scholarly journals Terapijski pristup bolnim sindromima posle povreda perifernih nerava

2004 ◽  
Vol 51 (4) ◽  
pp. 65-68 ◽  
Author(s):  
V. Bascarevic ◽  
M. Samardzic ◽  
S. Ivanovic ◽  
M. Micovic ◽  
I. Cvrkota
Keyword(s):  
Brachial Plexus ◽  
Acute Phase ◽  
Peripheral Nerves ◽  
Nervous Tissue ◽  
Reflex Sympathetic Dystrophy ◽  
Brachial Plexus Injury ◽  
Regenerative Process ◽  
Burning Pain ◽  
Pain Pattern ◽  
Autonomic Disturbances

There are a variety of reasons that pain might persist beyond the period of normal healing, and usually these reasons are complex and multifactorial. The acute phase of denervation of muscles, especially that of large ones, can be quite painful. Also, during the early months of regenerative process patient may experience associated paresthesias or dysesthesias. Such a pain pattern is self limited, just as is the regenerative process. Neuropathy is a condition in which pain impulses are generated and perpetuated by injured, malfunctioning nervous tissue itself. Causalgia and reflex sympathetic dystrophy are terms reserved to describe a very characteristic burning pain, accompanied by hyperesthesia and autonomic disturbances. In this study we analyzed a series of 727 patients operated on Institute of neurosurgery with injury of one or more peripheral nerves, and 170 patients with brachial plexus injury.

How to Do It: Microsurgical DREZotomy for Pain After Brachial Plexus Injury: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Manon Duraffourg ◽  
Andrei Brinzeu ◽  
Marc Sindou
Keyword(s):  
Spinal Cord ◽  
Pain Relief ◽  
Brachial Plexus ◽  
Dorsal Horn ◽  
Brachial Plexus Injury ◽  
Dorsal Column ◽  
Motor Deficit ◽  
Complete Disappearance ◽  
Burning Pain ◽  
Root Entry Zone

Abstract More than three-quarters of victims of brachial plexus injury suffer from refractory neuropathic pain.1-6 Main putative mechanism is paroxysmal hyperactivity in the dorsal horn neurons at the dorsal root entry zone (DREZ) as demonstrated by microelectrode recordings in animal models7 and patients.8 Pain relief can be achieved by lesioning the responsible neurons in the spinal cord segments with avulsed rootlets.9,10  This video illustrates the technique for microsurgical DREZotomy.11,12 A C3-C7 hemilaminectomy is performed to access the C4-Th1 medullary segments. After opening the dura and arachnoid, and freeing the cord from arachnoid adhesions, the dorsolateral sulcus is identified. Identification can be difficult when the spinal cord is distorted and/or has a loss of substance. The dorsolateral sulcus is then opened with a microknife, so that microcoagulations are performed: 4 mm deep, at 35° angle in the axis of the dorsal horn, every millimeter in a dotted fashion along the avulsed segments. Care should be taken not to damage the corticospinal tract, laterally, and the dorsal column, medially.  The patient consents to the procedure. In the presented case, surgery led to complete disappearance of the paroxysmal pain and reduced the background of burning pain to a bearable level without the need of opioid medication. There was no motor deficit or ataxia in the ipsilateral lower limb postoperatively. According to Kaplan-Meier analysis at 10 yr follow-up, in our overall series, microsurgical DREZotomy achieved total pain relief without any medication in 60% of patients, and in 85% without the need for opioids.10,13-15  Microelectrode recording at 1:26 reproduced from Guenot et al7 with permission from JNSPG.

scholarly journals A young female patient with reflex sympathetic dystrophy of the upper limb in whom amputation became inevitable

1997 ◽  
Vol 21 (2) ◽  
pp. 159-161 ◽  
Author(s):  
J. H. B. Geertzen ◽  
J. S. Rietman ◽  
A. J. Smit ◽  
K. W. Zimmerman
Keyword(s):  
Range Of Motion ◽  
Female Patient ◽  
Upper Limb ◽  
Reflex Sympathetic Dystrophy ◽  
Young Female ◽  
Restricted Range ◽  
Burning Pain ◽  
Life Threatening ◽  
Unbearable Pain ◽  
Autonomic Disturbances

Reflex sympathetic dystrophy (RSD) is characterized mostly by: (burning) pain, restricted range of motion, oedema and autonomic disturbances. Amputations in case of RSD patients should only be performed in cases of a dysfunctional limb, life threatening conditions such as untreatable infections or in cases of unbearable pain. The authors describe a patient in whom amputation became inevitable because of threatening infections.

scholarly journals Guillain-Barré syndrome after brachial plexus trauma: case report

2006 ◽  
Vol 64 (4) ◽  
pp. 1039-1040 ◽  
Author(s):  
Marcos R.G. de Freitas ◽  
Osvaldo J.M. Nascimento ◽  
Maria Beatriz B.P. Harouche ◽  
Adolfo Vasconcelos ◽  
Heloy Darroz Jr ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Head Trauma ◽  
Peripheral Nerves ◽  
Brachial Plexus Injury ◽  
Demyelinating Polyneuropathy ◽  
Guillain Barre Syndrome ◽  
Immune Mediated ◽  
Trauma Case ◽  
Guillain Barré

The Guilllain-Barré syndrome (GBS) is an acute predominantly demyelinating polyneuropathy. In many cases GBS is preceding by infection, immunization, surgery or trauma. Although there are a few reports of GBS after head trauma, there is no report of this syndrome after brachial plexus injury. We report on a 51 years-old man who presented GBS fifteen days after a brachial plexus trauma. The polineuropathy resolved completely in a few weeks. We believe that GBS was triggered by the trauma that evoked an immune mediated disorder producing inflammation and demyelination of the peripheral nerves.

RESTORATION OF HAND FUNCTION AFTER BRACHIAL PLEXUS INJURY

Hand Clinics ◽  
1995 ◽  
Vol 11 (4) ◽  
pp. 647-656
Author(s):  
Chantal Bonnard ◽  
Algimantas Narakas
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function

scholarly journals Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doria Mohammed Gad ◽  
Mostafa Thabet Hussein ◽  
Nagham Nabil Mahmoud Omar ◽  
Mohamed Mostafa Kotb ◽  
Mohamed Abdel-Tawab ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Tissue Characterization ◽  
Brachial Plexus Injury ◽  
Imaging Modality ◽  
Preoperative Evaluation ◽  
Diagnostic Modality ◽  
Non Invasive ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus ◽  
Sensitivity Specificity

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

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