{"id":7907,"date":"2023-03-11T13:56:55","date_gmt":"2023-03-11T12:56:55","guid":{"rendered":"https:\/\/scholbach.de\/?page_id=7907"},"modified":"2023-03-20T13:02:16","modified_gmt":"2023-03-20T12:02:16","slug":"severe-neurologic-disorders-as-a-consequence-of-abdominal-compression-syndromes-complete-disappearance-after-decompression-of-the-left-renal-vein","status":"publish","type":"page","link":"https:\/\/scholbach.de\/sv\/severe-neurologic-disorders-as-a-consequence-of-abdominal-compression-syndromes-complete-disappearance-after-decompression-of-the-left-renal-vein","title":{"rendered":"Sv\u00e5r ataxi hos en ung kvinna med allvarlig ryggm\u00e4rgsinflammation &#8211; fullst\u00e4ndig uppl\u00f6sning efter dekompression av den v\u00e4nstra njurvenen."},"content":{"rendered":"<p>Det finns m\u00e5nga konsekvenser av en ryggm\u00e4rgssammandragning som en f\u00f6ljd av kompression av v\u00e4nster njurvena och v\u00e4nster iliacalvena hos patienter med midline congestion syndrome.<\/p>\n<p><a href=\"https:\/\/scholbach.de\/neurological-consequences-of-the-midline-congestion-syndrome\">De m\u00f6jliga m\u00e5nga kliniska konsekvenserna beskrivs p\u00e5 en separat sida.<\/a><\/p>\n<p>Jag rapporterar h\u00e4r om en ung kvinna som utvecklade sv\u00e5ra vegetativa symtom, buksm\u00e4rtor, kramper och gynekologiska problem p\u00e5 grund av flera kompressionssyndrom i buken p\u00e5 grundval av ett hypermobilt Ehlers-Danlos syndrom.<\/p>\n<p>Hon blev rullstolsbunden p\u00e5 grund av extrem ataxi i b\u00e5len, huvudet och extremiteterna. Rutinm\u00e4ssig neurologisk diagnostik och standardbilddiagnostik i hennes hemland och utomlands avsl\u00f6jade inte n\u00e5gon behandlingsbar orsak till hennes lidande.<\/p>\n<p>Endast funktionell f\u00e4rgdopplersonografi med kvantifiering av alla relevanta buk- och b\u00e4ckenk\u00e4rl kunde p\u00e5visa sj\u00e4lva orsaken till hennes lidande &#8211; en massiv ven\u00f6s tr\u00e4ngsel i ryggm\u00e4rgen som matas av en tronc r\u00e9no-rachidi\u00e8n med h\u00f6gt fl\u00f6de som f\u00f6rbinder den tr\u00e4ngda, eftersom den \u00e4r helt blockerad, v\u00e4nstra njurvenen med det epidurala plexuset i ryggm\u00e4rgskanalen. Detta gav upphov till ett neurologiskt underskott kompressionen och den efterf\u00f6ljande ven\u00f6sa \u00f6verbelastningen av ryggm\u00e4rgen.<\/p>\n<p>Denna video visar hennes el\u00e4ndiga tillst\u00e5nd f\u00f6re operationen i maj 2022.<\/p>\n<div style=\"width: 320px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-7907-11\" width=\"320\" height=\"576\" loop autoplay preload=\"metadata\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1376134703169370.mp4?_=11\" \/><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1376134703169370.mp4\">https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1376134703169370.mp4<\/a><\/video><\/div>\n<p>&nbsp;<\/p>\n<p>Denna video togs i mars 2023, 7,5 m\u00e5nader efter den framg\u00e5ngsrika dekompressionen av den v\u00e4nstra njurvenen och den efterf\u00f6ljande fullst\u00e4ndiga kollapsen av tronc r\u00e9no-rachidi\u00e8n.<\/p>\n<div style=\"width: 368px;\" class=\"wp-video\"><video class=\"wp-video-shortcode\" id=\"video-7907-12\" width=\"368\" height=\"640\" loop autoplay preload=\"auto\" controls=\"controls\"><source type=\"video\/mp4\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1406167236851234.mp4?_=12\" \/><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1406167236851234.mp4\">https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/received_1406167236851234.mp4<\/a><\/video><\/div>\n<h2><\/h2>\n<p>Medicinsk historia<\/p>\n<p>Januari 2016<\/p>\n<p>Hyperexcitabilitet, muskelkramper, vikt\u00f6kning p\u00e5 grund av \u00f6dem i benen.<\/p>\n<p>Januari 2017<\/p>\n<p>Gick till akutmottagningen p\u00e5 grund av sv\u00e5ra muskelkramper och kramper.<br \/>\nArytmi, yrsel, kr\u00e4kningar, domningar i b\u00e5da h\u00e4nderna och tremor i b\u00e5len.<br \/>\nPresenterar flera g\u00e5nger till akutmottagningen p\u00e5 psykiatriska sjukhuset p\u00e5 grund av allm\u00e4n skakighet. D\u00e4r fick hon diagnosen psykisk st\u00f6rning: \u00e5ngestsyndrom.