2,279 results match your criteria axillary plexus


Ferumoxytol-enhanced vascular suppression in magnetic resonance neurography.

Skeletal Radiol 2021 May 7. Epub 2021 May 7.

Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.

Objective: To evaluate ferumoxytol-enhanced vascular suppression for visualizing branch nerves of the brachial plexus in magnetic resonance (MR) neurography.

Materials And Methods: Signal simulations were performed to determine ferumoxytol's effect on nerve-, fat-, and blood-to-muscle contrast and to optimize pulse sequence parameters. Prospective, in vivo assessment included 10 subjects with chronic anemia who underwent a total of 19 (9 bilateral) pre- and post-infusion brachial plexus exams using three-dimensional (3D), T-weighted short-tau inversion recovery (T-STIR) sequences at 3. Read More

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A meta-analysis on the anatomical variability of the brachial plexus: Part I - roots, trunks, divisions and cords.

Ann Anat 2021 Apr 30:151751. Epub 2021 Apr 30.

Department of Anatomy, Second Faculty of Medicine, Charles University, Plzenska 130/221, 150 06 Prague 5, Czech Republic; Clinic of Trauma Surgery, Masaryk Hospital, Socialni pece 3316/12A, 400 11 Usti nad Labem, Czech Republic.

Introduction: The brachial plexus is a complex anatomical structure that gives rise to all the nerves of the upper limb. Its variability is frequently observed and represents a challenge for interventions in the lower neck and axilla. The aim of this study was to present a comprehensive and evidence-based review with meta-analytic techniques on the variability of roots, trunks, divisions and cords of the brachial plexus. Read More

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Transient median nerve palsy following ultrasound-guided subscapularis plane block: a case report.

Braz J Anesthesiol 2021 Apr 27. Epub 2021 Apr 27.

Dr. Soetomo General Hospital, Department of Anaesthesiology & Intensive Therapy, Surabaya, Indonesia.

The subscapularis plane block is an effective approach to anesthetize axillary and upper subscapular nerves. There have been no reports regarding brachial plexus paralysis as a potential complication to date. Described here is a case of median nerve palsy following ultrasound-guided subscapularis plane block for awake frozen shoulder manipulation that was performed on a 52-year-old female diagnosed with adhesive capsulitis. Read More

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Surgical Treatment of Iatrogenic Nerve Injury Following Arthroscopic Capsulolabral Repair.

J Hand Surg Am 2021 Apr 23. Epub 2021 Apr 23.

Department of Orthopedic Surgery, Hand and Upper Extremity, Hospital for Special Surgery, New York, NY.

Purpose: Case reports of nerve injuries following arthroscopic capsulolabral repair emphasize the proximity of major nerves to the glenoid. This study describes preoperative localization using nerve-sensitive magnetic resonance imaging in a small cohort of patients with iatrogenic nerve injuries following arthroscopic capsulolabral repair and the outcomes of nerve repair in these patients.

Methods: Cases of iatrogenic nerve injury following arthroscopic capsulolabral repair referred to 2 surgeons from January 2017 to December 2019 were identified. Read More

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Distribution of injectates in the thoracic paravertebral space of the dog and cat: A cadaveric study.

Open Vet J 2021 Jan-Mar;11(1):27-35. Epub 2021 Jan 14.

Ambulatorio Veterinario S. Andrea, Lugo, Italy.

Background: Thoracic paravertebral block (TPVB) entails injecting a local anesthetic inside the thoracic paravertebral space (TPVS). Loss of resistance to air injection (air-LOR) was the first technique described in humans to locate the TPVS. To date, no study has investigated the spread of any substance after injection into the TPVS using the air-LOR technique nor has described the cranial and caudal limits of the space. Read More

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January 2021

Permanent hemidiaphragmatic paresis after interscalene brachial plexus block: a case report.

Braz J Anesthesiol 2021 Mar-Apr;71(2):175-177. Epub 2021 Feb 3.

