Combat Injury of the Sciatic Nerve - An Institutional Experience.

Introduction: Combat injury of the sciatic nerve tends to be severe with variable but often profound consequences, is often associated with widespread soft tissue and bone injuries, significant neurologic impairment, severe neuropathic pain, and a prolonged recovery time. There is little contemporary data that describes the treatment and outcome of this significant military acquired peripheral nerve injury. We describe our institution's experience treating patients with combat-acquired sciatic nerve injury in the recent Iraq and Afghanistan wars.

High-resolution ultrasound in combat-related peripheral nerve injuries.

Introduction: Peripheral nerve injuries (PNI) sustained in combat are typically severe and are frequently associated with marked soft tissue damage, anatomic distortion, and retained metallic fragments. These features complicate clinical and electrodiagnostic assessment and may preclude MRI.

Methods: We describe 4 cases of military personnel who sustained high-velocity gunshot wounds or blasts with metal fragment injuries in which high resolution peripheral nerve ultrasound (US) proved beneficial.

Neuralgic amyotrophy manifested by severe axillary mononeuropathy limited only to the anterior branch.

Introduction: In this study we describe a case demonstrating clinical, radiographic, electrophysiologic, and surgical evidence of a restricted but severe anterior branch axillary nerve mononeuropathy due to neuralgic amyotrophy (NA).

Methods: On each diagnostic modality there was severe involvement of the anterior and lateral deltoid muscle with sparing of the posterior deltoid and teres minor muscles and cutaneous innervation to the skin overlying the lateral shoulder.

Results: No structural etiologies were discovered during surgical exploration.

Management of childhood neurotrauma.

A summary of some of the more important aspects of brain, spinal, peripheral nerve and sport injuries of childhood is presented. Guidelines for the treatment of severe brain injury have been developed for adults, are currently employed with success to treat children, but much information still needs to be acquired about childhood brain injury so that better age specific treatment modalities could be implemented. The unique anatomy of the spine during childhood predisposes to cervical spinal injury without radiographic abnormality; immobilization is the primary treatment and a minority of cases require surgery.

Recovery from Cruciate Paralysis Due to Axial Subluxation from Metastatic Breast Carcinoma: A Case Report.

Cruciate paralysis is an uncommon and potentially life-threatening myelopathy thought to arise from injury to the corticospinal tracts at a high cervical spinal level. The authors report on the case of a woman who developed cruciate paralysis secondary to axial subluxation of the cervical spine due to invasion by metastatic breast carcinoma. Correct bedside diagnosis, prompt spinal alignment via halo traction, and surgical spinal decompression with fusion stabilization reversed the paralysis completely.