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brachial plexus syndrome

Kevin T Jubbal, Dmitry Zavlin, Joshua D Harris, Shari R Liberman, Anthony Echo
BACKGROUND: Thoracic outlet syndrome (TOS) is a complex entity resulting in neurogenic or vascular manifestations. A wide array of procedures has evolved, each with its own benefits and drawbacks. The authors hypothesized that treatment of TOS with first rib resection (FRR) may lead to increased complication rates. METHODS: A retrospective case control study was performed on the basis of the National Surgical Quality Improvement Program database from 2005 to 2014...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Amgad Hanna, Larry O'Neil Bodden, Gabriel R L Siebiger
Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus...
January 2018: Journal of Brachial Plexus and Peripheral Nerve Injury
Silvia Duong, Daniela Bravo, Keith J Todd, Roderick J Finlayson, De Q Tran
PURPOSE: Although multiple treatments have been advocated for complex regional pain syndrome (CRPS), the levels of supportive evidence are variable and sometimes limited. The purpose of this updated review is to provide a critical analysis of the evidence pertaining to the treatment of CRPS derived from recent randomized-controlled trials (RCTs). SOURCE: The MEDLINE, EMBASE, Psychinfo, and CINAHL databases were searched to identify relevant RCTs conducted on human subjects and published in English between 1 May 2009 and 24 August 2017...
February 28, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
INTRODUCTION: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to re-operate is rare. We report our experience with re-operation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, re-operation, and final outcomes...
February 22, 2018: Annals of Vascular Surgery
Darryl B Sneag, Schneider K Rancy, Scott W Wolfe, Susan C Lee, Vivek Kalia, Steve K Lee, Joseph H Feinberg
INTRODUCTION: The aim of this study was to characterize lesion distribution in Parsonage-Turner Syndrome (PTS) using high-resolution MRI. METHODS: The MRIs of 27 patients with clinically confirmed PTS were reviewed. Two radiologists independently evaluated the brachial plexus proper, side and terminal plexus branches, and more distal, upper extremity nerves. RESULTS: All patients had at least 1 clinically involved nerve. On MRI, the plexus appeared normal in 24/27 patients; in 3 others, signal hyperintensity was seen immediately proximal to the take-off of abnormal side or terminal branch nerves...
February 20, 2018: Muscle & Nerve
Rashmi Datta, Jyotsna Agrawal, Amit Sharma, Vikram Singh Rathore, Shivesh Datta
Background and Aims: The effect of stellate ganglion blocks (SGBs) was examined in complex regional pain syndromes (CRPS) of the upper body. Material and Methods: A total of 287 SGB were given to patients with documented CRPS on medications. Spontaneous and provoked pain assessment was done with numeric pain rating scale (NPRS). The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and range of motion (ROM) was recorded before and after each blockade...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Joseph M White, Andrew J Soo Hoo, Scott R Golarz
Background: Neurogenic thoracic outlet syndrome (nTOS) is a relatively common disorder and often affects younger, physically active populations. The modern American military is a population at risk for the development of nTOS given the intense physical training requirements. The purpose of this study is to determine functional recovery in the active duty military population resulting in full, unrestricted return-to-duty status following supraclavicular thoracic outlet decompression with partial first rib resection, partial anterior scalenectomy, and brachial plexus neurolysis...
January 1, 2018: Military Medicine
Robert R Hagan, Joseph A Ricci, Kyle R Eberlin
Thoracic outlet syndrome (TOS) is a cause of upper extremity and shoulder dysfunction. TOS can present with a wide range of symptoms due to compression of the brachial plexus or its branches during their passage through the cervicothoracobrachial region or scalene triangle. There are three types of TOS: arterial, venous, and neurogenic. Neurogenic TOS (nTOS) is by far the most frequent type and represents more than 95% of all cases. Historically, surgical intervention for all types of TOS has evolved based on the treatment for a vascular etiology and has typically included a first rib resection...
February 2, 2018: Journal of Reconstructive Microsurgery
Hosseinali Abdolrazaghi, Azade Riyahi, Morteza Taghavi, Pezhman Farshidmehr, Abolfazl Mohammadbeigi
We report a rare case of multiple hereditary exostosis where patient presented with bilateral base of neck exostoses with concurrent compression of brachial plexus and subclavian artery and vein. The patient was a young 26-year-old woman with chief complaints of pain in the left upper extremity, paresthesia in the left ring and little finger, and weakness in hand movement and grip. On referral, history, physical examination, radiological imaging, and electrodiagnostic tests evaluated the patient. Due to severe pain and disability in performing routine activities, surgical intervention was necessary...
January 2018: Annals of Cardiac Anaesthesia
Shangming Zhang, Lucy Q Zhang, Megan Wright, David R Gater
Neuralgic amyotrophy (NA) is a neurological syndrome of unknown etiology primarily affecting the brachial plexus. We are reporting an unusual case of acute bilateral NA that was possibly secondary to Lyme disease. The patient demonstrated significant functional gains and was discharged home after 2 weeks of inpatient rehabilitation, supporting the role of inpatient rehabilitation in acute NA. In this report, we discussed the diagnosis, electrodiagnostic progression, pain management, goals for inpatient rehabilitation and overall prognosis of NA...
December 20, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
J A W Teijink, N Pesser, R van Grinsven, H van Suijlekom, M R H M van Sambeek, B F L van Nuenen
Neurogenic thoracic outlet syndrome (nTOS) is a type of thoracic outlet syndrome (TOS) where compression of the brachial plexus is responsible for development of upper-extremity, head and neck symptoms. We present a 16-year-old and a 34-year-old patient with nTOS. Diagnosis in both cases was done by following the recently published reporting standards for (n)TOS. After this multidisciplinary diagnostic work-up we performed a transaxillary thoracic outlet decompression (TOD). Due to lack of literature, difficult nomenclature and complexity of diagnosis and treatment, diagnosis of nTOS is often delayed...
