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World Neurosurg 2022 May 22;161:e101-e108. Epub 2022 Jan 22.

Department of Surgery, Division of Neurosurgery, Gaffrée e Guinle University Hospital, School of Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address:

Background: Traumatic brachial plexus injuries are devastating lesions, and neurotization is an usually elected surgical therapy. The phrenic nerve has been harvested as a motor fibers donor in brachial plexus neurotization, showing great results in terms of motor reinnervation. Unfortunately, these interventions lack solid evidence regarding long-term safety and possible late respiratory function sequelae, raising crescent concerns after the COVID-19 pandemic onset and possibly resulting in reduced propensity to use this technique. Read More

Neurotherapeutics 2021 10 2;18(4):2368-2383. Epub 2021 Dec 2.

Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.

Peripheral neuropathies account for the most frequent disorders seen by neurologists, and causes are manifold. The traditional diagnostic gold-standard consists of clinical neurologic examinations supplemented by nerve conduction studies. Due to well-known limitations of standard diagnostics and atypical clinical presentations, establishing the correct diagnosis can be challenging but is critical for appropriate therapies. Read More

PLoS One 2021 19;16(11):e0259804. Epub 2021 Nov 19.

Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.

The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ulnar nerve conduction characteristics to aid in the differential diagnosis of ulnar neuropathy (UN) in leprosy and that of non-leprosy etiology. In addition, we include putative markers to better understand the inflammatory process that may occur in the nerve. Read More

BMC Musculoskelet Disord 2021 Oct 5;22(1):848. Epub 2021 Oct 5.

Department of Spine Surgery, Affiliated Hospital of Chengde Medical College, Chengde, 067000, Hebei, China.

Background: Sciatica pain is a typical symptom of lumbar disc herniation (LDH), but some neurogenic and malignant tumours surrounding the sciatic nerve can also cause similar symptoms. These tumours are often misdiagnosed or even mistreated as LDH in clinical practice.

Case Presentation: In our clinical practice, we found two patients with malignant tumours who were misdiagnosed with LDH. Read More

J Vet Intern Med 2021 Nov 2;35(6):2837-2845. Epub 2021 Oct 2.

Ecole nationale vétérinaire d'Alfort, Univ Paris Est Créteil, INSERM, IMRB, Maisons-Alfort, France.

Background: The imaging and electrodiagnostic (EDX) characteristics of traumatic brachial plexus injury (TBPI) are incompletely reported.

Objectives: To describe the epidemiological, clinical, and EDX characteristics of TBPIs in a series of cases in dogs and cats; to determine the association between clinical data, EDX findings, and clinical outcomes; and to assess the sensitivity and specificity of EDX studies to classify nerve lesions.

Animals: One hundred and seventy-five dogs and 51 cats with TBPI and EDX exploration of radial nerve, ulnar nerve, or both nerves. Read More

Unfallchirurg 2021 Oct 20;124(10):823-831. Epub 2021 Sep 20.

Klinik für Plastische, Hand und wiederherstellende Chirurgie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Deutschland.

Background: Traumatic nerve injuries are associated with a high morbidity and long rehabilitation times. The extent of a nerve lesion and the related regeneration potential can often only be estimated during the course, whereby the time window for successful surgical interventions is limited.

Objective: The incidence and distribution of traumatic nerve lesions are reported. Read More

Behav Neurol 2021 9;2021:5586523. Epub 2021 Sep 9.

Department of Plastic and Reconstructive Surgery, Aichi Cancer Center, Japan.

Peripheral nerve injuries (PNIs) are some of the most common types of traumatic lesions affecting the nervous system. Although the peripheral nervous system has a higher regenerative ability than the central nervous system, delayed treatment is associated with disturbances in both distal sensory and functional abilities. Over the past decades, adult stem cell-based therapies for peripheral nerve injuries have drawn attention from researchers. Read More

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S68-S71. Epub 2021 Jun 5.

Department of ENT, SMBT Institute of Medical Science and Research Centre, Nashik, Maharashtra, India.

Background: Soft tissues of the head and neck areas are a very frequent site of occurrence of certain benign tumors of the peripheral nerve sheath, especially the neurofibromas. Hence, the present study was conducted for assessing clinical, radiographic, and treatment profile of 10 cases of neurogenic tumors and tumor-like lesions of the oral and maxillofacial region.

Materials And Methods: Data records of a total of 10 patients who were diagnosed with tumors of neurogenic origin were enrolled in the present study. Read More

Hand Surg Rehabil 2022 02 15;41S:S39-S43. Epub 2021 Aug 15.

Institut de la Main, Paris Shoulder Unit, Clinique Bizet, 23, Rue Georges Bizet, 75116 Paris, France. Electronic address:

The lack of active external rotation following a brachial plexus injury in adults is very disabling and very challenging to solve. If direct nerve surgery or nerve transfer fails or if the patient is seen too late, palliative surgery is the last resort. Shoulder fusion can stabilize the joint to increase strength at the elbow, but the patient loses all external rotation. Read More

Eur Arch Otorhinolaryngol 2022 Feb 17;279(2):1091-1097. Epub 2021 Aug 17.

ENT Department, Pitié-Salpêtrière Hospital, AP-HP, Paris, France.

Purpose: To evaluate functional results of facial nerve repair by direct nerve suture or grafting, compare results between a traumatic and a tumoral group and identify prognostic factors.

Methods: A retrospective monocentric cohort study was studied in a university ENT department. Thirty-one patients who benefited from facial nerve suture or grafting, with at least 12 months postoperative follow-up were included. Read More

Int Orthop 2021 10 10;45(10):2687-2697. Epub 2021 Aug 10.

