Top Tweets for #CompressiveNeuropathy

4 months ago

Compressive Neuropathy: When Pressure Finds the Vulnerable #CompressiveNeuropathy #PressurePalsy #EntrapmentNeuropathy #Neuropraxia #Demyelination #AxonalInjury #Hypothyroidism #DiabetesNeuropathy #PositioningMatters #RegionalAnesthesia #PostoperativeNeuropathy #AnatomyMatters #TipOfTheDay #MyRATips Tip of the Day: 🧠 Pathology - What Really Happens? 🔹 Sustained mechanical pressure → structural deformation 🔹 Endoneurial capillary collapse → ischemia 🔹 Intraneural edema → rising compartment pressure 🔹 Early phase → conduction block (neuropraxia) 🔹 Prolonged compression → segmental demyelination 🔹 Severe/untreated → axonal degeneration 🔹 Metabolic disorders (e.g., hypothyroidism, diabetes) → reduced tolerance to pressure Core Formula: Pressure × Duration × Susceptibility = Dysfunction ⚠️ Risk Factors - Who Is Prone? 🔸 Prolonged posture (kneeling, lithotomy, leg crossing) 🔸 Rapid weight loss (loss of protective padding) 🔸 Diabetes mellitus 🔸 Hypothyroidism 🔸 Rheumatoid arthritis 🔸 Pregnancy / fluid retention states 🔸 Tight casts, splints, tourniquets 🔸 Repetitive occupational positioning 🔸 ICU immobilization 🩺 Clinical Clues - What Raises Suspicion? 🔹 Sudden weakness after sustained posture 🔹 Focal motor deficit > sensory symptoms 🔹 Symptoms appearing after surgery or prolonged positioning 🔹 Normal proximal function with distal weakness 🔹 History of metabolic vulnerability ⏳ Prognosis - What to Expect? 🟢 Neuropraxia → recovery in weeks 🟡 Demyelination → recovery in months 🔴 Axonal injury → prolonged or incomplete recovery 🔵 Early identification dramatically improves outcome Golden principle: The earlier the decompression, the better the recovery. 💊 Treatment - What To Do? 🛑 Remove compression source 🛏️ Correct posture and ergonomics 💉 Optimize thyroid, glucose, metabolic status 🧊 Reduce edema 🦿 Splinting to prevent contractures 🏋️ Targeted physiotherapy 🔪 Surgical decompression in selected chronic entrapments 🎯 Regional Anesthesia Implications 🩻 Pre-Block Assessment 🔹 Screen for diabetes, hypothyroidism, neuropathy history 🔹 Document baseline motor & sensory status 🔹 Identify preexisting deficits clearly 🪑 Positioning Matters 🔸 Avoid prolonged extreme flexion or compression during block 🔸 Protect superficial structures near bone 🔸 Reassess padding in sedated patients 🔸 Extra vigilance in lithotomy and long procedures 💉 Block Considerations 🔹 Avoid high injection pressures 🔹 Use ultrasound to minimize intraneural injection risk 🔹 Be cautious with dense motor blocks in high-risk patients 🔹 Consider lower concentration when appropriate ⚖️ Postoperative Dilemma 🔸 New deficit after surgery? → Is it surgical? → Position-related? → Block-related? → Metabolic vulnerability unmasked? 🔹 Early differentiation prevents unnecessary blame on the block. 🚨 Medicolegal Insight ✨ Many postoperative neuropathies are positional or compressive - not anesthetic toxicity. ✨ Proper documentation protects both patient and anesthesiologist. 💡 High-Yield Pearls ✨ Metabolic disease lowers pressure tolerance. ✨ Sedation hides warning symptoms. ✨ Compression + duration is more dangerous than brief intense pressure. ✨ Not every postoperative weakness is “block-related.”

KartikBSonawane's tweet photo. Compressive Neuropathy: When Pressure Finds the Vulnerable

#CompressiveNeuropathy #PressurePalsy #EntrapmentNeuropathy #Neuropraxia #Demyelination #AxonalInjury #Hypothyroidism #DiabetesNeuropathy #PositioningMatters #RegionalAnesthesia #PostoperativeNeuropathy #AnatomyMatters
#TipOfTheDay #MyRATips

Tip of the Day:

🧠 Pathology - What Really Happens?

