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Brachial plexus

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https://www.readbyqxmd.com/read/28644402/choosing-surgery-for-neurogenic-tos-the-roles-of-physical-exam-physical-therapy-and-imaging
#1
REVIEW
David P Kuwayama, Jason R Lund, Charles O Brantigan, Natalia O Glebova
Neurogenic thoracic outlet syndrome (nTOS) is characterized by arm and hand pain, paresthesias, and sometimes weakness resulting from compression of the brachial plexus within the thoracic outlet. While it is the most common subtype of TOS, nTOS can be difficult to diagnose. Furthermore, patient selection for surgical treatment can be challenging as symptoms may be vague and ambiguous, and diagnostic studies may be equivocal. Herein, we describe some approaches to aid in identifying patients who would be expected to benefit from surgical intervention for nTOS...
June 23, 2017: Diagnostics
https://www.readbyqxmd.com/read/28637068/traumatic-suprascapular-nerve-injury-at-the-notch-a-reason-for-the-posterior-approach-in-brachial-plexus-reconstruction
#2
Marc A Seifman, Scott Ferris
No abstract text is available yet for this article.
June 21, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28631870/thalamic-deep-brain-stimulation-for-neuropathic-pain-efficacy-at-three-years-follow-up
#3
Vasco Abreu, Rui Vaz, Virgínia Rebelo, Maria José Rosas, Clara Chamadoira, Martin J Gillies, Tipu Z Aziz, Erlick A C Pereira
OBJECT: Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain...
June 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28629251/neonatal-complications-amoung-596-infants-delivered-by-vacuum-extraction-in-relation-to-characteristics-of-the-extraction
#4
Cecilia Ekéus, Karin Wrangsell, Sandra Penttinen, Katarina Åberg
OBJECTIVE: To investigate the association between complicated vacuum extraction deliveries and neonatal complications. METHODS: Observational study including data on the management of 596 consecutive VE-deliveries at 6 different birth clinics in Sweden in 2013. We used logistic regression to examine the association between a complicated VE and: extracranial bleeding, severe neonatal complication (intracranial hemorrhage and/or asphyxia/low Apgar score and/or convulsions, and/or encephalopathy) and brachial plexus injury...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28628623/use-of-the-deka-arm-for-amputees-with-brachial-plexus-injury-a-case-series
#5
Linda Resnik, Christopher Fantini, Gail Latlief, Samuel Phillips, Nicole Sasson, Eve Sepulveda
OBJECTIVE: Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm. METHODS: This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis...
2017: PloS One
https://www.readbyqxmd.com/read/28627963/the-natural-history-of-recovery-of-elbow-flexion-after-obstetric-brachial-plexus-injury-managed-without-nerve-repair
#6
T E J Hems, T Savaridas, D A Sherlock
In this study, we report the outcome for spontaneous recovery of elbow flexion in obstetric brachial plexus injury managed without nerve reconstruction. Excluding those with transient paralysis, our records revealed 152 children with obstetric brachial plexus injury born before our unit routinely offered brachial plexus reconstruction. Five had had nerve repairs. Of the remainder, only one patient had insufficient flexion to reach their mouth. Elbow flexion started to recover clinically at a mean age of 4 months for Narakas Group 1, 6 months for Group 2, 8 months for Group 3 and 12 months for Group 4...
June 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28626999/presence-of-time-dependent-diffusion-in-the-brachial-plexus
#7
Zaid B Mahbub, Andrew M Peters, Penny A Gowland
PURPOSE: This work describes the development of a method to measure the variation of apparent diffusion coefficient (ADC) with diffusion time (Δ) in the brachial plexus, as a potential method of probing microstructure. METHODS: Diffusion-weighted MRI with body signal suppression was used to highlight the nerves from surrounding tissues, and sequence parameters were optimized for sensitivity to change with diffusion time. A porous media-restricted diffusion model based on the Latour-Mitra equation was fitted to the diffusion time-dependent ADC data from the brachial plexus nerves and cord...
