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At least 19 recordsLinked to original sources

PubMed1975

Recurrent brachial plexus neuropathy.

The clinical, electrophysiological and pathological changes in 3 patients with recurrent attacks of non-traumatic brachial plexus neuropathy have been described. Two had recurrent attacks and a dominant family history of similar attacks, together with evidence of lesser degrees of nerve involvement outside the brachial plexus. In one patient the attacks were moderately painful, while in the other there was little or no pain. Only one showed undue slowing of motor nerve conduction during ischaemia, but in both cases the sural nerves had the changes of tomaculous neuropathy, with many sausage-shaped swellings of the myelin sheaths, and extensive segmental demyelination and remyelination. The third patient had two attacks of acute brachial plexus neuropathy which were both extremely painful. The clinical features were compatible with a diagnosis of neuralgic amuotrophy. In the second attack, there was vagus nerve involvement and the sural nerve showed evidence of healed extensive segmental demyelination. The various syndromes presenting with acute non-traumatic brachial plexus neuropathy are reviewed, and a tentative nonsological classification advanced. Most patients fall into the category of acute, painful paralysis with amyotrophy, with no family history and no evidence of lesions outside the brachial plexus. It is suggested that the term "neuralgic amyotrophy" be restricted to this group. Patients with features outside this clinical picture probably suffer from other disease entities presenting with brachial plexus neuropathy. The familial cases constitute one or more aetioliogical subgroups, differing from neuralgic amyotrophy in the frequency of recurrences, the relative freedom from pain in the attacks, the frequency of nerve lesions outside the brachial plexus, and of hypotelorism. Individual attacks of acute brachial plexus neuropathy, however, may be identical in patients with the different diseases, and further pathological and biochemical studies are awaited to aid in nosology.

Acute Disease↗

PubMed1979

Management of brachial plexus tumors.

Three cases are reported of brachial plexus tumors that presented as a lump in the neck. Problems that arise when faced with such a diagnosis are discussed. A suggested protocol of management of these cases is described. The possibility of a brachial plexus tumor should be included in the differential diagnosis of a patient presenting with a mass in the neck.

Adult↗

PubMed1978

[Brachial plexus paralysis after stellate blockade and plexus anaesthesia (author's transl)].

Brachial plexus paralysis is a serious complication of stellate blockade (n = 2) and plexus anaesthesia (n = 6) as was observed in 8 patients. It is frequently characterised by localised motor and sensory defects in the affected arm and sometimes accompanied by a causalgia-like pain. Pathogenetically mechanical factors--needle trauma, injection pressure, volume, and velocity--are of decisive importance. Prophylactically intraneural injections must be avoided. The electrifying pain during insertion of the needle and (or) immediate anaesthetic effect require correction of needle position.

Adolescent↗

PubMedDate not supplied

A parascalene technique of brachial plexus anesthesia.

A technique for brachial plexus anesthesia is described consisting of the injection of 20 ml of local anesthetic solution into the lower part of the posterior triangle of the neck at a point 1.5 to 2 cm above the clavicle at the lateral border of the anterior scalene muscle. The technique is simple, safe, and produced satisfactory anesthesia of the entire extremity in 97 of the first 100 cases in which it was used. Side effects and complications were minor and transient.

Adolescent↗

PubMed1977

Surgical management of brachial plexus injuries.

Exploration of the brachial plexus was done as an elective procedure in 56 patients with complete or partial lesions. The indications were based on clinical findings, a Tinel-Hoffman sign indicating that at least one root was available for direct repair, or a cessation of signs of progressive recovery. In young patients with supraganglionic lesions and evidence of root avulsion, nerve grafts from intercostals to various portions of the plexus were done. Evaluation of the results of motor functions showed that 38 of 54 (70 percent) recovered a useful motor function in at least one important area. There were two postoperative hematomas leading to delayed healing and failure of nerve recovery. Two patients had temporary loss of power in uninvolved muscles but both recovered satisfactory function. Only one patient had a persistent pain syndrome. Two failures were due to the late operation (19 months after injury) and one because of a 15 cm. which was grafted.

Adolescent↗

PubMed1979

Anomalous reinnervation as a sequel to obstetric brachial plexus palsy.

