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Adult Brachial Plexus Injuries: Evaluation: Radiologic Evaluation

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Operative Brachial Plexus Surgery

Abstract

Advanced imaging is critical in the evaluation of adult preganglionic brachial plexus injury. The identification of nerve root avulsions is a vital component of prognostication and surgical decision-making. The principal modalities used to assess injuries proximal to the dorsal root ganglia are conventional myelography, CT myelography, and MRI, including myelography-type MRI sequences. In this chapter, the imaging modalities, normal imaging anatomy, and imaging findings of preganglionic brachial plexus injury in adult non-penetrating trauma will be considered. Although CT myelography is considered the imaging gold standard and probably the first choice for advanced imaging in adults at most centers, MRI also offers excellent diagnostic performance. Due to their differing strengths and weaknesses, the two modalities are considered complementary at many institutions. Both modalities can detect the hallmark primary findings of preganglionic brachial plexus injury: nerve root avulsions (complete or partial) and pseudomeningocele formation. Secondary findings of preganglionic brachial plexus injury may also be observed, typically better on MRI. These findings include injury of the spinal cord, physiologic findings such as nerve root enhancement or denervation changes in the paraspinal muscles, and, uncommonly, CSF leak or superficial siderosis.

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Correspondence to Felix E. Diehn .

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Diehn, F.E., Benson, J.C., Kim, D.K. (2021). Adult Brachial Plexus Injuries: Evaluation: Radiologic Evaluation. In: Shin, A.Y., Pulos, N. (eds) Operative Brachial Plexus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-69517-0_10

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  • DOI: https://doi.org/10.1007/978-3-030-69517-0_10

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