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Brachial nerve injury

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https://www.readbyqxmd.com/read/28445364/n-acetylcysteine-prevents-retrograde-motor-neuron-death-after-neonatal-peripheral-nerve-injury
#1
Joseph Catapano, Jennifer Zhang, David Scholl, Cameron Chiang, Tessa Gordon, Gregory H Borschel
BACKGROUND: Neuronal death may be an overlooked and unaddressed component of disability following neonatal nerve injuries, such as obstetric brachial plexus injury. N-acetylcysteine and acetyl-L-carnitine improve survival of neurons after adult nerve injury, but it is unknown whether they improve survival after neonatal injury, when neurons are most susceptible to retrograde neuronal death. The authors' objective was to examine whether N-acetylcysteine or acetyl-L-carnitine treatment improves survival of neonatal motor or sensory neurons in a rat model of neonatal nerve injury...
May 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28435568/early-vessels-exploration-of-pink-pulseless-hand-in-gartland-iii-supracondylar-fracture-humerus-in-children-facts-and-controversies
#2
T Z Tunku-Naziha, Wms Wan-Yuhana, D Hadizie, Muhammad-Paiman, S Abdul-Nawfar, W S Wan-Azman, M S Arman-Z, S Abdul-Razak, M Z Rhendra-Hardy, W I Wan-Faisham
The management of pink pulseless limbs in supracondylar fractures has remained controversial, especially with regards to the indication for exploration in a clinically well-perfused hand. We reviewed a series of seven patients who underwent surgical exploration of the brachial artery following supracondylar fracture. All patients had a non-palpable radial artery, which was confirmed by Doppler ultrasound. CT angiography revealed complete blockage of the artery with good collateral and distal run-off. Two patients were more complicated with peripheral nerve injuries, one median nerve and one ulnar nerve...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28434767/extrarenal-rhabdoid-tumor-presented-with-an-immobile-arm-in-a-one-year-old-boy
#3
Chi-Ting Chung, Yen-Lin Liu, Chien-Jui Cheng, Kevin Li-Chun Hsieh, Min-Lan Tsai, Tai-Tong Wong
Infants with an immobile arm may be easily overlooked in primary care settings. Differential diagnoses include injuries, infections, neuropathies, ischemia and rarely, neoplasms. We report the case of a one-year-old boy with weakness in his left arm after minor trauma with a diagnosis of brachial plexus palsy initially. After rehabilitation for 2months, his weakness progressed to unsteady gait and quadriparesis. MRI revealed a huge solid tumor in the left supraclavicular fossa, which also involved the left brachial plexus, upper thoracic cavity, and left paravertebral space with invasion into the spinal canal...
April 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28429047/therapeutic-outcome-of-ct-guided-radiofrequency-ablation-in-patients-with-osteoid-osteoma
#4
Louis Lassalle, R Campagna, G Corcos, A Babinet, F Larousserie, J Stephanazzi, A Feydy
OBJECTIVE: To assess the long-term outcome of computed tomography-guided radiofrequency ablation (CT-guided RFA) in patients with suspected osteoid osteoma (OO). MATERIALS AND METHODS: Single-center retrospective study. Patients with clinical suspicion and imaging diagnosis of osteoid osteoma were treated by CT-guided RFA using the same device with either a 7- or 10-mm active tip electrode. Specific precautions were applied in case of articular or spinal OO. Patients were contacted by phone to evaluate the long-term outcome in terms of pain, ability to perform daily activities (including sports), and long-term complications...
April 20, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28428928/origin-branching-and-communications-of-the-intercostobrachial-nerve-a-meta-analysis-with-implications-for-mastectomy-and-axillary-lymph-node-dissection-in-breast-cancer
#5
REVIEW
Brandon Michael Henry, Matthew J Graves, Jakub R Pękala, Beatrice Sanna, Wan Chin Hsieh, R Shane Tubbs, Jerzy A Walocha, Krzysztof A Tomaszewski
The intercostobrachial nerve (ICBN), which usually originates from the lateral cutaneous branch of the second intercostal nerve, innervates areas of the axilla, lateral chest, and medial arm. It is at risk for injury during operative procedures that are often used in the management of breast cancer and such injury has been associated with postoperative sensory loss and neuropathic pain, decreasing the quality of life. PubMed, Excerpta Medica Database (EMBASE), ScienceDirect, Google Scholar, China National Knowledge Infrastructure (CNKI), Scientific Electronic Library Online (SciELO), Biosciences Information Service (BIOSIS), and Web of Science were searched comprehensively...
