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Intern Med 2021 Feb 22. Epub 2021 Feb 22.

Department of Neurology, Graduate School of Medicine, The University of Tokyo, Japan.

Brain Sci 2020 Dec 22;11(1). Epub 2020 Dec 22.

Department of Human Neuroscience, Sapienza University of Rome, Viale Università, 30-00185 Rome, Italy.

Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory system. Neuropathic pain represents a broad category of pain conditions, common complications of peripheral neuropathies, which are characterized by a combination of positive symptoms, including paresthesia and/or dysesthesia and sensory deficits in the painful area. In the present paper, we aimed to assess neuropathic pain frequency and clinical characteristics of peripheral neuropathies due to different aetiologies according to grading system criteria of the International Association for the Study of Pain for a definitive diagnosis of neuropathic pain. Read More

Autops Case Rep 2020 Sep 2;10(3):e2020202. Epub 2020 Sep 2.

Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, Instituto de Psiquiatria, Peripheral Nerves Group, São Paulo, SP, Brasil.

Radiation-induced brachial plexus neuropathy (RIBPN) is a rare and delayed non-traumatic injury to the brachial plexus, which occurs following radiation therapy to the chest wall, neck, and/or axilla in previously treated patients with cancer. The incidence of RIBPN is more common in patients treated for carcinoma of the breast and Hodgkin lymphoma. With the improvement in radiation techniques, the incidence of injury to the brachial plexus following radiotherapy has dramatically reduced. Read More

Surg Neurol Int 2020 29;11:358. Epub 2020 Oct 29.

Department of Neurosurgery, Hospital da Restauracao, Av Agamenon Magalhaes, Recife, Pernambuco, Brazil.

Background: Distal nerve transfers are an innovative modality for the treatment of C8-T1 brachial plexus lesions. The purpose of this case series is to report the authors' results with hand restoration function by nerve transfer in patients with lower brachial plexus injury.

Methods: Three consecutive nerve transfers were performed in a series of 11 patients to restore hand function after injury to the lower brachial plexus: brachialis motor branch to anterior interosseous nerve (AIN) and supinator branch to the posterior interosseous nerve (PIN) in a first surgical procedure, and AIN to pronator quadratus branch of ulnar nerve between 4 and 6 months later. Read More

Radiographics 2020 Oct;40(6):1686-1714

From the Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill (B.M.G., S.D.D.); and Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Box 8131, St Louis, MO 63110 (M.S.P.).

The brachial plexus is an intricate anatomic structure with an important function: providing innervation to the upper extremity, shoulder, and upper chest. Owing to its complex form and longitudinal course, the brachial plexus can be challenging to conceptualize in three dimensions, which complicates evaluations in standard orthogonal imaging planes. The components of the brachial plexus can be determined by using key anatomic landmarks. Read More

Muscle Nerve 2020 11 14;62(5):E81-E82. Epub 2020 Sep 14.

Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, New York, USA.

Curr Rev Musculoskelet Med 2020 Dec;13(6):651-662

Rothman Orthopaedic Institute, Thomas Jefferson University, 925 Chestnut Street, 5th Floor, Philadelphia, PA, 19107, USA.

Purpose Of Review: Particularly common in collision sports such as American football or rugby, stingers are a traumatic transient neuropraxia of a cervical nerve root(s) or brachial plexus that may last anywhere from minutes to hours. This review summarizes the knowledge on the diagnosis and management of stingers in college and professional collision athletes by providing an overview of their epidemiology and pathophysiology, followed by a discussion on current treatment guidelines and return-to-play recommendations.

Recent Findings: Despite modifications to tackling technique, increasing awareness, and various equipment options, American football continues to have a high rate of cervical spine injuries, the majority of which occur in preseason and regular season competition settings. Read More

Acta Neurochir (Wien) 2020 12 6;162(12):3179-3187. Epub 2020 Jul 6.

Department of Neurosurgery, Mayo Clinic, 200 First St. SW, Gonda 8-214, Rochester, MN, 55905, USA.

