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J Hand Surg Asian Pac Vol 2019 Mar;24(1):118-122

1 Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Ottawa, Faculty of Medicine, Ottawa, Ontario, Canada.

A 25-year-old man sustained a right-sided brachial plexus injury from a high-velocity motocross accident. Physical examination and electromyography were consistent with a pan-brachial plexopathy with no evidence of axonal continuity. The patient underwent a spinal accessory to suprascapular nerve transfer and an intercostal to musculocutaneous nerve transfer with interpositional sural nerve grafts. Read More

J Am Acad Orthop Surg 2019 Feb 5. Epub 2019 Feb 5.

From the Emory University Department of Orthopaedics, (Dr. Ahearn and Dr. Seiler), and Georgia Hand, Shoulder and Elbow (Dr. Starr and Dr. Seiler), Atlanta, GA.

Traumatic upper trunk brachial plexopathy, also known as a stinger or burner, is the most common upper extremity neurologic injury among athletes and most commonly involves the upper trunk. Recent studies have shown the incidence of both acute and recurrent injuries to be higher in patients with certain anatomic changes in the cervical spine. In addition, despite modern awareness, tackling techniques, and protective equipment, some think the incidence to be slowly on the rise in contact athletes. Read More

Neurol India 2019 Jan-Feb;67(Supplement):S118-S124

Department of Plastic Surgery, King George Medical University, Lucknow, Uttar Pradesh, India.

Magnetic resonance neurography (MRN) is recognized as the imaging modality of choice in the evaluation of patients with brachial plexopathy. It adds vital information to the results of the clinical evaluation and electrodiagnostic tests and facilitates patient management. Its indications include both trauma and non-traumatic forms of plexopathy such as inflammatory, neoplastic and compressive. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2018;118(10):10-13

Medical Center 'Motus', Yaroslavl, Russia.

Aim: To describe the sonographic phenomenon of the focal 'hourglass-like constriction' of the peripheral nerves (FCPN).

Material And Methods: The authors described 7 patients meeting the criteria for the diagnosis of neuralgic amyotrophy with unilateral FCPN identified with ultrasound in 4 cases and detected intraoperatively in 3 cases (preliminary ultrasound was not performed). The US scanner Sonoscape Pro mode gray scale in the transverse and longitudinal scanning, linear probe 8-15 MHz and Logiq9 scanner with elastography were used. Read More

Plast Reconstr Surg 2019 01;143(1):151-158

Rochester, Minn. From the Department of Orthopedic Surgery, Mayo Clinic.

Background: There is controversy regarding the effectiveness of brachial plexus reconstruction for elbow function in older patients, as reported outcomes are generally poor. The purpose of this study was to evaluate elbow function outcomes in patients older than 50.

Methods: Fifty-eight patients older than 50 years underwent nerve grafting, transfers, or free functioning muscle transfer to improve elbow function after traumatic brachial plexus injury. Read More

Acta Ortop Bras 2018 Mar-Apr;26(2):131-134

. Hand and Microsurgery Group, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.

Objective: To compare magnetic resonance imaging and intraoperative findings in patients diagnosed with traumatic injury to the brachial plexus.

Methods: Patients with a diagnosis of traumatic injury to the brachial plexus admitted to the hand and microsurgery outpatient consult of the Hospital das Clínicas at the University of São Paulo were selected during December 2016. A total of three adult patients with up to six months of injury who underwent surgical treatment were included in the study. Read More

Spinal Cord Ser Cases 2018 21;4:44. Epub 2018 May 21.

1Department of Physical Medicine, Rehabilitation and Sport Medicine, University of Puerto Rico-School of Medicine, San Juan, Puerto Rico.

Introduction: Brown-Séquard Syndrome (BSS) is one of the rarest incomplete spinal cord syndromes. The combination of injuries to peripheral nerves and the central nervous system result in an array of symptoms that can result in overlapping clinical presentations and delayed diagnosis. Early detection of spinal cord injury in patients with peripheral nerve injury has been observed to have a positive effect on outcomes. Read More

World Neurosurg 2018 Jul 11;115:128-133. Epub 2018 Apr 11.