<\/p>\n<p>Februari 2017<\/p>\n<p>Kom till akutmottagningen med sm\u00e4rta p\u00e5 h\u00f6ger sida av ryggraden och pollacisuria.<br \/>\nF\u00f6rdes till den psykiatriska avdelningen p\u00e5 grund av upprepade generaliserade kramper.<br \/>\nPsykiatrikern v\u00e4grar st\u00e4lla diagnosen \u00e5ngestsyndrom.<br \/>\nUpprepade kramper<\/p>\n<p>Maj 2017<\/p>\n<p>Diagnostiserades med syndrom med bakteriell \u00f6verv\u00e4xt i tarmen och eosinofil \u00f6sofagit.<\/p>\n<p>Maj 2021<\/p>\n<p>Hade bes\u00f6kt m\u00e5nga l\u00e4kare i hemlandet och utomlands utan att f\u00e5 en korrekt diagnos och behandling f\u00f6r sin \u00f6kande instabilitet i b\u00e5len och sina kramper.<br \/>\nLider ocks\u00e5 av buksm\u00e4rtor som \u00e4r lokaliserade under diafragman och som str\u00e5lar ut mot b\u00e5da sidorna och som \u00f6kar postprandialt.<br \/>\nKalla allakan inte andas ordentligt.<br \/>\nSv\u00e5righeter att sv\u00e4lja<br \/>\nBr\u00f6stsm\u00e4rta.<br \/>\nAlltid uppr\u00f6rd<br \/>\nSv\u00e5r hj\u00e4rndimma, synst\u00f6rningar, migr\u00e4n, yrsel, k\u00e4nns som att vara berusad, ryggsm\u00e4rta, kalla och bl\u00e5aktiga h\u00e4nder, svaga f\u00f6tter och h\u00e4nder.<br \/>\n\u00d6kande tr\u00f6tthet<br \/>\n\u00d6verflexibilitet i lederna<\/p>\n<p>&nbsp;<\/p>\n<p>F\u00f6rsta presentationen p\u00e5 min klinik f\u00f6r funktionell f\u00e4rgdopplersonografi i juni 2021.<\/p>\n<p>F\u00f6ljande diagnoser hade fastst\u00e4llts vid den f\u00f6rsta unders\u00f6kningen:<\/p>\n<ul>\n<li>B\u00e4ckenstockningssyndrom som en f\u00f6ljd av<\/li>\n<li>Ett May-Thurner-syndrom med en ven\u00f6s sporre.<\/li>\n<li>Sv\u00e5r lordos i l\u00e4ndryggen som huvudorsak till alla k\u00e4rlkompressionssyndrom hos patienten.<\/li>\n<li>Fullst\u00e4ndig lordogenetisk kompression av den v\u00e4nstra njurvenen med en bypass via en<\/li>\n<li>Tronc r\u00e9no-rachidi\u00e8n som matar epiduralplexus och en<\/li>\n<li>En utvidgad v\u00e4nster \u00e4ggstocksvena som transporterar blod ner mot b\u00e4ckenet.<\/li>\n<li>Betydande ven\u00f6s pooling i uppr\u00e4tt l\u00e4ge som ett tecken p\u00e5 en kliniskt relevant bindv\u00e4vssjukdom &#8211; i enlighet med vissa kliniska tecken p\u00e5 en s\u00e5dan sjukdom.<\/li>\n<li>Sv\u00e5rt median arcuate ligament syndrom med typiska symtom, patientens huvudsakliga symtom.<\/li>\n<li>Ptosis i b\u00e5da njurarna<\/li>\n<li>Allvarlig strypning av blodfl\u00f6det till b\u00e5da njurarna, fr\u00e4mst p\u00e5 v\u00e4nster sida p\u00e5 grund av njurptosen i uppr\u00e4tt st\u00e4llning &#8211; detta bidrar i h\u00f6g grad till ansamling av ven\u00f6st blod i b\u00e4ckenet och i b\u00e5da benen.<\/li>\n<li>Kraftig minskning av den cirkulerande blodvolymen i aorta n\u00e4r man \u00e4r uppr\u00e4ttst\u00e5ende.<\/li>\n<li>Dubbla livmodern<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<ol start=\"11\">\n<li style=\"list-style-type: none;\"><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7903 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie5.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7906 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie2.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7904 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie4.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7901 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie7.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7900 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie8.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a> <a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7899 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9-300x169.jpg\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9-300x169.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9-1024x576.jpg 1024w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9-768x432.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9-640x360.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Folie9.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n<h2>Preoperativ njurparenkymperfusionsm\u00e4tning i juni 2021<\/h2>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Preop-PixelFlux-measurements-in-truncal-ataxia.