Traumatic brachial plexus injury

Case contributed by Dr Ahmed Abd Rabou

Presentation

Left upper limb weakness and diminished sensation occurs 2 weeks following motor vehicle accident.

Patient Data

Age: 25 years old
Gender: Male
MRI

MRI of brachial plexus (BPI)

There are avulsions of the left C7 and C8 root sleeves, a tear in the dural sac with left C6-7 and C7-T1 pseudomeningocele formation. The adjacent muscles are intact with no signs of atrophy or edema.

Diagnosis: Traumatic avulsion of left C7 and C8 root sleeves with meningocele formation (M type)

Case Discussion

Severe traction on the upper limb in for example motor vehicle accident can lead to avulsion of the brachial plexus root sleeves or nerve roots. This is manifested clinically by upper limb weakness and sensory loss. 

CT myelography, conventional MRI and MR myelography are the methods of choice to detect nerve discontinuity as well as associated findings e.g. meningocele while MRI is more powerful to diagnose cord abnormalities e.g. edema, hemorrhage or myelomalacia and associated muscle atrophy or edema.

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Case information

rID: 24547
Case created: 25th Aug 2013
Last edited: 11th Dec 2015
Inclusion in quiz mode: Included

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