In 3 patients with sequelae of brachial plexus birth injury we observed associated movements and also synchronous motor unit potentials and motor axo-axonic reflexes between different muscles, sometimes with antagonist function. To explain these synkineses is necessary to assume that there is simultaneous innervation by the same motoneurone of 2 or more "motor subunits" in different muscles. Therefore we suggest that the motoneurone branches originate proximally from the primary trunk of the brachial plexus. Careful clinical and neurophysiological study can show these complex simultaneous innervations and also suggest correct kinesiotherapy.

Adult↗

PubMed1979

Neurogenic tumors of the brachial plexus: report of two cases.

Two cases of solitary neurogenic tumors of the brachial plexus unassociated with von Recklinghausen's disease are presented. One patient had a malignant schwannoma. The lesion of the other patient was benign and was diagnosed pathologically as a plexiform neurofibroma. These uncommon neurogenic tumors of the brachial plexus unassociated with von Recklinghausen's disease pose diagnostic and surgical problems. The initial clinical presentation is usually that of a painless supraclavicular mass. At the time of surgical exploration, the exact site or nerve of origin cannot always be identified. If motor loss is caused by such a tumor of the brachial plexus, it usually indicates a malignant lesion and a poor prognosis. Although wide radical excision of a malignant neurogenic tumor is indicated surgically, one of our patients had an early malignant recurrence that necessitated immediate amputation.

Adult↗

PubMed1979

[Evaluation of brachial plexus block. Comparison between supraclavicular and interscalene approach (author's transl)].

A scheme for evaluating brachial plexus block was developed, which is based on anatomical structures and which utilizes simple neurological examination techniques. It facilitates the localization of the tip of the cannula near the plexus, gives an idea of the spread of the local anesthetic in the region of the trunks and cords, gives well timed judgement on the success of the block and allows a comparison of the development of the block when using various techniques. Using this scheme, the development of the block was examined following use of the supraclavicular and interscalene approach. With the supraclavicular technique, motor as well as sensory blockade of all nerves of the brachial plexus occurred with about the same frequency; with the interscalene technique, the centre of the block affected the caudal nerves of the cervical plexus and the cranial nerves of the brachial plexus. Following both approaches, the blockade developed from proximal to distal areas, the motor blockade preceding the sensory blockade.

Brachial Plexus↗

PubMed1978

Carcinomatous versus radiation-induced brachial plexus neuropathy in breast cancer.

A retrospective study was performed of 18 women in whom ipsilateral brachial plexus neuropathy developed after treatment for carcinoma of the breast. In the absence of metastatic tumor elsewhere, the only distinguishing feature between carcinomatous neuropathy and radiation-induced neuropathy was the symptom-free interval after mastectomy and radiation therapy. Women with an interval of less than a year have radiation-induced neuropathy. Brachial plexus exploration in difficult diagnostic situations will permit early treatment and avoid debilitating loss of function. Brachial plexus exploration for biopsy is safe and free of complications if performed carefully. Treatment of carcinomatous neuropathy is most likely to succeed if the tumor is hormonally sensitive, but radiotherapy may also be effective. Treatment of radiation-induced neuropathy remains largely ineffective.

Adenocarcinoma↗

PubMed2026

Effects of single-injection vs. continuous brachial plexus blocks for shoulder surgeries on patient-reported outcomes: a systematic review and meta-analysis with trial sequential analysis of randomised controlled trials.

