title: Medial medullary injury during adenoidectomy.
abstract: We report medullary injury during adenoidectomy in two children who received injections of local anesthetic agents into the operative bed. Initial manifestations included hemiparesis, nystagmus, and ataxia. Magnetic resonance imaging showed hemorrhagic, paramedian medullary lesions in both patients. The mechanism of injury is likely to be injection of fluid into the medulla.
authors.affiliation: Division of Neurology, Department of Radiology, and Division of Otolaryngology, the Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, USA.
authors.forename: P B
authors.initials: PB
authors.lastname: Kang
authors.forename: H K
authors.initials: HK
authors.lastname: Phuah
authors.forename: R A
authors.initials: RA
authors.lastname: Zimmerman
authors.forename: S D
authors.initials: SD
authors.lastname: Handler
authors.forename: L S
authors.initials: LS
authors.lastname: Dure
authors.forename: S G
authors.initials: SG
authors.lastname: Ryan
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000009:adverse effects*; D001259:Ataxia / Q000209:etiology; D001933:Brain Stem / Q000293:injuries*; D002648:Child; D002675:Child, Preschool; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D007267:Injections / Q000009:adverse effects*; D008012:Lidocaine / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D009759:Nystagmus, Pathologic / Q000209:etiology; D010291:Paresis / Q000209:etiology*; D018570:Risk Assessment
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D004837:Epinephrine