La Clinica terapeutica
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La Clinica terapeutica · Nov 2012
Case ReportsSpinal arteriovenous malformation presenting with prolapsed intervertebral disc: a diagnostic dilemma.
The availability of multiple investigating modalities should be utilized to arrive at the correct diagnosis of the spinal arteriovenous malformation (AVM). We hereby report the case of a 21-year-old, obese female, who presented with paraplegia and impaired bowel control two years after an episode of the fall. ⋯ A diagnosis of a spinal arterio-venous fistula was confirmed after a spinal angiogram. The dilemma of treating the right pathology for the clinical signs and symptoms are being discussed.
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La Clinica terapeutica · Nov 2012
Unusual innervation pattern of pectoralis minor muscle-anatomical description and clinical implications.
The highlight of the current case study is unique branching pattern of the medial pectoral nerve in relation to the pectoralis minor muscle. In addition, the third thoracic spinal nerve also was observed to penetrate the muscle. The lateral pectoral nerve did not innervate the muscle. ⋯ The possible clinical consequence of much an anomaly could be motor and sensory loss associated with accidental injury of these multiple nerves penetrating the substance of pectoralis minor while performing axillary lymphadenectomy. In accordance to the above case description, the surgeon should be cautioned of these possible neural branches while performing axillary dissection in mastectomy. Additionally, iatrogenic sensory or motor losses may be prevented by appropriate knowledge of these variations.