Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves

Baba, H.; Okumura, Yasuhiro; Furusawa, Nobuaki; Omori, Hironori; Kawahara, Hideo; Fujita, T; Katayama, Kanji; Noriki, Sakon

doi:10.1038/sj.sc.3100550

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…There are reports of gluteal abscesses, both septic and tuberculous, causing SN. 12,13 Extrinsic compression occurred in 6 patients, 3 of whom were teenagers. One 17-year-old patient had bilateral SN following prolonged unconsciousness in supine position after an overdose of phencyclidine; this has been reported after heroin overdose 14 and alcohol intoxication.…”

Section: Resultsmentioning

confidence: 99%

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Pediatric sciatic neuropathies

Srinivasan¹,

Ryan

Escolar³

et al. 2011

Neurology

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Objective: The incidence, cause, and prognosis of sciatic neuropathy in children is not well understood. We report our 30-year experience of 53 patients with pediatric sciatic neuropathies (SN).Methods: Prospective review of the history, physical examination, electrophysiologic findings, and clinical course of children with SN. Results:The etiology of SN injury was varied and included trauma (13), iatrogenic causes (13) (8 orthopedic surgeries and 5 miscellaneous surgeries), prolonged extrinsic compression and immobilization (6), tumors (7), vascular (5), idiopathic and progressive (4), infantile and nonprogressive (2), and unknown, presumed postviral (3). Electrophysiologic studies demonstrated abnormalities in motor conduction studies of the peroneal nerve in 44/53 (83%) or tibial nerve in 35/51 (67%). Sensory conduction studies were abnormal in sural nerve in 34 of 43 cases (79%), and superficial peroneal nerves in 15/25 (60%). Needle EMG was abnormal in peroneal innervated muscles in all subjects, in tibial nerve innervated muscles in 43/51 (84%), and in the hamstrings in 18/29 (62%). Prognosis for recovery was variable and depended on the etiology and the severity of the nerve injury. Mononeuropathies are uncommon in children; however, in our experience, pediatric sciatic neuropathy (SN) represents approximately one-fourth of all mononeuropathies. Conclusions:1 SN lesions may be underappreciated in childhood. We describe the clinical features of children who presented with SN over a 30-year period. Clinical assessment. Staff neurologists, neurosurgeons, or orthopedic surgeons evaluated all children in the study before EMG evaluation. A staff electromyographer reviewed the history and neurologic examination at the time of the EMG with the patient and parents/ guardians. Follow-up data were obtained by clinical examination, review of charts, telephone conversations, and occasionally a repeat EMG. Electrophysiologic evaluation.Nerve conduction studies (NCS) and needle EMG were performed in children using Dantec Counterpoint (Dantec Electronic, Tonsbakken, Skovlunde, Denmark), TECS TE42 machine (Teca Corporation, Pleasantville, NY) or the Teca TM Synergy N-EM-EMG monitoring systems (Oxford Instruments, Oxford, UK); standard filter settings were utilized. Electrophysiologic studies were performed without sedation in the majority; in rare instances, sedation was used. In each child with a suspected SN, motor NCS included responses from the extensor digitorum brevis, abductor hallucis brevis, and in some instances tibialis anterior. Sensory NCS included sural nerve and in some instances superficial peroneal nerve responses. Plantar sensory responses were studied in preference to the technically difficult sural response in infants. Contralateral limbs were studied if there was possibility of a systemic process or multiple limb involvement. Normative data were as previously published. 1 H-reflex studies and F-wave studies were performed infrequently. Muscles

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Section: Resultsmentioning

confidence: 99%

“…Following the earthquake in Bam, Iran, in 2003, sciatic injuries were common. 5 Iatrogenic mechanisms were relatively common (13) and occurred after orthopedic interventions in 8 children. Hip surgeries associated with SN included surgery for slipped capital femoral epiphysis (2); this has been previously reported.…”

Section: Resultsmentioning

confidence: 99%

Pediatric sciatic neuropathies

Srinivasan¹,

Ryan

Escolar³

et al. 2011

Neurology

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“…Lesions within the sciatic notch have the capability and the capacity to grow extremely large and form extensive dumbbell-shaped masses, 1,13 often before producing clinical symptoms or neurological findings. Surgery has proven formidable for these tumors, and demanded the need for combined operative exposures because of the tumor's size and the difficult anatomical relationships between the tumors and the sciatic nerves.…”

Section: Discussionmentioning

confidence: 99%

Resection of benign sciatic notch dumbbell-shaped tumors

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Endo

Amrami

et al. 2006

JNS

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A combined one-stage transabdominal and transgluteal approach allows safe resection of selected benign but extensive sciatic notch tumors. High-resolution MR imaging is a useful tool in the management of these tumors because it allows the surgeon to visualize the anatomical relationships of the tumor to the sciatic nerve. The authors believe that as this imaging technology advances, it will provide surgeons with a method to predict definitively which sciatic notch tumors displace rather than directly involve the sciatic nerve, and therefore indicate which tumors can be resected safely and completely.

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Pelvic and Intrapelvic Infections

Akhaddar

2023

Atlas of Sciatica

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Dumb-bell shaped tuberculous abscess across the greater sciatic notch compressing both sciatic nerves

Cited by 5 publications

References 4 publications

Pediatric sciatic neuropathies

Pediatric sciatic neuropathies

Resection of benign sciatic notch dumbbell-shaped tumors

Pelvic and Intrapelvic Infections

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