March 17, 2017: Curēus
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#6
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#7
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398932/brachial-arterial-pressure-monitoring-during-cardiac-surgery-rarely-causes-complications
#8
Asha Singh, Bobby Bahadorani, Brett J Wakefield, Natalya Makarova, Priya A Kumar, Michael Zhen-Yu Tong, Daniel I Sessler, Andra E Duncan
BACKGROUND: Brachial arterial catheters better estimate aortic pressure than radial arterial catheters but are used infrequently because complications in a major artery without collateral flow are potentially serious. However, the extent to which brachial artery cannulation promotes complications remains unknown. The authors thus evaluated a large cohort of cardiac surgical patients to estimate the incidence of related serious complications. METHODS: The institutional Society of Thoracic Surgeons Adult Cardiac Surgery Database and Perioperative Health Documentation System Registry of the Cleveland Clinic were used to identify patients who had brachial artery cannulation between 2007 and 2015...
April 10, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28387564/reliability-of-functioning-free-muscle-transfer-and-vascularized-ulnar-nerve-grafting-for-elbow-flexion-in-complete-brachial-plexus-palsy
#9
S M Potter, S I Ferris
We compared outcomes of primary vascularized ulnar nerve grafts from the C5 root neurotizing biceps and brachialis muscles, and gracilis functioning free muscle transfer neurotized by the distal spinal accessory nerve, as a primary or salvage procedure after complete brachial plexus injury. At 45 months, three of eight primary vascularized ulnar nerve graft patients regained grade 4 elbow flexion, while one regained grade 3. All 13 primary gracilis transfer patients regained grade 4 elbow flexion. Four patients with vascularized ulnar nerve grafts failed and subsequently had salvage functioning free muscle transfer procedures resulting in delayed recovery...
April 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28387164/rectus-abdominis-motor-nerves-as-donor-option-for-free-functional-muscle-transfer-a-cadaver-study-and-case-series
#10
Aaron B Mull, Michael C Nicoson, Amy M Moore, Dan A Hunter, Thomas H Tung
BACKGROUND: Current management of brachial plexus injuries includes nerve grafts and nerve transfers. However, in cases of late presentation or pan plexus injuries, free functional muscle transfers are an option to restore function. The purpose of our study was to describe and evaluate the rectus abdominis motor nerves histomorphologically and functionally as a donor nerve option for free functional muscle transfer for the reconstruction of brachial plexus injuries. METHODS: High intercostal, rectus abdominis, thoracodorsal, and medial pectoral nerves were harvested for histomorphometric analysis from 4 cadavers from levels T3-8...
April 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28381927/the-effects-of-minocycline-on-spinal-root-avulsion-injury-in-rat-model
#11
Tan Yew Chin, Sim Sze Kiat, Hizal Ghazali Faizul, Wutian Wu, Jafri Malin Abdullah
BACKGROUND: The neuroprotective role of minocycline in the treatment of brachial plexus injury is controversial. OBJECTIVE: To study the neuroprotective effect of minocycline via different routes in adult Sprague Dawley rats with brachial plexus injury. METHODS: The C7 nerve roots of the animals were avulsed via an anterior extravertebral approach. Traction force was used to transect the ventral motor nerve roots at the preganglionic level...
March 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28362958/outcomes-of-transferring-a-healthy-motor-fascicle-from-the-radial-nerve-to-a-branch-for-the-triceps-to-recover-elbow-extension-in-partial-brachial-plexus-palsy
#12
Leandro Pretto Flores
BACKGROUND: Triceps reinnervation is an important objective to pursue when repairing the brachial plexus for cases with upper roots injuries, and a number of different techniques have been developed in order to restore elbow extension in such cases. OBJECTIVE: To demonstrate the surgical outcomes associated with the technique of transferring a single healthy motor fascicle from the radial nerve of the affected arm to a branch innervating 1 of the 3 heads of the triceps...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28352498/traumatic-cervical-nerve-root-avulsion-with-pseudomeningocele-formation
#13
Ali S Haider, Ian T Watson, Suraj Sulhan, Dean Leonard, Eliel N Arrey, Umair Khan, Phu Nguyen, Kennith F Layton
Cervical nerve root avulsion is a well-documented result of motor vehicle collision (MVC), especially when occurring at high velocities. These avulsions are commonly traction injuries of nerve roots that may be accompanied by a tear in the meninges through the vertebral foramina with associated collections of cerebrospinal fluid (CSF), thereby resulting in a pseudomeningocele. We present a case of a 19-year-old male who experienced an MVC and was brought to the emergency department (ED) with right arm paralysis and other injuries...
February 14, 2017: Curēus
https://www.readbyqxmd.com/read/28340085/prevalence-of-neuropathic-pain-in-patients-with-traumatic-brachial-plexus-injury-a-multicenter-prospective-hospital-based-study
#14
Palma Ciaramitaro, Luca Padua, Grazia Devigili, Eugenia Rota, Stefano Tamburin, Roberto Eleopra, Giorgio Cruccu, Andrea Truini
Objective. : Prevalence and clinical characteristics of neuropathic pain due to traumatic brachial plexus injury. Design. : Observational epidemiological study. Setting. : Hospital-based multicenter study. Subjects. : One hundred seven prospectively enrolled patients with brachial plexus injury. Methods. : All the patients underwent clinical examination and neurophysiological testing for a definitive diagnosis of the brachial plexus lesion...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28318741/neonatal-magnetic-resonance-imaging-without-sedation-correlates-with-injury-severity-in-brachial-plexus-birth-palsy
#15
Andrea S Bauer, Peter Y Shen, Anna E Nidecker, Paul S Lee, Michelle A James
PURPOSE: Which infants with brachial plexus birth palsy (BPBP) should undergo microsurgical plexus reconstruction remains controversial. The current gold standard for the decision for plexus reconstruction is serial clinical examinations, but this approach obviates the possibility of early surgical treatment. We hypothesize that a new technique using 3-dimensional volumetric proton density magnetic resonance imaging (MRI) without sedation can evaluate the severity of BPBP injury earlier than serial clinical examinations...