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7919 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Preop-PixelFlux-measurements-in-truncal-ataxia-300x158.jpg\" alt=\"\" width=\"300\" height=\"158\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Preop-PixelFlux-measurements-in-truncal-ataxia-300x158.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Preop-PixelFlux-measurements-in-truncal-ataxia.jpg 605w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Patienten opererades i juni 2021 och juli och dekomprimerade celiacus trunc (vilket var komplicerat p\u00e5 grund av den tunga \u00e4rrv\u00e4vnad som fanns runt coeliacus trunc) och skyddade v\u00e4nster vena iliacus och v\u00e4nster njurvena med hj\u00e4lp av ett ringf\u00f6rst\u00e4rkt PTFE-transplantat.<\/p>\n<p>Operationen utf\u00f6rdes av professor Sandmann vid kliniken BelEtage i D\u00fcsseldorf (Tyskland). Jag \u00e4r mycket tacksam f\u00f6r hans \u00f6ppna samarbete och till\u00e5telse att publicera hans intraoperativa bilder.<\/p>\n<div id=\"attachment_7893\" style=\"width: 235px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-rotated.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7893\" class=\"wp-image-7893 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-225x300.jpg 225w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-768x1024.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-1152x1536.jpg 1152w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-640x853.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Truncus-aus-Narbengewebe-ausgeschaelt-rotated.jpg 1512w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-7893\" class=\"wp-caption-text\">Befrielse av coeliakif\u00f6rloppet efter att massiv \u00e4rrv\u00e4vnad som komprimerar det har avl\u00e4gsnats.<\/p><\/div>\n<p>&nbsp;<\/p>\n<div id=\"attachment_7896\" style=\"width: 235px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-rotated.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7896\" class=\"wp-image-7896 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-225x300.jpg 225w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-768x1024.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-1152x1536.jpg 1152w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-640x853.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/May-Thurner-syndrome-rotated.jpg 1512w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-7896\" class=\"wp-caption-text\">Sv\u00e5r kompression av v\u00e4nster vena iliacalis av den korsande h\u00f6ger vena iliacalis &#8211; sonografiskt diagnostiserat May Thurners syndrom.<\/p><\/div>\n<div id=\"attachment_7895\" style=\"width: 235px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-rotated.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7895\" class=\"wp-image-7895 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-225x300.jpg 225w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-768x1024.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-1152x1536.jpg 1152w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-640x853.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/MTS-li-V.-Iliaca-com-hat-keine-normale-Wand-rotated.jpg 1512w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-7895\" class=\"wp-caption-text\">Degenererad v\u00e4gg i v\u00e4nster vena iliacalis vid korsningspunkten med h\u00f6ger vena iliacalis.<\/p><\/div>\n<div id=\"attachment_7898\" style=\"width: 235px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-rotated.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7898\" class=\"wp-image-7898 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-225x300.jpg 225w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-768x1024.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-1152x1536.jpg 1152w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-640x853.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierenvene-mit-tronc-reno-rachidien-rotated.jpg 1512w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-7898\" class=\"wp-caption-text\">Befriad v\u00e4nster njurvena med tronc r\u00e9no-rachidi\u00e8n &#8211; gul slinga (bl\u00e5 slinga: v\u00e4nster \u00f6vernjurvena, r\u00f6d slinga: v\u00e4nster \u00e4ggstocksvena)<\/p><\/div>\n<div id=\"attachment_7897\" style=\"width: 235px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-rotated.