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Results for “SACRAL PLEXUS”

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At least 163 records · Page 9Linked to original sources
PubMed1991

MR imaging of spinal neurofibromatosis.

The MR findings in 7 patients with neurofibromatosis involving the spine were evaluated. Six patients had paraspinal tumors at multiple levels. In 4 they were bilateral. Five patients had multiple intraspinal lesions, frequently with growth through the neural foramen. In one patient paraspinal tumors were found in the lumbar sacral plexus and in another bony dysplasia and meningoceles but no tumors were disclosed. In 2 patients the lesions were associated with bilateral acoustic neuromas and multiple intracranial meningeomas. In one of these a spinal meningeoma with signal characteristics close to spinal cord was found. The other tumors had a signal that was equal to or slightly lower than the spinal cord and slightly higher than muscle on T1-weighted images. On T2-weighted images the tumors had a markedly increased signal compared to surrounding tissue. In 3 patients with tumors larger than 4 cm the signal intensity was inhomogeneous with decreased signal in the center on T2-weighted images, indicating the presence of increased fibrous tissue. Gadolinium-DTPA was given to one patient with marked increase in intensity of small tumors on T1-weighted images. The study shows that MR imaging is the modality of choice for evaluating most aspects of spinal and paraspinal neurofibromatosis.

Adolescent↗
PubMedDate not supplied

[Intracavernous pharmacotherapy in men who have undergone cystectomy for neoplasia].

Impotentia erigendi is a consequence of radical surgery such as cystectomy due to neoplasia. It is caused by damage to neurovascular structures, and in particular to the nerve fibres of the sacral plexus. Current therapies include the use of penile prostheses or drug therapy. The paper reports the Authors' personal experience of the use of intracavernous drug therapy in 24 patients cystectomised due to vesical carcinoma. Objectively valid results were obtained in 33% of patients. No complications were observed and the treatment represents a valid alternative to mechanical prosthesis.

Aged↗
PubMedDate not supplied

CT evaluation of the greater sciatic foramen in patients with sciatica.

Sciatic and lower extremity neurologic symptoms may be from pathologic involvement of the sacral plexus or sciatic nerve in the region of the greater sciatic foramen. Twenty-five patients were reviewed who presented consecutively over a 4 year period with sciatic symptoms secondary to pathologic changes in the greater sciatic foramen. Malignant neoplasm alone (18 patients) and malignant neoplasm associated with infection (two patients) account for most of these cases. Neurogenic tumors (three patients), both benign and malignant, and infection alone (three patients) were less frequent. Although sciatic symptoms usually derive from spinal abnormalities, the evaluation of sciatic symptoms should not be considered complete without CT scanning of the greater sciatic foramen.

Adult↗
PubMed1988

[Neural complications of injuries of the pelvis].

5 cases of serious neurological complications of pelvic trauma are reported. All consisted of lesions of the lumbo-sacral plexus. The course is similar to that seen in severe forms of untreated brachial plexus lesions since recovery is always very slow and very incomplete. No curative methods of management were used in the series described. Only secondary palliative surgery was carried out.

Adolescent↗
PubMed1987

[Macroscopic study and structure of the nerve of the levator muscle of the anus].

Beginning at the sacral plexus the nerve disposition can be found to follow two modalities: first disposition in 2/3 of all cases having a cranial nerve branch for the elevator portion and a caudal nerve branch for the sphincter portion; second disposition in 1/3 of all cases having a branch divided in its terminal part into 2 ramus branches, one for the elevator portion and one for the sphincter portion. On the average the nerve contains 539 fibers of which 73% are myelinated and 27% non myelinated. The fibrillar content is identical for both branches of either disposition.

Anal Canal↗
PubMed1986

The innervation of the muscles of continence.

Electrophysiological evidence is presented that suggests that the innervation of the human puborectalis muscle differs from that of the external anal sphincter muscle. The latter is innervated by branches of the pudendal nerves, and the former by direct branches of the sacral plexus that enter the muscle from its pelvic surface. The striated urinary sphincter musculature also receives a dual innervation. The periurethral component is innervated by perineal branches of the pudendal nerves and the intramural portion by a different pathway, probably consisting of supralevator branches derived from the pelvic nerves. These findings are relevant to understanding the embryological derivation of these muscles and have practical importance in the surgery of this region of the body, particularly in the treatment of incontinence.

