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Harvest of Supraspinal Nerve Grafts

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Anatomy of the Sural Nerve
The sural nerve consists of two parts: a medial sural cuteus nerve and lateral sural cuteus nerve.

This nerve arises from the tibial nerve just below the knee joint and runs downward between the gastronemius heads.

Located on the posterolateral side of the calf, the lateral sural cutaneous nerve arises from the common peroneal nerve.

A sensory cutaneus nerve (also known as short saphenous nerve), except for some unmyelinated autonomic fibers, emerges from the root of the S1 or S2 nerve.With a relatively easy technique, up to 25 cm of nerve graft can be harvested. The sural nerve innervates the lateral third of the leg, the side of the foot, the heel, and the side of the ankle. Sural nerve grafts are frequently used as cable grafts.

Indications

The graft is accessible to the distal and proximal segments of an intact motor or sensory nerve.

Contraindications

Peripheral neuropathy with compromised sensation to the lower extremity may also create a contraindication if the patient requires intact foot and lower leg sensation (for employment or sports reasons).

Graft Harvesting Technique

It is best to identify the sural nerve approximately 2 cm posterior to the lateral malleolus and approximately 2 to 3 cm proximal. In this area, it has not undergone significant branching.It is necessary to make a longitudinal incision in the region above, and if the saphenous vein is visible, the nerve or a branch of it is close by. The nerve can be traced proximally through this incision or through a series of “stairstep” transverse incisions.

After exposing the nerve proximally and distally, the nerve is cut proximally and distally and placed on moist gauze. The proximal incisions are determined by gently pulling the nerve at the distal incision.Sutures of 4-0 Vicryl are used to close the donor site, and staples or nylons are used to close the skin.


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Health

Does energy drink have any health benefits?

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Energy Drinks – what are they?

They are marketed to increase energy, weight loss, stamina, athletic performance, promote wakefulness, and enhance weight loss. Energy drinks contain caffeine, taurine, vitamins, and herbal supplements in addition to sugar or sweeteners.

Although they may seem like a new fad, these drinks have been available to the public for some time. For instance, Red Bull (currently one of the most popular energy drinks) was introduced in Austria in 1987 and to the United States in 1997.The original coca leaf (from which cocaine is derived) and kola nut (from which caffeine is derived) form of cola soft drinks was available in 1886, with similar results to energy drinks at the time.

There are many energy drinks that are packed full of caffeine, taurine, l-carnitine, carbohydrates, glucuronolactone, vitamins, and herbal supplements, such as ginseng and guarana.

It is not required that manufacturers of energy drinks include the caffeine content of herbal supplements such as guarana, yerba mate, cocoa, and kola nuts in the nutritional information, so consumers are unaware of this aspect.There are different brands of energy drinks that contain caffeine ranging from 50mg to 550mg per can or bottle

In high doses, caffeine may cause abnormal stimulation of the nervous system, and is one of the most commonly consumed alkaloids worldwide in the form of coffee, tea, and soft drinks.

Energy drinks contain caffeine, which can have adverse effects on the cardiovascular, hematological, and gastrointestinal systems. Many contain 70 to 80 mg of caffeine per 8-ounce serving (*3 times more than in cola drinks).It is possible for the caffeine content of 16-ounce drinks to be nearly five times that of 8 oz of cola drinks when packaged as “energy shots” (0.8-3 oz) or as 16-oz drinks

There are now 11 percent of energy drinks sold in the U.S. that are energy shots, a type of energy drink. Energy shots are the fastest-growing segment of the energy drink market.Most energy drinks come in 12 and 16 ounce (355 and 474 ml) cans or bottles, whereas energy shots come in smaller 50 ml bottles. Both energy drinks and energy shots contain the same amount of caffeine, however, energy shots tend to contain more sugar.


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Tic douloureux

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Trigeminal neuralgia, also known as tic douloureux, is a chronic pain condition that causes burning or shock-like pain in the face. Nicolaus Andre, a French physician, coined the term “tic douloureux” in 1756 in reference to the facial spasms that can occur during severe pain attacks.

The pain that occurs in short, unpredictable episodes rarely lasts more than a few seconds or a minute or two in a trigeminal neuralgia attack. The pain can feel like an electric shock or can be described as a sharp shooting pain.

Generally, trigeminal neuralgia affects just one side of the face. The pain is felt on the lower part of the face. Trigeminal neuralgia can progress to cause longer, more frequent attacks of searing pain.

The pain can sometimes affect both sides of the face, though not always at the same time.

The intensity of pain can be physically and psychologically incapacitating. People with tic douloureux may have regular attacks for days, weeks or months at a time. In severe cases attacks may happen hundreds of times a day.

Even though it can be debilitating, this disorder does not pose a life-threatening threat. A spontaneous remission is possible, although most people experience episodes over a long period of time.

The anatomy of the trigeminal nerve

This nerve supplies the face with sensory information and provides motor and sensory input to the masticatory muscles. It is a fifth cranial nerve (CN V).

Three trigeminal nerves split off from the trigeminal nerve (trigeminal = threefold):

  1. Ophthalmic (V1): Supplies the eye, upper eyelid, and the forehead
  2. Maxillary (V2): Supplies lower eyelid, cheek, nostril, upper lip, and upper gum
  3. Mandibular (V3): Supplies the lower lip, lower gum, jaw and the muscles of mastication

The mandibular division of the trigeminal nerve provides somatic motor innervation for the chewing muscles. The trigeminal nerve is a mixed nerve and it supplies the general somatic sensory function for touch, temperature, and pain in the face.

