Peripheral nerve lesions associated with missile-induced pseudoaneurysms

Abstract

Whether or not a missile-induced pseudoaneurysm associated with a nerve lesion will be recognized before surgery depends on its location and clinical presentation. The nerves involved almost invariably exhibit a lesion in continuity, but the resulting nerve damage can be severe, particularly if surgery is delayed for more than 3 to 4 days after neurological worsening has begun. A successful outcome may be expected if an appropriate surgical technique (neurolysis or grafting) is chosen on the basis of the intraoperative discovery of nerve action potentials.

Traumatic Pseudoaneurysm of Axillary Artery Combined with Brachial Plexus Injury

“…In our series, four of nine patients (44.4%) had sustained a stab injury, another four patients (44.4%) had sustained a traffic accident injury, and the other one patient (11.1%) had sustained a fall accident injury. Thus, in contrast to previous reports [1] , [2] , [9] , [10] , [11] , [12] we found that violent blunt trauma, e.g., from traffic accidents, was a notable cause of traumatic pseudoaneurysms of the axillary artery combined with brachial plexus injury.…”

“…Traumatic pseudoaneurysms of the axillary artery are rarely encountered in civilian clinical practice, with case reports comprising the majority of the literature on this condition. Penetration trauma, such as stab wounds and gun missile wounds, is the most common cause of pseudoaneurysms [9] . In our series, four of nine patients (44.4%) had sustained a stab injury, another four patients (44.4%) had sustained a traffic accident injury, and the other one patient (11.1%) had sustained a fall accident injury.…”

“…Neurological compression may present as a complication in 10% to 30% of patients with a pseudoaneurysm [9] . A patient with a pseudoaneurysm could present with pain or signs of a neurological deficit several hours or many years after the initial injury [9] , [15] .…”

“…Neurological compression may present as a complication in 10% to 30% of patients with a pseudoaneurysm [9] . A patient with a pseudoaneurysm could present with pain or signs of a neurological deficit several hours or many years after the initial injury [9] , [15] . However, in patients with a traumatic axillary artery pseudoaneurysm combined with a brachial plexus injury, neurological compression can be closely related to the anatomic axilla and a host of neurovascular structures in this region.…”

Lokale Applikation von Deferroxamin zur Verbesserung der Regeneration peripherer Nerven im Tierversuch

“…Als weitere Beispiele sind zu nennen die Nervenverletzungen, die bei offenen Frakturen, onkologischen Erkrankungen oder einfachen Schnittwunden auftreten. Nicht unerwähnt bleiben sollten an dieser Stelle auch die iatrogenen Verletzungen peripherer Nerven im Rahmen invasiver Diagnostik oder operativer Eingriffe [14,23].…”