Stimați colegi,

Vă invităm să participați la Cel de-al XXIV-lea Congres SNPCAR şi a 46-a Conferinţă Naţională de Neurologie-Psihiatrie a Copilului şi Adolescentului şi Profesiuni Asociate din România cu participare internaţională

25-28 septembrie 2024 – CRAIOVA, Hotel Ramada

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Vă așteptăm cu drag!

Asist. Univ. Dr. Cojocaru Adriana – Președinte SNPCAR

Informații şi înregistrări: vezi primul anunț 


CRANIAL NERVE IMPAIRMENT SECONDARYTO TRAUMATIC, UMORAL AND VASCULAR PATHOLOGY

Autor: Mihaela Axente Andrada Mirea Veronica Morcov Liliana Pădure
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ABSTRACT:

Symptoms like anosmie (I) unpleasant perception of food, (I) amaurozâ (II), unilateral blindness (II), ocular deviation in the world outside (III) ptosis (III), mydriasis (III) diplopia (III and IV) weakness mandible (V), asymmetric fades with lateral mouth deviation (VII), lagoftalmie (VII), loss of taste in the first two thirds of previous ipsilaterale (VII) of the tongue, uni or bilateral hypoacusie (VIII), disorders of deglutition for liquids and solids (IX-X) în patients who arrived m our centre after a coma în various conditions led us to detect damage of cranial nerves in the vascular, tumoral, post injury pathology. The 12 cra­nial nerves having trajectory inside of cranial cavity and not having dorsal and ventral roots (like spinal nerves), but only motor, sensitive, sensory or mixed parts are affected when the vascular disturbance, tumoral process or cranio-cerebral injuries în various accidents affecting origin or their strictly intracranial trajectory, clinical expression reflecting their touch. Material and method:

The paper of the team of the National Centre for Rehabilitation “Dr. N. Robânescu ” proposed to present the cranial nerve damage in a diverse pathology occurred after ischemic or hemorrhagic AVC (rupture of vascular malformations), cranio-cerebral trauma, eradicate or not brain tumours. Casuistry of our Centre contains 36 cases with posttraumatic, tumour, vascular pathology associated with paresis involving the cranial nerve, of which: cranio-cerebral trauma -18 cases, AVC – 8 cases and haemorrhagic stroke, brain tumours -10 cases. Results:

Changes clinical secondary to damage of cranial nerves were systematized as follows:

—       symmetric fades with lateral mouth deviation + / – palpebral fantes inequality (lagoftalmie) +/ – disorders of taste previous 2 / 3 of tongue (VII nerve paresis, central / peripheral) – in 30 cases

—       palpebral ptosis +/ – divergent strabismus + / – unilateral mydriasis + / – diplopia (III nerve paresis, complete / incom­plete) – 7 cases

—       unilateral convergent strabismus, diplopia (VI nerve paresis) – 3 cases

—       hypoestezie-hemiface + scalp (frontal-central-parietal) + mandible weakness + anhidrozâ (keratoconjunctivitis) (paresis of nerve V) -1 case (post trauma)

—       uni / bilateral anosmie (nerve I) -1 case (post trauma)

—       uni / bilateral hypoacousie (paresis of nerve VIII) -1 case (post-tumoral)

—       disorders of deglutition (paresis of nerve IX-X) -1 case (post-tumoral)

—    uni / bilateral blindness (nerve paresis of II) – 4 cases Conclusions:

Clinical examination may discover, easily and with a meticulous search, signs of damage based on the global or hemicorp cranial nerve motor deficit for what the patient is brought to our centre from reanimation department of the Emergency Hospital all over the country. Mostly affecting cranial nerves means lesions severity symptoms sometimes improved means the beginning of healing. In over half of the cases, symptoms persist and there are few favourable prognostic elements for perspective.