Journal of Brachial Plexus and Peripheral Nerve Injury最新文献

{"title":"A Case of Pancoast Tumor with Unusual Presentation","authors":"B. Calabek, S. Meng, S. Pollanz, W. Klepetko, K. Hoetzenecker, F. Oberndorfer, W. Grisold","doi":"10.1055/s-0035-1551654","DOIUrl":"https://doi.org/10.1055/s-0035-1551654","url":null,"abstract":"Abstract Introduction The Pancoast syndrome (PS) has been termed after Henry Pancoast. Its neurologic core symptoms include pain, radicular sensory and motor syndromes, and Horner syndrome. A PS is often the presenting sign of lung cancer and bears a grim prognosis. Methods This case report describes an atypical onset of a lung tumor causing a PS. Electrophysiological examination was not conclusive. The diagnosis was confirmed by MRI, CT scan, and biopsy. The intervention consisted of preoperative chemo- and radiotherapy and was followed by an extensive surgical approach with histologically confirmed perineural invasion of the brachial plexus. Results The postoperative period was dominated by neuropathic pain. Despite considerable loss of distal sensorimotor function of the right hand, the patient uses the extremity and has returned to professional life. Discussion This observation triggered by the advances in general oncology and surgery also demonstrates the management of a lesion of the peripheral nervous system caused by cancer.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2015-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0035-1551654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58057017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elbow Flexion Contractures in Childhood in Obstetric Brachial Plexus Lesions: A Longitudinal Study of 20 Neurosurgically Reconstructed Infants with 8-Year Follow-up.","authors":"M. V. D. Sluijs, W. J. Ouwerkerk, J. A. Sluijs, B. J. Royen","doi":"10.1055/S-0035-1549368","DOIUrl":"https://doi.org/10.1055/S-0035-1549368","url":null,"abstract":"Objective  Little knowledge exists on the development of elbow flexion contractures in children with obstetrical brachial plexus lesion (OBPL). This study aims to evaluate the prognostic significance of several neuromuscular parameters in infants with OBPL regarding the later development of elbow flexion contractures. Methods  Twenty infants with OBPL with insufficient signs of recovery in the first months of life who were neurosurgically reconstructed were included. At a mean age of 4.6 months, the following neuromuscular parameters were assessed: existence of flexion contractures, cross-sectional area (CSA) of upper arm muscles on MRI, Narakas classification, EMG results, and elbow muscle function using the Gilbert score. In childhood at follow-up at mean age of 7.7 years, we measured the amount of flexion contractures and the upper arm peak force (Newton). Statistical analysis is used to assess relations between these parameters. Results  Flexion contractures of greater than 10 degrees occurred in 55% of our patient group. The relation between the parameters in infancy and the flexion contractures in childhood is almost nonexistent. Only the Narakas classification was related to the development of flexion contractures in childhood ( p  = 0.006). Infant muscle CSA is related to childhood peak muscle force. Conclusion  The role of infancy upper arm muscle hypotrophy/hypertrophy, reinnervation, and early elbow muscle function in the development of childhood elbow contractures remains unclear. In this cohort prediction of childhood flexion, contractures were not possible using infancy neuromuscular parameters. We suggest that contractures might be an adaptive process to optimize residual muscle function.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2015-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/S-0035-1549368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58048985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve Transfer in Delayed Obstetrical Palsy Repair","authors":"F. Senes, N. Catena, J. Senes","doi":"10.1055/s-0035-1549367","DOIUrl":"https://doi.org/10.1055/s-0035-1549367","url":null,"abstract":"Abstract Objective When root avulsions are detected in children suffering from obstetrical brachial plexus palsy (OBPP), neurotization procedures of different nerve trunks are commonly applied in primary brachial plexus repair, to connect distally the nerves of the upper limbs using healthy nerve structures. This article aims to outline our experience of neurotization procedures in OBPP, which involves nerve transfers in the event of delayed repair, when a primary repair has not occurred or has failed. In addition, we propose the opportunity for late repair, focusing on extending the time limit for nerve surgery beyond that which is usually recommended. Although, according to different authors, the time limit is still unclear, it is generally estimated that nerve repair should take place within the first months of life. In fact, microsurgical repair of OBPP is the technique of choice for young children with the condition who would otherwise have an unfavorable outcome. However, in certain cases the recovery process is not clearly defined so not all the patients are direct candidates for primary nerve surgery. Methods In the period spanning January 2005 through January 2011, among a group of 105 patients suffering from OBPP, ranging from 1 month to 7 years of age, the authors have identified a group of 32 partially recovered patients. All these patients underwent selective neurotization surgery, which was performed in a period ranging from 5 months to 6.6 years of age. Results Late neurotization of muscular groups achieved considerable functional recovery in these patients, who presented with reduced motor function during early childhood. The said patients, with the exception of five, would initially have avoided surgery because they had not met the criteria for nerve surgery. Conclusion We have concluded that the execution of late nerve surgical procedures can be effective in children affected by OBPP.