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Brachial nerve injury

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https://www.readbyqxmd.com/read/28102168/brachial-plexus-root-avulsion-injury-with-occipital-condyle-fractures-case-study
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/27913804/restoration-of-shoulder-abduction-in-brachial-plexus-avulsion-injuries-with-double-neurotization-from-the-spinal-accessory-nerve-a-report-of-13-cases
#5
K W S J Huan, J S W Tan, S H Tan, L C Teoh, F C Yong
: In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries...
December 1, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27911674/cross-sectional-imaging-anatomy-and-pathologic-conditions-affecting-thoracic-nerves
#6
Kristopher W Cummings, Sreevathsan Sridhar, Matthew S Parsons, Cylen Javidan-Nejad, Sanjeev Bhalla
While in many cases they are not directly visualized, awareness of the thoracic nerves and their courses at cross-sectional imaging is important for radiologists. An understanding of the normal function of each nerve is important, as many patients present with neurologic signs and symptoms that can be used to reinforce search patterns for disease and detection of supportive radiologic abnormalities. In the case of primary neoplasms, understanding the expected presence of a nerve in the location of a mass can enhance and improve the accuracy of differential diagnoses...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27904475/transforming-growth-factor-beta-1-a-cytokine-with-regenerative-functions
#7
REVIEW
Wale Sulaiman, Doan H Nguyen
We review the biology and role of transforming growth factor beta 1 (TGF-β1) in peripheral nerve injury and regeneration, as it relates to injuries to large nerve trunks (i.e., sciatic nerve, brachial plexus), which often leads to suboptimal functional recovery. Experimental studies have suggested that the reason for the lack of functional recovery resides in the lack of sufficient mature axons reaching their targets, which is a result of the loss of the growth-supportive environment provided by the Schwann cells in the distal stump of injured nerves...
October 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27891243/a-comprehensive-musculoskeletal-and-peripheral-nervous-system-assessment-of-war-related-bilateral-upper-extremity-amputees
#8
Mostafa Allami, Batool Mousavi, Mehdi Masoumi, Ehsan Modirian, Hadi Shojaei, Fatemeh Mirsalimi, Maryam Hosseini, Pirouz Pirouzi
BACKGROUND: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation. METHODS: The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb...
2016: Military Medical Research
https://www.readbyqxmd.com/read/27866248/microanatomy-of-the-brachial-plexus-roots-and-its-clinical-significance
#9
Li-Yuan Zhong, Ai-Ping Wang, Li Hong, Sheng-Hua Chen, Xian-Qin Wang, Yun-Cheng Lv, Tian-Hong Peng
PURPOSE: To provide the anatomical basis of brachial plexus roots for the diagnosis and treatment of brachial plexus root avulsion injury. METHODS: The morphological features of brachial plexus roots were observed and measured on 15 cervicothoracic spine of adult cadavers. The relationship of brachial plexus nerve roots and the surrounding tissues also were observed, as well as the blood supply of anterior and posterior roots of the brachial plexus. RESULTS: Origination of the nerve roots in the dorsal-ventral direction from the midline was fine-tuned at each level along the spinal cord...
November 19, 2016: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/27858573/multiple-nerve-and-tendon-transfers-a-new-strategy-for-restoring-hand-function-in-a-patient-with-c7-t1-brachial-plexus-avulsions
#10
Bin Xu, Zhen Dong, Cheng-Gang Zhang, Yu-Dong Gu
C7-T1 brachial plexus palsies result in a loss of finger motion and hand function. The authors have observed that finger flexion motion can be recovered after a brachialis motor branch transfer. However, finger flexion strength after this procedure merely corresponds to Medical Research Council Grades M2-M3, lowering the grip strength and practical value of the reconstructed hand. Therefore, they used 2 donor nerves and accomplished double nerve transfers for stronger finger flexion. In a patient with a C7-T1 brachial plexus injury, they transferred the pronator teres branch to the anterior interosseous nerve and the brachialis motor branch to the flexor digitorum superficialis branch for reinnervation of full finger flexors...
