Brachial plexopathy

Case contributed by Dr Ali Abougazia

Presentation

This patient underwent cervical disc surgery about 6 months ago. Afterwards, she began experiencing left upper limb weakness.

Patient Data

Age: 55
Gender: Female
MRI

Evidence of C3/C4 and C4/C5 discectomy and cage placement.

The lower cervical spinal nerves of the left brachial plexus, and their dorsal root ganglia from C5 to D1 are seen thickened eliciting slightly high T2/FLAIR signal with subtle post-contrast enhancement. No definite loss of fiber continuity or related masses.

The left shoulder girdle muscles as well as left arm, pectoralis major and latissimus dorsi muscles show reduced girth with high T2/STIR signals and post-contrast enhancement.

Annotated image

High FLAIR signal and swelling of the left brachial plexus.

Large left brachial plexus roots, best noted at C8.

Normal right brachial plexus roots as seen here for comparison.

Coronal FIESTA explicitly shows the difference in size between left and right brachial plexuses.

Case Discussion

Left brachial plexopathy, likely post-operative sequelae due to excessive traction or malpositioning, or less commonly post-operative infection, with subsequent left shoulder girdle and left upper limb muscles atrophy and edema.

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Case information

rID: 21844
Published: 21st Feb 2013
Last edited: 17th Sep 2018
Inclusion in quiz mode: Included

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