Brachial plexus post-ganglionic root avulsion

Discussion:

Postganglionic lesions of the brachial plexus occur distal to the dorsal root ganglion and can be managed with nerve grafting to provide a better prognosis.  MRI features of post-ganglionic lesions include 1,2:

  • Hypo to isointense appearance of the affected nerve on T1-weighted imaging, hyperintense on T2-weighted imaging
  • Nerve fibers appear in discontinuity and distal nerve contraction ball visible if avulsion injury
  • Can have direct compression of involvement of nerves by hematoma, fracture fragment, exuberant callus secondary to fracture

 Case courtesy of A/Prof Pramit Phal.

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