Journal of Brachial Plexus and Peripheral Nerve Injury最新文献

{"title":"Median Nerve Variation: A Complete Spin before Terminal Branching.","authors":"Amgad S Hanna,&nbsp;Zhikui Wei,&nbsp;Barbara A Hanna","doi":"10.1055/s-0039-3402734","DOIUrl":"https://doi.org/10.1055/s-0039-3402734","url":null,"abstract":"<p><p>Median nerve anatomy is of great interest to clinicians and scientists given the importance of this nerve and its association with diseases. A rare anatomical variant of the median nerve in the distal forearm and wrist was discovered during a cadaveric dissection. The median nerve was deep to the flexor digitorum superficialis (FDS) in the carpal tunnel. It underwent a 360-degree spin before emerging at the lateral edge of FDS. The recurrent motor branch moved from medial to lateral on the deep surface of the median nerve, as it approached the distal carpal tunnel. This variant doesn't fall into any of Lanz's four groups of median nerve anomalies. We propose a fifth group that involves variations in the course of the median nerve. This report underscores the importance of recognizing variants of the median nerve anatomy in the forearm and wrist during surgical interventions, such as for carpal tunnel syndrome.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"15 1","pages":"e1-e4"},"PeriodicalIF":0.7,"publicationDate":"2020-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-3402734","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37641024","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":"Index","authors":"","doi":"10.1215/9781478012221-016","DOIUrl":"https://doi.org/10.1215/9781478012221-016","url":null,"abstract":"","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"3 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73052671","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":"A Lingering Cold (War)?","authors":"Anne-Emanuelle Birn, R. López","doi":"10.1215/9781478012221-014","DOIUrl":"https://doi.org/10.1215/9781478012221-014","url":null,"abstract":"","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"18 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72712036","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":"Evaluation of Brachial Plexus Using Combined Stereological Techniques of Diffusion Tensor Imaging and Fiber Tracking.","authors":"Niyazi Acer,&nbsp;Mehmet Turgut","doi":"10.1055/s-0039-1687913","DOIUrl":"10.1055/s-0039-1687913","url":null,"abstract":"<p><p><b>Background</b>  Brachial plexus (BP) is composed of intercommunications among the ventral roots of the nerves C5, C6, C7, C8, and T1 in the neck. The in vivo and in vitro evaluation of axons of the peripheral nervous system is performed using different techniques. Recently, many studies describing the application of fiber tractography and stereological axon number estimation to peripheral nerves have been published. <b>Methods</b>  Various quantitative parameters of nerve fibers, including axon number, density, axonal area, and myelin thickness, can be estimated using stereological techniques. In vivo three-dimensional reconstruction of axons of BP can be visualized using a combined technique of diffusion tensor imaging (DTI) and fiber tracking with the potential to evaluate nerve fiber content. <b>Conclusion</b>  It is concluded that terminal branches of BP can be successfully visualized using DTI, which is a highly reproducible method for the evaluation of BP as it shows anatomical and functional features of neural structures. We believe that quantitative morphological findings obtained from BP will be useful for new experimental, developmental, and pathological studies in the future.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e16-e23"},"PeriodicalIF":0.7,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1687913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37068578","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":"Anomalous Innervation to the Extensor Digitorum Brevis.","authors":"Marc A Swerdloff,&nbsp;Danielle F Stewart","doi":"10.1055/s-0039-1685531","DOIUrl":"https://doi.org/10.1055/s-0039-1685531","url":null,"abstract":"The nerve supply of the extensor digitorum brevis (EDB) usually arises from the deep peroneal nerve. An anomalous innervation arising from the accessory deep peroneal nerve is described in 15% of cases.1 An “all tibial foot” innervation pattern has been reported.2,3 In our clinic, electromyographic findings revealed the presence of a deep peroneal to posterior tibial nerve anastomosis similar to the forearm anastomosis of the median to ulnar nerve of Martin and Gruber. In ►Fig. 1, tracings of the EDB compound muscle action potential (CMAP) were generated after stimulation at various sites in the foreleg (►Fig. 2). The medially located tarsal tunnel is a site that will not generate an EDB CMAP unless there is an anomalous innervation to the EDB. In our cases, the distal peroneal site of stimulation failed to generate a maximal CMAP. Additional amplitude occurred after stimulation of the distal tibial nerve in the tarsal tunnel. Proximal peroneal and distal tibial nerve stimulations are characteristics of a cross over in the foreleg from the peroneal to the tibial nerve (►Fig. 3). Of 72 patients, 11% (8/72) showed these results. It was present