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brachial plexus lesions

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https://www.readbyqxmd.com/read/28993994/efficacy-and-factors-determining-the-outcome-of-dorsal-root-entry-zone-lesioning-procedure-drezotomy-in-the-treatment-of-intractable-pain-syndrome
#1
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...
October 9, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28989239/scarring-of-the-c8-t1-roots-with-partial-avulsion-in-situ-in-total-obstetric-brachial-plexus-palsy
#2
Mohammad M Al-Qattan, Amel A F El-Sayed
BACKGROUND: Primary exploration of the brachial plexus in infants with obstetric palsy may reveal scarring of the lower roots with evidence of partial avulsion-in-situ. As we have been treating this lesion by neurolysis only, we aimed to investigate the recovery of hand function following such approach. METHODS: A series of 14 cases of total obstetric palsy with with evidence of partial avulsion-in-situ of the lower roots were included. All lesions were treated by neurolysis only (with no neurotization of the lower roots)...
2017: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28984513/fascicular-shifting-a-novel-technique-to-overcome-large-nerve-defects
#3
Maria Hader, Matthias E Sporer, Aidan D Roche, Ewald Unger, Konstantin D Bergmeister, Robert Wakolbinger, Oskar C Aszmann
OBJECTIVE Over the last decade, a number of authors have investigated the utility of different biological and synthetic matrices as alternatives to conventional nerve grafts. However, the autologous nerve graft remains the gold standard, even though it often involves using a pure sensory nerve to reconstruct a mixed or even a pure motor nerve. Furthermore, limited donor sites often necessitate a significant mismatch of needed nerve tissue, especially for large proximal nerve defects such as brachial plexus lesions...
October 6, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28982108/intraoperative-neurophysiological-monitoring-motor-and-somatosensory-evoked-potentials-in-dorsal-root-entry-zone-lesioning-for-brachial-plexus-avulsion-pain
#4
Byung-Chul Son, Jin-Gyu Choi, Sang-Woo Ha, Deog-Ryeong Kim
AIMS: To address the feasibility and importance of intraoperative neurophysiological monitoring (IONM) in dorsal root entry zone (DREZ) lesioning for brachial plexus avulsion pain. METHODS: Muscle motor evoked potential (mMEP) and somatosensory evoked potential (SSEP) were applied during DREZ lesioning for brachial plexus avulsion pain. RESULTS: IONM of mMEPs and SSEPs was feasible for monitoring of the spinal cord during DREZ lesioning. With the exception of 3 unrecordable mMEPs in ipsilateral arms, mMEPs were preserved and referenced to look for changes according to lesioning in 6 upper extremities (66...
October 6, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28976477/diagnostic-value-of-magnetic-resonance-neurography-in-cervical-radiculopathy-plexus-patterns-and-peripheral-nerve-lesions
#5
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
https://www.readbyqxmd.com/read/28944700/participation-restrictions-among-adolescents-and-adults-with-neonatal-brachial-plexus-palsy-the-patient-perspective
#6
Menno van der Holst, Jeroen Groot, Duco Steenbeek, Willem Pondaag, Rob Ghh Nelissen, Thea Pm Vliet Vlieland
PURPOSE: To examine the impact of neonatal brachial plexus palsy (NBPP) on societal participation of adolescents and adults. METHODS: This cross-sectional study was conducted among patients with NBPP, aged ≥16 years, who had visited our NBPP clinic. Patients completed questions on the influence of NBPP on their choices regarding education/work and their work-performance, the Impact on Participation/Autonomy questionnaire and the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P)...
September 24, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28927209/intraoperative-imaging-in-traumatic-peripheral-nerve-lesions-correlating-histologic-cross-sections-with-high-resolution-ultrasound
#7
S Shelby Burks, Iahn Cajigas, Jean Jose, Allan D Levi
BACKGROUND: Intraoperative ultrasound (US) has been used as a guide during surgery to better identify deep neuroanatomical structures. OBJECTIVE: To correlate histologic cross-sections from nerve samples taken at the time of surgery with axial, high-resolution US images at similar locations and validate this important tool for intraoperative guidance in nerve surgery. METHODS: Three subjects undergoing nerve repair procedures after traumatic nerve injuries were enrolled prospectively...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28884109/brachial-plexus-injury-secondary-to-pseudoaneurysm-of-axillary-artery-after-glenohumeral-dislocation-case-report
#8
Douglas Ribas Schumann, Mauro José Superti, Felipe Candido Seyboth, Gabriella Eduarda Jacomel
Lesions of the axillary artery and consequent compression of the brachial plexus are extremely rare in patients with glenohumeral dislocation and may have greatly varying clinical manifestations. This joint is one of the most affected by dislocation in the human body, accounting for approximately 45% of cases. Less than 1% of patients with shoulder dislocation have vascular complications; however, when there is damage in the axillary artery, the incidence of associated brachial plexus injury is 27% to 44%. The authors report on a case of brachial plexus compression by an axillary artery pseudoaneurysm after a glenohumeral dislocation, aiming to highlight the existence of this association, in order to make an early diagnosis and avoid serious complications, such as neurologic injury...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28844723/cocontraction-measured-with-short-range-stiffness-was-higher-in-obstetric-brachial-plexus-lesions-patients-compared-to-healthy-subjects
#9
Galia V Anguelova, Erwin de Vlugt, Alistair N Vardy, Erik W van Zwet, J Gert van Dijk, Martijn J A Malessy, Jurriaan H de Groot
We suggest short range stiffness (SRS) at the elbow joint as an alternative diagnostic for EMG to assess cocontraction. Elbow SRS is compared between obstetric brachial plexus lesion (OBPL) patients and healthy subjects (cross-sectional study design). Seven controls (median 28years) and five patients (median 31years) isometrically flexed and extended the elbow at rest and three additional torques [2.1,4.3,6.4Nm] while a fast stretch stimulus was applied. SRS was estimated in silico using a neuromechanical elbow model simulating the torque response from the imposed elbow angle...
