We present the case of a cervicothoracic epidural pseudomeningocele with spinal cord compression 18 years after a brachial plexus injury. PURPOSE: To present a case report of a patient and literature review on cases with epidural pseudomeningoceles. [ncbi.nlm.nih.gov]

• Falling

  One patient sustained a fall resulting in stretch injury to the transfer, underwent successful revision surgery, and regained 100° active shoulder external rotation away from the abdomen more than a year after revision surgery. [ncbi.nlm.nih.gov]

  This is typically seen in rugby injuries, falls from horses and falls from motorcycles. In these cases the upper roots are more vulnerable to injury (ie C4/C5), as shown. [rcemlearning.co.uk]

  But older children sometimes incur brachial plexus injuries, as well, from traumatic events such as falling off of a jungle gym or a car accident. Most brachial plexus injuries result from the bruising or stretching of the nerves. [stanfordchildrens.org]

  Most brachial plexus injuries are caused by trauma such as motor vehicle accidents, sports injuries or falls, but they can also result from cancer and radiation therapy. Brachial plexus injury can also occur during birth. [hopkinsmedicine.org]

  Traumatic Brachial Plexus Injuries These can occur as the result of a number of reasons, including: high falls where the body lands on its side and shoulder violence or gunshot wounds traction on the arm motor vehicle accidents attempts to reduce shoulder [beaumont.org]

• Limb Pain

  An electric shock or burning sensation running down your arm Loss of sensation leading to numbness in whole or part of your upper limb Pain ranging from mild, to severe in case of nerve root avulsion Diagnosis Your doctor will first take your medical [riversideorthopedics.com]

  Loss of sensation leading to numbness in whole or part of your upper limb. Pain ranging from mild, to severe in case of nerve root avulsion. Diagnosis. [ypo.education]

  Specific physical signs suggesting differentiation of the limb, including Horner’s sign or severe pain in an anesthetic extremity, indicate that the BPI is proximal to the spinal foramen (preganglionic). [thenerve.net]

• Arm Pain

  The syndrome can begin with severe shoulder or arm pain followed by weakness and numbness. Brachial plexus injuries can happen during birth if the baby's shoulder is stretched as the baby passes through the birth canal. [ohsu.edu]

  This syndrome can begin with severe shoulder or arm pain followed by weakness and numbness. [brainfacts.org]

• Fatigue

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 30, 2019 [patientslikeme.com]

  Finally, muscle fatigue is frequently overlooked and virtually impossible to predict. [oandplibrary.org]

• Weight Loss

  After we evaluated the patient's history and clinical symptoms, infection or tumor were excluded because there was no history of migraine headaches, recent fever, weight loss, seizures, facial palsy, skin lesions, or any specific underlying disease. [academic.oup.com]

• Decompression Sickness

  The aetiology is secondary to fracture / dislocation, steroid therapy, sickle cell disease, decompression sickness, or sepsis. Physiotherapy follow up Physiotherapy assessment consists of a combination of history and physical testing 19. [rcemlearning.co.uk]

• Miosis

  The phrenic nerve, comprised of fibers from C3 through C5, and the sympathetic fibers of T1 are affected commonly in brachial plexus injuries, resulting, respectively, in ipsilateral diaphragmatic paralysis and Horner syndrome (miosis, partial ptosis, [pedsinreview.aappublications.org]

  The child may have ptosis (drooping eyelid), miosis (smaller pupil of the eye) and anhydrosis (diminished sweat production in part of the face). The child may have a more severe injury of the brachial plexus. [childrenshospital.org]

  Horner's syndrome : ptosis, miosis, anhydrosis, enophthalmos and loss of ciliospinal reflex- may be associated. This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T1. [physio-pedia.com]

  All five nerves of the brachial plexus are involved (C5-T1) Presents with no movement at the shoulder, arm or hand May have no sensations throughout the arm Horner Syndrome Result of nerve damage affecting the eye including constriction of the pupil (miosis [cincinnatichildrens.org]

• Prolapse

  Breech babies are at an increased risk of injury and a prolapsed umbilical cord, which cuts off the baby's blood supply. [webmd.com]

• Unilateral Arm Weakness

  RESULTS: Five patients had unilateral arm weakness after the initiation of ECMO therapy. There was no neurological examination or electrophysiological testing data available for 3 patients. [ncbi.nlm.nih.gov]

• Contusion

  but preservation of the connective tissue framework of the nerve (the encapsulating tissue, the epineurium and perineurium, are preserved). [23] [25] Neurotmesis : The most severe form of nerve injury, in which the nerve is completely disrupted by contusion [en.wikipedia.org]

