brachial plexus syndrome

Spontaneous upper limb muscle haematomas are rare clinical phenomenons, which often go under- or misdiagnosed. They can present management challenges in the context of anticoagulant therapy, especially in the presence of other medical conditions. We present the case of a 52-year-old male with an initially missed presentation of a spontaneous muscle haematoma that progressed and re-presented to the emergency department (ED) with signs of mixed upper limb neuropathy requiring surgical evacuation and an emergency fasciotomy...

BACKGROUND: In low-risk pregnancies, third trimester ultrasound examination is indicated if fundal height measurement and gestational age discrepancy is observed. Despite potential improvement in detection of ultrasound abnormality, prior trials to date on universal third trimester ultrasound examination in low-risk pregnancies, compared to indicated ultrasound examination, have not demonstrated improvement in neonatal or maternal adverse outcomes. OBJECTIVE: The primary objective was to determine if universal third trimester ultrasound examination in low-risk pregnancies could attenuate composite neonatal adverse outcome...

BACKGROUND: There have been no reports on the successful implementation of stellate ganglion block (SGB) in mice. OBJECTIVES: This study aims to investigate a new method for implementing SGB in mice by placing them in a supine position with abducted upper limbs and touching the trachea and sternoclavicular joint with the hand. METHODS: Fifty BABL/C mice, 8-10 weeks, were selected and randomly divided into four groups: control group (n = 5); SGB-R group (n = 15); SGB-L group (n = 15); and SGB-L + R (group n = 15)...

BACKGROUND: The costoclavicular space serves as an alternative approach to the infraclavicular brachial plexus block, and numerous studies in adults have demonstrated promising outcomes for distal upper limb surgery. Blocking the brachial plexus at this level is potentially advantageous because the cords are relatively superficial, located in close proximity to each other and easily identified using ultrasound. AIMS: This study aimed to assess the success rate and feasibility of costoclavicular block in children undergoing unilateral below elbow upper limb surgery...

A crush injury results directly from a crushing force, while crush syndrome, or traumatic rhabdomyolysis, manifests as systemic consequences stemming from the breakdown of muscle cells. Hand crush injuries present intricate challenges involving damage to multiple structures, tissue loss, and potential digit amputation, often caused by high-energy trauma. Each case demands a unique management plan, with the critical decision between limb salvage and amputation. Early intervention to restore vascularity is pivotal for preserving hand function...

The aim of this study was to describe the gross and histopathological features of a neurological syndrome in endangered Western Australian Carnaby's black cockatoos (Zanda laitirostris) that was first observed in 2012. The syndrome, named hindlimb paralysis syndrome in Carnaby's cockatoos (CHiPS), is characterized by annual outbreaks of hindlimb paralysis with occasional loss of deep pain and cloacal tone, typically occurring between January and March. Previous limited investigations suggested a possible toxic aetiology...

BACKGROUND: Parsonage-Turner syndrome (PTS) is an inflammatory condition of the brachial plexus, with more than half of patients presenting a trigger, such as infection or vaccination. Our objective was to synthesize the clinical and paraclinical features, therapeutic responses, and outcomes of PTS post-COVID-19 vaccination. METHODS: We systematically reviewed two databases (LitCOVID and the WHO database on COVID-19) up to January 2024 following a published protocol (OSF registries)...

During the second wave of the COVID-19 pandemic, a young adult presented symptoms that were reported at first evaluation to be a frozen shoulder (adhesive capsulitis). The patient's history, clinical manifestations related to the onset of pain, unilateral weakness, and physical examination led to a physiotherapy referral. Subsequent instrumental investigations showed an idiopathic brachial neuritis known as Parsonage-Turner Syndrome (PTS). Contrary to recent descriptions in the literature, the patient did not experience PTS either after COVID-19 vaccination or after COVID-19 virus infection...

Botulinum toxin (BTX) injections into the musculature surrounding the brachial plexus have been examined as a potential treatment for neurogenic thoracic outlet syndrome (nTOS). This systematic review identified 15 publications, of which one was a randomized controlled trial. BTX injections performed with ultrasound or electromyographic guidance, and with the inclusion of the pectoralis minor muscle, in addition to the anterior and/or middle scalenes, tended to provide greater symptom improvement and may predict response to first rib resection...

Parsonage-Turner Syndrome, or neuralgic amyotrophy, is an acute-onset upper limb and shoulder girdle palsy that can occur in a post-viral, post-surgical or idiopathic setting. There have also been some reported cases of the syndrome occurring following vaccinations. The pathophysiology of neuralgic amyotrophy is not completely understood and many of the commonly used diagnostic imaging modalities we use to try and diagnose this syndrome are inaccurate and misleading. We present the case of a 40-year-old gentleman who presented with acute onset burning pain and fasciculations in his right upper extremity following vaccination with the second dose of the Pfizer-BioNTech COVID-19 vaccine...

