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Recruitment curve of H reflex in dignastics of radiculopathies.
Hrušková, Marcela ; Otáhal, Jakub (advisor) ; Ostrý, Svatopluk (referee)
Název práce: Náborová křivka H-reflexu v diagnostice radikulárních syndromů Cíle práce: Ověření spolehlivosti vyšetření náborové křivky H-reflexu a M-vlny diagnostice kompresivní radikulopatie Metody práce: U 24 osob s jednostranným kořenový syndromem S1 byl vyšetřen H-reflex m. soleus oboustranně bipolární stimulací n.tibialis v popliteální jamce. Elektromyografický signál byl digitalizován a následně byla hodnocena data pro asymptomatickou a symptomatickou končetinu. Hodnoceny byly prahy pro vyvolání H-reflexu a M-vlny, latence a amplitudy H-reflexu a M-vlny, strmost náborové křivky, její maxima Hmax. a Mmax. a poměr Hmax/Max . Tyto hodnoty pro symptomatickou stranu a asymptomatickou stranu byly statisticky porovnány. Výsledky: Výsledky měření potvrdily, že vyšetření náborové křivky H-reflexu je vhodnou diagnostickou metodou k objektivizaci radikulopatie S1. Na symptomatické straně došlo k signifikantnímu poklesu Mmax., Hmax, poměru Hmax/Mmax a sklonu náborové křivky H-reflexu. Klíčová slova: radikulopatie, EMG, H-reflex, M-vlna, náborová křivka
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Hypercapnia impact on vascular and neuronal reactivity in patients before and after carotid endarterectomy
Ostrý, Svatopluk ; Stejskal, Lubor (advisor) ; Šonka, Karel (referee) ; Zvěřina, Eduard (referee)
Indications for carotid endarterectomy (CEA) of symptomatic and asymptomatic internal carotid artery (ICA) stenosis were based on numerous randomised studies. The benefit was rated relative to the lowered risk of ipsilateral stroke relapse. There is evidence that rCBF correlates with brain electrical activity (EEG, SEPs). Somatosensory function is represented by evoked neuronal activity in central region. Can the neuronal activity in primary somatosensory cortex be influenced by hypercapnia-induced increased rCBF or CEA in patients with ICA stenosis or is a change such as that permanent? The aim of the present study was to determine whether CEA in unilateral symptomatic stenosis in the extracranial vascular system had a bearing on neuronal activity in the central region of the cerebral cortex. Material and methods The criteria for enrollment in the study were a history of ischaemic insult (TIA, RIND, minor stroke) less than six weeks before admission and unilateral stenosis of the ICA of 70-99 % measured on the DSA with the NASCET method. Patients were divided inti two groups: Group A (28 men and 13 women) with their initial NIHSS ≤ 2. Group B consisted of 12 men and 5 women, starting NIHSS was from 3 to 8. All patients were examined before CEA, on post-operative days 3-7 and 3 months after CEA. SEPs ans...
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Cervical spondylotic myelopathy: development of clinical symptoms and surgical management
Štěpánek, David ; Choc, Milan (advisor) ; Suchomel, Petr (referee) ; Ostrý, Svatopluk (referee)
Based on contemporary theoretical knowledge in this prospective study we outline the relationship between a chosen surgical approach (anterior or posterior approach) as it relates to the localization of spinal cord lesion (anterior or posterior spinal pathways) assessed by the use of evoked potentials (SEP, MEP) and the effect of this approach on the postoperative state of patients with cervical spondylotic myelopathy. Furthermore we evaluate clinical outcome of these patients according to several aspects of their MRI and X-ray findings. The study, from 2006 to 2010, comprised 65 patients with clinical signs of cervical myelopathy. These patients had been indicated for surgery, which subsequently was performed by using either the front (anterior - a) or back (posterior - p) approach. The patients were assessed using Nurick and mJOA scores before surgery, then at 12 months, and finally 24 months after surgery. In addition, they were preoperatively examined with a battery of evoked potentials (EP) - somatosensory evoked potential (SEP) and motor evoked potential (MEP) tests. Based on EP, principal spinal cord disability was determined: A - anterior (maximum changes in MEP), P - posterior - maximum change in SEP). The entire group was, on the basis of EP partitioning and the surgical approach used, divided...