Department of Neurosurgery, Mayo Clinic, Jacksonville, Florida, USA. Electronic address:

Background: Traumatic cervical pseudomeningoceles (TCPs) occur secondary to traction of the cervical nerve roots resulting in violation of the dura. Surgical repair is not necessary in most cases because pseudomeningoceles have a high propensity to spontaneously resolve with conservative management alone. Currently, there are a limited number of cases of large TCPs (large is defined as ≥6 cm in greatest diameter), and there is no established guideline for the management of such lesions. Read More

Plast Reconstr Surg 2018 04;141(4):949-959

Los Angeles, Calif. From the Division of Plastic and Maxillofacial Surgery, University of Southern California Keck School of Medicine, Children's Hospital Los Angeles.

Background: In late presentation of brachial plexus trauma, it is unclear whether donor nerves should be devoted to nerve reconstruction or reserved for free functional muscle transfer. The authors systematically reviewed recovery of elbow flexion after nerve reconstruction versus free functional muscle transfer for late, traumatic brachial plexus palsy.

Methods: A systematic review was performed using the PubMed, Embase, and Cochrane databases to identify all cases of traumatic brachial plexus palsy in patients aged 18 years or older. Read More

J Hand Surg Eur Vol 2018 Jul 16;43(6):596-608. Epub 2018 Mar 16.

1 Department of Orthopaedic Surgery, Ogori Daiichi General Hospital, Ogori, Japan.

The purpose of this study was to evaluate long-term outcomes of the free functioning gracilis transfer in children with traumatic total brachial plexus palsy. We used the free functioning gracilis transfer to reconstruct elbow flexion and prehension in 17 children with a mean age of 13.4 years (range 3-17) who were followed-up over a mean period of 6 years (range 2-16). Read More

NeuroRehabilitation 2018 ;42(1):113-119

Department of Physical Therapy and Special Motility, West University of Timişoara, Timişoara, Romania.

Introduction: Lower motor neurons are the only neurons of the central nervous system (CNS) with the ability to regenerate without any intervention after an axotomy.

Aim: This present study was conducted to analyze clinical and electrophysiological parameters in four groups of upper limb peripheral neuropathies, before and after treatment, comparing the results obtained after three cures of complex rehabilitation therapy.

Materials And Methods: We selected a number of 107 patients (66 women and 41 men) aged between 29 and 77 years (mean age = 49. Read More

Eur Radiol 2018 Jun 9;28(6):2417-2424. Epub 2018 Jan 9.

Department of Plastic Surgery, King George Medical University, Shah Meena Road, Chowk, Lucknow, 226003, India.

Objectives: Many studies have elaborated on the role of magnetic resonance neurography (MRN) in evaluating traumatic brachial plexopathies. Most of these deal with MR findings in adult traumatic plexopathies or children with obstetric brachial plexus palsy (OBPP). Hence, the authors felt the need for this particular study, which focuses on MRN findings in children with non-obstetric traumatic brachial plexus palsy, to find out the distribution and severity of injuries in these patients. Read More

Arq Neuropsiquiatr 2017 Sep;75(9):667-670

Universidade de São Paulo, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Grupo de Cirurgia do Nervo Periférico, São Paulo SP, Brasil.

The treatment of complete post-traumatic brachial plexus palsy resulting in a flail shoulder and upper extremity remains a challenge to peripheral nerve surgeons. The option of upper limb amputation is controversial and scarcely discussed in the literature. We believe that elective amputation still has a role in the treatment of select cases. Read More

Arq Neuropsiquiatr 2017 Sep;75(9):631-634

Universidade de São Paulo, Faculdade de Medicina, Instituto de Psiquiatria, Divisão de Neurocirurgia Funcional, Unidade de Cirurgia de Nervo Periférico, São Paulo, SP, Brasil.

