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Brachial nerve injury

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https://www.readbyqxmd.com/read/28318741/neonatal-magnetic-resonance-imaging-without-sedation-correlates-with-injury-severity-in-brachial-plexus-birth-palsy
#1
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
#2
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
#3
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
#4
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 26, 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
#5
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
#6
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
https://www.readbyqxmd.com/read/28245686/analyzing-cost-effectiveness-of-ulnar-and-median-nerve-transfers-to-regain-forearm-flexion
#7
Arvin R Wali, Charlie C Park, Justin M Brown, Ross Mandeville
OBJECTIVE Peripheral nerve transfers to regain elbow flexion via the ulnar nerve (Oberlin nerve transfer) and median nerves are surgical options that benefit patients. Prior studies have assessed the comparative effectiveness of ulnar and median nerve transfers for upper trunk brachial plexus injury, yet no study has examined the cost-effectiveness of this surgery to improve quality-adjusted life years (QALYs). The authors present a cost-effectiveness model of the Oberlin nerve transfer and median nerve transfer to restore elbow flexion in the adult population with upper brachial plexus injury...
March 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28236051/functional-connectivity-of-motor-cortical-network-in-patients-with-brachial-plexus-avulsion-injury-after-contralateral-cervical-nerve-transfer-a-resting-state-fmri-study
#8
Aihong Yu, Shufeng Wang, Xiaoguang Cheng, Wei Liang, Rongjie Bai, Yunhao Xue, Wenjun Li
INTRODUCTION: The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). METHODS: Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls...
February 24, 2017: Neuroradiology
https://www.readbyqxmd.com/read/28205463/peripheral-nerve-lymphomatosis
#9
Tun-Lin Foo, Ryan Yak, Mark E Puhaindran
Lymphoma involvement of peripheral nerves is rare and it may mimic benign neurogenic tumors or neuropraxic injury. This study presents three patterns of presentations in four patients with neurolymphomatous involvement of their peripheral nerves. We reviewed the clinical records of four patients who underwent exploratory brachial plexus surgery (n = 1), pronator tunnel decompression (n = 1) and peripheral nerve exploration (n = 2) and subsequently found to have neurolymphomatosis (NL). Histological diagnoses were diffuse large B-cell lymphoma (n = 3) and NK/T-cell lymphoma (n = 1)...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28198531/superficial-brachial-artery-a-possible-cause-for-idiopathic-median-nerve-entrapment-neuropathy
#10
Pilani Nkomozepi, Nkosi Xhakaza, Elaine Swanepoel
Nerve entrapment syndromes occur because of anatomic constraints at specific locations in both upper and lower limbs. Anatomical locations prone to nerve entrapment syndromes include sites where a nerve courses through fibro-osseous or fibromuscular tunnels or penetrates a muscle. The median nerve (MN) can be entrapped by the ligament of Struthers; thickened biceps aponeurosis; between the superficial and deep heads of the pronator teres muscle and by a thickened proximal edge of flexor digitorum superficialis muscle...
February 15, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28175932/-nerve-injuries-and-traumatic-lesions-of-the-brachial-plexus-imaging-diagnostics-and-therapeutic-options
#11
D Schwarz, M T Pedro, C Brand, M Bendszus, G Antoniadis
CLINICAL/METHODICAL ISSUE: Traumatic lesions of peripheral nerves and the brachial plexus are feared complications because they frequently result in severe functional impairment. The prognosis is greatly dependent on the correct early diagnosis and the right choice of treatment regimen. It is important to distinguish between open and closed injuries. STANDARD RADIOLOGICAL METHODS: Initial imaging must critically evaluate or prove nerve continuity and is commonly achieved by high-resolution ultrasonography...
February 7, 2017: Der Radiologe
https://www.readbyqxmd.com/read/28149223/successful-nerve-transfers-for-traumatic-brachial-plexus-palsy-in-a-septuagenarian-a-case-report
#12
Parker H Johnsen, Scott W Wolfe
Background: Conventional wisdom and the available literature demonstrate compromised outcomes following nerve reconstruction for traumatic brachial plexus palsy in the elderly. We present a 74-year-old male who was reconstructed with multiple nerve transfers for brachial plexus palsy after a ski accident. Methods: Triceps to axillary nerve transfer, spinal accessory to suprascapular nerve transfer, and ulnar to musculocutaneous nerve transfer were performed 16 weeks post injury. Results: At 11 years post-op, the patient could abduct to 65° and forward flex at M4 strength, limited only by painful glenohumeral arthritis...
