The role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus

Hems, Tej; Birch, R

doi:10.1016/s0266-7681(97)80192-1

Cited by 16 publications

(29 citation statements)

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“…Intradural ruptures (rootlet rupture proximal to the dorsal root ganglion) or central avulsions (rootlet and central nervous tissue avulsed from the spinal cord) 8,21,22 can result in anterior horn cell death 6 . Central avulsions intrinsically cause spinal cord damage; this is evidenced by signal intensity changes within the spinal cord on MRI in up to 20% of patients with brachial plexus injury 23 and by MRI findings of spinal cord hemorrhage, scarring, edema, and/or posttraumatic syrinx in preganglionic injuries 24,25 . Another mechanism by which preganglionic injuries may cause spinal cord injury is by acute spinal cord compression and/or displacement due to scar tissue 26 or epidural, subarachnoid, or subdural hematoma 10,11 .…”

mentioning

confidence: 99%

Concomitant Traumatic Spinal Cord and Brachial Plexus Injuries in Adult Patients

Rhee

Pirola

Hébert-Blouin

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

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mentioning

confidence: 99%

Concomitant Traumatic Spinal Cord and Brachial Plexus Injuries in Adult Patients

Rhee

Pirola

Hébert-Blouin

et al. 2011

The Journal of Bone and Joint Surgery-American Volume

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“…30,31 Its predictive value for detecting nerve root avulsions has been evaluated [32][33][34][35] and has been found to have similar 36,37 or greater 38 value compared with CT myelography in adults. MR myelography has also been evaluated in neonatal brachial plexus palsy 25,[39][40][41][42][43][44] but is yet to be widely adopted.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of CT Myelography, MR Myelography, and Both in Neonatal Brachial Plexus Palsy

Tse

Nixon²,

Iyer³

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Although most infants with brachial plexus palsy recover function spontaneously, approximately 10 -30% benefit from surgical treatment. Pre-operative screening for nerve root avulsions is helpful in planning reconstruction. Our aim was to compare the diagnostic value of CT myelography, MR myelography, and both against a surgical criterion standard for detection of complete nerve root avulsions in birth brachial plexus palsy.

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“…Controversy over the methods dates back to the early 1900s, when Adson described his test for TOS as being positive when it showed a loss of pulse and the onset of dysesthesia with arm abduction in the elevated posture [6][7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Background and Purposementioning

confidence: 99%

“…Ultrasound is used to visualize these nerve structures and the surrounding anatomy in real time, and although this technique has been used dynamically [9], in most cases of nerve pathology it is still used as a static study [32,2,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Section: Background and Purposementioning

confidence: 99%

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Dynamic Neuromusculoskeletal Ultrasound Documentation of Brachial Plexus/Thoracic Outlet Compression during Elevated Arm Stress Testing

Fried¹,

Nazarian

2013

Hand (New York, N,Y.)

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Background The diagnosis and validation of thoracic outlet syndrome/brachial plexopathy (TOS) remains a difficult challenge for surgeons, neurologists, and radiologists. This is due to the fact that the responses of standard elevated arm stress tests can be considered somewhat subjective and can vary. Therefore, non-vascular TOS cases are presently diagnosed clinically, and any objective diagnosis has been controversial. Methods This is a technique paper describing the use of dynamic neuromusculoskeletal ultrasound to assist in the diagnosis of thoracic outlet/brachial plexus pathology. We propose a new way to observe the brachial plexus dynamically, so that physical verification of nerve compression between the anterior and middle scalene muscles can be clearly made at the onset of clinical symptoms. This gives a way to objectively identify clinically significant brachial plexus compression. Results Dynamic testing can add objective analysis to tests such as the elevated arm stress tests and can correlate the onset of symptoms with plexus compression between the anterior and middle scalene muscles. With this, the area of pathologic compression can be identified and viewed while performing the dynamic testing. If compression is seen and the onset of symptoms ensues, this is a positive confirmatory test for the presence of TOS and a clinically significant disease. Conclusions This paper offers a simple, objective, and visual diagnostic test that can validate the presence or absence of brachial plexus compression during arm elevation in patients with brachial plexus injury and thoracic outlet syndrome.

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The role of magnetic resonance imaging in the management of traction injuries to the adult brachial plexus

Cited by 16 publications

References 0 publications

Concomitant Traumatic Spinal Cord and Brachial Plexus Injuries in Adult Patients

Concomitant Traumatic Spinal Cord and Brachial Plexus Injuries in Adult Patients

The Diagnostic Value of CT Myelography, MR Myelography, and Both in Neonatal Brachial Plexus Palsy

Dynamic Neuromusculoskeletal Ultrasound Documentation of Brachial Plexus/Thoracic Outlet Compression during Elevated Arm Stress Testing

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