Oberlin transfer and partial radial to axillary nerve neurotization to repair an explosive traumatic injury to the Brachial Plexus in a child: Case report

Purpose

Explosive injuries to the pediatric brachial plexus are exceedingly rare and as such are poorly characterized in the medical literature.

Methods

Herein, we describe an 8-year-old who was struck in the neck by a piece of shrapnel and suffered multiple vascular injuries in addition to a suspected avulsion of the cervical 5 and 6 ventral rami. The patient had a complete upper brachial plexus palsy and failed to demonstrate any clinical improvement at 6-months follow-up. He was taken to the operating from for a partial ulnar to musculocutaneous nerve neurotization as well as a partial radial to axillary nerve neurotization.

Results

The patient’s motor exam improved from a Medical Research Council scale 1 to 4+ for biceps brachii and 0 to 4 deltoid function with greater than 90° of shoulder abduction.

Conclusions

This outcome supports complex neurotization techniques as viable treatment options for persistent motor deficits following an upper brachial plexus injury in older, non-infant age, children.     

Robert Liston (1794–1847): surgical anatomist and resurrectionist with an interest in hydrocephalus

Introduction

The Scottish surgeon Robert Liston was an accomplished anatomist of the nineteenth century. The study of anatomy during this day was often overshadowed by the so-called resurrectionists. Conclusions: The present historic paper reviews the life and contributions of Robert Liston and discusses his fascination with childhood hydrocephalus.     

Enlarged parietal foramina: a review of genetics, prognosis, radiology, and treatment

Introduction

Enlarged parietal foramina are variable ossification defects in the parietal bones that present as symmetric radiolucencies on skull radiographs. In contrast to the normal small parietal foramina, enlarged parietal foramina are a hereditary condition and genes associated with it have been identified.

Methods

A literature review was performed to discuss the many known findings related to enlarged parietal foramina.

Conclusions

Even though they remain asymptomatic in the majority of cases, they may be associated with other pathologies and occasionally become symptomatic. This article provides a comprehensive review of the current knowledge of enlarged parietal foramina.     

Learning from the living to diagnose the dead – parallels between CT findings after survived drowning and fatal drowning

A case of survived drowning is presented where CT findings of the lungs were in keeping with several findings seen on post-mortem CT (PMCT) examination after fatal drowning. These findings include interlobular septal thickening, peribronichal cuffing, mosaic pattern ground glass opacities, and perivascular nodular ground glass opacities. The absence of confounding normal post-mortem changes allows for a discussion on subtle differences between findings related to aspiration and pulmonary edema after drowning. This case represents a learning opportunity for radiologists and pathologists challenged by the complex lung findings after drowning on PMCT.