Objective: To establish the correlation between clinical evaluation of motor function recovery and daily living activities in 30 patients with upper traumatic brachial plexus injury submitted to surgery.

Methods: The score of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Louisiana State University Health Sciences Center (LSUHSC) scale were determined in 30 patients. Epidemiologic factors were also examined and correlations were determined. Read More

Plast Reconstr Surg 2017 Aug;140(2):307e-317e

Rochester, Minn. From the Department of Orthopedic Surgery, Division of Hand Surgery, and the Department of Neurosurgery, Mayo Clinic.

Background: In adults with lower trunk brachial plexus injury, proximal nerve surgery for restoration of prehension demonstrates poor outcomes secondary to long distances required for nerve regeneration and time-dependent degradation of motor endplates. Options for reconstruction are limited to distal tendon or nerve transfers and free-functioning muscle transfers. In this article, the authors describe the long-term outcomes of brachialis muscle-to-flexor digitorum profundus transfer to restore prehension in patients with traumatic lower trunk brachial plexus injuries. Read More

J Hepatol 2017 11 20;67(5):925-932. Epub 2017 Jul 20.

Department of Neurology and Immunology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.

Background & Aims: Hepatitis E virus (HEV) has been associated with a number of neurological syndromes, but causality has not yet been established. The aim of this study was to explore the relationship between HEV and neurological illness by prospective HEV testing of patients presenting with acute non-traumatic neurological injury.

Methods: Four hundred and sixty-four consecutive patients presenting to hospital with acute non-traumatic neurological illnesses were tested for HEV by serology and PCR from four centres in the UK, France and the Netherlands. Read More

Neurosurg Focus 2017 Jul;43(1):E3

Department of Orthopaedics, Aswan University, Aswan, Egypt.

It is not uncommon for a severe traumatic brachial plexus injury to involve all 5 roots, resulting in a flail upper limb. In such cases, surgical reconstruction is often palliative, providing only rudimentary function. Nerve transfers are the mainstay of reconstructive strategies due to the predominance of root avulsions. Read More

BMJ Case Rep 2017 May 22;2017. Epub 2017 May 22.

Department of Plastic Surgery, Salisbury NHS Foundation Trust, Salisbury, UK.

Traumatic injuries to the brachial plexus are typically high impact and can be debilitating, life-changing injuries. Backpack palsy is a rare but well-established cause of brachial plexus injury, arising as a result of heavy backpack use. We present an unusual case of backpack palsy with Horner's syndrome. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2017;117(1. Vyp. 2):14-27

Kirov Military Medical Academy, St. Petersburg, Russia.

Aim: To identify neuroplastic changes in the brain structures during treatment of traumatic axonotomy of the brachial plexus (the pathology of peripheral nervous system).

Material And Methods: MRI morphometry of white and grey matter was studied in 62 patients with traumatic axonotomy of the brachial plexus.

Results: There were correlations between the thickness of sensorimotor cortex, morphometric parameters (volume, diffusion, fractional anisotropy) of subcortical formations (corticospinal tracts, the forceps minor), severity of neurological deficit and dynamics of clinical course depending on the therapeutic strategy. Read More

Pain Med 2017 Dec;18(12):2428-2432

Department of Neurology and Psychiatry, Sapienza University, Rome, Italy.

Objective: Prevalence and clinical characteristics of neuropathic pain due to traumatic brachial plexus injury.

Design: Observational epidemiological study.

Setting: Hospital-based multicenter study. Read More

J Hand Surg Am 2017 Apr 27;42(4):293.e1-293.e7. Epub 2017 Feb 27.

Department of Orthopedic Surgery, Division of Hand Surgery, Mayo Clinic, Rochester, MN. Electronic address:

Purpose: After complete 5-level root avulsion brachial plexus injury, the free-functioning muscle transfer (FFMT) and the intercostal nerve (ICN) to musculocutaneous nerve (MCN) transfer are 2 potential reconstructive options for restoration of elbow flexion. The aim of this study was to determine if the combination of the gracilis FFMT and the ICN to MCN transfer provides stronger elbow flexion compared with the gracilis FFMT alone.

