11/47. arteritis and brachial plexus neuropathy as delayed complications of radiation therapy.radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.- - - - - - - - - - ranking = 1keywords = pain, upper (Clic here for more details about this article) |
12/47. The protective effect of brachial plexus palsy in purpura fulminans.Acute infectious purpura fulminans is reported in a 16-month-old male with a history of posttraumatic asplenia and complete left brachial plexus palsy. This patient developed peripheral necrosis of both lower extremities and the right upper extremity, whereas the left upper extremity was completely spared from ischemia and tissue damage. amputation of four digits on the right hand and debridement of both lower extremities were required. This patient demonstrated the protective effect of a traumatic sympathectomy, which suggests the requirement of an intact sympathetic reflex in the development of purpura fulminans.- - - - - - - - - - ranking = 0.7447564469914keywords = upper (Clic here for more details about this article) |
13/47. A brachial plexopathy due to myositis ossificans. Case report and review of the literature.myositis ossificans (MO) is a disorder characterized by the intramuscular proliferation of fibroblasts and osteoblasts, with subsequent deposition of bone and cartilage. A typical clinical presentation involves traumatic injury to a young adult, usually localized to the thigh, buttock, or upper arm, with resultant MO and mildly restricted range of motion in adjacent joints. Rarely, MO is associated with peripheral neuropathies involving the radial, median, sciatic, and sural nerves. The authors present an unusual case of MO causing a brachial plexopathy. To their knowledge, this is the first description of such a presentation.- - - - - - - - - - ranking = 0.3723782234957keywords = upper (Clic here for more details about this article) |
14/47. delayed diagnosis of concomitant rotator cuff tear and brachial plexopathy in a patient with traumatic brain injury: a case report.Traumatic brain injury (TBI) is often accompanied by additional trauma that can be obscured by cognitive dysfunction or multiple injuries in the same region of the body. This report describes the case of an unhelmeted motorcycle rider who collided with a telephone pole. He sustained a diffuse subarachnoid hemorrhage, bilateral subdural hematomas (right frontal and left temporal), diffuse axonal injury in the subcortical and periventricular white matter, and a left tibial fracture. After medical and surgical stabilization, he was transferred to a subacute rehabilitation facility and then to a rehabilitation center. He was evaluated for pain and limited range of motion in his right shoulder, where both a rotator cuff tear and a brachial plexopathy were diagnosed. This report discusses concomitant injuries that occur with TBI, and the management of rotator cuff tears and brachial plexopathy.- - - - - - - - - - ranking = 0.6276217765043keywords = pain (Clic here for more details about this article) |
15/47. Cervico thoracic junction spinal tuberculosis presenting as radiculopathy.A case of cervico thoracic junctional area spinal tuberculosis presenting as painful radiculitis of the upper extremity is reported. The predominant symptom of radicular pain and muscle weakness in the hand, along with a claw deformity, led to considerable delay in diagnosis. The presence of advanced bone destruction with severe instability was demonstrated on the MRI scan done later. Surgical management by radical anterior debridement and fusion, along with chemotherapy, led to resolution of the upper extremity symptoms. The brachial plexus radiculopathy secondary to tuberculosis has not been reported. The absence of myelopathic signs even in the presence of advanced bone destruction, thecal compression and instability is uncommon in adults.- - - - - - - - - - ranking = 2keywords = pain, upper (Clic here for more details about this article) |
16/47. Brachial plexopathy due to chondrolipoangioma. Case report and review of the literature.Chondrolipoangioma is a mesenchymoma primarily composed of cartilage, with adipose tissue and vascular elements present in lesser proportions. Chondrolipoangiomas have been reported to occur in the extremities, chest wall, oral soft tissues, mediastinum, uterus and its round ligament, seminal vesicles, and heart. In this report, the authors present an unusual case in which a chondrolipoangioma caused a brachial plexopathy. To their knowledge, a chondrolipoangioma has never been reported in the neurosurgical literature.- - - - - - - - - - ranking = 0.040060448161368keywords = chest (Clic here for more details about this article) |