in both legs in half of the patients (4/8). The finding of a deep peroneal to posterior tibial anastomosis will be of interest to neurologists performing electromyographic studies and surgeons that deal with injuries to the foreleg. In our sample, it wasmore frequent than the more widely known accessory deep peroneal variant. Fig. 1 Compound muscle action potential (CMAP) of the extensor digitorum brevis (EDB) stimulating from various points on the foreleg. Normally the amplitude of the CMAP of the EDB obtained by stimulation of the deep peroneal nerve at the ankle would be equal to that obtained by stimulation at the popliteal fossa, that is, trace A would equal with B. With a deep peroneal to posterior tibial anastomosis, a response is elicited by stimulating the posttibial nerve at the medial ankle (trace D). If there was an accessory deep peroneal nerve contribution, trace C would have a response. Proximal tibial stimulation would elicit a robust response in trace E in an “all tibial foot.”","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e14-e15"},"PeriodicalIF":0.7,"publicationDate":"2019-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1685531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37212253","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":"Schwannomatosis of the Spinal Accessory Nerve: A Case Report.","authors":"Ramin A Morshed,&nbsp;Anthony T Lee,&nbsp;Young M Lee,&nbsp;Cynthia T Chin,&nbsp;Line Jacques","doi":"10.1055/s-0039-1685457","DOIUrl":"https://doi.org/10.1055/s-0039-1685457","url":null,"abstract":"<p><p>Schwannomatosis is a distinct syndrome characterized by multiple peripheral nerve schwannomas that can be sporadic or familial in nature. Cases affecting the lower cranial nerves are infrequent. Here, the authors present a rare case of schwannomatosis affecting the left spinal accessory nerve. Upon genetic screening, an in-frame insertion at codon p.R177 of the Sox 10 gene was observed. There were no identifiable alterations in NF1, NF2, LZTR1, and SMARCB1. This case demonstrates a rare clinical presentation of schwannomatosis in addition to a genetic aberration that has not been previously reported in this disease context.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e9-e13"},"PeriodicalIF":0.7,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1685457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37194620","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":"Does the Duration and Severity of Symptoms Have an Impact on Relief of Symptoms after Carpal Tunnel Release?","authors":"Mehreen Masud,&nbsp;Mamoon Rashid,&nbsp;Saleem Akhtar Malik,&nbsp;Muhommad Ibrahim Khan,&nbsp;Saad-Ur-Rehman Sarwar","doi":"10.1055/s-0038-1668552","DOIUrl":"https://doi.org/10.1055/s-0038-1668552","url":null,"abstract":"<p><p><b>Rationale</b>  Carpal tunnel syndrome (CTS) is the most frequently encountered compressive neuropathy of the upper limb. The treatment of CTS ranges from conservative management to carpal tunnel release. Many patients with misconception about the potential morbidity and with the hope of successful conservative treatment delay the surgical release of carpal tunnel. This delay results in reduced recovery of sensory and motor median nerve function. <b>Objective</b>  The aim of this study was to evaluate the influence of preoperative duration and severity of symptom on the outcome of carpal tunnel surgery. <b>Method</b>  It included 45 cases of CTS, all treated with limited access open carpal tunnel release. The duration of symptoms (i.e., pain, numbness, tingling, waking up at night because of pain/numbness, difficulty in grasping small objects, and their preoperative severity) was noted using Boston CTS questionnaire. To investigate the outcome, patients were divided into three groups based on their duration of symptoms. <b>Result</b>  Group1: The severity of symptoms was reduced to normal in a short period of time in patients who presented with duration of symptoms less than 6 months. Group 2: Patients in whom symptoms lasted for 6 to 12 months had reduced or delayed recovery of hand function as compared with first group. Group 3: Patients who had symptoms for more than 12 months had incomplete recovery of grip strength. Return to normal function took the longest time (median: 16 weeks) in this group. <b>Conclusion</b>  This study suggests that patients who present late have delayed/incomplete relief of symptoms after carpal tunnel release.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e1-e8"},"PeriodicalIF":0.7,"publicationDate":"2019-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0038-1668552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36938367","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 New Surgical Technique for Internal Shoulder Contractures Secondary to Obstetric Brachial Plexus Injury: An Anterior Coracohumeral Ligament Release","authors":"Ç. Saraç, S. Hogendoorn, R. Nelissen","doi":"10.1055/s-0039-1693746","DOIUrl":"https://doi.org/10.1055/s-0039-1693746","url":null,"abstract":"Abstract Background Obstetric brachial plexus injuries result from traction injury during delivery; 30% of these children sustain persisting functional limitations related to an external rotation deficit of the shoulder. The aim of