Presentation
Left upper limb weakness and diminished sensation occurs 2 weeks following motor vehicle accident.
Patient Data
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 oedema.
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. oedema, haemorrhage or myelomalacia and associated muscle atrophy or oedema.
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