模仿外围神经病变的外科手中风综合征:一个病例报告
Jeronimo Chapur1,2, Katarina Kojic3,4, Matthew Kula5,6
1Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
|October 3, 2023
概括
周围手术中风,特别是皮质手综合征,可以模仿周围神经损伤. 早期识别对于手部缺陷手术患者的及时诊断和治疗至关重要.
科学领域:
- 神经学 神经学
- 麻醉学 麻醉学
- 血管外科 血管外科
背景情况:
- 术后中风诊断和治疗仍然具有挑战性.
- 皮质手综合征是一种罕见的中风表现,影响前中心,经常呈现类似于外周神经损伤的症状.
- 之前没有关于皮质手综合征在外科手术前的情况的报道.
研究的目的:
- 提高麻醉师对皮质手综合征作为潜在的外科手术后并发症的认识.
- 在一个最初被误诊为外围神经病变的手术患者中呈现皮质手综合征的病例.
主要方法:
- 一个68岁的男性接受脏切除术的病例报告.
- 手术后的右手麻木和软弱的初始表现,被认为是外围神经病变.
- 通过CT扫描证实了诊断,显示在前中心中发生了急性皮质心脏病发作.
主要成果:
- 患者在手术后立即出现与皮质手中风综合征一致的症状.
- 进一步的评估显示了显著的左动脉狭窄,成功地通过Endarterectomy治疗.
- 神经学症状在干预后六周内大大消失.
结论:
- 皮层手中风综合征是一种不常见的外科手术中风表现,可以被误诊为外围神经病变.
- 强调在手部神经学缺陷患者中考虑术后中风的重要性,特别是那些有多个神经区域参与和中风风险因素的患者.
相关概念视频
Peripheral Artery Disease I: Introduction
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
Peripheral Artery Disease IV: Nursing Management
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...


