The double innervation of the thyroid comes from the sympathetic and parasympathetic nervous system. Injury rates during surgery are at 30% but can be minimized by upwardly preparing the thyroid vessels at the level of thyroid capsule. Several factors have been accused of increasing the risk of injury including age and tumor size. Our aim was to investigate of there is indeed any possible correlations between these factors and a possible increase in injury rates following thyroidectomy. Seven studies were included in the meta-analysis. Statistical correlation was observed for a positive relationship between injury of the sympathetic nerve and thyroid malignancy surgery (p 2 = 74%) No statistical correlations were observed for a negative or positive relationship between injury of the sympathetic nerve and tumor size. There was also no statistically significant value observed for the correlation of the patients' age with the risk of sympathetic nerve injury (p = 0.388). Lack of significant correlation reported could be due to the small number of studies and great heterogeneity between them.

• MeSH
• Humans MeSH
• Thyroid Neoplasms pathology   surgery   MeSH
• Intraoperative Complications * etiology   prevention & control   MeSH
• Peripheral Nerve Injuries * etiology   prevention & control   MeSH
• Thyroid Gland innervation   MeSH
• Sympathetic Nervous System injuries   MeSH
• Thyroidectomy adverse effects   methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Review MeSH

Prezentujeme případ náhodně zjištěného asymptomatického tumoru horního mediastina. Bylo indikováno jeho operační odstranění. Nádor byl odstraněn při zachování hlavního krčního trunku sympatiku. V pooperačním období se objevuje Hornerův syndrom, který se spontánně kompenzuje. Histologicky byl verifikován schwannom.

In this paper, we present a case report of an asymptomatic tumour of the upper mediastinum, incidentally found by MRI for lateral neck cyst. The tumour was surgically removed, preserving the neck sympathetic fibres. However, postoperative course was complicated by the Horner's syndrome that spontaneously resolved. A sympathetic schwannoma was confirmed by histology.

• Keywords
• krční sympatikus,
• MeSH
• Horner Syndrome * etiology   complications   MeSH
• Middle Aged MeSH
• Humans MeSH
• Head and Neck Neoplasms * diagnosis   surgery   pathology   MeSH
• Mediastinal Neoplasms diagnosis   surgery   pathology   MeSH
• Nervous System Neoplasms diagnosis   surgery   pathology   MeSH
• Neurilemmoma * diagnosis   surgery   pathology   MeSH
• Postoperative Complications etiology   MeSH
• Sympathetic Nervous System pathology   injuries   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH
• Research Support, Non-U.S. Gov't MeSH

AIM: TheAIM of this study was to identify retrospectively, lumbar sympathectomy (SE) using thermography (TG) and to evaluate clinically, the severity of post-sympathectomy (post-SE) dysfunction after anterior and lateral lumbar interbody fusion procedures (ALIF, XLIF). METHODS: Twenty eight patients with suspected SE were referred for TG to both legs. They completed our questionnaire on severity of difficulties after SE. We evaluated the ability of physical examinations to reveal the SE in contrast to TG and compared the symptoms (warmer leg and inhibited leg sweating) of SE with questionnaire responses as subjective measure and TG as objective measure. RESULTS: SE was diagnosed in 0.5% after ALIF at L5/S1, in 15% after ALIF at Th12-L5 and in 4% after XLIF at T12-L5. SE severely reduced the quality of life in two cases. The ability to distinguish differences in leg temperature by palpation after SE was found in 32%. All physical examinations together were insufficient for reliably disclosing SE. Subjective symptoms of SE were often false positive and proven SE by TG was often a clinically false negative. CONCLUSION: This is the first study to examine post-SE dysfunction objectivelya using TG after ALIF and XLIF, and the first to evaluate clinically, the severity of the post-SE syndrome. Before surgery we cannot foresee potentially poor SE results. For this reason, injury to the sympathetic chain during surgery must be avoided. The advantage of TG for identifying SE is its non-invasiveness and reliability.

• MeSH
• Lumbar Vertebrae surgery   MeSH
• Adult MeSH
• Spinal Fusion adverse effects   methods   MeSH
• Hypohidrosis etiology   MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Neurologic Examination methods   MeSH
• Postoperative Complications etiology   MeSH
• Trauma, Nervous System etiology   MeSH
• Retrospective Studies MeSH
• Sympathetic Nervous System injuries   MeSH
• Body Temperature physiology   MeSH
• Thermography MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Evaluation Study MeSH

Vertikalizace, změny polohy těla a řešení strategií přesunů jsou nedílná součást rehabilitačního programu a každodenních aktivit pacientů s míšním poraněním. Častý problém, který denně řeší personál spinálních jednotek, jsou symptomy ortostatické hypotenze, a to především při prvních změnách polohy těla pacienta po úrazu míchy. Závažný fakt je, že ortostatická hypotenze výrazně zhoršuje kvalitu života, a to zejména u pacientů s míšním poraněním v krční oblasti. Motorické a senzorické deficity jsou hodnoceny podle mezinárodních standardů pro neurologickou klasifikaci míšních poranění a podrobný popis zachované funkce autonomního nervového systému tvoří součást kompletního neurologického vyšetření jednotlivých pacientů. V následujícím přehledu uvádíme příčiny, symptomy a klinický obraz ortostatické hypotenze od akutního do chronického stadia v závislosti na výšce léze. Dále nabízíme souhrn možností nefarmakologických i farmakologických řešení tohoto fenoménu.

Verticalisation, posture changes and transport strategies form an integral part of rehabilitation programmes as well as daily activities of patients with spinal cord injury (SCI). Orthostatic hypotension symptoms represent a frequent problem, mainly early after SCI. Orthostatic hypotension markedly worsens quality of life, in particular in patients with cervical SCI. Motor and sensory deficits are evaluated according to the international standard for neurological classification of spinal cord injury; detailed description of residual autonomous nervous system general function constitutes a part of comprehensive neurological examination of these patients. In this paper, causes, symptoms and clinical picture of orthostatic hypotension from acute to chronic stage and with respect to the lesion position, are summarized. Also, an overview of non-pharmacological and pharmacological interventions is provided. Key words: spinal cord injury – orthostatic hypotension – autonomous nervous system The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manu­script met the ICMJE “uniform requirements” for biomedical papers.

• Keywords
• míšní poranění,
• MeSH
• Autonomic Nervous System physiopathology   MeSH
• Baroreflex MeSH
• Lower Extremity blood supply   MeSH
• Homeostasis MeSH
• Hypotension etiology   complications   MeSH
• Cervical Vertebrae injuries   MeSH
• Humans MeSH
• Autonomic Nervous System Diseases * etiology   physiopathology   MeSH
• Neurologic Examination MeSH
• Hypotension, Orthostatic * etiology   physiopathology   therapy   MeSH
• Paraplegia complications   rehabilitation   MeSH
• Patient Positioning adverse effects   MeSH
• Spinal Cord Injuries * complications   physiopathology   therapy   MeSH
• Posture physiology   MeSH
• Sympathetic Nervous System physiopathology   injuries   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH