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Clin Neurophysiol 2021 Jul 16;132(7):1398-1406. Epub 2021 Apr 16.

Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China. Electronic address:

Objective: To investigate the impact of early vs. delayed surgical decompression on peripheral motor axonal dysfunction following acute traumatic central cord syndrome (ATCCS).

Methods: Both axonal excitability testing and motor unit number estimation (MUNE) were performed in 30 ATCCS patients (early- vs. Read More

J Clin Neurosci 2021 May 20;87:116-124. Epub 2021 Mar 20.

Department of Neurology, Hospital da Luz Lisboa, Lisbon, Portugal; Department of Neurology, Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; Institute of Physiology, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.

Introduction: Potentially life-threatening disorders may present in the emergency department with acute tetraparesis, and their recognition is crucial for an appropriate management and timely treatment. Our review aims to systematize the differential diagnosis of acute non-traumatic tetraparesis.

Results: Causes of tetraparesis can be classified based on the site of defect: upper motor neuron (UMN), peripheral nerve, neuromuscular junction or muscle. Read More

Brain Sci 2021 Jan 30;11(2). Epub 2021 Jan 30.

Department of Diagnosis and Treatment Services, Radiodiagnostics, "Maggiore della carità" Hospital, University of Piemonte Orientale (UPO), Via Solaroli 17, 28100 Novara, Italy.

Background: Traumatic brachial plexus injuries are rare but serious consequences of major traumas. Pre-ganglionic lesions are considered irreparable, while post-ganglionic injuries can be potentially treated if an early diagnosis is available. Pre-surgical diagnosis is important to distinguish low-grade from high-grade lesions and to identify their location. Read More

Int J Mol Sci 2021 Jan 8;22(2). Epub 2021 Jan 8.

Neurosurgery Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126 Turin (TO), Italy.

Traumatic peripheral nerve lesions affect hundreds of thousands of patients every year; their consequences are life-altering and often devastating and cause alterations in movement and sensitivity. Spontaneous peripheral nerve recovery is often inadequate. In this context, nowadays, cell therapy represents one of the most innovative approaches in the field of nerve repair therapies. Read More

Diagnostics (Basel) 2020 Dec 26;11(1). Epub 2020 Dec 26.

Department of Neurology and Clinical Neurophysiology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.

Peripheral nerve injury is a potentially debilitating disorder that occurs in an estimated 2-3% of all patients with major trauma, in a similar percentage of medical procedures. The workup of these injuries has traditionally been clinical, combined with electrodiagnostic testing. However, this has limitations, especially in the acute phase of the trauma or lack of any recovery, when it is very important to determine nerve continuity and perform surgical exploration and repair in the case of the complete transection or intraneural fibrosis. Read More

J Oral Pathol Med 2021 May 30;50(5):492-501. Epub 2020 Dec 30.

Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Background: Brain-derived neurotrophic factor (BDNF) and neurotrophin receptors have been recognized as fundamental regulators of normal brain development, homeostasis, and plasticity. They have also been studied in the behavior of central nervous system tumors. Here, we studied the pattern of BDNF, TrkB and p75NTR immunoexpression in peripheral benign and malignant neural lesions in head and neck. 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

Eur J Trauma Emerg Surg 2020 Sep 26. Epub 2020 Sep 26.

Peripheral Nerve Surgery Unit, Division of Functional Neurosurgery, Institute of Psychiatry, University of São Paulo Medical School, Rua Sílvio Sacramento, 73, Pinheiros, São Paulo, 05408-040, Brazil.

Background: Shoulder abduction is crucial for daily activities, and its restoration is one of the surgical priorities. We evaluated the predictive factors of shoulder abduction functional outcome after spinal accessory nerve (SAN) to suprascapular nerve (SSN) transfer, with special emphasis on the effect of time from injury to the surgery, in the treatment of traumatic brachial plexus injuries.

Method: This cohort included adult patients who underwent SAN-to-SSN transfer with a preoperative Medical Research Council strength grade 0 and a follow-up of minimum 18 months. Read More

Neurol Res 2020 Dec 8;42(12):995-1002. Epub 2020 Sep 8.

Faculty of Medicine, University of Belgrade , Belgrade, Serbia.

Objective: Brachial plexus injuries are among the most complex injuries of the peripheral nervous system and among the most devastating injuries overall. In complete lesions, functional priorities include the reinnervation of the musculocutaneous and axillary nerves for proximal functions restoration. Three major nerves - radial, median, and ulnar - and the corresponding muscles remain denervated, which results in subsequent muscle atrophy. Read More

Orthop Traumatol Surg Res 2020 Oct 3;106(6):1095-1100. Epub 2020 Aug 3.

Department of Orthopedics - Service of Hand Surgery, Clinique du Mont-Louis, 8-10, rue de la Folie-Regnault, 75011 Paris, France.

Introduction: In traumatic proximal brachial plexus lesions (i.e., C5/C6), reconstruction of the musculocutaneous, axillary and suprascapular nerves yields satisfactory short- and medium-term functional outcomes. Read More

Muscle Nerve 2020 12 13;62(6):654-663. Epub 2020 Aug 13.

H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.

The sonographic appearance of soft tissue can be altered by trauma and positional change with torsional stress. This creates challenges for ultrasonographic interpretation, because most descriptive literature and standard instructional references are displayed in anatomically neutral or other conventional positions. Knowledge of anatomic alteration and changes in sonographic appearance with torsional stress is essential for accurately assessing soft tissue abnormalities in conditions of spasticity, traumatic and post-surgical changes, and other conditions that distort musculoskeletal relationships. Read More

Zentralbl Chir 2020 Dec 2;145(6):541-548. Epub 2020 Jul 2.

Klinik für Neurologie, Städtisches Klinikum Dessau, Deutschland.

Nerve ultrasound is a fairly new non-invasive method to visualise peripheral nerves and to detect peripheral nerve lesions. This technique can depict nerve compression syndromes and their aetiologies as well as fascicular torsions. It is also suitable for sonographically guided nerve interventions and for intraoperative navigation. Read More

Eur J Radiol 2020 Aug 11;129:109128. Epub 2020 Jun 11.

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, People's Republic of China; Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, 200030, People's Republic of China; Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, 200030, People's Republic of China. Electronic address:

Purpose: To evaluate whether gadolinium enhanced 3D SPACE STIR sequence technique increases the visualization of the lumbosacral plexus (LSP) and its small branches.

Methods: A retrospective study was performed on 24 patients who had underwent 3D SPACE STIR sequences scan with and without the administration of gadolinium contrast. In this study, we focused on the healthy sides of the LSP and its branches in each patient. Read More

Injury 2020 Dec 16;51 Suppl 4:S93-S95. Epub 2020 May 16.

School of Medicine, European University Cyprus, Nicosia, Cyprus.

Dysfunction of the facial nerve is frequently attributed to inflammation, followed by traumatic injury. Knowledge of the complex anatomical course of the facial nerve is critical to localize the site of pathology and for successful management. The multiplicity of etiologies and its complex anatomy often make facial paralysis a diagnostic challenge. Read More

Neuroreport 2020 06;31(9):672-677

Department of Neurology.

Despite the regenerative capacity of the peripheral nerve system (PNS), functional recovery after mechanical nerve trauma is often incomplete, resulting in motor, sensory, and autonomic deficits. The elucidation of key molecules involved in trauma-induced Wallerian degeneration and the ensuing regeneration processes is a prerequisite for the development of disease modifying drugs. The chemokine (C-X-C motif) receptor 3 (CXCR3) has been implicated in the recruitment of macrophages, the major immune cell population during the process of Wallerian degeneration. Read More

JPRAS Open 2020 Jun 18;24:20-24. Epub 2020 Mar 18.

Hand and Reconstructive Microsurgery Unit, Azienda Ospedaliero-Universitaria Careggi, Largo Palagi 1, Florence, Italy.

Background: Ulnar nerve lesions represent a rare complication of wrist fracture. The present manuscript describes the case of a particular traumatic mechanism in which the nerve resulted crushed between radial fracture fragments.

Case Presentation: A 47-year-old man suffered a subtotal lesion of the ulnar nerve following an open displaced distal radius fracture. Read More

Arch Orthop Trauma Surg 2020 Dec 6;140(12):1931-1937. Epub 2020 Apr 6.