🔹 Sustained mechanical pressure → structural deformation
🔹 Endoneurial capillary collapse → ischemia
🔹 Intraneural edema → rising compartment pressure
🔹 Early phase → conduction block (neuropraxia)
🔹 Prolonged compression → segmental demyelination
🔹 Severe/untreated → axonal degeneration
🔹 Metabolic disorders (e.g., hypothyroidism, diabetes) → reduced tolerance to pressure
Core Formula:
Pressure × Duration × Susceptibility = Dysfunction

⚠️ Risk Factors - Who Is Prone?

🔸 Prolonged posture (kneeling, lithotomy, leg crossing)
🔸 Rapid weight loss (loss of protective padding)
🔸 Diabetes mellitus
🔸 Hypothyroidism
🔸 Rheumatoid arthritis
🔸 Pregnancy / fluid retention states
🔸 Tight casts, splints, tourniquets
🔸 Repetitive occupational positioning
🔸 ICU immobilization

🩺 Clinical Clues - What Raises Suspicion?

🔹 Sudden weakness after sustained posture
🔹 Focal motor deficit > sensory symptoms
🔹 Symptoms appearing after surgery or prolonged positioning
🔹 Normal proximal function with distal weakness
🔹 History of metabolic vulnerability

⏳ Prognosis - What to Expect?

🟢 Neuropraxia → recovery in weeks
🟡 Demyelination → recovery in months
🔴 Axonal injury → prolonged or incomplete recovery
🔵 Early identification dramatically improves outcome

Golden principle: The earlier the decompression, the better the recovery.

💊 Treatment - What To Do?

🛑 Remove compression source
🛏️ Correct posture and ergonomics
💉 Optimize thyroid, glucose, metabolic status
🧊 Reduce edema
🦿 Splinting to prevent contractures
🏋️ Targeted physiotherapy
🔪 Surgical decompression in selected chronic entrapments

🎯 Regional Anesthesia Implications

🩻 Pre-Block Assessment
🔹 Screen for diabetes, hypothyroidism, neuropathy history
🔹 Document baseline motor & sensory status
🔹 Identify preexisting deficits clearly

🪑 Positioning Matters
🔸 Avoid prolonged extreme flexion or compression during block
🔸 Protect superficial structures near bone
🔸 Reassess padding in sedated patients
🔸 Extra vigilance in lithotomy and long procedures

💉 Block Considerations
🔹 Avoid high injection pressures
🔹 Use ultrasound to minimize intraneural injection risk
🔹 Be cautious with dense motor blocks in high-risk patients
🔹 Consider lower concentration when appropriate

⚖️ Postoperative Dilemma
🔸 New deficit after surgery?
→ Is it surgical?
→ Position-related?
→ Block-related?
→ Metabolic vulnerability unmasked?

🔹 Early differentiation prevents unnecessary blame on the block.

🚨 Medicolegal Insight

✨ Many postoperative neuropathies are positional or compressive - not anesthetic toxicity.
✨ Proper documentation protects both patient and anesthesiologist.

💡 High-Yield Pearls

✨ Metabolic disease lowers pressure tolerance.
✨ Sedation hides warning symptoms.
✨ Compression + duration is more dangerous than brief intense pressure.
✨ Not every postoperative weakness is “block-related.”