November 18, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27833275/passage-through-the-carotid-sheath-an-alternative-path-to-the-pre-spinal-route-for-direct-repair-of-contralateral-c7-to-the-lower-trunk-in-total-brachial-plexus-root-avulsion-injury
#11
Piyush Bhupendra Doshi, Yogesh Chimanbhai Bhatt
CONTEXT: In surgical management of global brachial plexus injuries, direct repair of contralateral C7 (cC7) to the anterior division of the lower trunk, can produce good extrinsic finger flexion. The pitfalls associated with the pre-spinal passage have, perhaps, proved to be a deterrent for using this technique routinely. AIMS: The aim of this study is to demonstrate an alternative to pre-spinal route for cC7 transfer in brachial plexus avulsion injuries. METHODS: We noted that the mobilised lower trunk, which reaches the level of the scalenus anterior by passage deep to the clavicle, can be brought to the suprasternal notch when brought out from below the clavicle...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27833273/debates-to-personal-conclusion-in-peripheral-nerve-injury-and-reconstruction-a-30-year-experience-at-chang-gung-memorial-hospital
#12
David Chwei-Chin Chuang
Significant progress has been achieved in the science and management of peripheral nerve injuries over the past 40 years. Yet there are many questions and few answers. The author, with 30 years of experience in treating them at the Chang Gung Memorial Hospital, addresses debates on various issues with personal conclusions. These include: (1) Degree of peripheral nerve injury, (2) Timing of nerve repair, (3)Technique of nerve repair, (4) Level of brachial plexus injury,(5) Level of radial nerve injury,(6) Traction avulsion amputation of major limb, (7) Proximal Vs distal nerve transfers in brachial plexus injuries and (8) Post paralysis facial synkinesis...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27830921/post-operative-physical-therapy-program-for-latissimus-dorsi-and-teres-major-tendons-transfer-to-rotator-cuff-in-children-with-obstetrical-brachial-plexus-injury
#13
Yasser A Safoury, Mohamed Eldesoky, Enas E Abutaleb, Mohamed Raafat, Ahmed M Gaber
BACKGROUND: The transfer latissimus dorsi and teres major tendons to rotator cuff have been developed to rebalance the muscular dysfunction and improve shoulder range of motion in children with obstetrical brachial plexus palsy (OBPP). No previous study reported the ideal postoperative physical therapy program for these cases. AIM: The aim of the present study was to design appropriate postoperative physical therapy (PT) program after latissimus dorsi and teres major tendons transfer to rotator cuff in OBPP to improve upper limb function...
November 10, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27830483/variations-in-the-innervation-of-the-long-head-of-the-triceps-brachii-a-cadaveric-investigation
#14
Alexandra J Erhardt, Bennett Futterman
BACKGROUND: Some leading anatomy texts state that all three heads of the triceps brachii are innervated by the radial nerve. The posterior cord of the brachial plexus bifurcates to terminate as the radial and axillary nerves. Studies have noted the presence of axillary innervation to the long head of the triceps brachii muscle, patterns different from the classic exclusive radial nerve supply. An understanding of these variations may assist the clinician in the assessment of shoulder weakness and in preoperative and operative planning of radial and axillary neuropathies...
January 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27823370/peripheral-neuropathy-of-a-forelimb-in-horses-27-cases-2000-2013
#15
Anne-Laure Emond, Lélia Bertoni, Maeva Seignour, Virginie Coudry, Jean-Marie Denoix
OBJECTIVE To describe the clinical features, diagnostic procedures, management, and outcome of horses with peripheral neuropathy of a forelimb. DESIGN Retrospective case series. ANIMALS 27 horses. PROCEDURES Records from 2000 to 2013 were reviewed to identify horses with peripheral neuropathy of a forelimb. Horses were grouped as having predominant lesions of a suprascapular nerve, axillary nerve, or radial nerve (alone or in association with other brachial plexus nerves) on the basis of physical examination and diagnostic imaging findings...