Department of Trauma Surgery and Orthopedics, Klinikum Stuttgart-Katharinenhospital, Kriegsbergstraße 60, 70174, Stuttgart, Germany.

Background: Humerus shaft fractures are common and often treated surgically with a proximal humerus internal locking system like the long PHILOS plate. Due to its close anatomical proximity to the humerus, the radial nerve is particularly susceptible to traumatic and iatrogenic damage. The iatrogenic radial nerve damage associated with internal locking systems is described in about 7% of the cases. Read More

Acta Biomed 2020 03 19;91(1):122-127. Epub 2020 Mar 19.

Radiology Department, National Cancer Institute Pascale Foundation, via M. Semmola 53, I-80131Naples Italy.

Neuroma, also known as traumatic neuroma or amputation neuroma or stump neuroma, is a focal non neoplastic area of proliferative hyperplastic reaction secondary to peripheral nerve damage that commonly occurs after a focal trauma (acute or chronic) or surgery, such as amputation or partial transection. Neuromas are more commonly located in the lower limbs, followed by head and neck; other extremely rare sites include the ulnar nerve followed by the radial nerve and the brachial plexus. A radiologic plan is necessary to recognize soft tissue lesions with a neural origin and whether they are a true tumor or a pseudotumor such as a neuroma, fibrolipoma, or peripheral nerve sheath ganglion. Read More

Neurophysiol Clin 2020 Apr 20;50(2):93-101. Epub 2020 Feb 20.

Division of Neurology, Institute of Clinical Neurophysiology, University Medical Centre Ljubljana, Zaloška cesta 2, SI-1525 Ljubljana, Slovenia. Electronic address:

Objective: To assess the indications for and utility of diagnostic ultrasonography (US) in a series of consecutive patients with suspected traumatic peripheral nerve lesions (TPNL).

Methods: We retrospectively reviewed the electronic medical records of consecutive patients referred from February 2013 to May 2018 to our US laboratory. All included patients were examined using standard US equipment, with a 4-13MHz linear array transducer. Read More

Unfallchirurg 2020 Mar;123(3):225-237

Unfallchirurgische Abteilung, Landeskrankenhaus Salzburg, Paracelsus Medizinische Universität, Salzburg, Österreich.

Lesions of peripheral nerves substantially influence the long-term prognosis and functional outcome. Approximately 70% of peripheral nerval lesions are associated with vascular injuries and occur more frequently with certain fractures and osteosynthesis types. The prognosis and treatment depend on the severity of the injury and the presence of axonal lesions, in particular, determines the further procedure. Read More

Eur J Ophthalmol 2020 Feb 16:1120672120906999. Epub 2020 Feb 16.

Laboratorio di Genetica Medica, Dipartimento di Scienze Biomediche e Oncologia Umana, Università degli Studi di Bari Aldo Moro, Bari, Italy.

Purpose: We investigated the molecular causes of an unusual pigmented and ulcerated iris lesion detected in a patient diagnosed with neurofibromatosis type 1 (NF1).

Case Report: A 52-year-old man was referred to our clinic with a non-traumatic ulcer in his left eye. Hyphema reabsorption disclosed a pigmented iris mass, thus ultrasound biomicroscopy and anterior segment fluorescein angiography were performed to investigate for the presence of a malignant lesion. Read More

J Med Life 2019 Oct-Dec;12(4):342-353

Department of Neurology, University Medical Center Schleswig-Holstein, Lübeck, Germany.

The restoration of voluntary muscle activity in posttraumatic paraplegia in both animal experiments and other clinical applications requires reproducibility of a technically-demanding microsurgical procedure, limited by physicians' understanding of Brunelli's spinal cord grafting paradigm. The insufficient clinical investigation of the long-term benefits of the CNS-PNS graft application warrants additional inquiry. The objective of this study is to explore the potential benefits of the first replicated, graft-induced neuroregeneration of denervated skeletal muscle regarding long-term clinical outcomes and to investigate the effect of Cerebrolysin on neuromodulation. Read More

Arch Orthop Trauma Surg 2020 Sep 24;140(9):1175-1180. Epub 2020 Jan 24.

AUVA Trauma Center Vienna Meidling, Kundratstraße 37, Vienna, 1120, Austria.

