Assessment of obstetric brachial plexus injury with preoperative ultrasound

Smith, Edward C.; Xixis, Kathryn; Grant, Gerald A.; Grant, Stuart A.

doi:10.1002/mus.24975

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…All nerve roots were visualized at the C5‐C7 levels, whereas, at the C8 level, 81.1% were visualized (except for neonates). The C8 nerve root was difficult to observe in neonates; the short neck meant that the examination position was insufficiently exposed, and the collarbone and lung gas limited the view. Normal reference values for the C5‐C8 nerve roots of the children were established (Tables ).…”

Section: Resultsmentioning

confidence: 99%

Sonographic measurements of normal C5‐C8 nerve roots in children

Wang

2020

Muscle and Nerve

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Introduction The aim of this study was to use ultrasound to measure the cervical nerve roots in normal children to determine normal reference values. Methods A total of 441 children of different ages at the Children's Hospital of Chongqing Medical University were examined by ultrasound. The diameter, circumference, and cross‐sectional area of the nerve roots were measured. Results Ultrasonographic measurements were consistent with the ranking C5 < C6 < C7. The C8 nerve root was thicker than C7 in 60% of the participants. The nerve root measurements increased with increasing age, height, weight, and body surface area. Discussion Normal reference ranges of the cervical nerve roots in children of different ages were established, and can serve as the basis for measurement in future studies.

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Section: Resultsmentioning

confidence: 99%

Sonographic measurements of normal C5‐C8 nerve roots in children

Wang

2020

Muscle and Nerve

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“…5,6 Because of the ease of availability and superior spatial resolution for a quick, real-time evaluation of nerves without sedation or contrast administration, ultrasound (US) has been increasingly used as the imaging technique of choice in recent years. [7][8][9] US can detect nerve injury in the form of a neuroma and/or scar tissue formation. 9,10 Detection of nerve root injuries has been reported to be 100% for C5-C7, 84% for C8, and 64% for T1 in adult patients.…”

mentioning

confidence: 99%

“…[7][8][9] US can detect nerve injury in the form of a neuroma and/or scar tissue formation. 9,10 Detection of nerve root injuries has been reported to be 100% for C5-C7, 84% for C8, and 64% for T1 in adult patients. 11 These nerve roots can also be evaluated in children with similar detection rates except the C8 and T1 nerve roots because of difficulty in evaluating C8 and T1.…”

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confidence: 99%

Brachial Plexus Ultrasound and MRI in Children with Brachial Plexus Birth Injury

Güneş

Bulut²,

Üzümcügil

et al. 2018

AJNR Am J Neuroradiol

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High-resolution sonography can identify and locate the postganglionic injury associated with the upper and middle trunks. The ability of sonography to evaluate pre- and the postganglionic injury associated with the lower trunk was quite limited. Sonography can be used as a complement to MR imaging; thus, the duration of the MR imaging examination and the need for sedation can be reduced by sonography.

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“…Disadvantages include their need for general anesthesia, the potential lack of availability, and cost. The utility of ultrasound (US) has not been extensively examined, but is promising …”

Section: Introductionmentioning

confidence: 99%

Early electrodiagnosis in the management of neonatal brachial plexus palsy: A systematic review

et al. 2019

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Neonatal brachial plexus palsy (NBPP) is a prominent form of newborn morbidity with a potentially disabling persistence. Neurosurgical intervention is indicated in select NBPP patients. Early prognostic assessment would facilitate rational selection of those infants for surgery. We conducted a systematic literature review to determine the prognostic value of early electrodiagnosis (EDx) in NBPP. We included 16 observational studies with a total sample size of 747 children. Risk of bias and quality of evidence were rated. Wide variation was found in EDx techniques, outcome algorithms, and decisionmaking. Nevertheless, the most methodologically sound studies support the use of EDx, at standardized time-frames, as a key prognostic modality for complementing clinical judgment and neuroimaging. An accurate knowledge of the underlying anatomy of the nerve injury helps to counsel families and to guide reconstructive strategy. K E Y W O R D S brachial plexus neuropathy, electrodiagnosis, electrodiagnostic testing, neonatal brachial plexus palsy, prognosis 1 | INTRODUCTION Neonatal brachial plexus palsy (NBPP) is reported to occur in 0.1 to 8.10 per 1000 live births worldwide. 1-6 It is the result of a closed nerve stretch injury to the brachial plexus during the perinatal period. The most common lesions occur within the C5 and C6 spinal nerves (80% of patients), with a smaller group of patients having more extensive lesions, ranging from C5 to C7 and from C5 to T1 (panplexopathy). 7Prevention is difficult due to the unpredictability and multifactorial nature of the risk factors. As severity varies from neurapraxia, axonotmesis, and neurotmesis, to root avulsion, and the extent of injury varies between damage to one nerve or all roots, the impact of neonatal plexopathy ranges from temporary functional impairment to a lifelong total paralysis of one arm. 3,5,[8][9][10][11][12][13][14] Early management includes parental counseling; family support; handling information; splinting; and appropriate, early, and supervised rehabilitation. Neurosurgical intervention is usually undertaken between 3 and 12 months of age in children who have shown little or no significant improvement in the affected muscle groups. 2,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] It is generally agreed that early surgical nerve repair can greatly improve the functional outcome in select patients. 15,20,22,24,[31][32][33] Delay to time of surgery often results in progressive worsening of deformity in the shoulder joint as contractures progress quickly over time in a rapidly growing infant. 34 Surgery in the first months of life is therefore indicated for serious Abbreviations:

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Assessment of obstetric brachial plexus injury with preoperative ultrasound

Abstract: US is a relatively inexpensive, noninvasive, painless diagnostic modality that can be used to assess OBPI. This case series suggests that US is a valuable adjunct to current diagnostic modalities. Muscle Nerve 53: 946-950, 2016.

Cited by 16 publications

References 15 publications

Sonographic measurements of normal C5‐C8 nerve roots in children

Sonographic measurements of normal C5‐C8 nerve roots in children

Brachial Plexus Ultrasound and MRI in Children with Brachial Plexus Birth Injury

Early electrodiagnosis in the management of neonatal brachial plexus palsy: A systematic review

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