Title: A Pictorial Essay of MRI Findings - Obstetric Brachial Plexopathy

Authors: Dr Dhruva B Shetty, Dr Balakrishna Shetty, Dr G Gurushankar, Dr Anand S.H

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.17

Abstract

   

Learning Objectives

Review of 25 patients with obstetric brachial plexus palsy and determine the effectiveness and spectrum of MRI findings in these infants, which will help in emphasizing on imaging techniques, subtypes of injuries and importance of early MRI.

Background

Brachial plexus palsy in neonates occurs when an infant's upper shoulder is obstructed by the pubic symphysis, nerve injury can occur anywhere along the brachial plexus. The most common site being supraclavicular part emanating varied neurologic deficits

Brachial plexopathies cannot be diagnosed accurately with clinical examination because of the complicated plexus design and also the types of lesions and injuries are frequently complex.

EMG provides functional involvement but lacks localization.
Improvements in the surgical field have made pre-surgical imaging a necessity.

The multiplanar, non-radiative and non invasive capabilities of MRI has made it the modality of choice

Objective

To determine the effectiveness and spectrum of MRI findings in infants with obstetric brachial plexus palsy, which will help in further management.

References

  1. Alka Agarwal et al., Role of MRI in Evaluation and Characterization of Brachial Plexopathies Sch. J. App. Med. Sci., August 2015; 3(5C):1949-1953.
  2. Somashekar, L.J.S. Yang, M. Ibrahim, and H.A. Parmar High-Resolution MRI Evaluation of Neonatal Brachial Plexus Palsy: A Promising Alternative to Traditional CT Myelography .AJNR Am J Neuroradiology .2014;35:1209 -13.
  3. Lawande M. Pictorial essay: role of magnetic resonance imaging in evaluation of brachial plexus pathologies. 2012 Oct - Dec. Volume 22 (No 4): p344-349.
  4. Baxter D. Tharin, Jonathan A. Kini, Gerald E. York, and John L. Ritter Brachial Plexopathy: A Review of Traumatic and Nontraumatic Causes American Journal of Roentgenology 2014 202:1, W67-W75.
  5. Gherman RB, Ouzounian JG, Satin AJ, Goodwin TM, Phelan JP. A comparison of shoulder dystocia-associated transient and permanent brachial plexus palsies. Obstetrics and Gynecology. 2003;102(3):544-548.
  6. Yoshikawa T, Hayashi N, Yamamoto S, et al. Brachial plexus injury: clinical manifestations, conventional imaging findings, and the latest imaging techniques. Radiographics 2006;26:S133-43.

Corresponding Author

Dr Dhruva B Shetty

Resident, Dept of Radiodiagnosis, Sri Siddhartha Medical College and Hospital Tumkur