17/47. Metastatic breast cancer delayed brachial plexopathy. A brief case report.Metastatic involvement of brachial plexopathy is a rare condition that is often associated with advanced systemic breast cancer and the role of surgeon appears to be restricted because radio-chemotherapy is better recommended in this setting. We report a case of a 64-year-old woman that presented a very delayed breast cancer metastatic lower trunks lesions without associated radiation injury, treated by surgery. MRI of plexus and CT of chest and axilla are methods of choice in preoperative radiological evaluation. Neurosurgeon effort is restricted to provide pathologic diagnosis (confirm of metastasis), adequate pain control and improvement of neurological function. So that surgical exploration and neurolysis should be performed as soon as possible after appearance of neurological deficits before denervation signs occurs. General surgeon presence should be warranted for more radical removal of remain lymph nodes and metastatic nodal infiltration of adjacent anatomical structures (vessels and so on) when detected by preoperative radiological work-up.- - - - - - - - - - ranking = 0.66768222466567keywords = pain, chest (Clic here for more details about this article) |
18/47. Surgically treated dumbbell schwannoma arising in the brachial plexus with intrathoracic extension.We report excision of a brachial plexus dumbbell tumor in the superior mediastinum in single-stage surgery via an anterior approach. A 40-year-old man found in the chest radiography to have a 3.5 cm mass in the right superior mediastinum was confirmed by chest computed tomography and cervical and chest magnetic resonance imaging to have a mass in the C-7 vertebral body and pedicle. The lesion was found to be a dumbbell schwannoma extending through the vertebral foramen. We attempted to resect the tumor via an anterior approach without changing the position. The methods appears to be safe and enabled us to avoid injuring adjacent nerves and vessels.- - - - - - - - - - ranking = 0.12018134448411keywords = chest (Clic here for more details about this article) |
19/47. Amyloidoma of the brachial plexus.BACKGROUND: Amyloidomas of the peripheral nervous system are rare lesions. Most commonly, they involve the gasserian ganglion and the branches of the fifth cranial nerve. No association with systemic amyloidosis has been reported. CASE DESCRIPTION: We describe an amyloidoma of the lower trunk of the right brachial plexus. At the age of 34 years, this 71-year-old female had undergone radical right mastectomy for breast cancer with axillary lymph node dissection followed by radiotherapy. On admission, she presented with burning pain to the right hand and mild motor deficit to the ulnar-innervated intrinsic hand muscles. A palpable lesion was found in the supraclavicular region. On surgical inspection, the lesion appeared to originate from the lower trunk of the right brachial plexus. The middle and upper trunks were dislocated. Histologically, fibrous connective tissue embedded small nerve bundles featuring perineurial and endoneurial fibrosis as well as amyloid. Amyloid featured immunoreactivity for both lambda and kappa chains. DISCUSSION: Localized amyloidoma of brachial plexus has never been reported. Because of compressive rather than infiltrative growth of the present lesion, a conservative surgery was achieved. Our immunohistochemical findings indicated that peripheral nerve amyloidomas are not, by definition, monoclonal in nature.- - - - - - - - - - ranking = 1keywords = pain, upper (Clic here for more details about this article) |
20/47. Illusory movements of the paralyzed limb restore motor cortex activity.In humans, limb amputation or brachial plexus avulsion (BPA) often results in phantom pain sensation. Actively observing movements made by a substitute of the injured limb can reduce phantom pain, Proc. R. Soc. london B Biol. Sci. 263, 377-386). The neural basis of phantom limb sensation and its amelioration remains unclear. Here, we studied the effects of visuomotor training on motor cortex (M1) activity in three patients with BPA. Functional magnetic resonance imaging scans were obtained before and after an 8-week training program during which patients learned to match voluntary "movements" of the phantom limb with prerecorded movements of a virtual hand. Before training, phantom limb movements activated the contralateral premotor cortex. After training, two subjects showed increased activity in the contralateral primary motor area. This change was paralleled by a significant reduction in phantom pain. The third subject showed no increase in motor cortex activity and no improvement in phantom pain. We suggest that successful visuomotor training restores a coherent body image in the M1 region and, as a result, directly affects the experience of phantom pain sensation. Artificial visual feedback on the movements of the phantom limb may thus "fool" the brain and reestablish the original hand/arm cortical representation.- - - - - - - - - - ranking = 3.1381088825215keywords = pain (Clic here for more details about this article) |
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