Anatomic Variation of the Phrenic Nerve and Brachial Plexus Encountered during 100 Supraclavicular Decompressions for Neurogenic Thoracic Outlet Syndrome with Associated Postoperative Neurologic Complications

2020 ◽  
Vol 62 ◽  
pp. 70-75 ◽  
Author(s):  
Scott R. Golarz ◽  
Joseph M. White
Keyword(s):  
Brachial Plexus ◽  
Phrenic Nerve ◽  
Thoracic Outlet Syndrome ◽  
Anatomic Variation ◽  
Neurologic Complications ◽  
Neurogenic Thoracic Outlet Syndrome

scholarly journals Neurogenic Thoracic Outlet Syndrome Caused by Vascular Compression of the Brachial Plexus: A Report of Two Cases

2018 ◽  
Vol 13 (01) ◽  
pp. e1-e3
Author(s):  
Amgad Hanna ◽  
Larry Bodden ◽  
Gabriel Siebiger
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Vascular Compression ◽  
Repetitive Motion ◽  
Physical Trauma ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Inferior Portion ◽  
Pass Through ◽  
Neurogenic Tos

AbstractThoracic outlet syndrome (TOS) is caused by compression of the brachial plexus and/or subclavian vessels as they pass through the cervicothoracobrachial region, exiting the chest. There are three main types of TOS: neurogenic TOS, arterial TOS, and venous TOS. Neurogenic TOS accounts for approximately 95% of all cases, and it is usually caused by physical trauma (posttraumatic etiology), chronic repetitive motion (functional etiology), or bone or muscle anomalies (congenital etiology). We present two cases in which neurogenic TOS was elicited by vascular compression of the inferior portion of the brachial plexus.

Neurogenic Thoracic Outlet Syndrome

2018 ◽  
Author(s):  
Pascal Lavergne ◽  
Hélène T. Khuong
Keyword(s):  
Brachial Plexus ◽  
Thoracic Outlet Syndrome ◽  
Botulinum Toxin Injection ◽  
Signs And Symptoms ◽  
Nerve Blocks ◽  
Initial Management ◽  
Supraclavicular Approach ◽  
Lower Trunk ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Electrophysiologic Studies

Neurogenic thoracic outlet syndrome is an entrapment neuropathy involving the brachial plexus along its trajectory from the cervical spine to the axilla. Clinical presentation includes cervical and upper extremity pain as well as neurologic signs and symptoms in the lower trunk territory. Radiologic and electrophysiologic studies are helpful adjuncts in correctly identifying the site of compression. Initial management is usually conservative, with medication, physical therapy, nerve blocks, or botulinum toxin injection. Surgery often consists of brachial plexus neurolysis and removal of compression points through the supraclavicular approach. Good outcomes can be expected with careful patient selection, but available literature is of limited quality.

Case 13

2018 ◽  
Author(s):  
Bashar Katirji
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Brachial Plexus ◽  
Carpal Tunnel ◽  
Thoracic Outlet Syndrome ◽  
Median Sternotomy ◽  
Cubital Tunnel Syndrome ◽  
Brachial Plexopathy ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Tunnel Syndrome ◽  
Neurogenic Disorder

Thoracic outlet syndrome remains a controversial syndrome despite being described more than a century ago. This syndrome has neurogenic, vascular, and disputed types. True neurogenic thoracic outlet syndrome is relatively rare syndrome often associated with a cervical rib or cervical band. Symptoms include pain, hand and forearm numbness, and hand weakness and atrophy. The true neurogenic disorder has classical electrodiagnostic presentations. This case highlights the anatomy of the brachial plexus and distinguishes true neurogenic thoracic outlet syndrome from carpal tunnel syndrome, cubital tunnel syndrome, C8 radiculopathy, T1 radiculopathy, and post-median sternotomy brachial plexopathy, with emphasis on the electrodiagnostic findings.

scholarly journals Case Report: Neurogenic Thoracic Outlet Syndrome Without Electrophysiologic Abnormality

2021 ◽  
Vol 12 ◽  
Author(s):  
Sun Woong Kim ◽  
Duk Hyun Sung
Keyword(s):  
Brachial Plexus ◽  
Ct Angiography ◽  
Clinical Features ◽  
Thoracic Outlet Syndrome ◽  
Imaging Techniques ◽  
Neurovascular Bundle ◽  
Brachial Plexopathy ◽  
Lower Trunk ◽  
Neurogenic Thoracic Outlet Syndrome ◽  
Electrophysiologic Studies

Neurogenic thoracic outlet syndrome (N-TOS) is a chronic compressive brachial plexopathy that involves the C8, T1 roots, and/or lower trunk. Medial antebrachial cutaneous (MABC) nerve conduction study (NCS) abnormality is reportedly one of the most sensitive findings among the features of N-TOS. The aim of the present study was to report clinical features, imaging findings, treatment, and prognoses of two N-TOS patients with no abnormalities in electrophysiological studies. Both patients presented with paresthesia of unilateral arm, and examination revealed no neurologic deficits. Electrophysiologic studies including MABC NCS were normal. Computed tomography (CT) angiography and brachial plexus magnetic resonance imaging (MRI) of the patients showed compression and displacement of the neurovascular bundle in the thoracic outlet by causative structures. Due to their sensory symptoms and CT angiography and brachial plexus MRI findings, after excluding other diseases, we diagnosed them with N-TOS. With the development of imaging techniques, more patients presenting with clinical features of lower trunk brachial plexopathy and anomalous structures compressing the neurovascular bundle on imaging studies can be diagnosed with N-TOS, even if electrophysiologic studies including MABC NCS do not show abnormalities.

scholarly journals Supraclavicular Resection of a Cervical Rib Causing Thoracic Outlet Syndrome: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (5) ◽  
pp. E520-E520
Author(s):  
Stephen Shelby Burks ◽  
Erin M Wolfe ◽  
Jang Won Yoon ◽  
Allan D Levi
Keyword(s):  
Brachial Plexus ◽  
Clinical Improvement ◽  
Anterior Approach ◽  
Thoracic Outlet Syndrome ◽  
Cervical Vertebrae ◽  
Cervical Rib ◽  
Rib Resection ◽  
Lower Trunk ◽  
Neurogenic Thoracic Outlet Syndrome

Abstract Presence of a cervical rib results from overdevelopment of the seventh cervical vertebrae.1-3 The cervical rib along with scalene muscles can cause neurogenic thoracic outlet syndrome.4,5 Rib resection is typically done via anterior approach, using either supraclavicular or transaxillary route.6,7 We present an operative video detailing supraclavicular resection of a cervical rib causing neurogenic thoracic outlet syndrome with direct decompression of the lower trunk of the brachial plexus. The patient presented with severe symptoms including hand atrophy. We were able to directly visualize the rib and resect it, along with scalene musculature. We present 3-mo follow-up data noting clinical improvement in neuropathic symptoms.

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