November 15, 2016: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/27803228/a-quantitative-assessment-of-the-functional-recovery-of-flexion-of-the-elbow-after-nerve-transfer-in-patients-with-a-brachial-plexus-injury
#16
T J Quick, A K Singh, M Fox, M Sinisi, A MacQuillan
AIMS: Improvements in the evaluation of outcome after nerve transfers are required. The assessment of force using the Medical Research Council (MRC) grades (0 to 5) is not suitable for this purpose. A ceiling effect is encountered within MRC grade 4/5 rendering this tool insensitive. Our aim was to show how the strength of flexion of the elbow could be assessed in patients who have undergone a re-innervation procedure using a continuous measurement scale. METHODS: A total of 26 patients, 23 men and three women, with a mean age of 37...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27801698/magnetic-resonance-neurographic-and-clinical-long-term-results-after-oberlin-s-transfer-for-adult-brachial-plexus-injuries
#17
Florian S Frueh, Michael Ho, Andreas Schiller, Pascal Ducommun, Andrei Manoliu, Gustav Andreisek, Maurizio Calcagni, Pietro Giovanoli
The primary goal of the surgical treatment of upper brachial plexus injuries is to restore active elbow flexion. Accordingly, Oberlin's transfer has been frequently performed since 1994 and has influenced the development of other nerve transfers. However, the window of opportunity for nerve transfers remains a subject of controversy. The objective of this study was to assess magnetic resonance (MR) neurographic, clinical and electrophysiological long-term results after Oberlin's transfer. For this purpose, we performed a retrospective follow-up study...
January 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27787271/bipolar-transfer-of-latissimus-dorsi-myocutaneous-flap-for-restoration-of-elbow-flexion-in-late-traumatic-brachial-plexus-injury-evaluation-of-13-cases
#18
Ahmed Abo-Hashem Azab, Mohammad Salah Alsabbahi
BACKGROUND: Restoration of elbow flexion following traumatic brachial plexus injury represents a great challenge to the reconstructive surgeons. Functional muscle transfers come next to the sophisticated types of nerve surgery in this area. Many transfers are well known for restoration of elbow flexion; bipolar or unipolar latissimus dorsi, triceps brachii, sternocleidomastoid, pectoralis major, and Steindler flexorplasty. OBJECTIVE: Evaluation of the outcome of bipolar transfer of latissimus dorsi myocutaneous flap when used to restore elbow flexion in late traumatic brachial plexus injury...
October 27, 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27783836/the-present-and-future-for-peripheral-nerve-regeneration
#19
Georgios N Panagopoulos, Panayiotis D Megaloikonomos, Andreas F Mavrogenis
Peripheral nerve injury can have a potentially devastating impact on a patient's quality of life, resulting in severe disability with substantial social and personal cost. Refined microsurgical techniques, advances in peripheral nerve topography, and a better understanding of the pathophysiology and molecular basis of nerve injury have all led to a decisive leap forward in the field of translational neurophysiology. Nerve repair, nerve grafting, and nerve transfers have improved significantly with consistently better functional outcomes...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27782162/diagnostic-value-and-surgical-implications-of-the-3d-dw-ssfp-mri-on-the-management-of-patients-with-brachial-plexus-injuries
#20
Ben-Gang Qin, Jian-Tao Yang, Yi Yang, Hong-Gang Wang, Guo Fu, Li-Qiang Gu, Ping Li, Qing-Tang Zhu, Xiao-Lin Liu, Jia-Kai Zhu
Three-dimensional diffusion-weighted steady-state free precession (3D DW-SSFP) of high-resolution magnetic resonance has emerged as a promising method to visualize the peripheral nerves. In this study, the application value of 3D DW-SSFP brachial plexus imaging in the diagnosis of brachial plexus injury (BPI) was investigated. 33 patients with BPI were prospectively examined using 3D DW-SSFP MR neurography (MRN) of brachial plexus. Results of 3D DW-SSFP MRN were compared with intraoperative findings and measurements of electromyogram (EMG) or somatosensory evoked potentials (SEP) for each injured nerve root...
October 26, 2016: Scientific Reports
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