March 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28316590/rehabilitation-using-guided-cerebral-plasticity-of-a-brachial-plexus-injury-treated-with-intercostal-and-phrenic-nerve-transfers
#16
Lars B Dahlin, Gert Andersson, Clas Backman, Hampus Svensson, Anders Björkman
Recovery after surgical reconstruction of a brachial plexus injury using nerve grafting and nerve transfer procedures is a function of peripheral nerve regeneration and cerebral reorganization. A 15-year-old boy, with traumatic avulsion of nerve roots C5-C7 and a non-rupture of C8-T1, was operated 3 weeks after the injury with nerve transfers: (a) terminal part of the accessory nerve to the suprascapular nerve, (b) the second and third intercostal nerves to the axillary nerve, and (c) the fourth to sixth intercostal nerves to the musculocutaneous nerve...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28293499/proximal-versus-distal-nerve-transfer-for-biceps-reinnervation-a-comparative-study-in-a-rat-s-brachial-plexus-injury-model
#17
Aleksandra M McGrath, Johnny Chuieng-Yi Lu, Tommy Naj-Jen Chang, Frank Fang, David Chwei-Chin Chuang
BACKGROUND: The exact role of proximal and distal nerve transfers in reconstruction strategies of brachial plexus injury remains controversial. We compared proximal with distal nerve reconstruction strategies in a rat model of brachial plexus injury. METHODS: In rats, the C6 spinal nerve with a nerve graft (proximal nerve transfer model, n = 30, group A) and 50% of ulnar nerve (distal nerve transfer model, n = 30, group B) were used as the donor nerves. The targets were the musculocutaneous nerve and the biceps muscle...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28249790/free-functioning-gracilis-muscle-transfer-with-and-without-simultaneous-intercostal-nerve-transfer-to-musculocutaneous-nerve-for-restoration-of-elbow-flexion-after-traumatic-adult-brachial-pan-plexus-injury
#18
Andrés A Maldonado, Michelle F Kircher, Robert J Spinner, Allen T Bishop, Alexander Y Shin
PURPOSE: After complete 5-level root avulsion brachial plexus injury, the free-functioning muscle transfer (FFMT) and the intercostal nerve (ICN) to musculocutaneous nerve (MCN) transfer are 2 potential reconstructive options for restoration of elbow flexion. The aim of this study was to determine if the combination of the gracilis FFMT and the ICN to MCN transfer provides stronger elbow flexion compared with the gracilis FFMT alone. METHODS: Sixty-five patients who underwent the gracilis FFMT only (32 patients) or the gracilis FFMT in addition to the ICN to MCN transfer (33 patients) for elbow flexion after a pan-plexus injury were included...
February 27, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28245732/cortical-plasticity-after-brachial-plexus-injury-and-repair-a-resting-state-functional-mri-study
#19
Dhananjaya I Bhat, B Indira Devi, Komal Bharti, Rajanikant Panda
OBJECTIVE The authors aimed to understand the alterations of brain resting-state networks (RSNs) in patients with pan-brachial plexus injury (BPI) before and after surgery, which might provide insight into cortical plasticity after peripheral nerve injury and regeneration. METHODS Thirty-five patients with left pan-BPI before surgery, 30 patients after surgery, and 25 healthy controls underwent resting-state functional MRI (rs-fMRI). The 30 postoperative patients were subdivided into 2 groups: 14 patients with improvement in muscle power and 16 patients with no improvement in muscle power after surgery...
March 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28245730/peripheral-nervous-system-injury-after-high-dose-single-fraction-image-guided-stereotactic-radiosurgery-for-spine-tumors
#20
Michael D Stubblefield, Katarzyna Ibanez, Elyn R Riedel, Ori Barzilai, Ilya Laufer, Eric Lis, Yoshiya Yamada, Mark H Bilsky
OBJECTIVE The object of this study was to determine the percentage of high-dose (1800-2600 cGy) single-fraction stereotactic radiosurgery (SF-SRS) treatments to the spine that result in peripheral nervous system (PNS) injury. METHODS All patients treated with SF-SRS for primary or metastatic spine tumors between January 2004 and May 2013 and referred to the Rehabilitation Medicine Service for evaluation and treatment of neuromuscular, musculoskeletal, or functional impairments or pain were retrospectively identified...
March 2017: Neurosurgical Focus
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