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Cervical spondylotic myelopathy: development of clinical symptoms and surgical management
Štěpánek, David ; Choc, Milan (advisor) ; Suchomel, Petr (referee) ; Ostrý, Svatopluk (referee)
Based on contemporary theoretical knowledge in this prospective study we outline the relationship between a chosen surgical approach (anterior or posterior approach) as it relates to the localization of spinal cord lesion (anterior or posterior spinal pathways) assessed by the use of evoked potentials (SEP, MEP) and the effect of this approach on the postoperative state of patients with cervical spondylotic myelopathy. Furthermore we evaluate clinical outcome of these patients according to several aspects of their MRI and X-ray findings. The study, from 2006 to 2010, comprised 65 patients with clinical signs of cervical myelopathy. These patients had been indicated for surgery, which subsequently was performed by using either the front (anterior - a) or back (posterior - p) approach. The patients were assessed using Nurick and mJOA scores before surgery, then at 12 months, and finally 24 months after surgery. In addition, they were preoperatively examined with a battery of evoked potentials (EP) - somatosensory evoked potential (SEP) and motor evoked potential (MEP) tests. Based on EP, principal spinal cord disability was determined: A - anterior (maximum changes in MEP), P - posterior - maximum change in SEP). The entire group was, on the basis of EP partitioning and the surgical approach used, divided...
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Recruitment curve of H reflex in dignastics of radiculopathies.
Hrušková, Marcela ; Otáhal, Jakub (advisor) ; Ostrý, Svatopluk (referee)
Název práce: Náborová křivka H-reflexu v diagnostice radikulárních syndromů Cíle práce: Ověření spolehlivosti vyšetření náborové křivky H-reflexu a M-vlny diagnostice kompresivní radikulopatie Metody práce: U 24 osob s jednostranným kořenový syndromem S1 byl vyšetřen H-reflex m. soleus oboustranně bipolární stimulací n.tibialis v popliteální jamce. Elektromyografický signál byl digitalizován a následně byla hodnocena data pro asymptomatickou a symptomatickou končetinu. Hodnoceny byly prahy pro vyvolání H-reflexu a M-vlny, latence a amplitudy H-reflexu a M-vlny, strmost náborové křivky, její maxima Hmax. a Mmax. a poměr Hmax/Max . Tyto hodnoty pro symptomatickou stranu a asymptomatickou stranu byly statisticky porovnány. Výsledky: Výsledky měření potvrdily, že vyšetření náborové křivky H-reflexu je vhodnou diagnostickou metodou k objektivizaci radikulopatie S1. Na symptomatické straně došlo k signifikantnímu poklesu Mmax., Hmax, poměru Hmax/Mmax a sklonu náborové křivky H-reflexu. Klíčová slova: radikulopatie, EMG, H-reflex, M-vlna, náborová křivka
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Hypercapnia impact on vascular and neuronal reactivity in patients before and after carotid endarterectomy
Ostrý, Svatopluk ; Stejskal, Lubor (advisor) ; Šonka, Karel (referee) ; Zvěřina, Eduard (referee)
Indications for carotid endarterectomy (CEA) of symptomatic and asymptomatic internal carotid artery (ICA) stenosis were based on numerous randomised studies. The benefit was rated relative to the lowered risk of ipsilateral stroke relapse. There is evidence that rCBF correlates with brain electrical activity (EEG, SEPs). Somatosensory function is represented by evoked neuronal activity in central region. Can the neuronal activity in primary somatosensory cortex be influenced by hypercapnia-induced increased rCBF or CEA in patients with ICA stenosis or is a change such as that permanent? The aim of the present study was to determine whether CEA in unilateral symptomatic stenosis in the extracranial vascular system had a bearing on neuronal activity in the central region of the cerebral cortex. Material and methods The criteria for enrollment in the study were a history of ischaemic insult (TIA, RIND, minor stroke) less than six weeks before admission and unilateral stenosis of the ICA of 70-99 % measured on the DSA with the NASCET method. Patients were divided inti two groups: Group A (28 men and 13 women) with their initial NIHSS ≤ 2. Group B consisted of 12 men and 5 women, starting NIHSS was from 3 to 8. All patients were examined before CEA, on post-operative days 3-7 and 3 months after CEA. SEPs ans...
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