Background: Perineural spread (PNS) is an emerging mechanism for progressive, non-traumatic brachial plexopathy. We aim to summarize the pathologies (tumor and infection) shown to have spread along or to the brachial plexus, and identify the proposed mechanisms of perineural spread.

Methods: A focused review of the literature was performed pertaining to pathologies with identified perineural spread to the brachial plexus. Read More

Muscle Nerve 2020 09 5;62(3):363-368. Epub 2020 Jul 5.

Clinical Unit "Eleous" at Religious Community "All Saints Parish in Minsk Eparchy of Belarusian Orthodox Church,", Minsk, Belarus.

Introduction: The main goal of this study was to determine the contribution of the anterior forearm muscles to the compound muscle action potential (CMAP) recorded from the extensor digitorum (ED) after proximal stimulation.

Methods: Twenty-one healthy volunteers and 114 patients with compressive and traumatic radial neuropathies were examined. Stimulation was carried out at six different points: distal third of the upper arm; Erb's point; axilla; medial upper arm; antecubital fossa; and ulnar groove. Read More

Acta Neurochir (Wien) 2020 08 18;162(8):1913-1919. Epub 2020 Jun 18.

Peripheral Nerve & Brachial Plexus Surgery Program, Department of Neurosurgery, Hospital de Clinicas, University of Buenos Aires School of Medicine, 1175 Torre 2 5A, 1428, Buenos Aires, La Pampa, Argentina.

Background: The purpose of this study was to assess the results of elbow flexion strength fatigue, rather than the maximal power of strength, after brachial plexus re-innervation with phrenic and spinal accessory nerves. We designed a simple but specific test to study whether statistical differences were observed among those two donor nerves.

Method: We retrospectively reviewed patients with severe brachial plexus palsy for which either phrenic nerve (PN) or spinal accessory nerve (SAN) to musculocutaneous nerve (MCN) transfer was performed. Read More

Acta Neurochir (Wien) 2020 08 6;162(8):1907-1912. Epub 2020 Jun 6.

Sarah Network of Rehabilitation Hospitals, Brasilia, Brazil.

Background: To recover biceps strength in patients with complete brachial plexus injuries, the intercostal nerve can be transferred to the musculocutaneous nerve. The surgical results are very controversial, and most of the studies with good outcomes and large samples were carried out in Asiatic countries. The objective of the study was to evaluate biceps strength after intercostal nerve transfer in patients undergoing this procedure in a Western country hospital. Read More

Vasc Endovascular Surg 2020 Jul 7;54(5):467-470. Epub 2020 May 7.

Division of Vascular Surgery, UT Southwestern Medical Center, Dallas, TX, USA.

We present a rare case of a 10-cm right subclavian artery pseudoaneurysm, with slow growth over 4 years after a traumatic fracture of the right clavicle. The patient had multiple prior endovascular attempts of embolization and stenting at other hospitals; despite this the pseudoaneurysm continued to grow and caused mass effect and neurologic symptoms. We present our open approach for the repair and a review of literature. Read More

J Clin Neurosci 2020 Aug 24;78:159-163. Epub 2020 Apr 24.

Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran; Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark; Research Unit of Clinical Physiology and Nuclear Medicine, Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; BRIDGE-Brain Research-Inter-Disciplinary Guided Excellence, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Research Unit of Psychiatry, Department of Psychiatry, Psychiatry in the Region of Southern Denmark, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark. Electronic address:

Different mechanisms including knee dislocation, replacement surgery, nerve tumor, lumbar disc herniation, sharp injury, and gunshot wound lead to foot drop. Several surgical techniques have been used for treatment of foot drop, however, they have had sub-optimal outcomes. Soleus branch of tibial nerve is a good donor for nerve transfer for treatment of foot drop. Read More

J Hand Surg Asian Pac Vol 2020 Jun;25(2):143-152

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

Trapezius transfer has shown promise to restore shoulder movements and has stood through the passage of time. We here in describe a modification of trapezius transfer technique and review the current literature available. The modified trapezius transfer in which the trapezius muscle is extended with folded tensor fascia lata graft and attached as distally possible to the deltoid insertion was done in twelve patients at tertiary health care centre in India. Read More

J Infect Public Health 2020 Jul 26;13(7):1047-1050. Epub 2020 Mar 26.

