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Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia

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Abstract

Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient’s arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication.

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Authors and Affiliations

  1. Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sridhar Shankar, Eric vanSonnenberg, Stuart G. Silverman & Kemal Tuncali

  2. Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Sridhar Shankar, Eric vanSonnenberg, Stuart G. Silverman & Kemal Tuncali

  3. Department of Anesthesia, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Hugh L. Flanagan Jr.

  4. Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Edward E. Whang

Authors
  1. Sridhar Shankar
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  2. Eric vanSonnenberg
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  3. Stuart G. Silverman
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  4. Kemal Tuncali
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  5. Hugh L. Flanagan Jr.
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  6. Edward E. Whang
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Correspondence to Sridhar Shankar.

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Shankar, S., vanSonnenberg, E., Silverman, S.G. et al. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia. Cardiovasc Intervent Radiol 28, 646–648 (2005). https://doi.org/10.1007/s00270-004-0282-3

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  • DOI: https://doi.org/10.1007/s00270-004-0282-3

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