Computer-Aided Localisation of Peripheral Nerve Lesions

The clinical localisation of peripheral nerve lesions can sometimes be difficult, particularly following injury to the brachial plexus when multiple lesions are often present. In this situation, computers may be of assistance in interpreting the complicated patterns of clinical findings. This paper describes the evaluation of a computer program that uses a simulation model of the consequences of nerve injury, based on a representation of the relevant anatomy. A retrospective study of 26 patients with upper limb nerve lesions was carried out. The computer program compared favourably with three clinicians in interpreting the findings correctly. It is suggested that this approach may be transferable to other applications.

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Compression neuropathies of the forearm: anatomy, clinical features and management

British Journal of Hospital Medicine ◽

10.12968/hmed.2021.0187 ◽

2021 ◽

pp. 1-10

Author(s):

Alexander Scarborough ◽

Robert J MacFarlane ◽

Michail Klontzas ◽

Rui Zhou ◽

Mohammad Waseem

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Upper Limb ◽

Peripheral Nerves ◽

Clinical Presentation ◽

Permanent Damage ◽

Peripheral Nerve Lesions ◽

Clinical Presentations ◽

Wide Range ◽

Prompt Diagnosis

The upper limb consists of four major parts: a girdle formed by the clavicle and scapula, the arm, the forearm and the hand. Peripheral nerve lesions of the upper limb are divided into lesions of the brachial plexus or the nerves arising from it. Lesions of the nerves arising from the brachial plexus are further divided into upper (proximal) or lower (distal) lesions based on their location. Peripheral nerves in the forearm can be compressed in various locations and by a wide range of pathologies. A thorough understanding of the anatomy and clinical presentations of these compression neuropathies can lead to prompt diagnosis and management, preventing possible permanent damage. This article discusses the aetiology, anatomy, clinical presentation and surgical management of compressive neuropathies of the upper limb.

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Magnetic resonance neurography for the evaluation of peripheral nerve, brachial plexus, and nerve root disorders

Journal of Neurosurgery ◽

10.3171/2009.7.jns09414 ◽

2010 ◽

Vol 112 (2) ◽

pp. 362-371 ◽

Cited By ~ 78

Author(s):

Rose Du ◽

Kurtis I. Auguste ◽

Cynthia T. Chin ◽

John W. Engstrom ◽

Philip R. Weinstein

Keyword(s):

Magnetic Resonance ◽

Mr Imaging ◽

Peripheral Nerve ◽

Brachial Plexus ◽

Nerve Root ◽

Consecutive Series ◽

Brachial Plexopathy ◽

Magnetic Resonance Neurography ◽

Nerve Lesions ◽

Peripheral Nerve Lesions

Object Treatment of spinal and peripheral nerve lesions relies on localization of the pathology by the use of neurological examination, spinal MR imaging and electromyography (EMG)/nerve conduction studies (NCSs). Magnetic resonance neurography (MRN) is a novel imaging technique recently developed for direct imaging of spinal and peripheral nerves. In this study, the authors analyzed the role of MRN in the evaluation of spinal and peripheral nerve lesions. Methods Imaging studies, medical records, and EMG/NCS results were analyzed retrospectively in a consecutive series of 191 patients who underwent MRN for spinal and peripheral nerve disorders at the University of California, San Francisco between March 1999 and February 2005. Ninety-one (47.6%) of these patients also underwent EMG/NCS studies. Results In those who underwent both MRN and EMG/NCS, MRN provided the same or additional diagnostic information 32 and 45% of patients, respectively. Magnetic resonance neurograms were obtained at a median of 12 months after the onset of symptoms. The utility of MRN correlated with the interval between the onset of symptoms to MRN. Twelve patients underwent repeated MRN for serial evaluation. The decrease in abnormal signal detected on subsequent MRN correlated with time from onset of symptoms and the time interval between MRN, but not with resolution of symptoms. Twenty-one patients underwent MRN postoperatively to assess persistent, recurrent, or new symptoms; of these 3 (14.3%) required a subsequent surgery. Conclusions Magnetic resonance neurography is a valuable adjunct to conventional MR imaging and EMG/NCS in the evaluation and localization of nerve root, brachial plexus, and peripheral nerve lesions. The authors found that MRN is indicated in patients: 1) in whom EMG and traditional MR imaging are inconclusive; 2) who present with brachial plexopathy who have previously received radiation therapy to the brachial plexus region; 3) who present with brachial plexopathy and have systemic tumors; and 4) in patients under consideration for surgery for peripheral nerve lesions or after trauma. Magnetic resonance neurography is limited by the size of the nerve trunk imaged and the timing of the study.