December 2016: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28145995/dynamic-alterations-of-the-levels-of-tumor-necrosis-factor-%C3%AE-interleukin-6-and-interleukin-1%C3%AE-in-rat-primary-motor-cortex-during-transhemispheric-functional-reorganization-after-contralateral-seventh-cervical-spinal-nerve-root-transfer-following-brachial-plexus
#13
Ming-Jie Yang, Shuang Li, Chen-Song Yang, Xu-Jia Wang, Shi-Min Chang, Gui-Xin Sun
The transfer of a contralateral healthy seventh cervical spinal nerve root (cC7) to the recipient nerve in the injured side is considered a reliable and effective procedure for restoration of the physiological functions of an injured hand after brachial plexus root avulsion injury (BPAI). Growing evidence shows that the transhemispheric cortical reorganization is induced after cC7 nerve transfer surgery. However, little is known about the underlying molecular mechanism. Proinflammatory cytokines reportedly play an important role in the neural plasticity...
January 31, 2017: Neuroreport
https://www.readbyqxmd.com/read/28132014/obstetrical-brachial-plexus-injury-obpi-canada-s-national-clinical-practice-guideline
#14
Christopher J Coroneos, Sophocles H Voineskos, Marie K Christakis, Achilleas Thoma, James R Bain, Melissa C Brouwers
OBJECTIVE: The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise. SETTING: The guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28126454/ultrasound-guided-retroclavicular-approach-infraclavicular-brachial-plexus-block-for-upper-extremity-emergency-procedures
#15
Josh Luftig, Daniel Mantuani, Andrew A Herring, Arun Nagdev
The America Society of Anesthesiology guidelines recommend multimodal analgesia that combines regional anesthetic techniques with pharmacotherapy to improve peri-procedural pain management and reduce opioid related complications. Commonly performed emergency procedures of the upper extremity such as fracture and dislocation reduction, wound debridement, and abscess incision and drainage are ideal candidates for ultrasound-guided (USG) regional anesthesia of the brachial plexus. However, adoption of regional anesthesia by emergency practitioners has been limited by concerns for potential complications and perceived technical difficulty...
January 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#16
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
https://www.readbyqxmd.com/read/28102168/brachial-plexus-root-avulsion-injury-with-occipital-condyle-fractures-case-study
#17
Alicja Baranowska, Joanna Baranowska, Agata Pydych, Paweł Baranowski
Avulsion injuries of the brachial plexus with occipital condyle fractures are very rare and usually result from motor vehicle accidents. This paper presents an analysis of the case of a 24-year-old male patient who sustained both these injuries in a car accident. Computed tomography revealed a fracture of the right occipital condyle and a magnetic resonance scan showed spinal nerve disruption at the C3-C7 level on the left. The patient underwent conservative treatment.
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28093018/algorithm-for-bionic-hand-reconstruction-in-patients-with-global-brachial-plexopathies
#18
Laura A Hruby, Agnes Sturma, Johannes A Mayer, Anna Pittermann, Stefan Salminger, Oskar C Aszmann
OBJECTIVE Global brachial plexus lesions with multiple root avulsions are among the most severe nerve injuries, leading to lifelong disability. Fortunately, in most cases primary and secondary reconstructions provide a stable shoulder and restore sufficient arm function. Restoration of biological hand function, however, remains a reconstructive goal that is difficult to reach. The recently introduced concept of bionic reconstruction overcomes biological limitations of classic reconstructive surgery to restore hand function by combining selective nerve and muscle transfers with elective amputation of the functionless hand and its replacement with a prosthetic device...
January 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28049512/a-stab-wound-to-the-axilla-illustrating-the-importance-of-brachial-plexus-anatomy-in-an-emergency-context-a-case-report
#19
Diogo Casal, Teresa Cunha, Diogo Pais, Inês Iria, Maria Angélica-Almeida, Gerardo Millan, José Videira-Castro, João Goyri-O'Neill
BACKGROUND: Although open injuries involving the brachial plexus are relatively uncommon, they can lead to permanent disability and even be life threatening if accompanied by vascular damage. We present a case report of a brachial plexus injury in which the urgency of the situation precluded the use of any ancillary diagnostic examinations and forced a rapid clinical assessment. CASE PRESENTATION: We report a case of a Portuguese man who had a stabbing injury at the base of his left axilla...
January 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27999953/the-role-of-magnetic-resonance-imaging-in-the-evaluation-of-peripheral-nerves-following-traumatic-lesion-where-do-we-stand
#20
REVIEW
Oswaldo Ribeiro Marquez Neto, Matheus Silva Leite, Tiago Freitas, Paulo Mendelovitz, Eric Arruda Villela, Iruena Moraes Kessler
BACKGROUND: Peripheral nerve injury is a common and important cause of morbidity and disability in patients who have suffered a traumatic injury, particularly younger people. Various different injuries can result in damage to specific nerves. In patients with multiple trauma, the prevalence of peripheral nerve injury is estimated at 2.8%, but can reach 5% with the inclusion of brachial plexus involvement. Physical examination, as well as the origin and location of the trauma, can indicate the nerve involved and the type of nerve damage...
February 2017: Acta Neurochirurgica
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