Objective: Cruciate paralysis is a rare, poorly understood condition of the upper craniovertebral junction that allows for selective paralysis of the upper extremities while sparing the lower extremities. Reported cases are few and best treatment practices remain up for debate. The purpose of this study was to conduct a systemic literature review in an attempt to identify prognostic predictors and outcome trends associated with cases previously reported in the literature.
Materials And Methods: We conducted a systematic literature review for all cases using the term "Cruciate Paralysis," reviewing a total of 37 reported cases. All outcomes were assigned a numerical value based on examination at the last follow-up. These numerical values were further analyzed and tested for statistical significance.
Results: Of the 37 cases, 78.4% were of traumatic causes. Of these, there were considerably worse outcomes associated with patients over the age of 65 years ( < 0.001). Those patients undergoing surgical treatment showed potentially worse outcomes, with a value approaching significance at = 0.08.
Conclusion: Numerous cases of trauma-associated cruciate paralysis have been reported in the literature; however, there remains a strong need for further study of the condition. While certain risk factors can be elicited from currently reported studies, insignificant data exist to make any sound conclusion concerning whether surgical intervention is always the best method of treatment.
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http://dx.doi.org/10.4103/0974-8237.193262 | DOI Listing |
Brain
May 2023
Division of Basic Biomedical Sciences, Laboratory of Neurological Sciences, The University of South Dakota, Sanford School of Medicine, Vermillion, SD 57069, USA.
We review the spatial organization of corticospinal outputs from different cortical areas and how this reflects the varied functions mediated by the corticospinal tract. A long-standing question is whether the primate corticospinal tract shows somatotopical organization. Although this has been clearly demonstrated for corticofugal outputs passing through the internal capsule and cerebral peduncle, there is accumulating evidence against somatotopy in the pyramidal tract in the lower brainstem and in the spinal course of the corticospinal tract.
View Article and Find Full Text PDFPLoS One
November 2022
Neuroscience Research Australia (NeuRA), Sydney, New South Wales, Australia.
In human applied physiology studies, the amplitude of recorded muscle electromyographic activity (EMG) is often normalized to maximal EMG recorded during a maximal voluntary contraction. When maximal contractions cannot be reliably obtained (e.g.
View Article and Find Full Text PDFJ Am Acad Orthop Surg
November 2022
From the Division of Sports Medicine, Department of Orthopedic Surgery, New York University Langone Health, New York, NY (Markus, Mojica, Bi, Mannino, E. F. Alaia, Jazrawi, and M. J. Alaia), and the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT (Kahan, Moran, and Medvecky).
Introduction: Peroneal nerve injuries are rare injuries and usually associated with multiligamentous knee injuries (MLKIs) involving one or both cruciate ligaments. The purpose of our study was to perform a multicenter retrospective cohort analysis to examine the rates of peroneal nerve injuries and to see whether a peroneal nerve injury was suggestive of a particular injury pattern.
Methods: A retrospective chart review was conducted in patients who were diagnosed with MLKI at two level I trauma centers from January 2001 to March 2021.
Cureus
May 2022
Spine and Scoliosis, KAT Attica General Hospital, Athens, GRC.
A 54-year-old male was admitted to our emergency department by air transport after being hit as a pedestrian by a motorcycle. He presented with impaired motor function in the upper extremities bilaterally while sensation was spared. He presented no motor or sensory impairment of the lower extremities.
View Article and Find Full Text PDFJ Neurosurg
May 2022
3Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
Objective: In some cases of incomplete cervical spinal cord injury (iSCI) there is marked paresis and dysfunction of upper-extremity movement but not lower-extremity movement. A continued explanation of such symptoms is a somatotopic organization of corticospinal tract (CST) fibers passing through the decussation at the craniovertebral junction (CVJ) and lateral CST (LCST). In central cord syndrome, it has been suggested that injury to the core of the cervical cord may include selective damage to medially located arm/hand LCST fibers, without compromising laterally located leg fibers.
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