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-7897\" class=\"wp-image-7897 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-225x300.jpg\" alt=\"\" width=\"225\" height=\"300\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-225x300.jpg 225w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-768x1024.jpg 768w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-1152x1536.jpg 1152w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-640x853.jpg 640w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Li-Nierevene-Mit-Rohrprothese-geschutzt-rotated.jpg 1512w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/a><p id=\"caption-attachment-7897\" class=\"wp-caption-text\">PTFE shield around the left renal vein protecting it from the compression from the aorta<br \/>Post-operative measurement of the renal parenchymal perfusion in November 2022 after further decompression of the left renal vein with a PTFE shield in July 2022.<\/p><\/div>\n<p><a href=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Postop-PixelFlux-measurements-in-truncal-ataxia.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-7920 size-medium\" src=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Postop-PixelFlux-measurements-in-truncal-ataxia-300x155.jpg\" alt=\"\" width=\"300\" height=\"155\" srcset=\"https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Postop-PixelFlux-measurements-in-truncal-ataxia-300x155.jpg 300w, https:\/\/scholbach.de\/wp-content\/uploads\/2023\/03\/Postop-PixelFlux-measurements-in-truncal-ataxia.jpg 605w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>I uppr\u00e4tt st\u00e4llning var v\u00e4nster\/h\u00f6gre njurperfusionskvoten 12 % och \u00e4r nu 31 %.<\/p>\n<p>Totalt sett uppn\u00e5ddes en mycket b\u00e4ttre perfusion av den v\u00e4nstra njuren genom operationen, vilket \u00f6kade fl\u00f6desvolymen mot den v\u00e4nstra njuren med 87 %.<\/p>\n<p>Samtidigt kunde inget blodfl\u00f6de genom tronc r\u00e9no-rachidi\u00e8n l\u00e4ngre p\u00e5visas, medan det f\u00f6re operationen hade pumpats cirka 1000 ml\/min via tronc r\u00e9no-rachidi\u00e8n in i epiduralplexus. Detta orsakade en avsev\u00e4rd trycks\u00e4ttning av den cerebrala ryggm\u00e4rgsv\u00e4tskan med en efterf\u00f6ljande session av ryggm\u00e4rgen.<\/p>\n<p>\u00c5ter\u00f6ppnandet av v\u00e4nster njurvena genom att omsluta den med ett PTFE-transplantat gjorde att fl\u00f6det \u00f6ver tronc r\u00e9no-rachidi\u00e8n det kliniska resultatet \u00e4r ett fullst\u00e4ndigt f\u00f6rsvinnande av alla neurologiska symtom hos patienten!<\/p>\n<p>Vi (Prof. Sandmann och jag) tackar patienten f\u00f6r hennes tillst\u00e5nd att publicera denna rapport och hennes videor och s\u00e4rskilt f\u00f6r hennes st\u00e5ndaktighet att inte ge upp hoppet om ett botemedel inf\u00f6r en progressiv, allvarlig sjukdom som inte kunde klarl\u00e4ggas i hennes hemland!<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>","protected":false},"excerpt":{"rendered":"<p>Det finns m\u00e5nga konsekvenser av en ryggm\u00e4rgssammandragning som en f\u00f6ljd av kompression av v\u00e4nster njurvena och v\u00e4nster iliacalvena hos patienter med midline congestion syndrome. De m\u00f6jliga m\u00e5nga kliniska konsekvenserna beskrivs p\u00e5 en separat sida. Jag rapporterar h\u00e4r om en ung kvinna som utvecklade sv\u00e5ra vegetativa symtom, buksm\u00e4rtor, kramper och gynekologiska problem p\u00e5 grund av flera [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"om_disable_all_campaigns":false,"footnotes":""},"class_list":["post-7907","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/pages\/7907","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/comments?post=7907"}],"version-history":[{"count":17,"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/pages\/7907\/revisions"}],"predecessor-version":[{"id":7975,"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/pages\/7907\/revisions\/7975"}],"wp:attachment":[{"href":"https:\/\/scholbach.de\/sv\/wp-json\/wp\/v2\/media?parent=7907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}