertebral osteomyelitis with spinal cord compression in the elderly.

Five elderly and debilitated patients presented with compressive myelopathy due to pyogenic spondylitis. All had undergone surgery which consisted of eradication of the infected tissue via an anterior approach followed by primary bone graft. Supplementary antibiotic treatment was determined by intraoperative bacteriological culture. This aggressive approach, disregarding the patients' advanced age and poor general medical state, resulted in total resolution of the neurological deficit and the patients' return to their preoperative everyday activity.

Aged↗
PubMed1992

Is the appearance of periarticular new bone formation related to local neurological disability?

The present work examined the relationship between the appearance of periarticular new bone formation (PNBF) and the presence of local sensorimotor disability, and the relationship between PNBF and the severity of the motor disability. The study population consisted of 18 patients with spinal cord lesions and 18 patients with traumatic brain injury. The confinement of PNBF below the level of neurological deficit in patients with spinal cord lesions, and mainly to paralysed or paretic limbs in brain injured patients, indicates a possible causal relationship between the presence of sensorimotor disability and PNBF. On the other hand, the high incidence of bilateral PNBF in patients with incomplete spinal lesions and the appearance of PNBF in some nonplegic and even paretic limbs in the brain injured patients, demonstrates the lack of connection between the severity of the motor deficit and the risk of PNBF. It is suggested that local factors which are related to sensorimotor disability are probably involved in PNBF induction, but additional elements may also play a role in the induction of PNBF and in its propagation.

Adolescent↗
PubMed1989

Sleep tonus inversion: a feature of juvenile dystonic parkinsonism.

Polysomnographic monitoring of a 16-year-old girl suffering from dopa-responsive dystonic parkinsonism showed a change in the distribution of muscle activity in thigh muscles during different stages of sleep. The hamstring muscles were hypertonic at sleep onset compared with the vastus lateralis of the quadriceps muscles. At the third sleep cycle of each of the 2 nights, the time at which sleep benefit becomes clinically evident, the hypertonia in the hamstring muscles was reversed and the vastus lateralis became more hypertonic. It is suggested that the muscle tonus inversion marks the moment at which the sleep process alleviates the dystonic parkinsonian state manifested at wakefulness as a circardian fluctuation. According to our data, the flexor-extensor tonus inversion during sleep was not yet described in the literature, and may be an associated feature of dopa-responsive dystonic parkinsonism.

Adolescent↗
PubMed1988

Late onset isofenphos neurotoxicity.

Late progressive polyneuropathy followed by pyramidal findings in a 20 year old agricultural labourer who ingested Isofenphos solution during his work, is presented. The patient was confined to a wheelchair within 6 weeks, regained walking ability within 6 months, and a 23 months' follow up revealed slight additional clinical improvement with minimal progression of the pyramidal signs. The neuropathic clinical manifestations, the EMG and the nerve conduction studies were compatible with a pathology of a distal, mainly axonal, mainly motor neuropathy.

Adult↗
PubMed1988

Blink reflex in stroke: follow-up and correlation with function and CT parameters.

Blink reflex (BR) was examined serially in patients 1, 2 and 3 months after unilateral hemispheric cerebrovascular accident and compared with functional state and CT findings of lesion extent and location. BR R2 components were depressed and correlated with lesion size. Initial walking ability was correlated with latency and amplitude of both direct and consensual R2 elicited by stimulation of the paretic side. No correlation was found between BR and arm function or the final ambulatory ability. A model suggesting a close association between BR projection-facilitating fibers and those mediating facial movements is presented.

Blinking↗
PubMed1987

Posterior fossa lesions in childhood and infancy. A CT study.

Forty-three children with CT studies demonstrating abnormalities in the posterior fossa are presented. Tumors constitute the largest group of lesions (53.5%). Their mean size at time of diagnosis was 39.5 mm. Astrocytomas, medulloblastomas, and ependymomas were the most frequent tumors and their CT features are described and discussed. The congenital group of lesions comprised 18.6% of the cases--the most frequent anomaly being arachnoid cyst. In the miscellaneous group (23.3%), cases with atrophy were the most frequent. The cerebellar hemispheres were the most involved sites (39.5%). Lesions located at the tentorial hiatus or near the clivus were rather rare.

Adolescent↗