Adult↗
PubMedDate not supplied

[Three new cases of presacral tumor (author's transl)].

Presacral tumors have miscellaneous histologic structures: some of them, among the most uncommon, are malignant tumors and lay it down that the extirpation must be the most complete as possible. Often they are uncovered when they compress adjoining organs (rectum, bladder, ureters, sacral plexus) and they appear voluminous, encrusted in the pelvic excavation, taking a rich vascularisation from surroundings. This adhesion involves a laborious extirpation, often hemorraegic, but needful even in benignant tumors. On this understanding and with the help of a good approach, pelvic organs can be decompressed with restricted risks of recurrence.

Adult↗
PubMed1982

[Morphological changes after permanent nerve block by freezing and ethanol injection of the sciatic nerve of the rabbit (author's transl)].

Permanent nerve blocks by intraneurally injected alcohol are often complicated by alcohol-neuritis. Encouraging clinical experiences with permanent blocks by freezing raises the question whether morphological differences between the nerve lesions could explain the difference in their side effects. On 30 rabbits both sciatic nerves were blocked after surgical preparation. The one by intraneural injection of 0,5 ml of 96% Ethanol, the other by freezing with a cryoprobe. The resulting degeneration and the beginning of recovery of the nerves was followed by histological evaluations of the sciatic nerves during the first 28 days after the blockade. The nerve lesions of both types of blockade were complete. That produced by the cryoprobe was limited to the small area of local freezing, whereas the alcohol-block produced the same type of nerve degeneration but with a wide-spread extension reaching the sacral plexus. We discuss whether this slight morphological difference might be sufficient to explain the higher complication rate of alcohol blocks.

Animals↗
PubMed1982

Neuropathy following paracervical block in the obstetric patient.

A distinct clinical syndrome of severe buttock pain radiating down the posterior surface of the ipsilateral leg and subsequent inability to ambulate has recently been recognized. The syndrome may develop in the parturient following a paracervical block. This study analyzes 4 cases from the authors' institution and reviews 2 cases from the literature. Onset of the syndrome ranges from 12 hours to 10 days but progressive improvement and complete recovery are the rule. The cause is believed to be secondary to direct trauma or hematoma formation in the area of the sacral plexus. Pelvic induration or a mass in the sacroiliac area may be noted bur abscess formation is not associated. Prevention is difficult but early recognition will facilitate treatment, which is mostly symptomatic.

Adolescent↗
PubMed1981

[Effects of monolateral ablations of the presumptive limb buds on the early developmental phases of the central and peripheral nervous system].

The size of the spinal ganglia, as well as of the posterior and lateral funiculi of the spinal cord, at the cervical, thoracic, lumbar and sacral levels, was carefully evaluated, on both sides, by measuring their surfaces on each transverse histological section from chick embryos submitted, at the second-second and a half day, to ablations of the right presumptive limb buds, and fixed at the 9th - 13th day. On the extirpation side, the ganglion and posterior funiculus size always resulted significantly smaller, the average degree of reduction being nearly the same at the levels of the brachial and the lumbo-sacral plexuses (-50-60% for the ganglia, -25-30% for the posterior funiculus). However, within the same group of metameres (e.g., the corresponding to the brachial plexus), the analysis carried out metamere by metamere showed that the reduction degree was not homogeneous, owing probably to a) the extent of the different peripheral fields supplied by the various metameres, b) the degree of the regulative processes occurred after the ablations, and/or c) the extent of the extirpated regions. The size reduction of the posterior funiculus, observed also in the neuromeres immediately cranial to those related to the plexuses, could depend upon its peculiar composition, relatively short intersegmental tracts representing the majority of its fibers. No significant reduction was remarked for the lateral funiculus size.

Animals↗
PubMed1978

[Urination disorders following general surgery].

