Magnetic resonance neurography for the diagnosis of extrapelvic sciatic endometriosis
Objective - To illustrate magnetic resonance neurography findings of severe sciatic injury and muscle denervation related to deep gluteal endometriosis at the sciatic notch. - Design - Case report. - Setting - Academic teaching hospital. - Patient(s) - A 39-year-old woman with a 4-year history of sc...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
10 February 2010
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| In: |
Fertility and sterility
Year: 2010, Volume: 94, Issue: 1, Pages: 351.e11-351.e14 |
| ISSN: | 1556-5653 |
| DOI: | 10.1016/j.fertnstert.2009.12.046 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.fertnstert.2009.12.046 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0015028209042952 
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| Author Notes: | Mirko Pham, Claudia Sommer, Carsten Wessig, Camelia-Maria Monoranu, José Pérez, Guido Stoll, and Martin Bendszus |
| Summary: | Objective - To illustrate magnetic resonance neurography findings of severe sciatic injury and muscle denervation related to deep gluteal endometriosis at the sciatic notch. - Design - Case report. - Setting - Academic teaching hospital. - Patient(s) - A 39-year-old woman with a 4-year history of sciatica related to the menstrual cycle. - Intervention(s) - Surgical exploration of the sciatic notch for diagnostic confirmation, external neurolysis of the sciatic nerve, and eventual pharmacologic treatment. - Main Outcome Measure(s) - Magnetic resonance neurography imaging revealed severe neuropathic injury and muscle denervation related to a deep infiltrative endometriotic focus at the sciatic notch, which was confirmed histologically on surgical exploration. Detailed electrodiagnostic and clinical neurologic examinations at initial presentation and during follow-up were obtained for further assessment of nerve degeneration, muscle denervation, and clinical recovery. - Result(s) - Initial gynecologic and eventual laparoscopic evaluation on persisting complaints were without pathological findings. When a progressive weakness of the leg was noted, magnetic resonance neurography revealed a severe axonal damage to the sciatic nerve and denervation of distal target muscles related to a diffuse infiltrative lesion at the sciatic notch. On surgical exploration, extragenital endometriosis was confirmed histologically. Considerable improvement in pain and strength occurred after pharmacologic therapy with a GnRH analogue. - Conclusion(s) - This is the first report to describe imaging findings of magnetic resonance neurography in severe neuropathic injury of the sciatic nerve and subsequent muscle denervation related to a deep infiltrative gluteal endometriotic focus. |
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| Item Description: | Gesehen am 03.05.2023 |
| Physical Description: | Online Resource |
| ISSN: | 1556-5653 |
| DOI: | 10.1016/j.fertnstert.2009.12.046 |