Cervical spinal ischemic reperfusion injury (CSIRI) refers to a state of sudden neurological deterioration after surgical spinal decompression. The CSCIRI refers to a state of sudden neurological deterioration after surgical spinal decompression. The pathophysiology is hypothesized to be due to instant relief of a chronically compressed spinal cord, leading to an inflammatory cascade named ischemic reperfusion injury. Deterioration of neurological function after cervical spine decompression surgery often occurs secondary to direct cord injury, compressing hematoma, or hardware failure. Complete loss of neurological function with no organic explanation is an extremely rare complication, with only a few cases reported in the literature. We are reporting a 67-year-old male patient diagnosed with severe cervical spinal canal stenosis at level C5/6 who underwent anterior cervical discectomy and fusion (ACDF). The patient developed complete transient loss of neurological functions after the surgery and was labeled as a case of CSCIRI after excluding compressing pathology. A literature review of the CSCIRI was carried out, and ten articles were included. Due to the rarity of these cases, there is no class 1 or 2 evidence to establish management protocol nor identifiable risk factors to predict their occurrence. However, we recommend using an intra-operative neurophysiology monitor in cases with long-standing severe cervical canal stenosis with myelomalacia and managing these cases according to the acute spinal cord injury management protocol after excluding compressing pathologies.
Background Migraine is a chronic episodic neurological disorder characterized by a myriad of neurological symptoms including multi-phase attacks of headache, photophobia, phonophobia, and dizziness. To the best of our knowledge, there are no studies conducted about the public perception and attitudes towards migraine in Saudi Arabia. This study aims to determine the public perception and attitudes towards migraine in Jeddah, Saudi Arabia. This cross-sectional study was conducted during the period between September 2019 and January 2020 in various public places including malls in Jeddah, Saudi Arabia. The study utilized a 40-item self-administered survey questionnaire divided into two sections: demographic data of the participants and perception of participants towards migraine, which consisted of three parts—knowledge towards migraine, attitudes towards migraine, and the expected behavior of migraine patients. Results The total number of participants was 385. Three hundred and thirty-nine of the participants (88.1%) heard about migraine before. Relatives and friends are the main source of information for 213 participants (55.3%). In gender predominance, 137 (35.6%) believed that migraine affects both genders equally. Complications of migraine headache are not known for 240 participants (62.3%). The existence of medications or methods for treating migraine is not known for 195 (50.6%). The quality of life for patients with migraine is negatively affected according to 275 (70.9%). One hundred sixty-six participants (43.1%) believe that depression and anxiety are more common in migraineurs. Two hundred forty-four (63.4%) considered migraine to cause a huge psychological and social impact. Two hundred fifteen (55.8%) do not have the knowledge to deal with migraineurs. Conclusion The present study demonstrated a lack of knowledge in certain aspects of migraine in Jeddah, Saudi Arabia. This study will serve as a basis for developing a health educational program aiming to increase public awareness about migraine. It will also improve the understanding of society regarding migraine, which will subsequently improve the way they interact with migraineurs and understand their difficulties. In addition, finding a trusted source for information about different kinds of medical conditions including migraine is crucial in educating the community and providing them with the most recent and correct information.
BackgroundCranioplasty (CP) is a common cranial reconstructive procedure. It is performed after craniectomy due to various causes such as relieving increased intracranial pressure, infection, and tumor infiltration. Although CP is an easy procedure, it is associated with a high rate of complications. We aimed to retrospectively investigate the outcomes of CP at the King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Jeddah (KAMC-J). MethodsThis is a retrospective observational study that included all patients who had CP (first time or redo) at KAMC-J from 1st January 2010 to 31st December 2020. Patients with congenital cranial malformation were excluded. ResultA total of 68 patients underwent CP. Of those, 23 (34%) had complications. The most common complication was infection (10.3%). Twelve of the 23 patients had major complications that necessitated reoperation. Of those 12, six underwent redo CP; three out of these six patients had further complications which were also managed surgically. On bivariate analysis, cranial defects over 50 cm² were associated with a higher rate of both infection and hydrocephalus (p=0.018) while the frontal site was associated with a higher rate of infection (p=0.014). Moreover, traumatic brain injury as an etiology was exclusively associated with postcranioplasty hydrocephalus (p=0.03). ConclusionPatients undergoing CP after craniectomy are prone to a considerably high rate of adverse outcomes. The overall rate of complications in this study was 34%, with an infection rate of 10.3% and a 1.5% mortality rate. Consistent with other studies, larger cranial defects as well as frontal sites have a higher rate of infection.
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