The disturbance of miction after general surgical operations has three causes. They exist individually and combined. The first cause is a relative trauma of anaesthesiological remedies. They have a central site of action in the brain stem and a peripheral one in the parasympathetic and sympathetic ganglian of the urinary bladder. The second cause is an operative trauma of the abdomino-pelvic initial reflex of the miction. The two traumata, the vegetative and the mechanical one, decompensate an imminent neuropathic or obstructive reduction of the urinary bladder. The two traumata are prolonged by abdominal, pulmonary and cerebral insufficiency. The third cause is a direct lesion of the sacral plexus pelvicus. - The postoperative disturbance of miction concerns about 25% of all operated persons. Children are specifically rarely concerned. Operations on the lower half of the body cause the disturbance of miction by far more frequently than operations on the upper half of the body or on extremities. The therapy consists of a rational, liberal and differentiated use of the catheter, further in parasympathomimetic and sympatholytic medication, in the obstructively or neuropathically decompensated cases in transurethral operative correction of the outlet of the urinary bladder.

Anesthesia, General↗
PubMed1994

Pain control with morphine for vertebral metastases and sciatica in advanced cancer patients.

Morphine was administered to 56 advanced cancer patients; of that number spinal metastases had induced bone pain in 28 and malignant tumors had induced sciatica in 28. The sciatica was caused in 16 patients by direct invasion of the sacral plexus, in four by lumbar bone metastases, and in eight by pelvic bone metastases. Spinal bone pain was controlled adequately with morphine. However, sciatica required larger dosages of morphine than did bone pain. Among the group with sciatica, rectal cancer patients needed larger dosages of morphine than the other cancer patients. Even with high doses of morphine, it was occasionally difficult to control neuropathic pain of the sciatic nerve caused by intrapelvic cancer.

Adult↗
PubMed1993

Electromyography of the pelvic diaphragm and anal sphincter in dogs with perineal hernia.

The innervation of the levator ani and coccygeal muscles and the external anal sphincter was studied by anatomic dissection in 6 clinically normal male dogs and by electrical stimulation in 5 clinically normal male dogs. Variations in innervation occasionally were found that were comparable to those reported in previous studies. Electromyographic recordings were made from the levator ani and coccygeal muscles and from the anal sphincter in 40 dogs during perineal hernia repair. Spontaneous potentials of 4 types were found in 35 dogs: fibrillation potentials, positive sharp waves, complex repetitive discharges, and fasciculations. Biopsy specimens of the cranial part of the levator ani muscle were taken in 12 dogs during perineal hernia repair. Histologic examination revealed atrophy in 7 specimens. Spontaneous potentials were recorded from all muscles with histologic evidence of atrophy. All examinations of the levator ani muscle concerned the cranial part of this muscle, because the caudal part was absent in all 40 dogs. From combined results of electromyography and histologic examination, it was concluded that atrophy of the muscles of the pelvic diaphragm, which develops in some dogs with perineal hernia, is likely to be of neurogenic origin. Nerve damage is localized in the sacral plexus proximal to the muscular branches of the pudendal nerve or in the muscular branches separately.

Anal Canal↗
PubMed1996

Intra-arterial chemotherapy for muscle-invasive urinary bladder cancer.

A total of 9 patients with muscle-invasive bladder cancer (T3 or T4N0M0) were treated with a modified intra-arterial M-VEC (IA-M-VEC) regimen beginning in October 1992 to evaluate its therapeutic efficacy, and in 3 evaluable patients who subsequently underwent radical cystectomy, the possibility of bladder preservation was assessed. The responses of the 8 evaluable patients were rated as complete response (CRs) in 3, partial response (PRs) in 3 and no change (NCs) in 2. The objective response rate (PR + CR) was 75%. An obvious down-staging (T3 --> pT1b) was confirmed in 2 of the 3 evaluable patients, suggesting the possibility of bladder preservation. Otherwise similar changes to hemorrhagic cystitis with minimal muscular fibrosis were conspicuous in the normal bladder wall. These pathological findings corresponded with those obtained by dynamic single photon emission computed tomography (D-SPECT) using 99mTC-macroaggregate albumin (99mTC-MAA). Besides a buttock-to-perianal erosion with neuralgia on the injection side, mild to moderate sensory disturbance of the sacral plexus was observed.

Aged↗
PubMedDate not supplied

[Neurovascular implications in total meso-rectal excisions. A prospective study of sexual function after surgery for rectal cancer].

