MR neurography of sciatic nerve injection injury

Pham, Mirko; Wessig, Carsten; Brinkhoff, Jörg; Reiners, Karlheinz; Stoll, Guido; Bendszus, Martin

doi:10.1007/s00415-010-5895-7

Cited by 29 publications

(20 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This decrease of FA values and increase of RD values becomes more conspicuous at the compression site or traction/transection point, as well as in the distal segment, probably due to a Wallerian degeneration mechanism (39). These changes are less evident at proximal segments of the damaged nerve (37). Respecting AD, it might theoretically decrease at the distal segment of a damaged PN as there is interruption of the normal axonal flow (27).…”

Section: Peripheral Nerve Traumatic Lesionsmentioning

confidence: 98%

“…However, these parameters may appear insufficient for an adequate nerve evaluation and may not show statistically significant differences between each nerve segments. Thanks to the development of DTN sequences, diverse studies have demonstrated a decrease of FA values, due to the loss of fiber anisotropy and the presence of edema (37). At the same nerve segment, an increase of RD is depicted due to the existence of a facilitated diffusion within the perpendicular plane owing to the disruption of physiological barriers that impeded the motion of water molecules in the short PN axis, mainly myelin sheaths but also endoneurium and perineurium (38) ( Figure 5).…”

Section: Peripheral Nerve Traumatic Lesionsmentioning

confidence: 99%

See 1 more Smart Citation

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Noguerol¹,

Barousse²,

Socolovsky

et al. 2017

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

Traumatic conditions of peripheral nerves and plexus have been classically evaluated by morphological imaging techniques and electrophysiological tests. New magnetic resonance imaging (MRI) studies based on 3D fat-suppressed techniques are providing high accuracy for peripheral nerve injury evaluation from a qualitative point of view. However, these techniques do not provide quantitative information. Diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) are functional MRI techniques that are able to evaluate and quantify the movement of water molecules within different biological structures. These techniques have been successfully applied in other anatomical areas, especially in the assessment of central nervous system, and now are being imported, with promising results for peripheral nerve and plexus evaluation. DWI and DTI allow performing a qualitative and quantitative peripheral nerve analysis, providing valuable pathophysiological information about functional integrity of these structures.In the field of trauma and peripheral nerve or plexus injury, several derived parameters from DWI and DTI studies such as apparent diffusion coefficient (ADC) or fractional anisotropy (FA) among others, can be used as potential biomarkers of neural damage providing information about fiber organization, axonal flow or myelin integrity. A proper knowledge of physical basis of these techniques and their limitations is important for an optimal interpretation of the imaging findings and derived data. In this paper, a comprehensive review of the potential applications of DWI and DTI neurographic studies is performed with a focus on traumatic conditions, including main nerve entrapment syndromes in both peripheral nerves and brachial or lumbar plexus.

show abstract

Section: Peripheral Nerve Traumatic Lesionsmentioning

confidence: 98%

Section: Peripheral Nerve Traumatic Lesionsmentioning

confidence: 99%

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Noguerol¹,

Barousse²,

Socolovsky

et al. 2017

Quant. Imaging Med. Surg.

View full text Add to dashboard Cite

show abstract

“…The peroneal division of the sciatic nerve is more frequently injured than the tibial division because of its more lateral position, reduced protective connective tissues, and the relative tethering of the nerve course. 2,13,18 Anatomical variations, such as an absence of (or abnormal subdivision of) the piriformis muscle, or the passing of the peroneal division through the piriformis muscle, may also be associated with nerve injuries after injection. 19,20 The length of the needle, the angle of the needle and the position of the patient during injection (such as lateral decubitus, upright or leaning forward instead of prone) are other major factors in NII.…”