This figure shows the fifth cranial nerve, the trigeminal nerve.

Tic douloureux causes

Trigeminal neuralgia, also known as tic douloureux, occurs when the trigeminal nerve’s function is disrupted. Most cases result from compression of the trigeminal nerve root near its entry point into the pons.The problem is usually caused by a contact between a blood vessel – in this case, an artery or a vein – and the trigeminal nerve at the base of your brain. This pressure puts pressure on the nerve, causing it to malfunction.


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Health

Does sparkling water have any negative health effects?

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Discover the truth behind the fizz.

You might turn to sparkling water – the fizzy, sugar-free alternative to soda and sports drinks. Sports drinks, iced teas, and juices are loaded with sugar or artificial sweeteners.

Whether it’s low-calorie seltzers, antioxidant-infused seltzers or even those that taste like soda, these bubbly drinks can be hard to resist. But are they really healthy?

How does sparkling water work?

Carbon dioxide is added to regular water to make sparkling water. Adding sodium carbonate to water helps water absorb CO2, hence the name “soda water.”

You can drink seltzer if you like the taste and fizz of soda but don’t want the calories. It’s helped many people cut sugar from their diets. But remember, there are such things as “too much of a good thing.”

When does seltzer become harmful?

The process of adding carbon dioxide to water creates carbonic acid, which lowers the pH level and makes the drink more acidic. It is likely to erode your teeth’s enamel over time if you drink a lot of sparkling water.

A sparkling water can also contain citric acid, which can further increase its acidity and lower its pH level. Some sparkling waters also contain carbonic acid for flavor.

The combination of carbonation and sugar in seltzer water can cause dental decay. You’ll want to avoid seltzer that contains sugars to prevent dental decay, says Dr. Guerrier.

Tip: If you love lemon or lime flavor but want to protect your teeth, try adding a slice of lemon or lime to plain seltzer water. It’s a less acidic way to add a little taste to plain water.

It is important to remember that not all clear, fizzy drinks are created equal. Some drinks that look like seltzer and claim “zero calories” actually contain artificial sweeteners, so check the labels to find the healthiest alternative.


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There is a wide variety of possible causes of neuralgia, and it can affect different parts of the body.

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Trigeminal Neuralgia: Angioneuropathy involves pain from the trigeminal nerve, which travels from the brain to the face. It’s believed that a blood vessel presses against the trigeminal nerve at the point where it meets the brainstem.Trigeminal neuralgia causes pain in the face, usually on one side, and is most common in the elderly.

Postherpetic Neuralgia: This type of neuralgia occurs as a complication of shingles and may occur anywhere on the body. Shingles is caused by a virus that causes a blistering rash.There is an increased risk of neuropathy occurring in the area where the shingles outbreak occurred, and it may be mild, moderate, or severe, persistent, or intermittent, and may last for months or years.

Glossopharyngeal Neuralgia: Glossopharyngeal neuralgia produces neck and throat pain. It is not quite as common as cranial neuralgia.

Causes of Neuralgia

Any type of neuralgia is caused by damage to a nerve. Your body’s nerves are covered by a protective sheath called the myelin sheath. When this is damaged or worn away, you experience the stabbing, severe, shock-like pain that is characteristic of neuralgia.

There are numerous factors, including old age, that can cause myelin damage. Unfortunately, the cause of neuralgia is often never determined.

A variety of infections can cause postherpetic neuralgia, including chicken pox, shingles, Lyme disease, and HIV. Syphilis can also trigger the condition.

Multiple Sclerosis: There are many symptoms associated with multiple sclerosis (MS), including facial nerve pain. MS is caused by degradation of myelin.

Pressure on Nerves: Several different pressure sources can wear away the myelin on nerves, including bones, ligaments, blood vessels, and tumors. The pressure of swollen blood vessels is a common cause of trigeminal neuralgia.

Diabetes (Diabetic Neuropathy):There is a high probability that people with diabetes will experience some form of neuralgia because excess glucose in the bloodstream can damage the myelin.

Less Common Causes: In cases where neuralgia cannot be attributed to infections, multiple sclerosis, diabetes, or pressure on the nerves, it may be due to one of many less common factors. These include:

  • chronic kidney disease
  • porphyria (a rare blood disease)
  • medications like cisplatin, paclitaxel, or vincristine (prescribed to cancer patients)
  • trauma, such as that caused by surgery
  • chemical irritation

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A systematic review of the literature and an illustrated case report on Scalp Cirsoid Aneurysm

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Scalp cirsoid aneurysms are arteriovenous fistulas in the scalp without vascular access to the brain.

Draining veins dilatation can cause headache, tinnitus, and hemorrhage, as well as cosmetic concerns, masses, and local pain.

The etiopathogenesis of this condition is poorly understood. Treatment consists of surgery (fistula repair by simple surgical ligation until gross total resection), embolization (either endovascular or percutaneous), or a combination of both.

The last 10 years’ publications were reviewed in an updated systematic review.

A young boy with a posttraumatic cirsoid aneurysm with compelling documentation of head vascular examinations and multiple treatment options is described as well.The use of coils and cyanoacrylate for percutaneous embolization or endovascular embolization, respectively)This is accompanied by a reduction of pulsatile mass.

The final esthetic result was extremely pleasing due to a cosmetic surgery team that performed gross total resection.


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