August 24, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28828137/radiologic-manifestation-of-the-malignant-peripheral-nerve-sheet-tumor-involving-the-brachial-plexus
#10
Shima Aran, Gloria Suarez Duran, Valeria Potigailo, Andrew E Kim
A 63-year-old African American female with history of bilateral breast cancer status after lumpectomy and radiation therapy presented with right hand, wrist, and arm pain. She was found to have a right axillary mass and a large lesion in the right brachial plexus. A biopsy of the brachial plexus mass came back as a malignant peripheral nerve sheath tumor. This case report illustrates the critical value of multiple imaging modalities in definitive diagnosis of this rare pathologic entity.
September 2017: Radiology case reports
https://www.readbyqxmd.com/read/28764228/idiopathic-brachial-neuritis-in-a-patient-with-multiple-myeloma
#11
Lale Cerrahoglu, Ozlem Erol, Tuba Cerrahoglu Sirin
Idiopathic Brachial Neuritis (IBN), is a rare brachial plexopathy with an unknown aetiology. Multiple myeloma is a neoplastic plasma cell disease characterised by bone lesions. In this article, we present the case of a 59-year-old male patient with IBN associated with multiple myeloma, who was admitted to our clinic with right shoulder pain and right arm weakness. He experienced muscle weakness and atrophy in his right arm after a sudden onset of pain attack in the shoulder. Plexus and cervical vertebral MRI showed no pathology...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28752008/importance-of-sonography-for-guiding-central-venous-cannulation-in-patients-with-neurofibromatosis
#12
V K Mohan, Neisevilie Nisa
A 15-year-old boy with neurofibromatosis type 1 (NF1) was referred to us for central venous catheter insertion, and on ultrasound of the neck, he was found to have extensive involvement of the brachial plexus due to the nerve sheath tumour. Multiple hypoechogenic lesions resembling the internal jugular vein and internal carotid artery were visualised and could be differentiated from the vessels by Doppler ultrasound. The importance of analyzing sonographic images of nerve sheath tumours, which can mimic blood vessels, and the importance of Doppler ultrasound for guiding central venous catheters in such patients to avoid nerve injury are discussed in this case report...
June 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28723713/somatotopic-fascicular-lesions-of-the-brachial-plexus-demonstrated-by-high-resolution-magnetic-resonance-neurography
#13
Tim Hilgenfeld, Johann Jende, Daniel Schwarz, Philipp Bäumer, Jennifer Kollmer, Sabine Heiland, Martin Bendszus, Mirko Pham
OBJECTIVES: The aim of this study was to evaluate whether high-resolution brachial plexus (BP) magnetic resonance neurography (MRN) is capable of (1) distinguishing patients with compressive neuropathy or noncompressive plexopathy from age- and sex-matched controls, (2) discriminating between patients with compressive neuropathy and noncompressive plexopathy, and (3) detecting spatial lesion patterns suggesting somatotopic organization of the BP. MATERIALS AND METHODS: Thirty-six patients (50...
July 18, 2017: Investigative Radiology
https://www.readbyqxmd.com/read/28711374/the-components-of-shoulder-and-elbow-movements-as-goals-of-primary-reconstructive-operation-in-obstetric-brachial-plexus-lesions
#14
Jerzy Luszawski, Wiesław Marcol, Marek Mandera
Most of the cases of obstetric brachial plexus lesions (OBPL) show satisfactory improvement with conservative management, but in about 25% some surgical treatment is indicated. The present paper analyzes the effects of primary reconstructive surgeries in aspect of achieving delineated intraoperatively goals. Children operated before the age of 18 months with follow-up period longer than 1 year were selected. Therapeutic goals established during the operation were identified by analysis of initial clinical status and operative protocols...