this study was to compare the intraoperative gain in external rotation after a posterior subscapular release and an anterior coracohumeral ligament release. Methods This is a prospective study on 102 children with an internal rotation contracture of the shoulder who received either a posterior subscapular release (posterior skin incision along the medial border of the scapula of 3–5 cm) or an anterior (5-mm skin incision) coracohumeral ligament release between 1996 and 2010. After general anesthesia, internal and external rotations in both adduction and abduction were measured before and after the surgical release. Results After a posterior subscapular release, the intraoperative external rotation improved with a mean of 64 degrees (95% confidence interval [CI]: 54–74; p < 0.001) in adduction and with a mean of 41 degrees (95% CI: 32–49; p < 0.001) in abduction. After an anterior coracohumeral ligament release, external rotation increased with a mean of 61 degrees (95% CI: 56–66; p < 0.001) in adduction and a mean of 42 degrees in abduction (95%CI: 39–45, p < 0.001). Differences between these two groups were not statistically different. Conclusion The anterior release technique shows comparable results with the posterior subscapular release. And since it is performed through a smaller incision of 5 mm, this is our preferred method to increase passive external rotation. Level of evidence II.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e35 - e38"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1693746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46484398","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":"The Pathogenesis of Glenohumeral Deformity and Contracture Formation in Obstetric Brachial Plexus Palsy—A Review","authors":"P. Olofsson, A. Chu, A. Mcgrath","doi":"10.1055/s-0039-1692420","DOIUrl":"https://doi.org/10.1055/s-0039-1692420","url":null,"abstract":"Abstract Contractures of the shoulder joint and glenohumeral joint dysplasia are well known complications to obstetrical brachial plexus palsy. Despite extensive description of these sequelae, the exact pathogenesis remains unknown. The prevailing theory to explain the contractures and glenohumeral joint dysplasia states that upper trunk injury leads to nonuniform muscle recovery and thus imbalance between internal and external rotators of the shoulder. More recently, another explanation has been proposed, hypothesizing that denervation leads to reduced growth of developing muscles and that reinnervation might suppress contracture formation. An understanding of the pathogenesis is desirable for development of effective prophylactic treatment. This article aims to describe the current state of knowledge regarding these important complications.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e24 - e34"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1692420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42682836","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":"A Comparison of Patients from Argentina and Germany to Assess Factors Impacting Brachial Plexus and Brain Injury","authors":"M. Socolovsky, G. Antoniadis, A. Lovaglio, G. Durner, Gonzalo Bonilla, Markus Schmidhammer, G. di Masi","doi":"10.1055/s-0039-1693687","DOIUrl":"https://doi.org/10.1055/s-0039-1693687","url":null,"abstract":"Abstract Background Traumatic brachial plexus injuries (BPIs) represent a major cause of disability in young patients. The purpose of this study was to compare two populations (from Argentina and Germany) who suffered a traumatic BPI after a motorcycle accident to identify predictors of BPI and brain injury severity. Methods Univariate and multivariable intergroup comparisons were conducted, and odds ratios were calculated to assess the associations between the different demographic, morphometric, and trauma-related variables, and the type and severity of patients' injuries. Pearson correlation coefficients were generated to identify statistically significant correlations. Results A total of 187 patients were analyzed, 139 from Argentina and 48 from Germany. The two countries differed significantly in age and several morphometric and trauma-related variables. The clinical presentation was also convincingly different in the two countries. The following three variables remained as statistically significant predictors of a complete (vs. partial) BPI: living in Argentina (p < 0.001), presenting prior to 2015 (p = 0.004), and greater estimated speed at the time of impact (p = 0.074). As for BPIs, a disproportionate percentage (85.6%) of more severe brain injuries occurred in Argentinian patients (p < 0.001) and among those whose accident involved striking a stationary vertical object. Conclusions This study identified several factors that might be considered when planning governmental policies and education initiatives to reduce BPI and brain injuries related to motorcycle use. Level of evidence II-2 (evidence obtained from case–control studies).","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":"14 1","pages":"e39 - e46"},"PeriodicalIF":0.7,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0039-1693687","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44523703","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}