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2015-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0035-1549367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58048931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Sensory Switching” in Elbow Reconstruction","authors":"S. Sakakibara, K. Hashikawa, H. Terashi","doi":"10.1055/s-0035-1549369","DOIUrl":"https://doi.org/10.1055/s-0035-1549369","url":null,"abstract":"Abstract In the treatment of the soft tissue defect of the elbow, flap reconstruction is necessitated in many cases because of thinness of soft tissue at this region. In addition, reacquirement of tactile sensation is desirable because of the anatomical and specific functions of the elbow. Of three cases treated for elbow defects, one was reconstructed with a pedicled island forearm flap containing the lateral cutaneous nerve of the forearm, another was reconstructed with a venoneuro-accompanying artery fasciocutaneous flap (VNAF flap) containing the basilic vein, and the third with the VNAF flap containing the cephalic vein. The three cases demonstrated a sudden change of sensory territory 4 to 6 months after surgery, which was confirmed by touching the reconstructed region with patients' eye-closed: from its original territory to the elbow in a “switching”-like action. Here we describe and discuss the concept of “sensory switching.”","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2015-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0035-1549369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"58049020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on nerve repair by biological tubulization.","authors":"Stefano Geuna, Pierluigi Tos, Paolo Titolo, Davide Ciclamini, Teresa Beningo, Bruno Battiston","doi":"10.1186/1749-7221-9-3","DOIUrl":"10.1186/1749-7221-9-3","url":null,"abstract":"<p><p>Many surgical techniques are available for bridging peripheral nerve defects. Autologous nerve grafts are the current gold standard for most clinical conditions. In selected cases, alternative types of conduits can be used. Although most efforts are today directed towards the development of artificial synthetic nerve guides, the use of non-nervous autologous tissue-based conduits (biological tubulization) can still be considered a valuable alternative to nerve autografts. In this paper we will overview the advancements in biological tubulization of nerve defects, with either mono-component or multiple-component autotransplants, with a special focus on the use of a vein segment filled with skeletal muscle fibers, a technique that has been widely investigated in our laboratory and that has already been successfully introduced in the clinical practice. </p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2014-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3953745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40291822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Report of an unusual combination of arterial, venous and neural variations in a cadaveric upper limb.","authors":"Theodore G Troupis,&nbsp;Adamantios Michalinos,&nbsp;Vasiliki Manou,&nbsp;Dimitrios Vlastos,&nbsp;Elizabeth O Johnson,&nbsp;Theano Demesticha,&nbsp;Panayiotis Skandalakis","doi":"10.1186/1749-7221-9-2","DOIUrl":"https://doi.org/10.1186/1749-7221-9-2","url":null,"abstract":"<p><p>In this study an unusual combination of arterial, venous and neural variations discovered during dissection of cervical, axillary and brachial area of a cadaver is described. Variations are thoroughly described and literature is briefly reviewed. Lateral cord of brachial plexus was not formed; Eight Cervical root divided into anterior and posterior division before uniting with First Thoracic root and Upper Trunk was unusually short. Axillary artery gave origin to a superficial brachial artery and then continued as deep brachial artery. Multiple variations in typical axillary artery branches were present including existence of inferior pectoral artery. Cephalic vein was absent. A variety of interventions, from relative simple as central venous catheter placement to most complicated as brachial plexus injury repair demand thorough knowledge of area's regional anatomy. Familiarity with anatomic variations allows more precise and careful interventions. Research on these variations is valuable for anatomists and embryologists but also for clinicians because it may provide useful information for non - typical cases but also helps in raising a high level of suspicion. </p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2014-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1749-7221-9-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32089323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.","authors":"Debora Garozzo,&nbsp;Gianluca Zollino,&nbsp;Stefano Ferraresi","doi":"10.1186/1749-7221-9-1","DOIUrl":"https://doi.org/10.1186/1749-7221-9-1","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic lumbosacral plexus injuries seem to be rare events, spontaneously recovering in high percentage: as surgery is often challenging and results in poor outcome, many Authors have advocated conservative treatment only. Nevertheless surgery should not be ruled out: in invalidating injuries, it can restore basic function in the lower extremities.Therefore, it might be necessary to establish guidelines for the management and the indication to surgery in such cases.This study aims to identify indicators predicting spontaneous recovery or the need for surgery.</p><p><strong>Method: </strong>The clinical and radiological data of 72 patients with a post-traumatic lumbosacral plexus injury were reviewed. A follow up equal or superior to 3 years is available in 42 cases.