Pain that accompanies deafferentation is one of the most mysterious and misunderstood medical conditions. Prevalence rates for the assorted conditions vary considerably but the most reliable estimates are greater than 50% for strokes involving the somatosensory system, brachial plexus avulsions, spinal cord injury, and limb amputation, with controversy surrounding the mechanistic contributions of deafferentation to ensuing neuropathic pain syndromes. Deafferentation pain has also been described for loss of other body parts (e...

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BACKGROUND: At present, some Guillain-Barre syndrome (GBS) patients have a relatively poor prognosis due to the lack of timely diagnosis, and the risk of death is difficult to reduce. At present, the level of clinical diagnosis of GBS is not ideal, and the time of clinical examination and diagnosis is relatively long. How to improve the level of clinical diagnosis, clinical treatment and prognosis of GBS has always been the focus of clinical research of GBS. This study mainly analyzes the application efficacy of limb peripheral nerve ultrasound in the diagnosis, classification and disease assessment of GBS, hoping to supplement the application research of limb peripheral nerve ultrasound in the diagnosis of GBS and provide some reference for the development of clinical diagnosis of GBS...

BACKGROUND: The optimal surgical approach to treat neurogenic thoracic outlet syndrome (nTOS) depends on the individual patient's anatomy as well as the surgeon's experience. The authors present a minimally invasive posterior approach for the resection of a prominent transverse process to reduce local muscular trauma. OBSERVATIONS: A 19-year-old female presented with painful sensations in the right arm and severe fine-motor skill dysfunction in the right hand, each of which had been present for several years...

In Waldenström macroglobulinemia (WM), confirming the presence of Bing-Neel syndrome (BNS) is important because drugs that penetrate the central nervous system (CNS) must be selected. We report the case of a 75-year-old man for whom tirabrutinib, a second-generation Bruton's tyrosine kinase inhibitor (BTKi), was useful in treating WM-associated peripheral neuropathy (PN) with BNS. Numbness and muscle weakness in the fingers occurred three years after the initial treatment of WM. WM-associated PN due to demyelinating disease was diagnosed based on the results of a nerve conduction study and magnetic resonance imaging showing bilateral symmetric swelling of the brachial plexus...

Neurogenic thoracic outlet syndrome results from compression of the brachial plexus. The symptoms are mainly pain, upper-limb weakness and paresthesia. Management always starts with a rehabilitation program, but failure of rehabilitation may necessitate surgery. In practice, we observed that several patients developed secondary distal nerve entrapment in the months following surgery, with no preoperative compression. We aimed to assess the occurrence of distal nerve entrapment after surgery for neurogenic thoracic outlet syndrome in a retrospective cohort study...

BACKGROUND: Neurogenic Thoracic Outlet Syndrome (nTOS) describes a complex of symptoms caused by the compression of neural structures at the upper thoracic outlet. Typical symptoms include pain, numbness and motor weakness of the affected extremity. The incidence of nTOS is 2-3 per 100,000 and is highest between the ages of 25 and 40. There are only a few studies evaluating the surgical outcomes of nTOS in adolescent patients. In particular, there is a lack of long-term data. MATERIALS AND METHODS: In a retrospective study of nTOS cases receiving surgical treatment in our clinic between 2002 and 2021, eight patients between 15 and 18 years of age were included...

PURPOSE: This study aimed to assess both nonsurgical and operative treatment outcomes of pediatric and young adult patients with thoracic outlet syndrome (TOS) at a tertiary care pediatric hospital. METHODS: A retrospective chart review of patients diagnosed with TOS, who were seen between January 2010 and August 2022 at a tertiary care pediatric hospital, was conducted. Collected pre- and postoperative data included symptoms, provocative testing (ie, Roo's, Wright's, and Adson's tests), participation in sports or upper-extremity activities, additional operations, and surgical complications...

INTRODUCTION: This systematic review and meta-analysis aimed to assess the efficacy and safety of interscalene brachial plexus block (ISB) techniques in upper limb and shoulder surgeries. EVIDENCE ACQUISITION: We conducted a comprehensive search of PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, Medline, and Scopus databases up to May 14th , 2023. We employed a search strategy involving keywords such as "brachial plexus block," "interscalene brachial plexus block," "ISB," "extrafascial," and "intrafascial," without applying search restrictions or filters...

Thoracic outlet syndrome (TOS) is a pathology caused by compression on the neurovascular bundle by the first rib. The treatment of TOS is conservative management by analgesia and physiotherapy; however, if there is no response to conservative treatment, surgery is indicated through thoracic outlet decompression by first rib resection. Several surgical techniques are available, including supraclavicular, transaxillary, and transthoracic first rib resection approaches. The transaxillary approach provides better visualization on the neurovascular bundle and, thus, is sometimes the preferred method of treatment...