Brachial plexus injury
| Brachial plexus injury | |
|---|---|
| Classification and external resources | |
| Specialty | emergency medicine |
| ICD-10 | G54.0, P14.3, S14.3 |
| ICD-9-CM | 353.0, 767.6, 953.4 |
| DiseasesDB | 31267 |
| MedlinePlus | 001418 |
| MeSH | D020516 |
A brachial plexus injury (BPI), also known as brachial plexus lesion, is an injury to the brachial plexus, the network of nerves that conducts signals from the spinal cord to the shoulder, arm and hand. These nerves originate in the fifth, sixth, seventh and eighth cervical (C5–C8), and first thoracic (T1) spinal nerves, and innervate the muscles and skin of the chest, shoulder, arm and hand.
Brachial plexus injuries can occur as a result of shoulder trauma, tumours, or inflammation. The rare Parsonage-Turner Syndrome causes brachial plexus inflammation without obvious injury, but with nevertheless disabling symptoms. But in general, brachial plexus injury can be classified as either traumatic or obstetric. Obstetric injuries may occur from mechanical injury involving during difficult childbirth. Traumatic injury may arise from several causes. "The brachial plexus may be injured by falls from a height on to the side of the head and shoulder, whereby the nerves of the plexus are violently stretched....The brachial plexus may also be injured by direct violence or gunshot wounds, by violent traction on the arm, or by efforts at reducing a dislocation of the shoulder joint".
Signs and symptoms may include a limp or paralyzed arm, lack of muscle control in the arm, hand, or wrist, and lack of feeling or sensation in the arm or hand. Although several mechanisms account for brachial plexus injuries, the most common is nerve compression or stretch. Infants, in particular, may suffer brachial plexus injuries during delivery and these present with typical patterns of weakness, depending on which portion of the brachial plexus is involved. The most severe form of injury is nerve root avulsion, which results in complete weakness in corresponding muscles. This usually accompanies high-velocity impacts that commonly occur during motor-vehicle collisions or bicycle accidents.
Based on the location of the nerve damage, brachial plexus injuries can affect part of or the entire arm. For example, musculocutaneous nerve damage weakens elbow flexors, median nerve damage causes proximal forearm pain, and paralysis of the ulnar nerve causes weak grip and finger numbness. In some cases, these injuries can cause total and irreversible paralysis. In less severe cases, these injuries limit use of these limbs and cause pain.
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Wikipedia