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Diagnosis of neurogenic claudication is based on typical clinical features, the physical exam, and findings of spinal stenosis on computer tomography (CT) or X-ray imaging. [1] In addition to vascular claudication, diseases affecting the spine and musculoskeletal system should be considered in the differential diagnosis. [9]
Spinal or neurogenic claudication may be differentiated from arterial claudication based on activity and position. In neurogenic claudication, positional changes lead to increased stenosis (narrowing) of the spinal canal and compression of nerve roots and resultant lower extremity symptoms. Standing and extension of the spine narrows the spinal ...
Intermittent claudication, also known as vascular claudication, is a symptom that describes muscle pain on mild exertion (ache, cramp, numbness or sense of fatigue), [1] classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest.
Lying on the side is often more comfortable than lying flat, since it permits greater lumbar flexion. Vascular claudication can resemble spinal stenosis, and some individuals experience unilateral or bilateral symptoms radiating down the legs rather than true claudication. [7] The first symptoms of stenosis include bouts of low back pain.
Critical limb ischemia is diagnosed by the presence of ischemic rest pain, and an ulcers that will not heal or gangrene due to insufficient blood flow. [3] Insufficient blood flow may be confirmed by ankle-brachial index (ABI), ankle pressure, toe-brachial index (TBI), toe systolic pressure, transcutaneous oxygen measurement (TcpO2 ), or skin perfusion pressure (SPP).
Zamboni and colleagues claimed that in MS patients diagnosed with CCSVI, the azygos and IJV veins are stenotic (abnormally narrowed) in around 90% of cases. Zamboni theorized that malformed blood vessels cause increased deposition of iron in the brain, which in turn triggers autoimmunity and degeneration of the nerve's myelin sheath.
Neurogenic shock results from damage to the spinal cord above the level of the 6th thoracic vertebra. [5] It is found in about half of people who have a spinal cord injury within the first 24 hours, and usually persists for one to three weeks. [5] Neurogenic shock may be caused by severe brain injury. [6]
Interspinous process decompression, or IPD, is a minimally invasive surgical procedure in which an implant is placed between the spinous processes of the symptomatic disc levels. IPD's were developed for patients who have lumbar spinal stenosis , suffer symptoms of neurogenic intermittent claudication , and who are able to relieve their ...