Centre Hospitalier de Montauban, Département d'Anesthésia, France. Electronic address:

Interscalene brachial plexus block has been widely used in shoulder surgery. We report one case of long-term phrenic palsy following ultrasound-guided interscalene brachial plexus block and we will discuss the possible etiology and mechanism of this disability. For painful shoulder surgery, ultrasound-guided interscalene brachial plexus block remains topical. Read More

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February 2021

Brachial Plexus Injuries - Review of the Anatomy and the Treatment Options.

Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2021 Apr 23;42(1):91-103. Epub 2021 Apr 23.

University Clinic for Plastic and Reconstructive Surgery, Skopje, RN Macedonia.

Brachial plexus injuries are still challenging for every surgeon taking part in treating patients with BPI. Injuries of the brachial plexus can be divided into injuries of the upper trunk, extended upper trunk, injuries of the lower trunk and swinging hand where all of the roots are involved in this type of the injury. Brachial plexus can be divided in five anatomical sections from its roots to its terminal branches: roots, trunks, division, cords and terminal branches. Read More

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Debridement of axillary necrotizing fasciitis under anesthetic blocks of the serratus plane and supraclavicular brachial plexus: a case report.

Braz J Anesthesiol 2021 Apr 19. Epub 2021 Apr 19.

Hospital Metropolitano Odilon Behrens, Prefeitura Municipal de Belo Horizonte, Departamento de Anestesiologia, Belo Horizonte, MG, Brazil.

The regional techniques for axillary analgesia are well established. However, few studies have investigated surgical anesthesia. In this report, extensive debridement of axillary necrotizing fasciitis, including the posteromedial region of the right arm, performed under exclusive regional anesthesia in a patient with probable difficult airway is described. Read More

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Prevention and Treatment of Nerve Injuries in Shoulder Arthroplasty.

J Bone Joint Surg Am 2021 Mar 11. Epub 2021 Mar 11.

Departments of Orthopaedic Surgery (M.F., R.P., and T.L.) and Plastic and Reconstructive Surgery (R.P. and H.B.), University of Toronto, Toronto, Ontario, Canada.

»: Nerve injuries during shoulder arthroplasty have traditionally been considered rare events, but recent electrodiagnostic studies have shown that intraoperative nerve trauma is relatively common.

»: The brachial plexus and axillary and suprascapular nerves are the most commonly injured neurologic structures, with the radial and musculocutaneous nerves being less common sites of injury.

»: Specific measures taken during the surgical approach, component implantation, and revision surgery may help to prevent direct nerve injury. Read More

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[Surgical treatment of a post-traumatic giant pseudoaneurysm of the axillary artery: a case report].

Angiol Sosud Khir 2021 ;27(1):159-163

Department of General Surgery #1, Perm State Medical University named after Academician E.A. Wagner under the RF Ministry of Public Health, Perm, Russia.

A false aneurysm of the axillary artery is an extremely rare complication of a lesion of this vessel. As few as several dozens of similar cases have been described in the available literature. We herein report a clinical case concerning surgical treatment of a 41-year-old patient who after a knife-inflicted injury had developed a 66x67 mm pseudoaneurysm of the axillary artery. Read More

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Functional Evaluation of Levator Scapulae Tendon to Supraspinatus in Adult Brachial Plexus Injuries.

Indian J Plast Surg 2021 Jan 8;54(1):38-45. Epub 2021 Feb 8.

Department of Plastic and Reconstructive Surgery, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.

 Brachial plexus injuries are severe life-altering injuries. The surgical method to restore shoulder abduction in adult upper brachial plexus injuries involves the usage of nerve grafts and nerve transfers targeting the suprascapular and/or the axillary nerve. When the primary nerve surgery has been unsuccessful or recovery has been incomplete or with a late presentation, muscle transfer procedures are needed to provide or improve shoulder abduction. Read More

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January 2021

Brachial plexopathy as a complication of COVID-19.

BMJ Case Rep 2021 Mar 25;14(3). Epub 2021 Mar 25.

