Foot and ankle injuries due to motor vehicle accidents (MVAs) present unique challenges to the astute foot and ankle physician. Even more challenging than the pathology, however, is ability to return to pre-injury level. Published medical literature provides strong evidence for risk of post-traumatic arthritis after a heel bone (calcaneus) fracture - this post-MVA condition can manifest as residual deformity and resulting arthritis, thus precluding the ability to rapidly return to pre-accident levels. Hence it is imperative that an erudite foot and ankle clinician ascertain the appropriate treatment and long-term prognosis of foot and ankle injuries due to MVAs.
Occipital neuralgia is characterized by severe pain, accompanied by tenderness and trigger points, in the distribution of the greater, lesser, and/or third occipital nerves. Occipital neuralgia is typi- cally idiopathic, but also is characterized as a common form of posttraumatic headache. Typical treatments include nerve blocks with local anesthetic, nerve stimulation, pulsed radiofrequency, and cryoablation. OnabotulinumtoxinA (ONA) has recently been utilized in nerve blocks to treat occipital neuralgia, with the potential for a longer duration of pain relief than local anesthetic.
Occipital neuralgia, while typically idiopathic in presentation, is a common form of posttraumatic headache. It is associated with severe pain in the greater, lesser, and/or third occipital nerves, and often accompanied by tenderness or trigger points in the surrounding musculature. OnabotulinumtoxinA (ONA) has been recently utilized in nerve blocks to treat occipital neuralgia, but current literature supporting such use is scarce. We describe a case of occipital neuralgia in a patient following C1 fracture and vertebral artery dissection due to gunshot injury. Successful treatment with bilateral ONA nerve blocks led to an 80% - 90% improvement in pain, with decreased Visual Analog Scale (VAS) pain scores immediately following treatment and upon follow-up 1 month later.
The Medtronic's Enpulse Model E2DR21P Serial number PMU411109 as well as the Atrial Lead (model #496525, SN: LBT042477R-Epicardial Unipolar and the Ventricular Lead (model #496525, SN: LEN036731R- Bipolar Epicardial had been used to continually pace patient in the DDD pacing mode during patient's lifetime. The expert referred to all Medtronic specifications; warnings; and advisories relevant to both the pacemaker and pacing leads used for pacing this completely pacemaker dependent patient).
1986: Crocket, Dolsky, Lack, Leventhal, Nathanson and Jackson visited London, France and Italy, observing surgeons using different modalities at that time and then brought back their information and openly taught liposuction in the United States under the auspices of the AACS. Other early teachers were Elam, Fenno, Tobin and others.
The primary management of hydatidiform moles remains surgical evacuation followed by human chorionic gonadotropin level monitoring. Although suction dilatation and evacuation is the most frequent technique for molar evacuation, hysterectomy is a viable option in older patients who do not wish to preserve fertility. Despite advances in chemotherapy regimens for treating malignant gestational trophoblastic neoplasia, hysterectomy and other extirpative procedures continue to play a role in the management of patients with both lowrisk and high-risk gestational trophoblastic neoplasia.
As part of their educational process, practitioners of manipulative procedures are made aware of the possible association between neck manipulation and cerebrovascular accidents[i] (CVAs) as well as what to do in the event a CVA occurs during treatment.[ii] For any litigation considered regarding a stroke that closely follows spinal manipulation, the starting point for retained counsel is to ask what else could have caused or contributed to the stroke. Screening issues to consider include the following:
Lawsuits pertaining to injuries from laser treatments gone awry or just not as expected are on the rise. Part of the issue is the lack of objective training protocols. There is relatively vague legal language across many state medical boards and often lax regulation of these procedures, who is allowed to perform them, and what training and supervision is required.
Following a neurological event such as a traumatic brain injury, cerebrovascular event, multiple sclerosis, etc., the medical needs of the person are of primary importance initially, for purposes of survival. As medical treatment proceeds and the survival needs of the person are met, the team of rehabilitation professionals will be established in an attempt to improve upon function performance in order to sustain quality of life. The rehabilitation team may be composed of a physician, physical therapist, occupational therapist, speech therapist, recreational therapist, vocational specialist, case manager, the psychologist, social worker, and nurse, to name several. It is often during this tim e that additional medical and rehabilitative needs are identified through diagnosis or observation by member s of the rehabilitation team.
Abstract -- Traumatic Brain Injury (TBI) is complex and unique, encompassing a myriad of challenges for the person with the injury, rehabilitation counselors, and the survivor's family and friends. The challenges can affect work and family reintegration. Sustaining a TBI can result in familial strain as it affects the role and function of the individual with TBI in the family. Manifestations can include financial, psychological, and caregiver-related stress. Since individual and family coping mechanisms interrelate, it is important for rehabilitation counselors to appreciate theoretical constructs of family resiliency. This article explores the rehabilitation counselor's need to assess the connectedness of family resiliency and community reintegration outcomes in persons with TBI; it also underscores the importance of evaluating family-inclusive rehabilitative interventions.