• Anhidrosis

  […] comprised of fibers from C3 through C5, and the sympathetic fibers of T1 are affected commonly in brachial plexus injuries, resulting, respectively, in ipsilateral diaphragmatic paralysis and Horner syndrome (miosis, partial ptosis, slight enophthalmos and anhidrosis [pedsinreview.aappublications.org]

  Review Topic QID: 4750 1 The injury has likely resulted in the avulsion of several nerve roots 2 Physical exam would likely reveal drooping of his left eyelid and anhidrosis 3 Intact paraspinal musculature on EMG is suggestive of a post-ganglionic lesion [orthobullets.com]

  Avulsion or damage of the C8 and T1 nerve roots from which the cervical sympathetic chain arises cause Horner syndrome, which is characterized by ptosis, meiosis, anhidrosis of the cheek and enophthalmos. [thenerve.net]

• Confusion

  Do not confuse the management of proximal and distal biceps tendon injury, as the latter usually requires surgery. [rcemlearning.co.uk]

  REHABILITATION Modern surgical advances have resulted in a much less predictable range of impairment following BPI, and the prosthetist-orthotist is now faced with a confusing array of residual functions. [oandplibrary.org]

• Dysesthesia

  In addition, injuries nearer the spinal cord may cause a burning numbness, which is called paresthesias or dysesthesias. [orthoinfo.aaos.org]

  Two-thirds of the patients have a long-term effect, but about 10% experienced dysesthesia and ipsilateral leg weakness 1, 26). [thenerve.net]

• Areflexia

  Neurological examination showed a brachial diplegia, distal vibratory, thermic and algic hypoesthesia, deep tendon areflexia in upper limbs. There was no sensory or motor deficit in lower extremities. No cognitive disturbances were detected. [ncbi.nlm.nih.gov]

• Paresis

  Out of these, one donor had residual paresis. The reasons could be application of retractors, which may have led to traction and compression above the nerve roots. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

The authors present the first cost-effectiveness model to directly compare the different treatment strategies available to a patient with PBPI. [ncbi.nlm.nih.gov]

[…] recovery of reconstructed plexus can take up to 3 years nerve regeneration occurs at speed of 1mm/day infraclavicular plexus injuries have better prognosis than supraclavicular injuries upper plexus injuries have improved prognosis preservation of hand [orthobullets.com]

This makes predicting a prognosis of brachial plexus injuries difficult. Early Intervention Early detection and timely treatment of brachial plexus injuries are the most important factors that lead to a positive prognosis. [birthinjuryguide.org]

When considering the etiology and treatment of such injuries, it is important to make a distinction between adult versus obstetric brachial plexus injury. [ncbi.nlm.nih.gov]

Although trauma remains the probable etiology for many brachial plexus injuries, other, nontraumatic etiologies need to be considered. [jaoa.org]

Design: Observational epidemiological study. Setting: Hospital-based multicenter study. Subjects: One hundred seven prospectively enrolled patients with brachial plexus injury. [ncbi.nlm.nih.gov]

Although the ability to predict brachial plexus injury antenatally remains elusive, knowledge of its epidemiology, risk factors, variations in presentation, prognosis, and management can guide therapeutic decisions and potentially avoid lifelong disability [pedsinreview.aappublications.org]

Epidemiology Frequency United States Brachial plexus injuries are the most common peripheral nerve injuries seen in athletes. True rate of brachial plexus injuries is difficult to determine due to significant underreporting. [emedicine.medscape.com]

"Epidemiology of Brachial Plexus Injuries in a Multitrauma Population". Neurosurgery. 40 (6): 1182–8, discussion 1188–9. doi : 10.1097/00006123-199706000-00014. PMID 9179891. External links [ edit ] [en.wikipedia.org]

BACKGROUND: Assessment of muscle atrophy and fatty degeneration in brachial plexus injury (BPI) could yield valuable insight into pathophysiology and could be used to predict clinical outcome. [ncbi.nlm.nih.gov]

The pathomechanics, pathophysiology and prevention of cervical spinal cord and brachial plexus injuries in athletics. Sports Med. 2010. 40(1):59-75. [Medline]. Terzis JK, Kokkalis ZT. [emedicine.medscape.com]

Pathophysiology of the BPI Root injury is defined as root avulsion from the spinal cord and rupture in the preganglionic root zone or dorsal ganglion at the vertebral foramen. [thenerve.net]

This article will also discuss the etiology and pathogenesis of nerve injury after MVD and the means to prevent them. METHODS: Intraoperative SSEP monitorings for 485 patients who underwent MVD surgery were reviewed. [ncbi.nlm.nih.gov]