J Korean Neurosurg Soc.  2021 Mar;64(2):255-260. 10.3340/jkns.2020.0187.

Brachial Plexus Injuries in Adults with Traumatic Brain Injury : A Retrospective Study

• Tezel N
• Can A
• Cankurtaran D
• Akyüz E
• Çakcı A

• KMID: 2513856
• DOI: http://doi.org/10.3340/jkns.2020.0187

Abstract

Objective
: We aimed to investigate the presence of brachial plexus injury (BPI) in traumatic brain injury (TBI) patients and to draw attention to BPI, which can be overlooked by physicians in TBI patients. Methods : The study was designed retrospectively by examining the files of 58 patients with moderate to severe TBI to investigate coexistence of TBI and BPI. Results : BPI was detected in six of 58 TBI patients (10.3%). BPI was detected after an average 116 days from the initial injury. Three patients had lower trunk BPI and three patients had panplexopathy. Conclusion : Diagnosis of BPI in patients with TBI is delayed in the acute period of injury. The clinicians should keep in mind that BPIs may occur and remain undiagnosed in patients with TBI.

Keyword

Brachial plexus; Brain injuries, Traumatic; Electromyography

Figure

• 

  Fig. 1. The ow-sheet for diagnosis fo BPI and other PNIs of upper extremity in TBI patients. TBI : traumatic brain injury, BPI : brachial plexus injury, PNIs : peripheral nerve injuries, ENMG : electroneuromyography.

Reference

References

1. Brien WW, Gellman H, Becker V, Garland DE, Waters RL, Wiss DA. Management of fractures of the humerus in patients who have an injury of the ipsilateral brachial plexus. J Bone Joint Surg Am. 72:1208–1210. 1990.

2. Ciaramitaro P, Mondelli M, Logullo F, Grimaldi S, Battiston B, Sard A, et al. Traumatic peripheral nerve injuries: epidemiological findings, neuropathic pain and quality of life in 158 patients. J Peripher Nerv Syst. 15:120–127. 2010.

3. Dang B, Chen W, He W, Chen G. Rehabilitation treatment and progress of traumatic brain injury dysfunction. Neural Plast. 2017:1582182. 2017.

4. de Moraes FB, Kwae MY, da Silva RP, Porto CC, Magalhães Dde P, Paulino MV. Clinical aspects of patients with traumatic lesions of the brachial plexus following surgical treatment. Rev Bras Ortop. 50:556–561. 2015.

5. Garland DE, Keenan MA. Orthopedic strategies in the management of the adult head-injured patient. Phys Ther. 63:2004–2009. 1983.

6. Kim DH, Murovic JA, Kline DG. Brachial plexus injury: mechanisms, surgical treatment and outcomes. Korean Neurosurg Soc. 36:177–185. 2004.

7. Mansukhani KA. Electrodiagnosis in traumatic brachial plexus injury. Ann Indian Acad Neurol. 16:19–25. 2013.

8. Menon DK, Schwab K, Wright DW, Maas AI; Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health. Position statement: definition of traumatic brain injury. Arch Phys Med Rehabil. 91:1637–1640. 2010.

9. Midha R. Epidemiology of brachial plexus ınjuries in a multitrauma population. Neurosurgery. 40:1182–1189. 1997.

10. Noble J, Munro CA, Prasad VS, Midha R. Analysis of upper and lower extremity peripheral nerve injuries in a population of patients with multiple injuries. J Trauma. 45:116–122. 1998.

11. Park HR, Lee GS, Kim IS, Chang JC. Brachial plexus injury in adults. The Nerve. 3:1–11. 2017.

12. Robbins W, Cifu D. Geriatric Traumatic Brain Injury. In : Eapen BC, Cifu DX, editors. Rehabilitation After Traumatic Brain Injury. ed 1.St. Louis: Elsevier;2018. p. 109–114.

13. Robinson LR. Traumatic injury to peripheral nerves. Muscle Nerve. 23:863–873. 2000.

14. Stone L, Keenan MA. Peripheral nerve injuries in the adult with traumatic brain injury. Clin Orthop Relat Res. (233):136–144. 1988.