Brachial plexus injury following brachial plexus block

A patient developed paralysis over the left upper limb 2 days after an otherwise uneventful supraclavicular brachial plexus block. Symptoms continued for 8 weeks after the block. The various possible causes for this complication are discussed. Although brachial plexus injury following the block is rare, some recommendations are made to reduce the incidence of this complication.     

Brachial plexus injury occurring during breast surgery

A case of brachial plexus injury occurring during axillary dissection as part of breast conservative surgery for breast cancer is reported. The mechanisms, diagnosis and management of such injury are discussed. Proper positioning of the patient is the key to preventing brachial plexus injury.      

Brachial plexus injury caused by impalement.

Open injuries of the brachial plexus are rare. One such case, that of a 68-year-old impaled on a fence spike, is presented here. Certain principles to guide evaluation and treatment are discussed. Concomitant injury to the pleura or to vascular structures requires immediate attention; the extent and type of plexus damage may be determined from physical findings and the nature of injury. The results of plexus reconstruction are variable and routine exploration may be detrimental. The Brooks classification is reviewed.     

Brachial plexus injury during subclavian vein catheterization for hemodialysis

Although the subclavian vein is often used for placement of double-lumen hemodialysis catheters, the risk factors for complications for the patients with chronic renal failure are underestimated. We report a case of a patient with chronic renal failure in whom brachial plexus injury was caused by both a compressive hematoma and direct insertion of a needle resulting from a subclavian vein catheterization attempt for hemodialysis. This case emphasizes the need for determining the coagulation status of the patient especially with chronic renal failure before performing invasive procedures.     

Brachial plexus injury caused by electric current through the ulnar nerve

Summary A case of brachial plexus injury caused by electric current is reported. A 14-year-old boy touched a bare electric cord with his right fifth finger. The electric current ran from the finger through the extremity to the neck. Then it caused brachial plexus palsy gradually. The clinical course and the electrophysiological examination revealed that the affected nerve fibers were in a state of neurapraxia.     

Brachial plexus injury after shoulder dislocation: a literature review

Neurosurgical Review - Brachial plexus injuries are among the rarest but at the same time the most severe complications of shoulder dislocation. The symptoms range from transient weakening or...     

Brachial plexus injury in Thailand: A report of 520 cases

Between October 1984 and October 1993, 520 patients with traumatic brachial plexus injuries were treated at the Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok. There were 486 male and 34 female patients. Eighty-two percent of the injuries were caused by motorcycle accidents, 9% by other traffic accidents, and 9% by gunshot, stabbing, and other means. The initial physical examination revealed 332 (63.8%) complete paralyses and 88 (36.2%) incomplete paralyses. One hundred twenty-seven patients were treated conservatively, 43 patients were observed before definitive treatment was given, and 350 patients were treated by operative means. Four hundred and twenty-one surgical procedures were performed, consisting of 314 neurotisations (250 spinal accessory, 14 plexo-plexal, 21 intercostal, 21 phrenic, 4 cervical plexus, 1 long thoracic, and 3 neuromuscular), 38 neurolyses, 23 nerve grafting, 16 free muscle transfers combined with neurotisations, and 30 musculotendinous transfers. Motor functional recovery of patients followed up for more than 2 years was evaluated. Nerve grafting gave 82% good (more than MRC grade 3) and 18% fair and poor recovery. Neurolysis gave 69% good and 31% fair and poor recovery. In patients with neurotisation, the spinal accessory (to supra-scapular, axillary, and musculocutaneous), intercostal (to musculocutaneous), phrenic (to suprascapular, axillary, and musculocutaneous), and plexo-plexal methods gave a significant number of good results. © Wiley-Liss, Inc. © 1995 Wiley-Liss, Inc.     

Brachial plexus injury after transfer of free Iatissimus dorsi musculocutaneous flap

Free latissimus dorsi muscle transfer is widely used for functional reconstruction of flexion of elbow and fingers after brachial plexus injury at later stage, as well as for soft tissue coverage because of its large size and long and reliable pedicle with adequate vessel diameter.     

Brachial plexus injury following subclavian vein catheterization: a case report

Subclavian vein cannulation may be complicated by lesions of the peripheral nervous system, such as injury to the recurrent laryngeal nerve, phrenic nerve, and brachial plexus. We describe a case of lesion of the upper trunk of the brachial plexus during multiple attempts at subclavian vein catheterization. This type of complication, ascribed to erroneous application of procedures or anatomical variations, may be minimized by abstaining from multiple attempts at venipuncture.     

Brachial plexus injury by nonviolent means in an adolescent baton twirler

Brachial plexus injuries are usually the result of violent trauma, or they may be chronic and recurrent with thoracic outlet syndrome. The case presented is an acute, nonrecurrent injury sustained by minor trauma. The injury to the brachial plexus occurred while a 15-year-old girl reached overhead to catch a baton. The treatment was conservative, and the patient made an almost complete recovery.