Section: Direct Needle Traumamentioning

confidence: 99%

Sciatic nerve injection injury

Kim

Park

2014

J Int Med Res

View full text Add to dashboard Cite

Nerve injury is a common complication following intramuscular injection and the sciatic nerve is the most frequently affected nerve, especially in children, the elderly and underweight patients. The neurological presentation may range from minor transient pain to severe sensory disturbance and motor loss with poor recovery. Management of nerve injection injury includes drug treatment of pain, physiotherapy, use of assistive devices and surgical exploration. Early recognition of nerve injection injury and appropriate management are crucial in order to reduce neurological deficit and to maximize recovery. Sciatic nerve injection injury is a preventable event. Total avoidance of intramuscular injection is recommended if other administration routes can be used. If the injection has to be administered into the gluteal muscle, the ventrogluteal region (gluteal triangle) has a more favourable safety profile than the dorsogluteal region (the upper outer quadrant of the buttock).

show abstract

“…The sciatic nerve derives from the fourth and fifth lumbar and first and second sacral roots, coursing down deeper to the piriformis muscle with anatomical variations. It continues posteromedially to the hip and distally deep in the thigh before dividing into the tibial and common peroneal nerves above the popliteal fossa [2,3].MR imaging patterns vary depending on the muscle denervation stage: acute and subacutely denervated muscles show high SI on fluid-sensitive images and normal SI on T1-weighted images; in chronic denervation, muscle atrophy and fatty infiltration demonstrate high SI on T1-weighted images in association with volume loss [4]. On the other hand, myonecrosis is revealed by high SI on T1-weighted images, heterogeneously high SI on T2-weighted images, and rim enhancement on contrastenhanced images [5].…”

mentioning

confidence: 99%

mentioning

confidence: 99%

Foot drop after a suicide attempt

2014

View full text Add to dashboard Cite

Sciatic neuropathy with denervation and myonecrosisA 33-year-old male presented with a 2-month history of left foot drop, starting upon waking up 3 days after a suicide attempt with ingestion of high doses of phenobarbital, clonazepam, and alcohol. Painful left drop foot, trophic changes in the lower extremities, and bilateral Achilles areflexia were noted. Magnetic resonance neurography (MRN) of the lumbosacral plexus and left thigh showed thickening and signal intensity (SI) abnormality in the left sciatic nerve along the pelvic outlet and proximal thigh (Fig. 1). Denervation of the lumbosacral plexus affecting the quadratus femoris, piriformis, obturator, and adductor muscles with areas without contrast enhancement consistent with myonecrosis was seen on the pelvis, while denervation of the hamstring muscles related to sciatic neuropathy was seen on the thigh (Fig. 2). Electroneuromyography showed complete motor and sensitive axonal impairment of the left peroneal nerve, partial impairment of the left tibial nerve (with reinnervation), and partial impairment of the left femoral nerve.A compressive-ischemic mechanism after a long-term sideways position during unconsciousness was indicated as the cause of the clinical and imaging findings in this case. Sciatic neuropathy is the second most common cause in the legs, after peroneal neuropathy, and may be caused by acute or chronic compression, stretching, ischemia, laceration, or toxic injury (injections) as well as iatrogenic lesions (hip arthroplasty). Increased pressure on the nerve can cause injury either directly or indirectly as a result of compression of the vasa nervorum if the ischemia is prolonged, which was the most likely mechanism in our case [1,2]. The sciatic nerve derives from the fourth and fifth lumbar and first and second sacral roots, coursing down deeper to the piriformis muscle with anatomical variations. It continues posteromedially to the hip and distally deep in the thigh before dividing into the tibial and common peroneal nerves above the popliteal fossa [2,3].MR imaging patterns vary depending on the muscle denervation stage: acute and subacutely denervated muscles show high SI on fluid-sensitive images and normal SI on T1-weighted images; in chronic denervation, muscle atrophy and fatty infiltration demonstrate high SI on T1-weighted images in association with volume loss [4]. On the other hand, myonecrosis is revealed by high SI on T1-weighted images, heterogeneously high SI on T2-weighted images, and rim enhancement on contrastenhanced images [5]. A possible overlap of denervation No related papers from the same study have been published or submitted.The case presentation can be found at

show abstract

MR neurography of sciatic nerve injection injury

Cited by 29 publications

References 17 publications

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Quantitative magnetic resonance (MR) neurography for evaluation of peripheral nerves and plexus injuries

Sciatic nerve injection injury

Foot drop after a suicide attempt

Contact Info

Product

Resources

About