Pathophysiology of nerve injury

Maggi, Sergio P.; Lowe, James B.; Mackinnon, Susan E.

doi:10.1016/s0094-1298(02)00101-3

Cited by 80 publications

(57 citation statements)

References 75 publications

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“…Direct end-to-end repair is technically challenging to perform and usually not feasible in many clinical cases. 28,29 Nerve grafts and conduits are becoming increasingly utilized, 30 and, in the future, the same methodology as in this study can be applied to regeneration of nerves with grafts and conduits. 31 Second, nerve regeneration was only followed for 8 weeks after surgery when gadofluorine enhancement of the injured nerve was still present.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Repair Effect of Toll-Like Receptor 4 Activation on Neurotmesis: Assessment Using MR Neurography

Zhang

et al. 2014

American Journal of Neuroradiology

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Section: Discussionmentioning

confidence: 99%

Enhanced Repair Effect of Toll-Like Receptor 4 Activation on Neurotmesis: Assessment Using MR Neurography

Zhang

et al. 2014

American Journal of Neuroradiology

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“…Understanding the anatomy is crucial to grasping the pathophysiologic concepts that underlie the clinical management of patients with peripheral nerve injuries (Burnett and Zager, 2004;Maggi et al, 2003). Because the clinical neurophysiologist works closely with the surgeon in managing these cases, it is also important to be familiar with surgical principles, approaches, and concerns.…”

Section: Neuropathology Of Peripheral Nerve Injurymentioning

confidence: 99%

Evaluation and management of peripheral nerve injury

Campbell

2008

Clinical Neurophysiology

605

462

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Common etiologies of acute traumatic peripheral nerve injury (TPNI) include penetrating injury, crush, stretch, and ischemia. Management of TPNI requires familiarity with the relevant anatomy, pathology, pathophysiology, and the surgical principles, approaches and concerns. Surgical repair of TPNI is done at varying time intervals after the injury, and there are a number of considerations in deciding whether and when to operate. In neurapraxia, the compound muscle and nerve action potentials on stimulating distal to the lesion are maintained indefinitely; stimulation above the lesion reveals partial or complete conduction block. The picture in axonotmesis and neurotmesis depends on the time since injury. The optimal timing for an electrodiagnostic study depends upon the clinical question being asked. Although conventional teaching usually holds that an electrodiagnostic study should not be done until about 3 weeks after the injury, in fact a great deal of important information can be obtained by studies done in the first week. Proximal nerve injuries are problematic because the long distance makes it difficult to reinnervate distal muscles before irreversible changes occur. Decision making regarding exploration must occur more quickly, and exploration using intraoperative nerve action potential recording to guide the choice of surgical procedure is often useful.

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“…38,39 This is technically challenging because nerve stumps must be repaired with minimal tissue damage, using a minimum of sutures or glue and requiring that the stumps be precisely aligned without tension. 40,41 The current criterion standard of repair for nerve gaps is autologous nerve grafting. 42,43 Nerve grafts, either allo-or autografts, are in use clinically and may be used as end-to-side or end-to-end repairs.…”

Section: Nerve Microsurgerymentioning

confidence: 99%

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

Thawait¹,

Wang

Subhawong

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY:High-resolution MRN is becoming increasingly available due to recent technical advancements, including higher magnetic field strengths (eg, 3T), 3D image acquisition, evolution of novel fat-suppression methods, and improved coil design. This review describes the MRN techniques for obtaining high-quality images of the peripheral nerves and their small branches and imaging findings in normal as well as injured nerves with relevant intraoperative correlations. Various microsurgical techniques in peripheral nerves, such as neurolysis, nerve repairs by using nerve grafts, and conduits are discussed, and MRN findings of surgically treated nerves are demonstrated.ABBREVIATIONS: AP ϭ anteroposterior; CPN ϭ common peroneal nerve; IV ϭ intravenous; LPN ϭ lateral plantar nerve; LR ϭ left-to-right; MIP ϭ maximum intensity projection; MPN ϭ medial plantar nerve; MPR ϭ multiplanar reconstruction; MRN ϭ MR neurography; SI ϭ signal intensity; SNR ϭ signal-to-noise ratio; SPACE ϭ sampling perfection with application-optimized contrasts by using different flip angle evolutions; SPAIR ϭ spectral-attenuated inversion recovery; STIR ϭ short tau inversion recovery; T1WI ϭ T1-weighted imaging; T2WI ϭ T2-weighted imaging; TSE ϭ turbo spin-echo

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Pathophysiology of nerve injury

Cited by 80 publications

References 75 publications

Enhanced Repair Effect of Toll-Like Receptor 4 Activation on Neurotmesis: Assessment Using MR Neurography

Enhanced Repair Effect of Toll-Like Receptor 4 Activation on Neurotmesis: Assessment Using MR Neurography

Evaluation and management of peripheral nerve injury

Peripheral Nerve Surgery: The Role of High-Resolution MR Neurography

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