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Purpose: An idea of "double-crush syndrome", introduced by Upton and McComas, is a concept considered for cervical disc disease and the carpal tunnel syndrome. Similar hypothesis can be put forward for lumbar disc disease and the tarsal tunnel syndrome, though the occurrence of the latter has not been studied up to date. The aim of this study was to examine the occurrence of the tarsal tunnel syndrome among patients surgically treated for lumbar disc disease. Material and methods: Electroneurographical examination was performed in 53 in-patients of the Department of Neurosurgery, Medical University of Białystok, who were admitted for surgical treatment of lumbar disc herniation. Results: In 9 of 53 patients, (17%) the terminal latency of the response in the tibial nerve was elongated and the amplitude was depressed to exceed the normal reference range of these parameters, thus diagnosing the tarsal tunnel syndrome. The occurrence of the tarsal tunnel syndrome on the side affected by disc disease was much higher than on the unaffected side (13.2% vs. 7.5%, respectively). Conclusions: A significant sub-group of patients with lumbar disc disease subject to surgical treatment suffer also from impairment of the tibial nerve at the level of the tarsal tunnel. This is likely to affect the results of surgical treatment of disc disease: failed back surgery ought to be considered in respect of this finding.
EN
Purpose: Cerebral vasospasm occurs frequently after aneurismal subarachnoid haemorrhage (SAH) and is a dangerous complication. Only a few cases of cerebral vasospasm after intracerebral haemorrhage (ICH) have been reported. To determine the incidence of vasospasm, the authors of this study evaluated the participants’ digital subtraction angiographies (DSA) after these patients had experienced ICH. Materials and methods: Sixty patients with ICH (26 women and 34 men between 20 and 69 years of age, mean age 49.6 years ± 13.9 SD) who underwent cerebral arteriography were included in this study. Cerebral vasospasm was graded as mild (up to 25% of vessel narrowing), moderate (26-50% of vessel narrowing), and severe (more than 50% of vessel narrowing). Results: Vasospasm of the ipsilateral middle cerebral artery (MCA) to the ICH was found in 13 patients (21.6%), the ipsilateral anterior cerebral artery (ACA) in 4 patients, and the posterior cerebral artery (PCA) in one patient. Two patients had a spasm of the contralateral MCA. Severe MCA spasm was found in 3 patients, moderate in 5, and mild in 5. All cases of ACA and PCA spasms were assessed as mild. Conclusions: Cerebral vasospasm is a rather frequent finding in patients who have just experienced ICH. Therefore, practitioners need to assess and monitor the status of the cerebral vasculature in these patients.
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