Methods: Sixty-five patients who underwent the gracilis FFMT only (32 patients) or the gracilis FFMT in addition to the ICN to MCN transfer (33 patients) for elbow flexion after a pan-plexus injury were included. Read More

Hand (N Y) 2016 12 9;11(4):NP30-NP33. Epub 2016 Sep 9.

The Hospital for Special Surgery, New York, NY, USA.

Conventional wisdom and the available literature demonstrate compromised outcomes following nerve reconstruction for traumatic brachial plexus palsy in the elderly. We present a 74-year-old male who was reconstructed with multiple nerve transfers for brachial plexus palsy after a ski accident. Triceps to axillary nerve transfer, spinal accessory to suprascapular nerve transfer, and ulnar to musculocutaneous nerve transfer were performed 16 weeks post injury. Read More

Acta Neurochir (Wien) 2017 02 20;159(2):281-290. Epub 2016 Dec 20.

Department of Neurosurgery, University Hospital of Brasilia, UnB, Secretaria de Clínica Cirurgica SGAN 605, Av. L2 Norte, Brasilia, DF, CEP: 70.830200, Brazil.

Background: Peripheral nerve injury is a common and important cause of morbidity and disability in patients who have suffered a traumatic injury, particularly younger people. Various different injuries can result in damage to specific nerves. In patients with multiple trauma, the prevalence of peripheral nerve injury is estimated at 2. Read More

Arq Neuropsiquiatr 2016 Nov;74(11):895-901

Universidade Federal da Bahia, Faculdade de Medicina, Programa de Graduação em Medicina e Saúde, Salvador BA, Brasil.

Objective: To describe the pain profile of patients with traumatic brachial plexus injury.

Methods: We enrolled 65 patients with traumatic brachial plexus injury. The Douleur Neuropathique 4 questionnaire was used to classify pain and the SF-36 was used to evaluate quality of life. Read More

Muscle Nerve 2017 07 2;56(1):99-106. Epub 2017 Mar 2.

Weill Medical College of Cornell University, New York, New York, USA.

Introduction: The role of MRI in identifying hourglass constrictions (HGCs) of nerves in Parsonage-Turner syndrome (PTS) is largely unknown.

Methods: Six patients with PTS and absent or minimal recovery underwent MRI. Surgical exploration was performed at identified pathologic sites. Read More

Hand Surg Rehabil 2016 09 27;35(4):283-287. Epub 2016 Jul 27.

Clinique Mont-Louis, 8, rue de la Folie-Regnault, 75011 Paris, France. Electronic address:

Consensus opinion is that active movement of the elbow is a priority in the surgical treatment of total brachial plexus injuries. But the indications and neurotization techniques used to restore motor function of the hand are the subject of discussion. The aim of this retrospective study was to evaluate, in adult patients with complete post-traumatic paralysis of the brachial plexus, the functional results of neurotization of four intercostal nerves on the musculocutaneous nerve and grafting of the C5 root by one strand on the nerve to the long head of triceps and three strands on the medial component of the median nerve. Read More

Singapore Med J 2016 Oct;57(10):552-560

Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Alexandra Health System, Singapore.

Adult-onset brachial plexopathy can be classified into traumatic and non-traumatic aetiologies. Traumatic brachial plexopathies can affect the pre- or postganglionic segments of the plexus. Non-traumatic brachial plexopathies may be due to neoplasia, radiotherapy, thoracic outlet syndrome and idiopathic neuralgic amyotrophy. Read More

Neuroimage Clin 2016 26;12:277-84. Epub 2016 Jul 26.

Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Neurologia Deolindo Couto, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

This study aims at the effects of traumatic brachial plexus lesion with root avulsions (BPA) upon the organization of the primary motor cortex (M1). Nine right-handed patients with a right BPA in whom an intercostal to musculocutaneous (ICN-MC) nerve transfer was performed had post-operative resting state fMRI scanning. The analysis of empirical functional correlations between neighboring voxels revealed faster correlation decay as a function of distance in the M1 region corresponding to the arm in BPA patients as compared to the control group. Read More

J Clin Neurophysiol 2016 Dec;33(6):549-553

Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.