510

Dr.Kartik Sonawane

@KartikBSonawane

4 months ago

💘 Decoding the Riddle “On Bended Knee, Love Changed His Step.” #OnBendedKnee #LoveChangedHisStep #ValentineDayRiddle #CommonPeronealNerve #CompressiveNeuropathy #Hypothyroidism #FootDrop #AnatomyInAction #RegionalAnesthesia #MyRARiddles #SolveMyPuzzle #SolveMyRiddle 🧠 Why Common Peroneal Nerve (CPN)? 📍 1️⃣ Anatomy Makes It Vulnerable 🔹 The CPN winds superficially around the fibular neck 🔹 It lies close to bone with minimal soft-tissue protection 🔹 It is highly susceptible to external compression 🪑 2️⃣ What Happened During the Proposal? When he knelt: 🔸 Prolonged knee flexion 🔸 Direct pressure from body weight 🔸 Possible ground compression at the lateral knee This causes: ➡ Mechanical compression ➡ Microvascular compromise ➡ Conduction block (neuropraxia) When he stood up: 🔹 Dorsiflexion failed 🔹 Toes could not lift 🔹 Acute foot drop appeared That’s the “love changed his step” moment. 🧬 Why Hypothyroidism Matters “Where subtle swell and quiet weight made narrow passages pay a price.” In hypothyroidism: 🔹 Glycosaminoglycan deposition → tissue thickening 🔹 Interstitial edema → increased compartment tightness 🔹 Reduced tolerance to pressure injury 🔹 Increased risk of compressive neuropathies Common examples: Carpal tunnel syndrome Entrapment neuropathies Pressure palsies So in this case: Hypothyroidism did not cause the injury directly. It lowered the threshold for compression. ⚙️ Mechanism Hypothyroidism → Soft tissue swelling + metabolic vulnerability → Reduced pressure tolerance → Prolonged kneeling → Compression at fibular neck → Neuropraxia → Acute foot drop on standing 🎯 What it Explains? ✨ Postural neuropathy ✨ Metabolic predisposition ✨ Superficial anatomical vulnerability ✨ Sudden postoperative-like presentation ✨ Not every sudden deficit is block-related. Sometimes it’s posture + predisposition.

KartikBSonawane's tweet photo. 💘 Decoding the Riddle
“On Bended Knee, Love Changed His Step.”

#OnBendedKnee #LoveChangedHisStep #ValentineDayRiddle #CommonPeronealNerve #CompressiveNeuropathy #Hypothyroidism #FootDrop #AnatomyInAction #RegionalAnesthesia
#MyRARiddles #SolveMyPuzzle
#SolveMyRiddle

🧠 Why Common Peroneal Nerve (CPN)?

📍 1️⃣ Anatomy Makes It Vulnerable

🔹 The CPN winds superficially around the fibular neck
🔹 It lies close to bone with minimal soft-tissue protection
🔹 It is highly susceptible to external compression

🪑 2️⃣ What Happened During the Proposal?

When he knelt:
🔸 Prolonged knee flexion
🔸 Direct pressure from body weight
🔸 Possible ground compression at the lateral knee

This causes:
➡ Mechanical compression
➡ Microvascular compromise
➡ Conduction block (neuropraxia)

When he stood up:
🔹 Dorsiflexion failed
🔹 Toes could not lift
🔹 Acute foot drop appeared

That’s the “love changed his step” moment.

🧬 Why Hypothyroidism Matters

“Where subtle swell and quiet weight made narrow passages pay a price.”

In hypothyroidism:
🔹 Glycosaminoglycan deposition → tissue thickening
🔹 Interstitial edema → increased compartment tightness
🔹 Reduced tolerance to pressure injury
🔹 Increased risk of compressive neuropathies

Common examples:
Carpal tunnel syndrome
Entrapment neuropathies
Pressure palsies

So in this case:

Hypothyroidism did not cause the injury directly.
It lowered the threshold for compression.

⚙️ Mechanism

Hypothyroidism →
Soft tissue swelling + metabolic vulnerability →
Reduced pressure tolerance →
Prolonged kneeling →
Compression at fibular neck →
Neuropraxia →
Acute foot drop on standing

🎯 What it Explains?

✨ Postural neuropathy
✨ Metabolic predisposition
✨ Superficial anatomical vulnerability
✨ Sudden postoperative-like presentation
✨ Not every sudden deficit is block-related.
Sometimes it’s posture + predisposition.

389

J Hand Surg Am- ASSH @JHandSurg

almost 3 years ago

#Misdiagnosis in Amyotrophic Lateral Sclerosis @BrownMedicine @UCincyMedicine @TriHealth #ALS #AmyotrophicLateralSclerosis #CarpalTunnelSyndrome #CompressiveNeuropathy #HandSurgery https://t.co/RO8Kjvuwa7

423

Tulane Orthopaedics @TulaneOrtho

about 3 years ago

Drs. Savoie and O'Brien conducted research on suprascapular nerve decompression with rotator cuff repairs. Check it out here-> https://t.co/ETm7aoY8Vu. #suprascapularnerve #compressiveneuropathy #rotatorcufftear #arthroscopy #tulanedoctors #orthotwitter