INTRODUCTION: Single-injection and continuous brachial plexus block techniques are used widely for postoperative analgesia in patients undergoing shoulder surgery. Although patient-reported outcomes are described in individual studies, their effects have not been synthesised comprehensively using a patient-centred framework. We sought to compare the effects of single-injection vs. continuous brachial plexus block techniques on patient-reported outcomes in adult patients following elective shoulder surgery. METHODS: Databases were searched from inception to October 2025 and randomised controlled trials reporting patient-reported outcomes were included. Co-primary outcomes were postoperative patient-reported pain intensity at rest and during movement at 12 h, 24 h and 48 h post-surgery. Secondary outcomes included nausea and vomiting; sleep quality; patient satisfaction; opioid requests; and functional scores. Random-effects meta-analysis and trial sequential analysis were performed, with risk of bias and quality of patient-reported outcome reporting assessed. RESULTS: Twenty randomised controlled trials that included 1198 patients were analysed. Continuous brachial plexus blocks were associated with lower pain at rest at 12 h, 24 h and 48 h, with mean differences (MD) of -1.96 (95%CI -2.81 to -1.11, p < 0.001), -1.66 (95%CI -2.27 to -1.05, p < 0.001) and - 1.18 (95%CI -1.84 to -0.53, p < 0.001), respectively. Pain on movement could only be pooled at 24 h and 48 h and showed MD -2.04 (95%CI -4.26-0.19, p = 0.07) and - 1.30 (95%CI -3.67-1.07, p = 0.28) respectively. The co-primary outcomes approached or exceeded the predefined minimal clinically important difference for pain scores after shoulder surgery, in favour of continuous techniques. DISCUSSION: Continuous brachial plexus blocks are associated with better pain at rest and other patient-centred outcomes following shoulder surgery, while effects on dynamic pain and long-term functional recovery remain uncertain.

Humans↗

PubMed1978

Supraclavicular traction injuries of the brachial plexus.

Thirty supraclavicular traction injuries of the brachial plexus are reported. Young motor cyclists are frequently involved. Recovery is slow and often incomplete. Myelography remains the most useful investigation for prognostic purposes. The management of intractable pain is discussed. An early assessment of prognosis is an important fact in planning and supervising the long-term management of these patients.

Adult↗

PubMed1978

Injury to the brachial plexus as a result of diagnostic arteriography.

Six cases of brachial plexus injury within the brachial sheath are reported following axillary-brachial arteriography. Direct compression resulted from leakage of arterial blood into the space formed by the fascial sheath. In one, hemorrhage occurred several days after arteriotomy. Early decompression and arteriorrhaphy resulted in restoration of normal function. Permanent nerve damage resulted when surgical decompression was delayed.

Aged↗

PubMed1977

Brachial plexus injury.

A 28-year-old man shot himself in the left posterior triangle of the neck with a shotgun. At the initial operation secondary repair of the resultant brachial plexus injury was decided upon in view of the difficulty in assessing lesions in continuity at this point after injury. The patient had total brachial plexus palsy. Nine weeks after the injury sensory and motor function were returning and the only element of the brachial plexus not showing evidence of nerve fibre continuity was the musculocutaneous nerve. Sural nerve autografts were sutured between the trimmed proximal and distal stumps of this nerve. By 4 months after the injury there was further improvement in both sensory and motor function, and by 18 months there was sensation in the autonomous zones of both median and ulnar nerves and good return of muscle power.

Adult↗

PubMed1977

[Electromyographical and clinical follow up study of brachial plexus lesions (author's transl)].

21 cases of brachial plexus lesions were reexamined clinically and electromyographically after a posttraumatic interval of 3 to 11 years. In accordance with Brooks (1) recovery--as judged by muscle strength, sensation and amount of EMG activity during volontary action--was relatively good in upper plexus lesions, fair in middle plexus lesions and very poor in lower plexus lesions (Fig. 1 A, B). Even in cases of incomplete lower plexus lesions with small residual innervation initially, recovery was only moderate (Fig. 1 C). The tendency for reinnervation decreased with increasing distance of target muscles from the lesion site in the plexus (Fig. 2). Motor and sensory deficits in corresponding dermaresp. myotomes were either congruent or more frequently incongruent with prevalence of motor deficits (Fig. 3). Earliest electromyographical signs of reinnervation were observed after 4 to 9 months (upper and middle plexus lesion). Reinnervation of proximal muscles was completed after 11 months to 2 years (Fig. 4). Posttraumatically regenerated nerve fibers had often decreased conduction velocities (some values as low as 7 m/sec) and showed sometimes abnormal target muscles leading to paradoxical innervation and synkinesias between antagonistic muscles.

Brachial Plexus↗

PubMed1979

[Intramedullary topography of the motor neurons of the brachial plexus of the rat. Preliminary study].

