scholarly journals Proximal Median Neuropathy Following Anterior Shoulder Dislocation: The Use of Magnetic Resonance Neurography

2020 ◽  
Vol 11 (1) ◽  
pp. 75-79
Author(s):  
Matthew Silsby ◽  
Alasdair Robertson ◽  
Con Yiannikas

Proximal median nerve injury is an uncommon consequence of anterior shoulder dislocation, especially occurring in isolation of other upper limb peripheral nerve injury. We report the case of an 82-year-old woman with a median nerve injury as detected by clinical and neurophysiological examination following a fall and anterior shoulder dislocation. Magnetic resonance neurography confirmed the diagnosis, but also detected asymptomatic brachial plexus and ulnar nerve involvement. Management was non-operative and there has been some improvement over several months. Our case expands the differential diagnosis for proximal median neuropathy and discusses the utility of neurography in cases of neural injury.

Author(s):  
Jefferson Braga Silva ◽  
Michel Chammas ◽  
Pierre-Emmanuel Chammas ◽  
Rubens Andrade ◽  
Bruno Hochhegger ◽  
...  

2003 ◽  
Vol 99 (1) ◽  
pp. 100-105 ◽  
Author(s):  
Thomas Hansson ◽  
Tom Brismar

Object. The aim of this study was to assess the effects of median nerve injury and regeneration on neuronal activation in the somatosensory cortex by means of functional magnetic resonance (fMR) imaging and somatosensory evoked potentials (SSEPs). Methods. Ten injured male patients (mean age 26 years) were examined 15 to 58 months after a total transection of the median nerve at the wrist that was repaired with epineural sutures. Two-point discrimination was lost in Digit II–III and sensory nerve conduction displayed decreased velocity (−29%) and amplitude (−84%) in the median nerve at the wrist. The fMR images were obtained during tactile stimulation (gentle strokes) performed separately on the volar surface of either Digit II–III or Digit IV–V (eight patients: two were excluded because of movement artifacts). The SSEPs were obtained using electrical stimulation proximal to the median nerve lesion. Conclusions. Patients with loss of sensory discrimination after median nerve damage and regeneration had larger areas of activation in fMR imaging near the contralateral central sulcus during tactile stimulation of the injured compared with the noninjured hand. The increase relative to the unaffected hand was 43% (p < 0.02) for Digit II–III stimulation and 46% (p < 0.02) for Digit IV–V stimulation. The SSEP data showed normal latency and amplitude. The enlarged area of cortical activation may be the result of reorganization, and it may indicate that larger cortical areas are involved in the discriminatory task after a derangement of the peripheral input.


1994 ◽  
Vol 67 (804) ◽  
pp. 1169-1172 ◽  
Author(s):  
F A Howe ◽  
D E Saunders ◽  
A G Filler ◽  
M A McLean ◽  
C Heron ◽  
...  

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