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Brachial Plexus Injury – Causes and Treatment

The brachial plexus is a network of nerves that originates from the neck that are responsible for movement and sensation in the shoulder, arms and hands. Injuries caused to these nerves can cause severe pain in shoulders or arms and limit movement and sensation in these areas. The condition is categorized according to the type of strain caused to the nerve. The severity of the nerve injuries can range from a mild stretch of the nerve to its tearing away from the spinal cord. The common types of brachial plexus injuries are as follows:

* Avulsion: In this condition, the nerve has been pulled out from the spinal cord, the most severe type of injury with fewer chances for recovery.

* Rupture: One or more of the nerves have been stretched and torn, but not at the spinal cord.

* Neurapraxia: The nerve has been stretched.

* Neuroma: In this condition, the scar tissue has grown around the injury site. This puts pressure on the injured nerve and prevents it from sending signals to the muscles.

Causes

* Birth defects: Injury caused to child’s brachial plexus during the delivery process may result in incomplete sensory and / or motor function of the involved arm.

* Trauma: Traumatic brachial plexus injuries may occur due to motorcycle or other motor vehicle accidents, animal bites, and bullet wounds.

* Tumors: Cancerous as well as non cancerous tumors can put pressure on the brachial plexus or spread to the nerves, causing damage to the brachial plexus.

* Inflammation: Sometimes, inflammation can cause damage to the brachial plexus. Parsonage-Turner syndrome is a rare condition that causes brachial plexus inflammation with no apparent shoulder injury.

Radiation treatment and stretching of brachial plexus beyond limit during collisions with other players also cause injury to the brachial plexus.

Treatment

Treatment depends on the extent of injury. Small injuries can be healed with therapy or with non-surgical treatment. Surgery is the only option for more severe injuries.

Non-surgical Treatment

Patients with neurapraxia can benefit from therapy to regenerate the healthy nerve tissue. The treatment will be focused on maintaining proper nutrition of the immobile muscles, to prevent further contraction of the muscles, and keep the joints mobile. Non-steroidal anti-inflammatory medications are prescribed to control the swelling at the injury site. Physical therapy can help improve movement and flexibility. If there is not improvement, the patient is assessed for internal nerve damage. If there is such injury, surgery may be recommended

Surgical Treatment

In adults, injured nerves are repaired using one of the following techniques or a combination of these

* Scar removal
* Direct nerve repair

Techniques for nerve repair include nerve grafting, nerve transfers, or both. Children with brachial plexus injury may have problems with the muscle, bone and joints. This can be corrected with nerve grafting, as the technique can improve function and growth. The surgery is performed under general anesthesia combined with procedures such as intraoperative electrical testing and microscopic magnification.

If you or a loved one has symptoms of brachial plexus injury, consult a board-certified plastic surgeon with experience in treating the condition. The surgeon will determine the nature of the injury after a thorough evaluation of your EMG (electrical) test reports and CT/MRI scan reports and recommend the suitable treatment.

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