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brachial plexus lesions

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https://www.readbyqxmd.com/read/28521852/upper-limb-nerve-transfers-a-review
#1
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
#2
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
#3
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)...
May 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/28490272/transfer-of-the-musculocutaneous-nerve-branch-to-the-brachialis-muscle-to-the-triceps-for-elbow-extension-anatomical-study-and-report-of-five-cases
#4
J A Bertelli, F Soldado, M F Ghizoni, A Rodríguez-Baeza
We report the study of the anatomical feasibility of transferring the nerve to the brachialis muscle to the upper medial head motor branch that innervate the triceps, and outcomes of such transfers in restoring elbow extension in five patients with posterior cord lesion of the brachial plexus. The length of the branches to the brachialis muscle measured 7.6 cm and the triceps upper medial head motor branch was 5 cm in 10 adult cadavers. Five male patients were treated with this transfer 5 months after the injury (range 4 to 6 months) after posterior cord injury of the brachial plexus with a mean follow-up of 31 months (range 28 to 36 months)...
February 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28488619/peripheral-nerve-injuries-a-retrospective-survey-of-1124-cases
#5
João A Kouyoumdjian, Carla R Graça, Vanessa F M Ferreira
BACKGROUND: Peripheral nerve injuries (PNIs) remain an important health problem often leading to severe motor disabilities predominantly in the younger population. OBJECTIVE: To analyze our experience of clinical and electrodiagnostic evaluation (EDX) of PNIs over a 26-year period. MATERIALS AND METHODS: Between 1989 and 2014, 1124 consecutive patients with 1418 PNIs were referred for clinical as well as EDX evaluation. These PNIs involved upper and lower limbs as well as the facial nerves...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28486591/hourglass-like-constriction-of-the-brachial-plexus-in-the-posterior-cord-a-case-report
#6
Yasunobu Nakagawa, Hitoshi Hirata
BACKGROUND AND IMPORTANCE: Hourglass-like constrictions are fascicular conditions confirmed definitively by interfascicular neurolysis. Certain peripheral nerves have vulnerable areas such as around the elbow in the posterior interosseous nerve. We report the first hourglass-like constriction in the brachial plexus supplying the radial innervated forearm musculature. Preoperative magnetic resonance imaging (MRI) findings of the brachial plexus were consistent with neuralgic amyotrophy (NA)...
May 9, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28479130/increased-brain-activation-during-motor-imagery-suggests-central-abnormality-in-neonatal-brachial-plexus-palsy
#7
Galia V Anguelova, Serge Rombouts, J Gert van Dijk, Pieter F Buur, Martijn J A Malessy
Neonatal Brachial Plexus Palsy (NBPP) may lead to permanent impairment of arm function. As NBPP occurs when central motor programs develop, these may be ill-formed. We studied elbow flexion and motor imagery with fMRI to search for abnormal motor programming. We compared the cortical activity of adults with conservatively treated NBPP to that of healthy individuals stratified for hand dominance, using fMRI BOLD tasks of elbow flexion and motor imagery of flexion. Additionally, resting-state networks and regional gray matter volume were studied...
May 4, 2017: Neuroscience Research
https://www.readbyqxmd.com/read/28458390/neuro-myelomatosis-of-the-brachial-plexus-an-unusual-site-of-disease-visualized-by-fdg-pet-ct-a-case-report
#8
Hisanori Fukunaga, Tatsushi Mutoh, Yasuko Tatewaki, Hideo Shimomura, Tomoko Totsune, Chiaki Terao, Hidemitsu Miyazawa, Yasuyuki Taki
BACKGROUND Peripheral or cranial nerve root dysfunction secondary to invasion of the CNS in multiple myeloma is a rare clinical event that is frequently mistaken for other diagnoses. We describe the clinical utility of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT scanning for diagnosing neuro-myelomatosis. CASE REPORT A 63-year-old woman whose chief complaints were right shoulder and upper extremity pain underwent MRI and 18F-FDG PET/CT scan. MRI revealed a non-specific brachial plexus tumor...
May 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28419287/prediction-algorithm-for-surgical-intervention-in-neonatal-brachial-plexus-palsy
#9
Thomas J Wilson, Kate W C Chang, Lynda J S Yang
BACKGROUND: Neonatal brachial plexus palsy (NBPP) results in reduced function of the affected arm with profound ramifications on quality of life. Advances in surgical technique have shown improvements in outcomes for appropriately selected patients. Patient selection, however, remains difficult. OBJECTIVE: To develop a decision algorithm that could be applied at the individual patient level, early in life, to reliably predict persistent NBPP that would benefit from surgery...
April 17, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28412107/glenoid-morphology-in-obstetrical-brachial-plexus-lesion-a-three-dimensional-computed-tomography-study
#10
Lars H Frich, Pernille H Schmidt, Trine Torfing
BACKGROUND: Obstetric brachial plexus lesion (OBPL) frequently leads to glenohumeral dysplasia, and excessive retroversion of the glenoid is among the best known developmental disturbances. Most analyses of the glenoid are based on 2-dimensional (D) imaging and do not address glenoid inclination or provide information on the glenoid in the sagittal plane. We aim to describe the 3-D deformity of the glenoid in children with OBPL. METHODS: Preoperative computed tomography (CT) scans of the nonaffected and the affected scapula of 24 children (aged 5 to 12 years) with developmental disturbances after OBPL years were analyzed...
