scholarly journals Microsurgery of peripheral nerve injuries: Analysis of twenty-five year experiences

2003 ◽  
Vol 50 (1) ◽  
pp. 7-14
Author(s):  
Miroslav Samardzic

Microsurgical procedures on injured peripheral nerves have been performed in Institute of neurosurgery in Belgrade for twenty-five years. During this period 1284 procedures, including 1029 on peripheral nerves, and 255 on brachial plexus were done. In this paper we analyze surgical results of individual procedures and the other factors influencing the outcome. Despite advances caused by introduction of the operating microscope, there are numerous controversies mainly in microsurgical technique that are discussed.

JMS SKIMS ◽  
2010 ◽  
Vol 13 (1) ◽  
pp. 7-10
Author(s):  
Owais Habib ◽  
Adil Hafeez ◽  
Abdul Rashid Bhat

Background: Peripheral neural trauma is a common injury seen both in civilian practice and warfare.Majority of such neural damage is caused by glass cut. The agent causes extnesive damage to te underlying structures from an apparantly looking small incised wound.Material and Method: We explored the wonds of 75 patients under anaesthesia to look for injury to the underlying peripheral nerves. Upon identifying the injured nerve, primary repair using epineural microsurgical technique was carried out using very fine sutures and micro- instruments. The patients were followed sequentailly in the post operative period.Conclusion:When such a protocol was adhered to, the results of nerve repair were excellent in majority of the patients. J Med Sci 2010;13(1):7-10


2014 ◽  
Vol 5 (3) ◽  
pp. 64-66
Author(s):  
Marina Nikolayevna Romanova ◽  
Nikolay Grigoryevich Zhila ◽  
Yelena Vladimirovna Sinelnikova

Ultrasound imaging of peripheral nerves can accurately determine the level of damage, and also to assess the extent of damage to the structure of the nerve fiber. Early detection of the type of damage can significantly improve patient outcomes.


1985 ◽  
Vol 62 (5) ◽  
pp. 711-715 ◽  
Author(s):  
Kathleen L. Brelsford ◽  
Sumio Uematsu

✓ Impaired function of cutaneous segments of monkey peripheral nerves experimentally blocked by lidocaine anesthesia was clearly visualized by means of elevated temperature measurements obtained on computerized color telethermography. Mean temperature elevations in the segments of anesthetized primate nerves were 2.40°C at the ulnar segment 17 minutes after nerve block, and 1.20°C at the peroneal nerve at 20 minutes. The vasomotor activity of specific nerves, recorded after local anesthesia and displayed by color telethermographic imaging, corresponded to the distribution of sensory segments identified by more cumbersome means. Telethermography is therefore shown to be a useful tool, both qualitatively and quantitatively, in mapping cutaneous distribution of peripheral nerves and for evaluation of peripheral nerve injuries.


1987 ◽  
Vol 6 (1) ◽  
pp. 135-158 ◽  
Author(s):  
Joseph J. Vegso, MS ◽  
Elisabeth Torg ◽  
Joseph S. Torg

2021 ◽  
pp. 361-368
Author(s):  
Lisa B.E. Shields ◽  
Brandon Sutton ◽  
Vasudeva G. Iyer ◽  
Christopher B. Shields ◽  
Abigail J. Rao

Iatrogenic peripheral nerve injuries may result from transection, stretch, compression, injections, ligature, heat, anticoagulant use, and radiation. Iatrogenic median nerve palsy has been reported rarely. We report a case of a woman who underwent craniectomy for treatment of trigeminal neuralgia. Intraoperatively, a transient decline in the amplitude of the left upper extremity somatosensory evoked potentials (SSEPs) was noted. This finding was presumed to be due to the traction on the brachial plexus as it improved with repositioning. Immediately upon waking from anesthesia, the patient experienced sensorimotor deficits in the left median nerve distribution. Ecchymoses from venipuncture were observed in this area. Electrodiagnostic studies confirmed a left median nerve neuropathy localized in the antebrachial area. Neurosurgeons and neurologists should be alert to potential iatrogenic median nerve palsy following vascular access at the antebrachial region. Vascular access could be performed under the ultrasound guidance when a patient is under anesthesia or unable to give sensory feedback. Furthermore, placing an additional recording electrode over the proximal upper arm during intraoperative SSEP monitoring aids in distinguishing between brachial plexus and peripheral nerve injuries.


Author(s):  
Jonathan Perera ◽  
Marco Sinisi

Stretching of more than 12% of a nerve or more than 8 hours of ischaemia will result in severe nerve injury. The force required to avulse cervical nerve roots is as little as 200 newtons. The nerve root exiting angles are very important, as different forequarter positions at the time of impact will result in differing force vectors and therefore differing injury. Nerve injuries can be extremely devastating not only for the patient but for their surrounding support structure as well. We discuss and detail the diagnosis and management of these lesions along with the useful investigations and treatment options. The appropriately timed management of these patients can allow good outcomes for both patient physical and subsequent mental health.


Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 887
Author(s):  
Chul-Hyun Cho ◽  
Don-Kyu Kim ◽  
Du Hwan Kim

Peripheral nerve injury after shoulder trauma is an underestimated complication. The distribution of the affected nerves has been reported to be heterogeneous in previous studies. This study aimed to describe the distribution of peripheral nerve injuries in patients with a history of shoulder trauma who were referred to a tertiary care electrodiagnostic laboratory. A retrospective chart review was performed for all cases referred to a tertiary care electrodiagnostic laboratory between March 2012 and February 2020. The inclusion criteria were a history of shoulder trauma and electrodiagnostic evidence of nerve injury. Data on patient demographics, mechanism of injury, degree of weakness, clinical outcomes at the final follow-up, and electrodiagnostic results were retrieved from medical records. Fifty-six patients had peripheral nerve injuries after shoulder trauma. Overall, isolated axillary nerve injury was the most common. A brachial plexus lesion affecting the supraclavicular branches (pan-brachial plexus and upper trunk brachial plexus lesions) was the second most common injury. In cases of shoulder dislocation and proximal humerus fracture, isolated axillary nerve injury was the most common. Among acromioclavicular joint injuries and clavicular fractures, lower trunk brachial plexus injuries and ulnar neuropathy were more common than axillary nerve or upper trunk brachial plexus injuries. Patients with isolated axillary nerve lesions showed a relatively good recovery; those with pan-brachial plexus injuries showed a poor recovery. Our study demonstrated the distribution of peripheral nerve injuries remote from displaced bony structures. Mechanisms other than direct compression by displaced bony structures might be involved in nerve injuries associated with shoulder trauma. Electrodiagnostic tests are useful for determining the extent of nerve damage after shoulder trauma.


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