June 30, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28662770/monitoring-intraoperative-neuromuscular-blockade-and-blood-pressure-with-one-device-tof-cuff-a-comparative-study-with-mechanomyography-and-invasive-blood-pressure
#15
G Veiga Ruiz, J García Cayuela, J Orozco Montes, M Parreño Caparrós, B García Rojo, J L Aguayo Albasini
OBJECTIVE: The overall objective of the study is to determine the ability of TOF-Cuff device (blood-pressure modified cuff, including stimulation electrodes) to monitor with the same device the non-invasive blood pressure (NIBP) and the depth of a neuromuscular blockade (NMB) induced pharmacologically, by stimulation of the brachial plexus at the humeral level and recording evoked changes in arterial pressure. MATERIAL AND METHOD: Clinical, single-centre, open-controlled study with 32 adult patients ASA I-III for scheduled elective surgery under general anaesthesia in supine position, for the validation of neuromuscular monitoring, comparing the values obtained from neuromuscular relaxation TOF-Cuff with those obtained by mechanomyography (MMG) (control method) during the recovery phase of NMB, when a TOF ratio>0...
June 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28656387/spontaneous-recovery-of-non-operated-traumatic-brachial-plexus-injury
#16
S H Lim, J S Lee, Y H Kim, T W Kim, K M Kwon
PURPOSE: We investigated the spontaneous recovery of non-operated traumatic brachial plexus injury (BPI). METHODS: A total of 25 cases of non-operated traumatic BPI were analysed by retrospective review of medical records; in all cases, consecutive electrodiagnostic studies (ES) were conducted from 1 to 4 months and 18 to 24 months post-trauma. Injury severity was assessed using a modified version of Dumitru and Wilbourn's scale (DWS) based on ES. Spontaneous recovery of brachial plexus components per subject was analysed using Wilcoxon's signed-rank test...
June 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28650063/-obstetric-brachial-plexus-palsy-incidence-monitoring-of-progress-and-prognostic-factors
#17
G Vaquero, A Ramos, J C Martinez, P Valero, N Nunez-Enamorado, R Simon-De Las Heras, A Camacho-Salas
INTRODUCTION: Obstetric brachial plexus palsy is related with shoulder dystocia, and its main risk factor is macrosomia. Its incidence is estimated to be between 0.1 and 6.3 cases per 1,000 live newborn infants. Most cases are resolved but can give rise to permanent functional deficiency, which means that there is an interest to identify possible prognostic factors. PATIENTS AND METHODS: We conducted a descriptive study of newborn infants with obstetric brachial plexus palsy born in our hospital between the years 2011 and 2015...
July 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28521852/upper-limb-nerve-transfers-a-review
#18
A Forli, M Bouyer, M Aribert, C Curvale, M Delord, D Corcella, F Moutet
While upper limb nerve transfers were first described and performed several years ago, they have seen expanded use in the past 20 years. Initially indicated for surgical repair of brachial plexus injuries with nerve root avulsion, the indications have been extended to post-ganglionic lesions because of the excellent results of certain intraplexus nerve transfers. The traditional nerve repair techniques - primary suture and nerve grafting - form the basis of nerve surgery. Although nerve transfer does not replace them, they are a useful supplement as they provide a targeted approach to reinnervation and recovery of key functions of the upper limb...
June 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28521032/a-neglected-cause-of-iatrogenic-brachial-plexus-injuries-in-psychiatric-patients
#19
José Fernando Guedes-Corrêa, Maristella Reis da Costa Pereira, Francisco José Lourenço Torrão-Junior, José Vicente Martins, Daniel Alves Neiva Barbosa
BACKGROUND: Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE: To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS: We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28500749/local-resectability-assessment-of-head-and-neck-cancer-positron-emission-tomography-mri-versus-positron-emission-tomography-ct
#20
Tetsuro Sekine, Felipe de Galiza Barbosa, Gaspar Delso, Irene A Burger, Paul Stolzmann, Edwin E Ter Voert, Gerhard F Huber, Spyros S Kollias, Gustav K von Schulthess, Patrick Veit-Haibach, Martin W Huellner
BACKGROUND: The purpose of this study was to compare the diagnostic accuracy of positron emission tomography (PET)/MRI with PET/CT for local resectability of head and neck cancer. METHODS: Sequential contrast-enhanced PET/CT-MRI was performed in 58 patients referred for the staging or restaging of head and neck cancer. Tumors were assessed with PET/CT and PET/MRI for the presence of resectability-defining factors: T4b status (mediastinal invasion, invasion of the prevertebral space, and vascular encasement), and another 8 findings that would imply obstacles for surgical cure (invasion of the laryngeal cartilage, invasion of the preepiglottic fat pad, perineural spread, orbital invasion, bone infiltration, skull base invasion, dural infiltration, and invasion of the brachial plexus)...
August 2017: Head & Neck
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