Total mesorectal excision (TME), well established in the modern curative surgery of rectal cancer, needs further investigation, especially with regards to the preservation technic of the autonomous abdominopelvic innervation currently used to prevent or reduce the urogenital sequelae. The Authors offer a perspective study over the recovery of sexual activity in a homogeneous group of 32 male patients submitted, because of cancer, to restorative proctectomy, with anatomical preparation of the hypogastric and sacral plexus. The criteria for eligibility were the followings: male under 70 years of age, excision of the primary rectal cancer with coloanal or colo-rectal anastomosis performed at less than 5 cm from the anal verge, staging not more than T3N2M0, without previous RT or other pelvic operations and without protective enterostomy, nor local or systemic recurrences during the follow up period. The functional results obtained on the basis of a questionnaire, filled in quarterly by the patients as well as their partners for at least a year, three months after the operation were: lack of sexual disorders in 37.5%, reduction of the sexual activity (partial erection, lack of ejaculation, anorgasmy) in the 34.4%, and no sexual activity in 28.1% of the patients. After 6 months the total lack of sexual activity was observed in only 15.6% of the patients, whereas after a year 65.6% of the patients showed a normal level of sexual activity. The Authors explain the preparatory technic to approach the mesorectum sparing the autonomous nerves and discuss the two fundamental surgical-anatomical aspects of the nerve-sparing technic still not sufficiently clarified as far as the behaviour of the pelvic visceral fascia and the course of the medial-rectal artery are concerned. The results obtained even considering the limitation in the evaluation and standardization of the genito-sexual disorders, show the need to extend and deepen the study relative to the nerve-sparing technics in rectal cancer surgery.

Adult↗
PubMed1996

[Maternal paralysis of obstetrical origin. Two case reports].

We report two cases of maternal obstetrical paralysis by injuries to the sacral plexus (lumbosacral trunk). This nervous lesion is rare and occurs more often in young small primigravidae, carrying a large fetus, during a prolonged labor and a delivery requiring midforceps. The symptoms appear usually a few hours after delivery: paresthesias of the leg and the foot as well as weakness and possible footdrop (the paralysis may be mild or severe). The different mechanisms involved are inspected. The prognosis of this lesion is good, the patients recover usually within a period of three months. The treatment appears to be physiotherapy.

Adult↗
PubMed1997

Lumbosacral perineural cysts as a cause for neurogenic muscular hypertrophy.

We report the case of a 40 year-old man with a severe lesion of the anterior rami of the left spinal nerves L5 and S1 who showed hypertrophy of the leg and atrophy of the intrinsic foot and gluteal muscles. In the biopsy of the hypertrophied gastrocnemius muscle, perivascular inflammatory infiltrates were observed, apart from atrophied and hypertrophied muscle fibres. Electromyography revealed no pathologic spontaneous activity but chronic neurogenic changes. The precise site of the lesion was predicted by electrophysiologic investigations. The lesion was caused by two perineural cysts in the region of the upper sacral plexus, as demonstrated by MRI and CT of the small pelvis and confirmed at operation. Three years earlier, when almost only L5 muscles were affected, an intervertebral disc prolapse L5/S1 had been suspected on myelography and CT but could not have been confirmed at operation.

Adult↗
PubMed2002

Unusual case of extradural choroid plexus papilloma of the sacral canal. Case report.

An unusual case of a sacral, extradural choroid plexus papilloma involving the S1-3 level is described. This 50-year-old woman presented with a 4-month history of pain involving her right buttock, perineum, and leg. Contrast-enhanced magnetic resonance (MR) imaging of the spine revealed a well-defined, mildly enhancing sacral canal mass at the S1-3 level; its appearance was consistent with that of a benign tumor. Intraoperatively, the lesion was found to be extradural in location and was entwined among nerve roots in the sacral canal. Microscopic examination of the gross totally resected tumor revealed typical features of a choroid plexus papilloma. Despite performing a thorough neuroimaging workup (craniospinal contrast-enhanced MR imaging) for an intracranial or spinal primary mass, none was found. The choroid plexus appeared entirely normal; however, both a cavum septum pellucidum and a cavum vergae were noted. Extraneural choroid plexus papilloma, specifically intrasacral, extradural choroid plexus papilloma has not been previously reported. The present example is thought to have arisen either from ectopic choroid plexus tissue or perhaps by metaplasia from ependymal rests.

Choroid Plexus Neoplasms↗