Background: Gracilis muscle graft transplantation is one of the last resort surgical options to restore elbow flexion in patients with chronic traumatic upper-trunk brachial plexopathies.

Methods: We retrospectively identified 34 patients who underwent surgeries between 1997 and 2014, and had postoperative follow-up for at least 12 months. Demographic, clinical, and electromyographic preoperative and postoperative data were analyzed. Read More

Orthopedics 2016 Jul 6;39(4):e756-9. Epub 2016 Jun 6.

Pectoralis major injuries are relatively uncommon and can pose a diagnostic challenge. Deformity and weakness of this muscle in weight lifters is typically due to traumatic tendon rupture and often requires surgical repair. However, there are other less common etiologies that can mimic the clinical presentation of pectoralis major wasting and weakness that require different treatment approaches. Read More

Acta Neurochir (Wien) 2016 09 4;158(9):1793-800. Epub 2016 Jun 4.

Peripheral Nerve Surgery Unit, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Background: The phrenic nerve can be transferred to the musculocutaneous nerve in patients with traumatic brachial plexus palsy in order to recover biceps strength, but the results are controversial. There is also a concern about pulmonary function after phrenic nerve transection. In this paper, we performed a qualitative systematic review, evaluating outcomes after this procedure. Read More

Hand Clin 2016 May 28;32(2):257-62. Epub 2016 Feb 28.

Department of Surgery, Palo Alto VA, Suite 400, 770 Welch Road, Palo Alto, CA 94304, USA; Division of Plastic Surgery, Stanford University, Suite 400, 770 Welch Road, Palo Alto, CA 94304, USA. Electronic address:

Traumatic nerve injuries can be devastating and life-changing events, leading to functional morbidity and psychological stress and social constraints. Even in the event of a successful surgical repair with recovered motor function, pain can result in continued disability and poor quality of life. Pain after nerve injury can also prevent recovery and return to preinjury life. Read More

Int J Orthop Trauma Nurs 2016 Aug 27;22:29-35. Epub 2015 Nov 27.

Scottish National Brachial Plexus Injury Service, New Victoria Hospital, Room 2.10M, Glasgow G42 9LF, UK. Electronic address:

There is limited qualitative research available that explores the impact of a traumatic brachial plexus injury on patients and their quality of life experiences. This paper builds upon previous work on this subject by this author. Patients were selected from those who were on the database for the Scottish National Brachial Plexus Injury Service between 2011 and 2013. Read More

Bone Joint J 2016 Feb;98-B(2):209-17

Ogori Daiichi General Hospital, 862-3, Shimogo, Ogori, Yamaguchi-City, Yamaguchi-Prefecture, 754-0002, Japan.

Aims: Between 2002 and 2011, 81 patients with a traumatic total brachial plexus injury underwent reconstruction by double free muscle transfer (DFMT, 47 cases), single muscle transfer (SMT, 16 cases) or nerve transfers (NT, 18 cases).

Methods: They were evaluated for functional outcome and quality of life (QoL) using the Disability of Arm, Shoulder and Hand questionnaire, both pre- and post-operatively. The three groups were compared and followed-up for at least 24 months. Read More

Pediatr Radiol 2016 May 30;46(5):695-703. Epub 2015 Dec 30.

Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children's Hospital, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.

Background: Ultrasound has been utilized in the evaluation of compressive and traumatic peripheral nerve pathology.

Objective: To determine whether US can provide comprehensive evaluation of the post-ganglionic brachial plexus in the setting of neonatal brachial plexus palsy and whether this information can be used to guide preoperative nerve reconstruction strategies.

Materials And Methods: In this retrospective cohort study, preoperative brachial plexus ultrasonography was performed in 52 children with neonatal brachial plexus palsy who were being considered for surgery. Read More

J Hand Surg Am 2016 Feb 22;41(2):173-9. Epub 2015 Dec 22.

Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY; Weill Medical College of Cornell University, New York, NY. Electronic address:

Purpose: To report short-term and long-term outcomes on a single patient cohort observed longitudinally after nerve reconstruction for adult brachial plexus injury.

Methods: Eleven male patients who underwent plexus reconstruction by the same surgeon at 2 institutions presented for clinical examination 7.5 or more years after surgery (average, 11. Read More

Neurosurgery 2016 Jun;78(6):844-50

Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.

Background: Depression has been associated with poor outcomes in neurosurgical patients, including increased pain, poorer functional recovery, delayed return to work, and decreased patient satisfaction. No reports exist regarding an association of psychiatric diagnoses with outcomes after brachial plexus reconstruction. As outcomes and patient satisfaction become increasingly important to payers and physician reimbursement, assessing modifiable preoperative risk factors for their association with poor outcome and patient satisfaction is imperative. Read More

Neurohospitalist 2015 Oct;5(4):212-6

UCSF Medical Center, San Francisco, CA, USA.

Three cases of longitudinally extensive cervical myelopathies temporally associated with neck injections are presented. The spinal cord injury was similar radiographically, despite a number of different needle approaches and substances injected. In recent years, there have been reports of an acute cervical myelopathy immediately following an injection procedure in the neck. Read More

J Spinal Cord Med 2017 03 27;40(2):175-180. Epub 2015 Aug 27.

a Department of Neurology , Third Faculty of Medicine, Charles University , Prague , Czech Republic.

Objective: Brachial plexus injuries are usually severe and involve the entire brachial plexus, sometimes occurring with root avulsions. Imaging and electrodiagnostic studies are an essential part of the lesion evaluation; however, the results sometimes show a discrepancy. The cutaneous silent period (SP) is a spinal inhibitory reflex mediated by small-diameter A-delta nociceptive fibers. Read More

J Neurosurg 2015 Jun 3;122(6):1413-20. Epub 2015 Apr 3.

2Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan.

Object: Complete avulsion traumatic brachial plexus injuries (BPIs) can be treated using nerve and musculoskeletal reconstruction procedures. However, these interventions are most viable within certain timeframes, and even then they cannot restore all lost function. Little is known about how patients make decisions regarding surgical treatment or what impediments they face during the decision-making process. Read More

Int J Orthop Trauma Nurs 2015 Feb 23;19(1):15-23. Epub 2014 Jan 23.

Scottish National Brachial Plexus Injury Service New Victoria Hospital, Glasgow. G42 9LF, United Kingdom.

This paper presents a case study that demonstrates how collaborative working between professionals enhanced the holistic care for a patient following a traumatic brachial plexus injury. The paper will describe the patient's journey of care from initial presentation, diagnosis and assessment, acute care provision, discharge & rehabilitation to ongoing supportive counselling. The care encompasses input from both a nursing and occupational therapy perspective. Read More

J Rehabil Med 2015 May;47(5):438-44

, Menzies Health Institute, Griffith University,, Queensland, Australia.

Objective: To identify the range of activities limited following adult traumatic brachial plexus injury and triangulate these with existing patient-reported outcome measures identified from the literature.

Design: A qualitative cross-sectional design.

Subjects: Adults with traumatic brachial plexus injury and expert clinicians. Read More

Eur J Radiol 2015 May 16;84(5):927-32. Epub 2015 Feb 16.

Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Vivekanandapuri, Lucknow 226 007, India.

Objectives: Imaging of the brachial plexus has come a long way and has progressed from plain radiography to CT and CT myelography to MRI. Evolution of MR imaging sequences has enabled good visualization of the small components of the plexus. The purpose of our study was to correlate the results of MR neurography (MRN) in patients with traumatic brachial plexopathy with their operative findings. Read More

A A Case Rep 2014 Aug;3(3):29-34

From the *Rehabilitation Institute of Chicago, Northwestern McGaw Medical Center; †Department of Physical Medicine and Rehabilitation; ‡Department of Anesthesiology, Advocate Illinois Masonic Medical Center; §Department of Anesthesiology, University of Illinois; and ‖Department of Physical Medicine and Rehabilitation, Rush University Medical Center, Chicago, Illinois.

