The Cause of Brachial Plexus Nerve Injury

The brachial plexus is an arrangement of nerves that runs from vertebrae C5 to T1. This area is from the spine, through the neck, the armpit region, and into the arm. This collection of nerves communicates with the muscles to lift, lower, straighten, and bend the arm. The nerve complex is also the pathway for communication of sensory perception to the brain.

Brachial Plexus Nerve Injury

A brachial plexus nerve injury occurs when there is damage to the nerve network that supplies signals from the spinal cord to the hand, arm, and shoulder. The injury can be caused when the nerves are overextended, stretched, or torn. An example of this type of injury is when the head and neck are pushed away from the shoulder in an aggressive manner. Activities such as high-contact sports, motorcycle or car accidents, or complications during birth. Usually a brachial plexus nerve injury can heal on it own; injuries that are more severe might require surgery.

Signs and Symptoms

When a brachial plexus nerve injury occurs, a patient will start to experience specific signs and symptoms. The damage affects the function of these nerves, and other nerves that receive impulses from the plexus. This type of damage will cause a decrease in feeling and mobility in the hands, arms, and shoulders. It situations that are minor, numbness and slight pain can occur in these areas. More severe situations can result in temporary or even permanent paralysis.

Treatment

For the treatment for brachial plexus nerve injury surgeons use nerve transfers, nerve grafts, and nerve repair to help restore function to this complex set of nerves. These techniques have improved and have been useful in recovering shoulder and elbow function.

During a nerve transfer an operating microscope is used to transfer a portion of an intact nerve from a functioning muscle. It is then re-attached to an undamaged portion of the nerve from another.

Nerve grafts are performed by harvesting donor nerves from other locations from other locations such as the lower leg regions or elbow region. Nerve function is usually restored after a few months but not as functional as the original nerve.

Another type of nerve repair is called Erb’s palsy. This procedure requires an incision to be made along the side of the neck and/or clavicle. The injured nerves are then identified and examined. Once the injured nerves have been examined and the severity of the injury is determined, the surgeon will perform one of the following: scar tissue removal, re-attach the nerves directly or with nerve grafts, or a nerve transfer is performed.

References

National Institute of Neurological Disorders and Stroke: Brachial Plexus Injuries - https://www.ninds.nih.gov/disorders/brachial_plexus/brachial_plexus.htm

Hospital for Special Surgery: Brachial Plexus Injuries - https://www.hss.edu/conditions_brachial-plexus-injuries-treatment-advances.asp