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Microsurgical procedures for peripheral nerve lesions: Choice of anesthesia

Acta chirurgica iugoslavica ◽

10.2298/aci0301027s ◽

2003 ◽

Vol 50 (1) ◽

pp. 27-31

Author(s):

Valentina Stevanovic ◽

Branko Milakovic ◽

Zorica Stanimirovic ◽

Mila Stosic

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Sural Nerve ◽

Brachial Plexus Block ◽

Body Position ◽

Nerve Lesions ◽

Axillary Approach ◽

Peripheral Nerve Lesions ◽

Plexus Block ◽

Endotracheal Anesthesia

Microsurgical procedures on peripheral nerve lesions have their own specifics. Those are: duration and extent of operation, and need to change body position during operation. General endotracheal anesthesia has been used for operations on brachial plexus lesions with neural transpher; on peripheral nerve lesions with sural nerve autotransplantations; on all extracranial lesions (facial n. and lesion hypoglossal n.); for lesions of plexus lumbalis and sciatic nerve. These operations are requesting turning of patient on the lateral or ventral position or they are performed on head and neck. Because operation and anesthesia last longer, general ET anesthesia is more suitable for neurosurgens and anesthesiologist's interventions. Regional anesthesia, i.e. neural plexus block, is suitable for operations on upper extremity. Then we perform brachial plexus block with more approaches. There has been frequently in use axillary approach which is easier to perform, has minimum of complications and is suitable for procedures at cubital region, forearm and hand.

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Problems in Managing Reconstructive Surgery for Brachial Plexus Lesions Contrasted with Peripheral Nerve Lesions

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681_86_90002-1 ◽

1986 ◽

Vol 11 (1) ◽

pp. 3-9

Author(s):

VICTORIA FRAMPTON

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Reconstructive Surgery ◽

Nerve Lesions ◽

Peripheral Nerve Lesions

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Problems in managing reconstructive surgery for brachial plexus lesions contrasted with peripheral nerve lesions

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(86)90002-1 ◽

1986 ◽

Vol 11 (1) ◽

pp. 3-9 ◽

Cited By ~ 3

Author(s):

V FRAMPTON

Keyword(s):

Peripheral Nerve ◽

Brachial Plexus ◽

Reconstructive Surgery ◽

Nerve Lesions ◽

Peripheral Nerve Lesions

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Peripheral Nerve Lesions of the Upper Limb (Differencial Diagnosis from the Cervical Osteochondrosis)

Orthopedics & Traumatology ◽

10.5035/nishiseisai.23.111 ◽

1974 ◽

Vol 23 (1) ◽

pp. 111-113

Author(s):

K. Oda ◽

S. Hattori ◽

S. Kawai ◽

N. Moriwaki ◽

K. Saeki

Keyword(s):

Peripheral Nerve ◽

Upper Limb ◽

Nerve Lesions ◽

Peripheral Nerve Lesions

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Regional musculoskeletal conditions: making a working diagnosis

Oxford Handbook of Rheumatology ◽

10.1093/med/9780199587186.003.0002 ◽

2011 ◽

pp. 19-148

Author(s):

Alan J. Hakim ◽

Gavin P.R. Clunie ◽

Inam Haq

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chest Pain ◽

Neck Pain ◽

Peripheral Nerve ◽

Upper Limb ◽

Wrist Pain ◽

Spinal Disorders ◽

Nerve Lesions ◽

Peripheral Nerve Lesions

Introduction 20 Neck pain 22 Shoulder pain 30 Pain around the elbow 42 Wrist pain 48 Symptoms in the hand 54 Upper limb peripheral nerve lesions 66 Thoracic back and chest pain 72 Low back pain and disorders in adults 78 Spinal disorders in children and adolescents ...

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