</p><p><strong>Results: </strong>Lumbosacral plexus injuries mostly occurred during road accidents. The incidence of associated lesions was relevant: bone injuries were found in 85% of patients, internal lesions in 30% and vascular injuries in 8%.Lumbosacral trunk and sacral plexus palsies were the most frequent injury patterns.Root avulsions were revealed in 23% of cases and only in sacral plexus and complete lumbosacral plexus injuries: L5 and S1 were the roots more prone to avulsions.About 70% of cases recovered spontaneously, mostly in 18 months. Spontaneous recovery was the rule in lumbar plexus and lumbosacral trunk injuries (where root avulsions never occurred) or in sacral and complete lumbosacral plexus palsies due to compression injuries.The causative mechanism correlated with the injury pattern, the associated bone injury being often predictive of the severity of the nerve injury.Lumbosacral plexus injuries occurred in car crashes were generally associated with fractures causing compression on the nerves, thus resulting in injuries often amenable of spontaneous recovery.Motorcycle accidents implied high kinetic energy traumas where traction played an important role, as the high percentage of sacroiliac joint separations demonstrated (found in more than 50% of cases and always associated to root avulsions).Loss of sphincteral control and excruciating leg pain were also invariably associated with avulsions.</p><p><strong>Conclusions: </strong>Clinical and radiological data can help to predict the occurrence of spontaneous recovery or the need for surgery in post-traumatic lumbosacral plexus injuries.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2014-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1749-7221-9-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32018625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schwannoma of the brachial plexus; report of two cases involving the C7 root.","authors":"Mamoon Rashid,&nbsp;Omer Salahuddin,&nbsp;Shumaila Yousaf,&nbsp;Uzair A Qazi,&nbsp;Kanwal Yousaf","doi":"10.1186/1749-7221-8-12","DOIUrl":"https://doi.org/10.1186/1749-7221-8-12","url":null,"abstract":"<p><p>Brachial plexus schwannomas are rare tumors. They are benign nerve sheath tumors and only about 5% of Schwannoma arise from the brachial plexus. They pose a great challenge to surgeons due to their rare occurrence and complex anatomical location. We present two cases who presented with a supraclavicular swelling, that were proven to be schwannoma on histopathology. </p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1749-7221-8-12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free functional muscle transplantation of an anomalous femoral adductor with a very large muscle belly: a case report.","authors":"Yukitoshi Kaizawa,&nbsp;Ryosuke Kakinoki,&nbsp;Souichi Ohta,&nbsp;Takashi Noguchi,&nbsp;Shuichi Matsuda","doi":"10.1186/1749-7221-8-11","DOIUrl":"https://doi.org/10.1186/1749-7221-8-11","url":null,"abstract":"<p><p>We report the case of a 34-year-old man with a total brachial plexus injury that was treated by free functional muscle transplantation to restore simultaneously elbow flexion and finger extension. The muscle had a very large muscle belly (12 cm width), which was considered anatomically to be a fusion of the gracilis and the adductor longus muscles. Although the muscle possessed two major vascular pedicles with almost equal diameters, only the proximal vascular pedicle was anastomosed to the recipient vessels during the transplantation surgery, resulting in partial necrosis of the muscle. Several authors have reported on the successful simultaneous transplantation of the gracilis and adductor longus muscles, because they are supplied generally by a single common vascular pedicle. However, the present study suggests that when a surgeon encounters an aberrant femoral adductor with a very large muscle belly that can be considered to be a fusion of these muscles, the surgeon should assess intraoperatively the vascularity of the muscle using Doppler sonography, indocyanine green fluorescence injection, or other techniques. </p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1749-7221-8-11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40270168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A modeling approach to compute modification of net joint forces caused by coping movements in obstetric brachial plexus palsy.","authors":"Tim Kleiber,&nbsp;Nikica Popovic,&nbsp;Jörg Bahm,&nbsp;Catherine Disselhorst-Klug","doi":"10.1186/1749-7221-8-10","DOIUrl":"https://doi.org/10.1186/1749-7221-8-10","url":null,"abstract":"<p><strong>Background: </strong>Many disorders of the musculoskeletal system are caused by modified net joint forces resulting from individual coping movement strategies of patients suffering from neuromuscular diseases. Purpose of this work is to introduce a personalized biomechanical model which allows the calculation of individual net joint forces via inverse dynamics based on anthropometry and kinematics of the upper extremity measured by 3D optoelectronical motion analysis.</p><p><strong>Methods: </strong>The determined resulting net joint forces in the anatomical axis of movement may be used to explain the reason for possible malfunction of the musculoskeletal system, especially joint malformation. For example the resulting net joint forces in the humerothoracic joint from simulations are compared to a sample of children presenting obstetric brachial plexus palsy showing an internal shoulder rotation position and a sample of healthy children.</p><p><strong>Results: </strong>The results presented from the simulation show that an increased internal shoulder rotation position leads to increased net joint forces in the humerothoracic joint. A similar behavior is presented for the subjects suffering from brachial plexus palsy with an internal shoulder rotation position.</p><p><strong>Conclusions: </strong>The increased net joint forces are a possible reason for joint malformation in the humerothoracic joint caused by coping movements resulting from neuromuscular dysfunction as stated in literature.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2013-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/1749-7221-8-10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31817912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}