Brachial plexus avulsion is a rare and debilitating condition frequently associated with severe, intractable neuropathic pain. Interventional treatment modalities include dorsal root entry zone lesioning, stellate ganglion blockade, and neuromodulation such as spinal cord stimulation. We present a case of a 42-year-old woman with a traumatic left upper extremity brachial plexus avulsion injury after a motor vehicle accident and treatment of deafferentation pain complicated by complex regional pain syndrome type II. Read More

Hand Surg 2015 ;20(1):39-45

Department of Orthopaedic Surgery and Rehabilitation, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Background: In Thailand, brachial plexus injury is a common traumatic injury that affects the function of the upper extremity. The current treatments focus mainly on improving the motor and sensory function. Apart from the motor and sensory deficit, these patients usually suffer from pain. Read More

Plast Reconstr Surg 2015 Jan;135(1):135e-41e

New York, N.Y. From the Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery.

Background: Nerve transfer surgery has revolutionized the management of traumatic brachial plexus injures. However, the optimal size ratio of donor to recipient nerve has yet to be elucidated. The authors investigated the axon count ratios of ulnar and median fascicular transfers to restore elbow flexion. Read More

Pain Med 2015 Apr 19;16(4):777-81. Epub 2014 Dec 19.

Department of Anesthesiology, Clement Zablocki VA Medical Center, Milwaukee, Wisconsin, USA; Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.

Objective: Phantom limb pain is a painful sensation perceived in the absent limb following surgical or traumatic amputation. Phantom limb sensations, which are nonpainful, occur in nearly all amputees. Deafferentation can also produce similar symptoms. Read More

J Neurosurg 2015 Jun 12;122(6):1421-8. Epub 2014 Dec 12.

1Department of Hand Surgery, Beijing Jishuitan Hospital, Peking University, Beijing;

Object: In this report, the authors review complications related to the modified prespinal route in contralateral C-7 transfer for repairing brachial plexus nerve root avulsion injury and suggest a prevention strategy.

Methods: A retrospective, nonselected amalgamation of every case of modified contralateral C-7 transfer through the prespinal route was undertaken. The study population comprised 425 patients treated between February 2002 and August 2009. Read More

Radiologia 2015 Jan-Feb;57(1):22-34. Epub 2014 Nov 15.

Departamento de Neurología, Fundación para la lucha de las enfermedades neurológicas de la infancia Dr. Raúl Carrea (FLENI), Buenos Aires, Argentina.

Magnetic resonance neurography is a technique that complements clinical and electrophysiological study of the peripheral nerves and brachial and lumbosacral plexuses. Numerous focal processes (inflammatory, traumatic, primary tumors, secondary tumors) and diffuse processes (diabetic polyneuropathy, chronic idiopathic demyelinating polyneuropathy due to amyloidosis or Charcot-Marie-Tooth disease) can involve the lumbosacral plexus. This article reviews the anatomy of the lumbosacral plexus, describes the technique for neurography of the plexus at our institution, and shows the diverse diseases that affect it. Read More

Acta Neurochir (Wien) 2014 Dec 18;156(12):2345-9. Epub 2014 Oct 18.

Department of Neurosurgery of Hospital of the Restoration, Recife, Brazil,

Objective: To evaluate the transfer of the spinal accessory nerve to the suprascapular nerve through the anterior or posterior approach in patients with late traumatic brachial plexus injuries.

Methods: This study includes patients with late brachial plexus injuries that underwent a spinal accessory-to-suprascapular nerve transfer. They were divided into two equal groups, A and B, in which the spinal accessory nerve was transferred to the suprascapular nerve, respectively, through the anterior or posterior approach. Read More