April 12, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28403100/delayed-bilateral-vocal-cord-paresis-after-a-continuous-interscalene-brachial-plexus-block-and-endotracheal-intubation-a-lesson-why-we-should-use-low-concentrated-local-anesthetics-for-continuous-blocks
#11
Hee-Sun Park, Ha-Jung Kim, Young-Jin Ro, Hong-Seuk Yang, Won-Uk Koh
RATIONALE: Recurrent laryngeal nerve block is an uncommon complication that can occur after an interscalene brachial plexus block (ISB), which may lead to vocal cord palsy or paresis. However, if the recurrent laryngeal nerve is blocked in patients with a preexisting contralateral vocal cord palsy following neck surgery, this may lead to devastating acute respiratory failure. Thus, ISB is contraindicated in patients with contralateral vocal cord lesion. To the best of our knowledge, there are no reports of bilateral vocal cord paresis, which occurred after a continuous ISB and endotracheal intubation in a patient with no history of vocal cord injury or surgery of the neck...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28340085/prevalence-of-neuropathic-pain-in-patients-with-traumatic-brachial-plexus-injury-a-multicenter-prospective-hospital-based-study
#12
Palma Ciaramitaro, Luca Padua, Grazia Devigili, Eugenia Rota, Stefano Tamburin, Roberto Eleopra, Giorgio Cruccu, Andrea Truini
Objective. : Prevalence and clinical characteristics of neuropathic pain due to traumatic brachial plexus injury. Design. : Observational epidemiological study. Setting. : Hospital-based multicenter study. Subjects. : One hundred seven prospectively enrolled patients with brachial plexus injury. Methods. : All the patients underwent clinical examination and neurophysiological testing for a definitive diagnosis of the brachial plexus lesion...
March 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28259372/-gas-tamponade-following-intraoperative-pneumothorax-on-a-single-lung-a-case-study
#13
S D El Jaouhari, O Mamane Nassirou, M Meziane, M Bensghir, C Haimeur
Intraoperative pneumothorax is a rare complication with a high risk of cardiorespiratory arrest by gas tamponade especially on a single lung. We report the case of a female patient aged 53 years who benefited from a left pneumonectomy on pulmonary tuberculosis sequelae. The patient presented early postoperative anemia with a left hemothorax requiring an emergency thoracotomy. In perioperative, the patient had a gas tamponade following a pneumothorax of the remaining lung, and the fate has been avoided by an exsufflation...
April 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28205463/peripheral-nerve-lymphomatosis
#14
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/28175932/-nerve-injuries-and-traumatic-lesions-of-the-brachial-plexus-imaging-diagnostics-and-therapeutic-options
#15
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/28161491/shoulder-and-elbow-kinematics-during-the-mallet-score-in-obstetrical-brachial-plexus-palsy
#16
Olivier Herisson, Nathalie Maurel, Amadou Diop, Morgane Le Chatelier, Adeline Cambon-Binder, Franck Fitoussi
BACKGROUND: The physical signs of obstetrical brachial plexus palsy range from temporary upper-limb dysfunction to a lifelong impairment and deformity in one arm. The aim of this study was to analyze the kinematics of the upper limb and to evaluate the contribution of glenohumeral and scapulothoracic joints of obstetrical brachial plexus palsy children. METHODS: Six children participated in this study: 2 males and 4 females with a mean age of 11.7years. Three patients had a C5, C6 lesion and 3 had a C5, C6, C7 lesion...
January 15, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28148670/injuries-to-the-upper-extremities-in-polytrauma-limited-effect-on-outcome-more-than-ten-years-after-injury-a-cohort-study-in-629-patients
#17
C Macke, M Winkelmann, P Mommsen, C Probst, B Zelle, C Krettek, C Zeckey
AIMS: To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. PATIENTS AND METHODS: A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status...
February 2017: Bone & Joint Journal
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/28041323/impact-of-cervicothoracic-region-stereotactic-spine-radiosurgery-on-adjacent-organs-at-risk
#19
Mayur Sharma, Elizabeth E Bennett, Gazanfar Rahmathulla, Samuel T Chao, Hilary K Koech, Stephanie N Gregory, Todd Emch, Anthony Magnelli, Antonio Meola, John H Suh, Lilyana Angelov
OBJECTIVE Stereotactic radiosurgery (SRS) of the spine is a conformal method of delivering a high radiation dose to a target in a single or few (usually ≤ 5) fractions with a sharp fall-off outside the target volume. Although efforts have been focused on evaluating spinal cord tolerance when treating spinal column metastases, no study has formally evaluated toxicity to the surrounding organs at risk (OAR), such as the brachial plexus or the oropharynx, when performing SRS in the cervicothoracic region. The aim of this study was to evaluate the radiation dosimetry and the acute and delayed toxicities of SRS on OAR in such patients...
January 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28018833/aneurysmal-bone-cyst-arising-from-the-first-rib-a-rare-cause-of-thoracic-outlet-syndrome
#20
Manuel Medina, Subroto Paul
Aneurysmal bone cyst is a rare benign cystic bone lesion with an incidence of only 0.14 per 100,000 individuals and most commonly affects the metaphyses of long bones, spine, and pelvis. We present a very rare case of a 17-year-old boy with a rapidly expanding aneurysmal bone cyst arising from the first rib, resulting in neurogenic thoracic outlet syndrome secondary to its compression of the brachial plexus. The patient's symptoms resolved after en bloc resection. To our knowledge there have been no other reports in the literature of thoracic outlet syndrome due to aneurysmal bone cyst arising from the first rib...
December 2016: Thoracic and Cardiovascular Surgeon Reports
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