Department of Internal Medicine, Grenoble University Hospital, Grenoble, France; Univ. Grenoble Alpes, Department of Internal Medicine CHU Grenoble, Inserm (U1036), CEA, BIG-BCI, France.

Introduction: Hepatitis E virus (HEV) infection has been reported to be associated with neurological disorders. However, the real prevalence of acute hepatitis E in those diseases is still unknown. We determined the prevalence of anti-HEV IgM antibody in a population with acute non-traumatic, non-metabolic, non-vascular neurological injury. Read More

J Hand Ther 2020 Oct - Dec;33(4):528-539. Epub 2020 Mar 7.

Occupational Therapy, Alfred Health, Melbourne, Victoria, Australia.

Study Design: Prospective longitudinal cohort study.

Introduction: Traumatic brachial plexus injuries (BPIs) can be devastating and negatively impact daily function and quality of life. Occupational therapists play an important role in rehabilitation; however, studies identifying outcomes are lacking. Read More

Clin Neurol Neurosurg 2020 04 23;191:105693. Epub 2020 Jan 23.

The Hand and Microsurgery Center of El Paso, 10175 Gateway West Suite 230, El Paso, Texas, 79925, United States; Clinical Professor, Burrell Osteopathic College of Medicine, Las Cruces, New Mexico, United States. Electronic address:

Objectives: Peripheral neuropathic pain is a common and disabling problem after traumatic brachial plexus injury with global plexopathy secondary to C5 rupture and avulsion of C6, C7, C8, and T1. The purpose of this paper is to evaluate restoration of sensation and pain levels before and after targeted muscle reinnervation to the hand using contralateral C7 nerve transfers in patients who have traumatic brachial plexus injuries with C5 rupture and avulsion of C6, C7, C8, and T1.

Patients And Methods: This paper presents a retrospective review of the outcomes of the surgical management of 11 patients with global plexopathy with C5 rupture and avulsion from C6 to T1 roots. Read More

J Ayub Med Coll Abbottabad 2019 Oct-Dec;31(4):640

Peripheral Nerve & Brachial Plexus Surgery Program, Department of Orthopaedics, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.

We have meticulously read the article titled "Outcome of dynamic compression plate with dorsal radial sliding graft technique for wrist arthrodesis in brachial plexus injury patients". We would like to comment on some aspects of the study and set forth our experience in wrist arthrodesis performed to improve functional outcome in the scenarios cited above. This manuscript aims to highlight the following. Read More

J Peripher Nerv Syst 2020 03 29;25(1):27-31. Epub 2020 Jan 29.

Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.

Brachial plexus neuropathy is often seen in the military population, especially due to pressure (backpack palsy, BPP) or idiopathic (neuralgic amyotrophy, NA). We aimed to gain insight in the disease characteristics of soldiers with brachial plexus neuropathies in the Dutch military population and to compare disease characteristics between patients with BPP and NA. In this retrospective chart review study we aimed to include all patients with brachial plexus neuropathy, who presented in the Joint Military Hospital between 1 January, 2011 and 31 December, 2016. Read More

Turk J Phys Med Rehabil 2019 Jun 22;65(4):411-414. Epub 2019 Nov 22.

Department of Physical Medicine and Rehabilitation, Gazi University Faculty of Medicine, Ankara, Turkey.

Peripheral nervous system complications such as acute demyelinating polyradiculopathy and mononeuropathy may rarely develop after substance use. A 27-year-old man used illegal drugs the day before his admission to the emergency service. Initially, he was suspected for rhabdomyolysis, due to elevated blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, myoglobin, and creatine kinase levels. Read More

BMJ Case Rep 2019 Dec 23;12(12). Epub 2019 Dec 23.