Neurology, Weill Cornell Medicine, New York City, New York, USA.

COVID-19 affects a wide spectrum of organ systems. We report a 52-year-old man with hypertension and newly diagnosed diabetes mellitus who presented with hypoxic respiratory failure due to COVID-19 and developed severe brachial plexopathy. He was not treated with prone positioning respiratory therapy. Read More

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Patterns of median nerve branching in the cubital fossa: implications for nerve transfers to restore motor function in a paralyzed upper limb.

J Neurosurg 2021 Mar 19:1-10. Epub 2021 Mar 19.

6Department of Anatomy, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.

Objective: The purpose of this study was to describe the anatomy of donor and recipient median nerve motor branches for nerve transfer surgery within the cubital fossa.

Methods: Bilateral upper limbs of 10 fresh cadavers were dissected after dyed latex was injected into the axillary artery.

Results: In the cubital fossa, the first branch was always the proximal branch of the pronator teres (PPT), whereas the last one was the anterior interosseous nerve (AIN) and the distal motor branch of the flexor digitorum superficialis (DFDS) on a consistent basis. Read More

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Axillary artery and brachial plexus injury secondary to blunt trauma.

J Surg Case Rep 2021 Mar 13;2021(3):rjab068. Epub 2021 Mar 13.

Department of Emergency Medicine, University Hospital Waterford, Waterford, Ireland.

Rupture of the axillary artery in the absence of a fracture of dislocation is a rare traumatic event. An associated injury to the brachial plexus may accompany an axillary artery injury but has rarely been reported in the literature. We present the case of an elderly female, who fell onto an outstretched arm and sustained an axillary artery rupture, combined with a brachial plexus injury. Read More

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Musculoskeletal ultrasound diagnosis of quadrilateral space syndrome: A case report.

Medicine (Baltimore) 2021 Mar;100(10):e24976

Department of Ultrasound, Baoji High-tech Hospital, Baoji, Shaanxi, China.

Introduction: Quadrilateral space syndrome (QSS) is a peripheral nerve entrapment disease, which can be misdiagnosed in clinic. In the past, QSS was mainly diagnosed by clinical symptoms combined with magnetic resonance imaging (MRI), electromyography (EMG), and arterial angiography. There are few reports on the diagnosis of QSS by musculoskeletal ultrasound (MSKUS) combined with clinical symptoms. Read More

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Atypical branching of the musculocutaneous and median nerves with associated unusual innervation of muscles in the anterior compartment of the arm: case report and plea for extension of the current classification system.

Surg Radiol Anat 2021 May 10;43(5):671-678. Epub 2021 Mar 10.

Second Faculty of Medicine, Department of Anatomy, Charles University, Plzenska 130/221, 150 06, Prague, Czech Republic.

Purpose: Variations of the peripheral nervous system in the upper limb, especially of the musculocutaneous and median nerves, are common, but closer attention to the knowledge of the variant anatomy should be paid to avoid iatrogenic injury or to understand the unusual clinical signs.

Methods: During a routine dissection course, bilateral variations were observed in a Central European male cadaver.

Results: Variable branching of the musculocutaneous and median nerves associated with atypical innervation of the muscles in the anterior compartment of the arm and other concomitant variations were found bilaterally. Read More

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Radiation-Induced Brachial Plexopathy in Patients With Breast Cancer Treated With Comprehensive Adjuvant Radiation Therapy.

Adv Radiat Oncol 2021 Jan-Feb;6(1):100602. Epub 2020 Oct 27.

Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri.

Purpose: Our purpose was to describe the risk of radiation-induced brachial plexopathy (RIBP) in patients with breast cancer who received comprehensive adjuvant radiation therapy (RT).

Methods And Materials: Records for 498 patients who received comprehensive adjuvant RT (treatment of any residual breast tissue, the underlying chest wall, and regional nodes) between 2004 and 2012 were retrospectively reviewed. All patients were treated with conventional 3 to 5 field technique (CRT) until 2008, after which intensity modulated RT (IMRT) was introduced. Read More

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October 2020

Analgesic Effect of the Topical Use of Dexamethasone in Ultrasound-Guided Axillary Brachial Plexus Blockade: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study.

