Irish medical journal
-
Four cases of Herpes Zoster Oticus (HZO) with facial paralysis are presented. HZO is a Herpes Zoster viral infection of the Geniculate Ganglion of the facial nerve. It presents classically with severe otalgia, a vesicular rash in the Concha or on the Pinna of the affected ear in association with a lower motor neurone lesion of the homolateral facial nerve. ⋯ Treatment consists of Acyclovir. One reference in the past refers to a clustering of the condition and its predisposition for females. Interestingly all cases presented were referred with incorrect diagnoses.
-
A 14 year old boy presented with deteriorating asthma and marked stridor. Neither asthma nor stridor responded to an increase in anti-asthma medication, including high dose oral steroids. ⋯ When gently confronted with these findings and offered psychological assistance the boy's symptoms abated totally. After two sessions of hypnotherapy he has had better control of both his physical (asthma) and psychological problems.
-
The Grosse-Kempf nail is a versatile interlocking intramedullary nail with proximal and distal locking. The locking transfixion screws afford additional axial and rotational stability and have expanded the use of intramedullary fixation to include all types of femoral fractures distal to the lesser trochanter and to within 7 cm of the knee joint. ⋯ Complications were directly related to technical difficulties and fracture personality. The surgical technique is demanding and requires special expertise training and equipment, but the benefits to the patient are so great that this is now regarded as the method of choice for treating femoral shaft fractures in adults.
-
Irish medical journal · Mar 1991
Case ReportsReflex spinal cord activity as a cause of a delay in the diagnosis of brain death.
A 56 year old woman was admitted to our hospital following a fall in which she sustained an acute subdural haematoma. She failed to respond to treatment despite surgical intervention and active brain protection measures. ⋯ This delayed decision making and organ donation. We report this case in order to highlight this problem which may be encountered during brain stem function testing.
-
Between January 1976 and December 1987 42 children with Down syndrome and congenital heart disease underwent cardiac surgery. Four children had two operations. Age at the time of surgery ranged from 11 days to 14 years. ⋯ Four patients died post-operatively, two following repair of a complete atrio-ventricular canal defect (CAVD), one following correction of tetralogy of Fallot in association with a CAVD, and a fourth following closure of ventricular septal defect and atrial septal defect. The mortality for those who had open heart surgery was 13.3% and for the series as a whole the mortality was 6.6% over a period of follow-up ranging from two months to four years. A relatively conservative approach has been adopted with regard to surgery, based on the shorter natural expectation of life in Down syndrome, the complexity of many of the cardiac lesions involved and the recognition of the frequency of early intellectual deterioration in Down patients.