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Treatment with Epidural Blood Patch for Iatrogenic Intracranial Hypotension after Spine Surgery
Kim, Jaekook,Lee, Sunyeul,Ko, Youngkwon,Lee, Wonhyung The Korean Neurosurgical Society 2012 Journal of Korean neurosurgical society Vol.52 No.3
Intracranial hypotension syndrome typically occurs spontaneously or iatrogenically. It can be associated with headache, drowsy mentality and intracranial heamorrhage, Iatrogenic intracranial hypotension can occur due to dural pucture, trauma and spine surgery. Treatment may include conservative therapy and operation. We report a case of a 54-year-old man who was successfully treated with epidural blood patches for intracranial hypotension due to cerebrospinal fluid (CSF) leakage into the lumbosacral area after spine surgery.
Sangwon Yun,Boohwi Hong,Hoseop Kim,Woosuk Chung,Youngkwon Ko,Yoon-Hee Kim 조선대학교 의학연구원 2021 Medical Bilogical Science and Engineering Vol.4 No.1
Cerebral venous sinus thrombosis (CVST), a rare cerebrovascular event, occurs in approximately 5 out of 1,000,000 people. Because subarachnoid hemorrhage (SAH) due to CVST during emergency cesarean section is rare, this condition is difficult to recognize and diagnose in patients under anesthesia. This report describes a parturient who experienced severe headache and motor weakness during an emergency cesarean section. The first manifestation of CVST was a severe headache, which overlapped with the presentation of SAH, making early diagnosis verydifficult. Anesthesiologists should be aware of the risk of CVST in pregnant women and closely monitor those who experience slight changes in intraoperative neurological symptoms.
Zhang, Enji,Lee, Sunyeul,Yi, Min-Hee,Nan, Yongshan,Xu, Yinshi,Shin, Nara,Ko, Youngkwon,Lee, Young Ho,Lee, Wonhyung,Kim, Dong Woon SPANDIDOS PUBLICATIONS 2017 MOLECULAR MEDICINE REPORTS Vol.16 No.2
<P>In previous studies that have profiled gene expression in patients with complex regional pain syndrome (CRPS), the expression of granulocyte colony-stimulating factor 3 receptor (G-CSFR) was elevated, as were a number of pain-associated genes. The present study determined the expression of G-CSFR and the mechanisms by which it may affect hypersensitivity, focusing on the signal transducer and activator of transcription 3 (STAT3)/transient receptor potential cation channel subfamily V 1 (TRPV1) signaling pathway in particular, which is an important mediator of pain. Following L5 spinal nerve ligation (SNL) surgery, the protein and mRNA levels of G-CSFR increased in the ipsilateral spinal dorsal horn when compared with the sham and/or contralateral control. Double immunofluorescence further demonstrated that G-CSFR colocalized with TRPV1 and phosphorylated STAT in the neurons of the spinal dorsal horn. G-CSF treatment led to an increase in G-CSFR and TRPV1 expression and phosphorylation of STAT3. These results indicate that G-CSF-induced G-CSFR expression may activate TRPV1 by promoting phosphorylation of STAT3. Collectively, the results suggest, for the first time, that the expression of G-CSFR in neurons following peripheral nerve injury may be involved in the induction and maintenance of neuropathic pain through the STAT3 and TRPV1 signaling pathway.</P>
오차현,Chan Noh,Hongsik Eom,Sangmin Lee,Seyeon Park,이선열,Yong Sup Shin,Youngkwon Ko,Woosuk Chung,Boohwi Hong 대한통증학회 2020 The Korean Journal of Pain Vol.33 No.2
Background: Hemidiaphragmatic paralysis, a frequent complication of the brachial plexus block performed above the clavicle, is rarely associated with an infraclavicu-lar approach. The costoclavicular brachial plexus block is emerging as a promising infraclavicular approach. However, it may increase the risk of hemidiaphragmatic paralysis because the proximity to the phrenic nerve is greater than in the classical infraclavicular approach.Methods: This retrospective analysis compared the incidence of hemidiaphragmatic paralysis in patients undergoing costoclavicular and supraclavicular brachial plexus blocks. Of 315 patients who underwent brachial plexus block performed by a single anesthesiologist, 118 underwent costoclavicular, and 197 underwent supraclavicu-lar brachial plexus block. Propensity score matching selected 118 pairs of patients. The primary outcome was the incidence of hemidiaphragmatic paralysis, defined as a postoperative elevation of the hemidiaphragm > 20 mm. Factors affecting the incidence of hemidiaphragmatic paralysis were also evaluated.Results: Hemidiaphragmatic paralysis was observed in three patients (2.5%) who underwent costoclavicular and 47 (39.8%) who underwent supraclavicular brachial plexus blocks (P < 0.001; odds ratio, 0.04; 95% confidence interval, 0.01-0.13). Both the brachial plexus block approach and the injected volume of local anesthetic were significantly associated with hemidiaphragmatic paralysis.Conclusions: The incidence of hemidiaphragmatic paralysis is significantly lower with costoclavicular than with supraclavicular brachial plexus block.