June 19, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28624567/results-of-operative-treatment-of-brachial-plexus-injury-resulting-from-shoulder-dislocation-a-study-with-a-long-term-follow-up
#8
Olga Gutkowska, Jacek Martynkiewicz, Sylwia Mizia, Michał Bąk, Jerzy Gosk
BACKGROUND: Injury to the infraclavicular brachial plexus is an uncommon but serious complication of shoulder dislocation. This work aims to determine the effectiveness of operative treatment in patients with this type of injury. METHODS: Thirty-three patients (26 males,7 females; mean age 45 years 3 months) treated operatively for brachial plexus injury resulting from shoulder dislocation between the years 2000-2013 were included in this retrospective case series...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28624495/comparison-of-ultrasound-and-electrostimulation-guided-nerve-blocks-of-brachial-plexus-in-dogs
#9
Minori Akasaka, Miki Shimizu
OBJECTIVE: To compare the effectiveness of ultrasound- and electrostimulation-guided nerve blocks of the brachial plexus and to determine whether ultrasound guidance is feasible in conscious dogs. STUDY DESIGN: Blinded, crossover, experimental study. ANIMALS: Six clinically healthy adult Beagle dogs. METHODS: The nerves of the brachial plexus of the right thoracic limb were blocked under ultrasound guidance (UNB) in conscious dogs and under electrostimulation guidance (ENB) in anesthetized dogs with bupivacaine (0...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28624267/endoscopic-robot-assisted-c7-nerve-root-retrophalangeal-transfer-from-the-contralateral-healthy-side-a-cadaver-feasibility-study
#10
C Bijon, L Chih-Sheng, D Chevallier, N Tran, F Xavier, P Liverneaux
Controlateral C7 nerve root transfer in brachial plexus palsy requires a nerve graft and large incisions. This study investigated the feasibility of transferring the right C7 to the left C7 nerve root, without a graft, via a minimally invasive retropharyngeal approach. After installation of 6 trocars of 1cm diameter in the supraclavicular space, a Da Vinci SI(®) robot was placed. After locating the right brachial plexus, the C7 root was sectioned flush with the clavicle, transferred behind the pharynx and sutured to the left C7 root severed at the foramen level...
June 14, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28623105/transfer-of-the-lateral-antebrachial-cutaneous-nerve-to-the-dorsal-branch-of-the-ulnar-nerve-without-nerve-graft-in-case-of-lower-brachial-plexus-injuries-anatomical-and-feasibility-study
#11
J Pauchot, U Assouline, S Valmary-Degano, B Constantinou, L Obert, D Lepage
In the context of lower (C8-T1) brachial plexus injury, transfer of the lateral antebrachial cutaneous nerve (LABCN) to the dorsal branch of the ulnar nerve (DBUN) with an interposed sural nerve graft has been proposed to restore sensitivity on the ulnar side of the hand. The purpose of this study was to assess the feasibility of performing this transfer directly - without interposition of a nerve graft - by intraneural dissection of the DBUN. An anatomical study was performed with 20 upper limbs from adult human cadavers...
June 13, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28616159/thoracic-outlet-syndrome-as-a-consequence-of-isolated-atraumatic-first-rib-fracture
#12
Aleem K Mirza, Audra A Duncan
Neurogenic thoracic outlet syndrome (nTOS) resulting from an isolated first rib fracture is extremely infrequent. We report a case of performance limiting nTOS in a college athlete who was initially evaluated and treated for upper extremity ligamentous injury with only transient improvement. Subsequent noninvasive studies were consistent with TOS physiology and MRA showed a large hypertrophic callus on the first rib adjacent to the brachial plexus. With continued athletic limitations and radiographic findings consistent with TOS, surgical decompression was performed resulting in resolution of symptoms...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28615808/triceps-to-biceps-transfer-for-restoration-of-elbow-flexion-following-upper-brachial-plexus-injury
#13
Pothula Durga Prasada Rao, Rayidi Venkata Koteswara Rao, R Srikanth
INTRODUCTION: Upper brachial plexus injury in adults causes loss of elbow fl exion; when the primary nerve surgery has failed or the patient seeks treatment after 12 months of injury and pedicled muscle transfers are required. Most commonly, the latissimus dorsi or the Steindler flexorplasty is used. MATERIAL AND METHODS: We have transferred one of the heads of triceps muscle to restore the elbow flexion in such cases. In addition to return of elbow flexion, extension of elbow following surgery is retained...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28612344/description-and-ultrasound-targeting-of-the-origin-of-the-suprascapular-nerve
#14
P Laumonerie, F Lapegue, E Chantalat, N Sans, P Mansat, M Faruch
INTRODUCTION: Anatomical variations in the suprascapular nerve (SSN) and its depth in the suprascapular notch can make it difficult to target with ultrasonography (US). One alternative could be a proximal approach to the SSN, if US provides a reliable description of its origin (orSSN). The primary objective of this study was to demonstrate that US can reliably locate the orSSN. The secondary objective was to describe the features of the proximal SSN. MATERIALS AND METHODS: Seventy brachial plexuses (BP) from 30 healthy volunteers (60 BP) and five cadavers (10 BP) were included...
