Resolution of Brachial Plexus Palsy Due to Hemangioma After Intravenous Corticosteroid Therapy

Abstract

The authors report a 7-day-old girl born with a hemangioma involving the right side of the scalp and neck who developed ipsilateral brachial plexus palsy at 5 days of age. Imaging studies confirmed the presence of a cavernous hemangioma in the vicinity of the brachial plexus. She was treated with intravenous corticosteroids and her palsy resolved in 5 days. Only 1 prior case of hemangioma producing brachial plexus palsy has been reported; this patient was not treated with corticosteroids and had a partial recovery. The authors believe that the quick recovery after initiating systemic steroids was due to relief of nerve compression (neuropraxia) resulting from shrinkage of the cavernous hemangioma. The purpose of this article is to describe an uncommon cause of neonatal brachial plexus palsy and to report the effectiveness of early intravenous corticosteroid treatment in a patient with brachial plexus palsy due to a cavernous hemangioma.

Neurogenic Blepharoptosis After Medial Orbital Wall Reconstruction

“…Some articles suggest that systemic steroid therapy has been effective in traumatic optic neuropathy, traumatic facial nerve palsy, and brachial plexus palsy after hemangioma surgery. [12][13][14] However, the mechanism of steroid therapy in the treatment of neuropathy is unclear and the protocol regarding the dosage and duration of medication is yet to be established. The role of steroid therapy in traumatic neuropathy remains controversial.…”

“…The effect of systemic steroid therapy in traumatic neuropathy has been discussed in several studies. Some articles suggest that systemic steroid therapy has been effective in traumatic optic neuropathy, traumatic facial nerve palsy, and brachial plexus palsy after hemangioma surgery 12–14 . However, the mechanism of steroid therapy in the treatment of neuropathy is unclear and the protocol regarding the dosage and duration of medication is yet to be established.…”

Large venous hemangioma of brachial plexus

“…[ 1 3 ] Such patients do not generally have neurologic deficits, but in case of neurologic deficits, surgery or biopsy is contraindicated. [ 4 5 6 7 ]…”