Department of Orthopaedics and Traumatology, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168, Rome, Italy.

Introduction: Pelvic ring injuries, frequently caused by high energy trauma, are associated with high rates of morbidity and mortality (5-33%), often due to significant blood loss and disruption of the lumbosacral plexus, genitourinary system, and gastrointestinal system. The aim of the present study is to perform a systematic literature review on male and female sexual dysfunctions related to traumatic lesions of the pelvic ring.

Methods: Scopus, Cochrane Library MEDLINE via PubMed, and Embase were searched using the keywords: "Pelvic fracture," "Pelvic Ring Fracture," "Pelvic Ring Trauma," "Pelvic Ring injury," "Sexual dysfunction," "Erectile dysfunction," "dyspareunia," and their MeSH terms in any possible combination. Read More

Otolaryngol Pol 2021 Feb;75(4):1-6

Department of Otolaryngology and Laryngological Oncology, Medical University of Poznan, Poland.

Introduction: The most common mechanism of post-traumatic facial nerve palsy are road accidents and falls. Treatment schemes as well as proper timing of surgery are still controversial. <br/><br/>Aim: The aim of the study was the evaluation of the effects of surgical treatment in patients with post-traumatic facial nerve palsy. Read More

Mol Neurobiol 2021 Oct 6;58(10):4980-4998. Epub 2021 Jul 6.

Division of Physiology and Biophysics, Department of Basic Life Sciences, Federal University of Juiz de Fora, Governador Valadares, Minas Gerais, 35010-177, Brazil.

Traumatic lesions in nerves present high incidence and may culminate in sensorimotor and/or autonomic dysfunctions or a total loss of function, affecting the patient's quality of life. Although the microenvironment favors peripheral nerve regeneration, the regenerative process is not always successful. Some herbs, natural products, and synthetic drugs have been studied as potential pro-regenerative interventions. Read More

Sci Rep 2021 06 25;11(1):13320. Epub 2021 Jun 25.

Department of Neuro-, Spine and Nerve Surgery, Christliches Krankenhaus Quakenbrück GmbH, Quakenbrück, Germany.

High-resolution neurosonography (HRNS) has become a major imaging modality in assessment of peripheral nerve trauma in the recent years. However, the vascular changes of traumatic lesions have not been quantitatively assessed in HRNS. Here, we describe the vascular-ratio, a novel HRNS-based quantitative parameter for the assessment of intraneural vascular alterations in patients with nerve lesions. Read More

Clin Neurophysiol 2021 07 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

Brain Res 2021 09 16;1766:147522. Epub 2021 May 16.

Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China; Key Laboratory of Neonatal Diseases, National Health Commission, China. Electronic address:

Hyaluronan is one of the major components of the neural extracellular matrix (ECM) and provides structural support in physiological conditions. Altered hyaluronan regulation is implicated in the pathogenesis of white matter injury (WMI), such as perinatal WMI, multiple sclerosis (MS), traumatic brain injury (TBI). Early research reported diverse central nervous system (CNS) insults led to accumulated high-molecular-weight (HMW) hyaluronan in hypomyelinating/demyelinating lesions. Read More

J Orthop Sci 2022 May 15;27(3):627-634. Epub 2021 Apr 15.

Department of Hand Surgery and Microsurgery, Azienda Ospedaliero Universitaria Modena, Largo Del Pozzo, 71, 41125 Modena, Italy.

Background: The incidence of median nerve injuries in pediatric elbow dislocations is approximately 3% and avulsion of the open medial epicondylar epiphysis in the pediatric population is one predisposing factor that may explain this age predilection. These lesions can be difficult to diagnose in the acute phase because symptoms tend to be mild or delayed, consequently their management can be challenging and functional outcome poorer.

Methods: We present the case of an unrecognized median nerve entrapment in a 16-year-old boy with posterior dislocation of the elbow and a medial epicondyle fracture, treated initially with close reduction and open stabilization with a cannulated screw. 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

Orthop Traumatol Surg Res 2021 04 28;107(2):102827. Epub 2021 Jan 28.

Hand Surgery and Reconstructive Microsurgery Group of the Institute of Orthopedics and Traumathology, Clinics Hospital of University of Sao Paulo, São Paulo, Brazil. Electronic address:

Introduction: The traumatic lesions of the brachial plexus in adults are devastating injuries causing continuous severe functional impairment for both work and daily living activities. The restoration of elbow flexion is one of the most important movements for patient recovery to previous activities. Free gracilis muscle transfer has good outcomes for cases with late presentation or as a rescue surgery to regain elbow flexion, however, bad results are present in all cohorts with insufficient recovery of muscle strength for elbow flexion. 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 2022 Apr 26;48(2):1217-1223. 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

J Cereb Blood Flow Metab 2021 03 5;41(3):511-529. Epub 2020 Aug 5.

Geriatric Research, Education and Clinical Center, Veterans Affairs Pittsburgh Health Care System, Pittsburgh, PA, USA.

Long-term neurological recovery after severe traumatic brain injury (TBI) is strongly linked to the repair and functional restoration of injured white matter. Emerging evidence suggests that the anti-inflammatory cytokine interleukin-4 (IL-4) plays an important role in promoting white matter integrity after cerebral ischemic injury. Here, we report that delayed intranasal delivery of nanoparticle-packed IL-4 boosted sensorimotor neurological recovery in a murine model of controlled cortical impact, as assessed by a battery of neurobehavioral tests for up to five weeks. 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