Acute Ischemic Neuropathy
The atherosclerosis of the main vessels is the most common reason of chronic obliterating diseases of aorta and arteries of the lower extremities with development of acute vascular insufficiency. Along with such severe and common complication, as extremity gangrene, development of ischemic neuropathy of peripheral nerves of extremities with motor deficiency, which is observed rather rarely, can also result in persistent disability.
Material and Methods. Clinical supervision of acute development of ischemic neuropathy, caused by obliterating defeat of abdominal aorta and arteries of the lower extremities, is presented.
Results. Acute impairment of arterial blood flow in the lower extremities has led to the development of ischemic neuropathy with 2-sided affection of fibular and tibial nerves with significant paresis of the feet. Duplex scanning of abdominal aorta and arteries of the lower extremities has revealed dense and soft circular atherosclerotic plaques in the abdominal aorta, signs of 2-sided occlusion of the general and external iliac arteries, 50% stenosis of the lumen of both general femoral arteries and considerable decrease in the speed of blood flow in the right deep and left superficial femoral arteries.
For the purpose of restoration of blood flow, surgical intervention was carried out — left lateral sympathectomy, thrombectomy from distal aorta, endarterectomy from superficial femoral artery of the left hip, bilateral aorto-femoral bypass. Following the surgery the blood flow in the lower extremities and function of fibular and tibial nerves recovered.
Conclusions. Early detection of ischemic neuropathy will promote more effective treatment and will help to prevent development of persistent disability at this pathology.
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Национальные рекомендации по ведению пациентов с сосудистой артериальной патологией (Российский cогласительный документ). Часть 1. Периферические артерии. — М.: Изд-во НЦССХ им. А.Н. Бакулева РАМН, 2010. — 176 с.
Bendixen B.H. Cholesterol emboli neuropathy / B.H. Bendixen, D.S. Younger, L.S. Hair // Neurology. — 1992. — V. 42(2). — Р. 428-430.
Gousheh J. Association between carpаl tunnel syndrome and arteriovenous fistula in hemodialysis patients / J. Gousheh, A. Iranpour // Plast. Reconstr. Surg. — 2005. — V. 116(2). — Р. 508-513.
Gray B.H. The impact of isolated tibial disease on outcomes in the critical limb ischemic population / B.H. Gray, A.A. Grant, C.A. Kalbaugh [еt al.] // Ann. Vasc. Surg. — 2010. — V. 24(3). — Р. 349-359.
Kaku D.A. Conduction block as an early sign of reversible injury in ischemic monomelic neuropathy / D.A. Kaku, R.I. Malamut, D.J. Frey, G.J. Parry // Neurology. — 1993. — V. 43(6). — Р. 1126-1130.
Kirksey L. Ischemic monomelic neuropathy: an underappreciated cause of pain and disability following vascular access surgery / L. Kirksey // J. Vasc. Access. — 2010. — V. 11(2). —
Namazi H. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis / H. Namazi, Z. Majd // Arch. Orthop. Trauma Surg. — 2007. — V. 127(8). — Р. 725-728.
Nukada H. Ischemic neuropathy / H. Nukada // Rinsho Shinkeigaku. — 1990. — V. 30(12). — Р. 1368-1370.
Rabbani M.A. Ischemic monomelic neuropathy: a complication of vascular access procedure / M.A. Rabbani, B. Ahmad, S.M. Shah, A. Ahmad // J. Pak. Med. Assoc. — 2005. — V. 55(9). — Р. 400-401.
Said G. The peripheral neuropathy of necrotizing arteritis: a clinicopathological study / G. Said, C. Lacroix-Ciaudo, H. Fujimura [еt al.] // Ann. Neurol. — 1988. — V. 23(5). — Р. 461-465.
Thermann F. Ischemic monomelic neuropathy: a rare but important complication after hemodialysis access placement – a review / F. Thermann, M. Kornhuber // J. Vasc. Access. — 2011.— V. 12(2). — Р. 113-119.
Vital C. Combined nerve and muscle biopsy in the diagnosis of vasculitic neuropathy. A 16-year retrospective study of 202 cases / C. Vital, A. Vital, M.H. Canron [еt al.] // J. Peripher. Nerv. Syst. — 2006. — V. 11(1). — Р. 20-29.
Ugalde V. Ischemic peripheral neuropathy / V. Ugalde, B.S. Rosen // Phys. Med. Rehabil. Clin. N. Am. — 2001. — V. 12(2). — Р. 365-380.
Wilbourn A.J. Ischemic monomelic neuropathy / A.J. Wilbourn, A.J. Furlan, W. Hulley, W. Ruschhaupt // Neurology. — 1983. — V. 33(4). — Р. 447-451.
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