June 13, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28609352/comparing-the-efficacy-of-triple-nerve-transfers-with-nerve-graft-reconstruction-in-upper-trunk-obstetrical-brachial-plexus-injury
#15
Kathleen M O'Grady, Hollie A Power, Jaret L Olson, Michael J Morhart, A Robertson Harrop, M Joe Watt, K Ming Chan
BACKGROUND: Upper trunk obstetrical brachial plexus injury (OBPI) can cause profound shoulder and elbow dysfunction. Although neuroma excision with interpositional sural nerve grafting is the current gold standard, distal nerve transfers have a number of potential advantages. The goal of this study was to compare the clinical outcomes and healthcare costs between nerve grafting and distal nerve transfers in children with upper trunk OBPI. METHODS: In this prospective cohort study, children who received triple nerve transfers were followed with the Active Movement Scale (AMS) for 2 years...
June 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28609340/effect-of-interscalene-brachial-plexus-block-on-the-pulmonary-function-of-obese-patients-a-prospective-observational-cohort-study
#16
M Stephen Melton, Hanni E Monroe, Wenjing Qi, Stephanie L Lewis, Karen C Nielsen, Stephen M Klein
BACKGROUND: The effect of interscalene block (ISB) on pulmonary function of obese participants has not been investigated. The goal of this study is to assess the association of obesity (body mass index [BMI] >29 kg/m vs BMI <25 kg/m) and change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) after ISB in participants undergoing outpatient shoulder surgery. METHODS: This prospective, observational cohort study compared obese (BMI >29 kg/m) and normal-weight (BMI <25 kg/m) groups undergoing ISB for ambulatory shoulder surgery, on preblock and postblock FVC and FEV1, at 30 minutes postblock and in the postanesthesia care unit (PACU)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28606839/brachial-plexus-injury-in-a-6-year-old-boy-with-100-displaced-proximal-humeral-metaphyseal-fracture-a-case-report
#17
Elizabeth Nora Jovanovich, James F Howard
Post-traumatic brachial plexopathies can occur following displaced proximal humeral fractures, causing profound functional deficits. Described here is an unusual case of a displaced proximal humeral metaphyseal fracture in a young child. The patient underwent closed reduction and serial casting, but hand weakness and forearm sensory loss persisted. Needle EMG localized the injury to the mid/proximal arm near the fracture site, resulting in damage to the posterior and medial cords of the brachial plexus with profound involvement of the radial, ulnar, and median nerves and sparing of the axillary nerve...
June 9, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28604465/brachial-plexus-injury-associated-with-subclavian-vein-cannulation-a-case-report
#18
Ezgi Gozubuyuk, Mehmet I Buget, Turgut Akgul, Demet Altun, Suleyman Kuçukay
We documented brachial plexus injury by electromyography and magnetic resonance imaging secondary to needle sticks for central line insertion. This type of complication is rare in the literature, as few case reports exist. Brachial plexus injury can happen because of anatomic variations. Nevertheless, multiple attempts or introducer needle rotations should be avoided during subclavian vein catheterization. Pain that emerges in the ipsilateral arm after subclavian catheter placement should be taken into serious consideration...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28603868/pre-operative-brachial-plexus-block-compared-with-an-identical-block-performed-at-the-end-of-surgery-a-prospective-double-blind-randomised-clinical-trial
#19
A Holmberg, A R Sauter, Ø Klaastad, T Draegni, J C Raeder
We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg(-1) ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28602269/sensory-outcomes-following-brachial-plexus-birth-palsy-a-systematic-review
#20
REVIEW
Joseph P Corkum, Victoria Kuta, David T Tang, Michael Bezuhly
BACKGROUND: Brachial plexus birth palsy (BPBP) affects approximately 1.5 in 1000 live births and can lead to significant functional impairment and reduced quality of life. To date, studies have focused on grading motor function and strength to assess patient outcomes, with less attention paid to sensory recovery. The authors aimed to systematically review the current literature on sensory outcomes following BPBP. METHODS: A systematic review of the best evidence available assessing sensory outcomes following BPBP was conducted...
May 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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