Camden Musculoskeletal Service, University College London Hospitals NHS Foundation Trust, London, UK.

We report a 28-year-old man admitted postmotorcycle versus car in September 2017. The patient sustained multiple injuries in both the upper and lower limbs. He sustained a complex brachial plexus injury on his left side and was transferred immediately to Stanmore Hospital to undergo specialist surgery (supraclavicular brachial plexus exploration and neurolysis) to repair his brachial plexus injury. Read More

Rinsho Shinkeigaku 2020 Jan 17;60(1):41-45. Epub 2019 Dec 17.

Department of Orthopaedic Surgery, Kyoto First Red Cross Hospital.

A 66-year-old woman was admitted to our institution with sudden-onset weakness of her left upper limb. Neurological examination revealed monoplegia and sensory loss of the limb. A brain MRI did not find evidence of an acute ischemic stroke. Read More

World Neurosurg 2020 Mar 16;135:e350-e357. Epub 2019 Dec 16.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address:

Objective: To investigate functional outcome from reconstructive surgery in adult traumatic brachial plexus injury (AT-BPI) with associated vascular lesions.

Methods: A retrospective review was performed of 325 patients with AT-BPI who underwent reconstructive surgery between 2001 and 2012. Patients with (vascular group) and without (control group) vascular injuries were identified by review of medical documentation. Read More

Muscle Nerve 2020 03 24;61(3):390-395. Epub 2019 Dec 24.

Department of Orthopaedic Surgery, University of California, Irvine, California.

Introduction: After traumatic nerve injury, neuromuscular junction remodeling plays a key role in determining functional outcomes. Immunohistochemical analyses of denervated muscle biopsies may provide valuable prognostic data regarding clinical outcomes to supplement electrodiagnostic studies.

Methods: We performed biopsies on nonfunctioning deltoid muscles in two patients after gunshot wounds and visualized the neuromuscular junctions using two-photon microscopy with immunohistochemistry. Read More

Clin Biomech (Bristol, Avon) 2019 12 19;70:209-216. Epub 2019 Oct 19.

Mayo Clinic Department of Orthopedic Surgery, 200 First Street SW, Rochester, MN, USA; Mayo Clinic Department of Physiology & Biomedical Engineering, 200 First Street SW, Rochester, MN, USA. Electronic address:

Background: Injuries to the brachial plexus leave individuals with lasting effects in upper extremity motor function, even with successful surgical restoration of elbow flexion. Quantitatively describing independent patient function during activities of daily living utilizing motion analysis could aid in prioritization of secondary surgical targets, as well as serve as an outcome measure. This study explored the upper extremity kinematic profiles during activities of daily living in adults with brachial plexus injury. Read More

Niger J Clin Pract 2019 Sep;22(9):1301-1303

Department of Anaesthesia and Intensive Care, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

Neuropathic pain responds poorly to common analgesics that effectively control nociceptive pain because its pathophysiology is different and it is usually associated with co-morbidities such as sleep disturbance, depression and anxiety. Patients with this chronic pain are sometimes left with neurolysis as the last resort. A 65-year-old male multiply-injured retiree presented with disabling pain following traumatic brachial plexus injury sustained from road traffic accident 5 years earlier. Read More

J Bone Joint Surg Am 2019 Aug;101(16):e80

Division of Hand and Upper Extremity Surgery, Department of Orthopaedic Surgery (T.S.H., A.T., R.S., D.M.B., and C.J.D.), Department of Neurosurgery (W.Z.R.), and Division of Public Health Sciences, Department of Surgery (C.J.D.), Washington University School of Medicine, Saint Louis, Missouri.

Background: Traumatic brachial plexus injuries (BPIs) disproportionately affect young, able-bodied individuals. Beyond direct costs associated with medical treatment, there are far-reaching indirect costs related to disability and lost productivity. Our objective was to estimate per-patient indirect cost associated with BPI. Read More