Cureus 2021 Jan 28;13(1):e12971. Epub 2021 Jan 28.

1st Department of Anaesthesiology, University of Athens Medical School, Athens, GRC.

Introduction Increasing the duration of regional anesthesia in orthopedic surgery is of vital importance, as it prolongs postoperative analgesia, allowing faster rehabilitation of patients. Dexamethasone has been found to extend the block duration in animal and human studies. The aim of this study is the assessment of the effect of the addition of dexamethasone to ropivacaine on the onset and duration of axillary brachial plexus block, along with the intensity of postoperative pain. Read More

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January 2021

A Comprehensive Review and Update of the Use of Dexmedetomidine for Regional Blocks.

Psychopharmacol Bull 2020 Oct;50(4 Suppl 1):121-141

Urits, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA. Berger, MD, PhD, Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA. Kaye, MD, PhD, Departments of Anesthesiology and Pharmacology, Toxicology and Neurosciences, Louisiana State University School of Medicine, Shreveport, LA. Virgen, BS, Alattar, BS, University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ. Jung, BS, Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, DC. Kassem, MD, Mount Sinai Medical Center, Department of Anesthesiology, Miami Beach, FL. Shehata, MD, Ain Shams University, Department of Anesthesiology, Cairo, Egypt. Elhassan, MD, Desert Regional Medical Center, Department of Anesthesiology, Palm Springs, CA. Viswanath, MD, Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA; Valley Pain Consultants - Envision Physician Services, Phoenix, AZ; University of Arizona College of Medicine-Phoenix, Department of Anesthesiology, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE.

Purpose Of Review: This evidence-based systematic review will focus on the use of dexmedetomidine and its role as adjuvant anesthetics in regional blocks to help better guide physicians in their practice. This review will cover background and mechanism of dexmedetomidine as well as the use in various regional blocks.

Recent Findings: Local anesthetics are preferred for nerve blocks over opioids; however, both due come with its own side effects. Read More

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October 2020

Complex Regional Pain Syndrome Caused by an Axillary Lipoma.

Cureus 2020 Dec 25;12(12):e12280. Epub 2020 Dec 25.

Surgery, Florida Atlantic University, Boca Raton, USA.

Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy syndrome, is a rare chronic neuro-inflammatory pain condition, which can follow a soft-tissue, bone (type I), or nerve injury (type II) that can be severe and often lasts longer than the original tissue damage. Lipomas impinging on the brachial plexus are rare. To date, there have been no documented cases of CRPS caused by a benign tumor. Read More

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December 2020

Complications associated to three brachial plexus blocking techniques: Systematic review and meta-analysis.

Rev Esp Anestesiol Reanim 2021 Jan 19. Epub 2021 Jan 19.

Hospital Universitario San Vicente Fundación. Sección de Anestesiología, Universidad de Antioquia, Medellín, Colombia.

Background: Brachial plexus block has become one of the most widely-used anaesthetic techniques in the world for upper limb anaesthesia. There are three different brachial blocks techniques: supraclavicular, infraclavicular and axillary block. However, its execution is not exempt from possible clinical complications, and it is not clear which of these is associated with a lower complication rate and greater anaesthetic success. Read More

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January 2021

Minimum Effective Volume of 0.75% Ropivacaine for Ultrasound-Guided Axillary Brachial Plexus Block.

Cureus 2020 Dec 22;12(12):e12229. Epub 2020 Dec 22.

Internal Medicine, Eras Lucknow Medical College, Lucknow, IND.

Background Ultrasound-guided peripheral nerve block provides direct visualization of nerve and reduces the complications associated with classical landmark guided technique, by reducing the dosage of local anesthetic drugs. This study aims to determine the minimum effective volume (MEAV) of 0.75% ropivacaine for ultrasound-guided axillary brachial plexus block. Read More

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December 2020

Scapulothoracic dissociation and blunt vertebral vascular injury: case report.