2017: Nederlands Tijdschrift Voor Geneeskunde
Xufeng Pan, Chang Gu, Rui Wang, Heng Zhao, Jun Yang, Jianxin Shi
Background: To review our experience of transmanubrial osteomuscular sparing approach (TMA) for resection of various lesions involving the thoracic inlet and to prove the feasibility and safety of the approach. Methods: Retrospective review of 58 consecutive cases, from April 2007 to January 2016, with surgical resection of cervico-thoracic lesions via TMA. Results: There were 22 neurogenic tumors, 21 bronchogenic tumors, and 15 other cases in the study...
September 2017: Journal of Thoracic Disease
Ingrid J T Herraets, H Stephan Goedee, Johan A Telleman, Jan-Thies H van Asseldonk, Leo H Visser, W Ludo van der Pol, Leonard H van den Berg
OBJECTIVE: Wartenberg's migrant sensory neuritis (WMSN) is a rare, patchy, pure sensory neuropathy of unknown etiology. High-resolution ultrasonography (HRUS) is an emerging diagnostic technique for neuropathies, but it has not been applied in WMSN. In this study we aimed to determine HRUS abnormalities in WMSN. METHODS: We performed a case-control study of 8 newly diagnosed patients with WMSN and 22 treatment-naive disease controls (16 patients with pure sensory axonal neuropathy and 6 with pure sensory chronic inflammatory demyelinating polyneuropathy (CIDP) or Lewis-Sumner syndrome (LSS))...
January 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Beatriz Mansilla, Alberto Isla, María Román de Aragón, Borja Hernández, Pablo García Feijoo, Alexis Palpán Flores, Susana Santiago
OBJECTIVE: Intraneural cysts are benign lesions located within the epineurium of some peripheral nerves and their aetiopathogenesis is controversial. Most are located at the level of the lower limbs. In the upper limbs, the most frequently affected nerve is the ulnar nerve. Suprascapular nerve entrapment syndrome due to the formation of an intraneural cyst is rare. In this article, we show a new case and perform a literature review of intraneural cysts located in the suprascapular nerve...
November 20, 2017: Neurocirugía
Bixin Zheng, Li Song, Hui Liu
The post-amputation (pain) syndrome, including stump pain, phantom limb sensation, and phantom limb pain is common but difficult to treat. Refractory stump pain in the syndrome is an extremely challenging and troublesome clinical condition. Patients respond poorly to drugs, nerve blocks, and other effective treatments like spinal cord stimulation and surgery. Pulsed radiofrequency (PRF) technique has been shown to be effective in reducing neuropathic pain. This report describes a patient with persistent and refractory upper limb stump pain being successfully relieved with PRF of brachial plexus under ultrasound guidance after a 6-month follow-up period, suggesting that PRF may be considered as an alternative treatment for refractory stump-neuroma pain...
2017: Journal of Pain Research
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
Aysun Ertikin, Güldeniz Argun, Mesut Mısırlıoğlu, Murat Aydın, Murat Arıkan, Nihal Kadıoğulları
Objective: In this study, we aimed to compare axillary brachial plexus block using the two-injection and four-injection techniques assisted with ultrasonography (USG) and nerve stimulator in patients operated for carpal tunnel syndrome with articaine. To evaluate which technique is more effective, we compared the onset time, effectiveness, and duration of block procedures, patient satisfaction, adverse effect of the drug, and complication rates of the motor and sensory blocks. Methods: Sixty patients were randomly divided into two groups...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
Kamran Aghayev, Ozcan Ciklatekerlio
BACKGROUND: There are several surgical treatment options for neurogenic thoracic outlet syndrome (n-TOS). However, the first rib has been shown to be the common denominator of all TOS forms and the degree of its resection has been shown to correlate with the long-term success. OBJECTIVE: To demonstrate the feasibility of posterior upper rib excision (PURE) and report early outcomes. METHODS: Nine patients presented with signs and symptoms of n-TOS...
July 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
Nontaphon Piyawattanametha, Bunpot Sitthinamsuwan, Pramote Euasobhon, Nantthasorn Zinboonyahgoon, Pranee Rushatamukayanunt, Sarun Nunta-Aree
BACKGROUND: Chronic pain is a disabling condition that adversely affects patient quality of life. The dorsal root entry zone lesioning procedure (DREZotomy) is a modality used to treat intractable pain caused by insults to neural structures. This study aimed to investigate the efficacy of and the factors that determine the outcome of microsurgical DREZotomy (MDT). METHOD: All consecutive patients who underwent MDT for treatment of intractable pain during September 2008 to December 2016 were enrolled...
December 2017: Acta Neurochirurgica
Daniel Schwarz, Henrich Kele, Moritz Kronlage, Tim Godel, Tim Hilgenfeld, Martin Bendszus, Philipp Bäumer
OBJECTIVE: The aim of this study was to assess the imaging appearance and diagnostic value of plexus and peripheral nerve magnetic resonance neurography (MRN) in cervical radiculopathy. MATERIALS AND METHODS: This prospective study was approved by our institutional ethics committee and written informed consent was obtained from all participants. A total of 24 patients were included with a diagnosis of cervical radiculopathy based on clinical examination, supporting electrophysiological examinations and spinal imaging consistent with the clinical syndrome...
October 2, 2017: Investigative Radiology
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