Background: The shoulder is the joint most prone to dislocating in the human body and accounts for 45% of all dislocations. In addition to ruptures of the soft tissue and bony injuries, lesions to vascular structures as well as the brachial plexus and its corresponding nerves might occur. With an incidence of up to 65%, nerve lesions are frequently reported after shoulder dislocations. Read More

J Hand Surg Eur Vol 2020 Mar 19;45(3):219-225. Epub 2020 Jan 19.

Department of Plastic and Hand Surgery, University of Bern, Inselspital, Bern, Switzerland.

High-resolution ultrasonography is an important tool used for the diagnosis and management of inflammatory arthritis of the hand and wrist. This imaging modality has also proven its utility in the evaluation of traumatic lesions of tendons, nerves, annular pulleys, ligaments, and carpal and digital injuries and for detecting foreign bodies and causes of joint locking. One of the great advantages is the possibility of getting an internal image of the involved anatomical structure in axial, coronal, and transversal planes, as well as the option for observing dynamic changes during motion. Read More

Ugeskr Laeger 2019 Dec;181(51)

This review summarises the current knowledge of peripheral nerve surgery (PNS) in Denmark, which comprises the surgery of traumatic nerve lesions, entrapment syndromes, nerve tumours, and biopsies. Although the Danish Health Authority generally works towards a centralisation of PNS, it is actually performed at a widespread number of hospitals, of which some perform a very low number of procedures per year. International standards are highly specialised centres with subspecialists of PNS, high caseload, and integrated rehabilitation facilities. Read More

Clin Neurophysiol 2020 02 9;131(2):446-450. Epub 2019 Nov 9.

Unit of High Intensity Neurorehabilitation, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy; Department of Geriatrics, Neurosciences & Orthopaedics, Università Cattolica, Largo Agostino Gemelli n8, 00168 Rome, Italy.

Objectives: To increase the specificity of motor unit potential (MUPs) detection by using ultrasound guided electromyography (USG-EMG) in patients with muscle plegia due to traumatic nerve lesions.

Methods: Forty-six patients with recent nerve trauma underwent baseline standard EMG (ST-EMG) evaluation with evidence of absent MUPs. In 41 of them, ST-EMG was repeated after 2-3 months (T1) and the patients were accordingly divided in two groups: ST-EMG+ (if MUPs were detected) or ST-EMG- (MUPs not detected). 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

Cells 2019 10 30;8(11). Epub 2019 Oct 30.

Institut de Neurociències (INc) and Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona (UAB) & Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Bellaterra, E-08193 Barcelona, Spain.

Complete restoring of functional connectivity between neurons or target tissue after traumatic lesions is still an unmet medical need. Using models of nerve axotomy and compression, we investigated the effect of autophagy induction by genetic and pharmacological manipulation on motor nerve regeneration. ATG5 or NAD-dependent deacetylase sirtuin-1 (SIRT1) overexpression on spinal motoneurons stimulates mTOR-independent autophagy and facilitates a growth-competent state improving motor axonal regeneration with better electromyographic records after nerve transection and suture. Read More

Chirurg 2019 Nov;90(11):941-954

Sektion "Periphere Nervenchirurgie", Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312, Günzburg, Deutschland.

Traumatic peripheral nerve lesions affect patients of all age groups. They are associated with functional deficits that have severe consequences for affected patients and prolonged or permanent inability to work has socioeconomic relevance. In order to improve prognoses and achieve the best possible outcome an early diagnosis and competent knowledge of the correct approach and treatment strategies are essential. Read More

Ann Clin Transl Neurol 2019 11 6;6(11):2175-2185. Epub 2019 Oct 6.

Department of Rehabilitation Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.

Objective: We aimed to investigate the clinical significance of increased uptake in F-fluorodeoxyglucose positron emission tomography in patients with peripheral nerve lesions.

Methods: We selected patients with unilateral peripheral nerve lesions confirmed with electromyography who had undergone F-fluorodeoxyglucose positron emission tomography covering the lesions. In the denervated muscles and their contralateral corresponding pairs, a mean (SUVmean) and maximum standardized uptake value (SUVmax) were obtained from F-fluorodeoxyglucose positron emission tomography images. Read More