Colomb Med (Cali) 2020 Sep 30;51(3):e504386. Epub 2020 Sep 30.

Department of General Surgery, Clínica Reina Sofía, Colsanitas, Bogotá, Colombia.

Case Description: A 24-year-old male suffers from a motor vehicle accident with penetrating neck trauma and concomitant closed left cervicothoracic trauma.

Clinical Findings: High impact trauma causing hypovolemic shock, left zone I penetrating neck trauma, ischemia due to blunt trauma to the axillary vessels, and brachial plexus injury. Transection of the vertebral artery on angiotomography. Read More

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September 2020

Management of benign nerve sheath tumors of the brachial plexus: relevant diagnostic and surgical features. About a series of 17 patients (19 tumors) and review of the literature.

Acta Neurol Belg 2021 Feb 2;121(1):125-131. Epub 2021 Jan 2.

Department of Neurosurgery, CHU Liege, Liège, Belgium.

Brachial plexus (BP) tumors are rare, potentially difficult-to-manage lesions. The method is retrospective chart analysis. Among the 17 patients, four had neurofibromatosis and one schwannomatosis (NF +). Read More

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February 2021

Long-Term Outcome of Phrenic Nerve Transfer in Brachial Plexus Avulsion Injuries.

Ann Plast Surg 2021 02;86(2):188-192

From the Department of Orthopedics and Traumatology, Reconstructive Microsurgery Unit, Assiut University School of Medicine, Assiut, Egypt.

Introduction: In brachial plexus injuries, useful recovery of arm function has been documented in most patients after phrenic nerve transfer after variable follow-up durations, but there is not much information about long-term functional outcomes. In addition, there is still some concern that respiratory complications might become manifest with aging. The aim of this study was to report the outcome of phrenic nerve transfer after a minimum follow-up of 5 years. Read More

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February 2021

Treatment of radiation-induced brachial plexopathy with omentoplasty.

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

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September 2020

Percutaneous Axillary Access for Placement of Microaxial Ventricular Support Devices: The Axillary Access Registry to Monitor Safety (ARMS).

Circ Cardiovasc Interv 2021 Jan 16;14(1):e009657. Epub 2020 Dec 16.

Division of Cardiology (R.T.), RWJ Barnabas Health, Newark, NJ.

Background: There has been increasing utilization of short-term mechanical circulatory support devices for a variety of clinical indications. Many patients have suboptimal iliofemoral access options or reasons why early mobilization is desirable. Axillary artery access is an option for these patients, but little is known about the utility of this approach to facilitate short-term use for circulatory support with microaxial pump devices. Read More

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January 2021

Right axillary artery cannulation for venoarterial extracorporeal membrane oxygenation: a retrospective single centre observational study.

Eur J Cardiothorac Surg 2021 Apr;59(3):601-609

Department of Cardiovascular Surgery, Université de Paris, Bichat-Claude Bernard Hospital, Paris, France.

Objectives: Our goal was to assess the safety, outcomes and complication rate of axillary artery cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Methods: A retrospective analysis was conducted on data obtained from the review of medical charts of all consecutive patients undergoing VA-ECMO implantation between January 2013 and December 2017 at a teaching hospital. Only patients with right axillary VA-ECMO implantation in a non-emergency setting were included. Read More

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Comparison between long and lower medial head triceps branches in dual neurotization for shoulder function restoration in upper brachial plexus palsy.

Microsurgery 2021 Feb 9;41(2):124-132. Epub 2020 Dec 9.

Rheumatology and Rehabilitation Department, Faculty of Medicine, Port Said University, Port Said, Egypt.

Purpose: In upper brachial plexus injury (UBPI), restoring shoulder function is crucial. This study compares the transfer of long and lower medial heads of triceps branches to the axillary nerve to achieve proper restoration of function.

Patients And Methods: A retrospective comparative study was conducted between two groups of patients with (UBPI). Read More

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February 2021