The exact localisation of the motor pools of anterior horn providing the different nerves of the brachial plexus remains unclear. The data obtained have been furnished by different methods: Nissl methods furnish cytoarchitectonic data -- Golgi methods furnish dendro-architectonic data. The topographical data were obtained by the chromatolytic modifications of the moto-neurons after a peripheral nerve injury. The recently used method of the retrograde transport of HRP permits to get information about the exact localisation and the dendritic extent of the neurons of a motor pool related to a particular nerve. We have studied the localisation of the nerves of the brachial plexus in the cervical enlargement of the spinal cord. We have determined the exact extent of the different motor pools in relation to each nerve. It seems that two different regions may be recognized in the anterior horn: a ventro lateral one in relation with the girdle muscles and a dorso lateral region related with the more distal muscles of the anterior limb.

Animals↗

PubMed1977

[Experiences with brachial plexus blocks (author's transl)].

Experiences and results of 7212 brachial plexus blocks by the supraclavicular and 404 by the axillary approach are reported. The times of onset and duration of several local anesthetics are compared. The incidence of pneumothorax was 0.42% (30 cases) when the supraclavicular approach was used. Therefore the axillary technique is recommended to avoid this serious complication.

Brachial Plexus↗

PubMed2026

Exploring the Diagnostic Utility of Ferumoxytol for Brachial Plexus MR Neurography.

Background Ferumoxytol has been described as an alternative contrast agent for vascular suppression in MR neurography (MRN), but its diagnostic utility in patients has yet to be evaluated. Purpose To evaluate the impact of ferumoxytol on vascular suppression, nerve conspicuity, and evaluation of nerve abnormalities at three-dimensional (3D) brachial plexus MRN, compared with noncontrast and gadolinium-enhanced MRN, in participants with suspected Parsonage-Turner syndrome (PTS) or thoracic outlet syndrome (TOS). Materials and Methods This prospective study included participants who underwent 3D MRN with and/or without gadolinium chelate for clinical suspicion of PTS or TOS and subsequently underwent 3D MRN with ferumoxytol (within 3 months of the clinical examination). Two musculoskeletal radiologists qualitatively evaluated 3D short-tau inversion-recovery fast spin-echo scans for the degree of vascular suppression, nerve conspicuity, and presence of nerve abnormalities. Wilcoxon signed-rank or McNemar tests were used for comparing noncontrast and gadolinium-enhanced scans with ferumoxytol-enhanced scans. Results This study included 18 participants (mean age, 42 years ± 15.2 [SD]; 10 men). Ferumoxytol-enhanced scans demonstrated improved vascular suppression compared with both noncontrast scans (both raters, P < .001) and gadolinium-enhanced scans (both P = .04). For rater 2, ferumoxytol-enhanced acquisitions demonstrated improved conspicuity of several nerve segments relative to the noncontrast scan, including segments of the suprascapular (P = .01), axillary (P = .02), and long thoracic nerves (P = .004). The distribution of scores for these nerve segments for rater 1 also favored ferumoxytol-enhanced versus noncontrast scans, but the differences were not statistically significant (all P ≥ .06). There was no evidence of a difference in nerve conspicuity between ferumoxytol-enhanced and gadolinium-enhanced scans (P ≥ .17 for all nerve segments) and also no evidence of discrepancies in abnormal nerve findings between the acquisitions (all P ≥ .48). Conclusion Ferumoxytol improved vascular suppression compared with noncontrast and gadolinium-enhanced 3D short-tau inversion-recovery fast spin-echo sequences in brachial plexus MRN, enhancing the conspicuity of several nerve branches versus noncontrast scans, with similar detection of abnormal nerve findings. © RSNA, 2026 Supplemental material is available for this article.

Humans↗

PubMed1977

Electrophysiological findings in pressure palsy of the brachial plexus.

Two patients with signs and symptoms of paralysis of the brachial plexus, caused by compression during surgery in one (case 1) and by a knapsack in the other (case 2), were examined. The characteristic electrophysiological findings were: (i) severe attenuation of amplitude of motor and sensory nerve action potentials evoked or recorded above the site of nerve injury compared to those evoked or recorded below, and (ii) slowing of motor and sensory conduction across the damaged area. Case 1 made a complete recovery clinically and electrophysiologically; EMG in case 2 suggested the presence of Wallerian degeneration. The palsies were classified as a local demyelinating block alone (case 1) or combined with axonal loss (case 2).

Action Potentials↗