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Utku Senol - One of the best experts on this subject based on the ideXlab platform.

  • mr imaging findings in brachial plexopathy with thoracic outlet syndrome
    American Journal of Neuroradiology, 2010
    Co-Authors: Ayse Aralasmak, Kamil Karaali, Can Cevikol, H Uysal, Utku Senol
    Abstract:

    SUMMARY: The BPL is a part of the peripheral nervous system. Many disease processes affect the BPL. In this article, on the basis of 60 patients, we reviewed MR imaging findings of subjects with brachial plexopathy. Different varieties of BPL lesions are discussed. AA : axillary artery ABD : abduction ADs : anterior divisions AS : anterior scalene muscle AV : axillary vein BPL : brachial plexus CC : costoclavicular space CL : clavicula EMG : electromyelography I : inferior trunk IS : interscalene triangular space LC : lateral Cord M : middle trunk MC : Medial Cord MRA : MR angiography MRV : MR venography MS : middle scalene NEU : neutral PC : posterior Cord PDs : posterior divisions PET : positron-emission tomography PMA : pectoralis major muscle PMI : pectoralis minor muscle RP : retropectoralis minor space S : superior trunk SA : subclavian artery STIR : short tau inversion recovery SV : subclavian vein T1WI : T1-weighted imaging T2WI : T2-weighted imaging TOS : thoracic outlet syndrome TSE : turbo spin-echo

Allan J. Belzberg - One of the best experts on this subject based on the ideXlab platform.

  • Nerve transfers for restoration of upper extremity motor function in a child with upper extremity motor deficits due to transverse myelitis: case report.
    Microsurgery, 2011
    Co-Authors: Michael J. Dorsi, Allan J. Belzberg
    Abstract:

    Transverse myelitis (TM) may result in permanent neurologic dysfunction. Nerve transfers have been developed to restore function after peripheral nerve injury. Here, we present a case report of a child with permanent right upper extremity weakness due to TM that underwent nerve transfers. The following procedures were performed: double fascicle transfer from median nerve and ulnar nerve to the brachialis and biceps branches of the musculocutaneous nerve, spinal accessory to suprascapular nerve, and Medial Cord to axillary nerve end-to-side neurorraphy. At 22 months, the patient demonstrated excellent recovery of elbow flexion with minimal improvement in shoulder abduction. We propose that the treatment of permanent deficits from TM represents a novel indication for nerve transfers in a subset of patients.

Asa J. Wilbourn - One of the best experts on this subject based on the ideXlab platform.

  • The utility of various sensory nerve conduction responses in assessing brachial plexopathies
    Muscle & nerve, 1995
    Co-Authors: Mark A. Ferrante, Asa J. Wilbourn
    Abstract:

    To determine which sensory nerve conduction studies (S-NCS) are helpful in detecting supraclavicular axon loss brachial plexopathies, we selected 53 cases (of 417 reviewed) in whom complicating factors were absent and which, by needle electrode examination findings, involved only a single "truncal" element (upper, middle, or lower) of the brachial plexus. Extensive S-NCS included: median, reCording thumb (Med-D1), index (Med-D2), and middle fingers (Med-D3); ulnar, reCording fifth finger (Uln-D5); dorsal ulnar cutaneous, reCording dorsum of the hand (DUC); radial, reCording base of thumb; and both Medial and lateral antebrachial cutaneous (MABC, LABC), reCording forearm. Except for the median sensory fibers, the "Cord" elements traversed by the sensory fibers assessed during the S-NCS listed above are anatomically defined (i.e., the sensory fibers enter the brachial plexus at only one Cord). In regard to the median sensory fibers, however, there are two possible pathways through the infraclavicular plexus: (1) the lateral Cord and/or (2) the Medial Cord. Because the lower trunk is only accessible via the Medial Cord, any sensory fibers found to be traversing the lower trunk had to first traverse the Medial Cord. Similarly, those traversing the upper and middle trunks must first be a component of the lateral Cord. The frequency that the various S-NCS responses were abnormal (unelicitable, below laboratory normal value, or < or = 50% of the contralateral response) for a given brachial plexus element lesion was as follows: (1) upper trunk (UT): 25 of 26 Med-D1, 25 of 26 LABC, 15 of 26 radial, 5 of 26 Med-D2, 2 of 26 Med-D3; (2) middle trunk (MT): 1 of 1 Med-D3; (3) lower trunk (LT): 25 of 26 Uln-D5, 22 of 23 DUC, 11 of 17 MABC, 3 of 23 Med-D3. With lower trunk brachial plexopathies, both "routine" (Uln-D5) and "uncommon" (DUC; MABC) S-NCS are abnormal. With upper trunk brachial plexopathies, in contrast, only the "uncommon" S-NCS (Med-D1; LABC) are consistently affected. The "routine" median S-NCS reCording digit 2 (Med-D2) is far less reliable than the median S-NCS reCording digit 1 (Med-D1) in detecting upper trunk axon loss brachial plexopathies. Additionally, the various pathways traversed by the fibers contributing to the individual S-NCS responses can be predicted, an important point when the full extent of a brachial plexus lesion is sought.

Junghee Choi - One of the best experts on this subject based on the ideXlab platform.

André P. Boezaart - One of the best experts on this subject based on the ideXlab platform.

  • At the Cords, the pinkie towards: Interpreting infraclavicular motor responses to neurostimulation.
    Regional anesthesia and pain medicine, 2004
    Co-Authors: Steven C. Borene, John N. Edwards, André P. Boezaart
    Abstract:

    Identification of elicited muscle twitches while performing infraclavicular block of the brachial plexus is often confusing but is critical for success of the block. An easily defined endpoint when evaluating these motor responses to neurostimulation is essential, as it is necessary to block the appropriate Cord or Cords. In addition to an extensive review of the motor and sensory neuroanatomy of the upper extremity, we describe an easy method to learn and remember the motor response to stimulation of each of the Cords of the brachial plexus. If the arm is positioned in the anatomical position, the 5th digit (pinkie) moves laterally (pronation of the forearm) when the lateral Cord is stimulated, posteriorly (extension) when the posterior Cord is stimulated, and Medially (flexion) when the Medial Cord is stimulated. The pinkie thus moves “toward” the Cord that is stimulated.