Summary
The objective of this chapter is to describe and discuss the radiographic, intraoperative, and histologic findings that are present after brachial plexus birth injury. This review is based on the authors’ clinical and operative experiences and a survey of the peer-reviewed literature. Together our findings provide evidence that in the vast majority of cases of brachial plexus birth palsy are secondary to a forceful traction injury affecting the brachial plexus that occurs when the child is born.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Allen RH. On the mechanical aspects of shoulder dystocia and birth injury. Clin Obstet Gynecol 2007;50:607–623.
Pitt M, Vredeveld JW. The role of electromyography in the management of the brachial plexus palsy of the newborn. Clin Neurophysiol 2005;16:1756–1761.
Koenigsberger MR. Brachial plexus palsy at birth: intrauterine or due to delivery trauma? [abstract] Ann Neurol 1980;8:228.
Alfonso I, Dias-Arca G, Alfonso DT, Shuhaiber HH, Papazian O, Price AE, Grossman JAI. Fetal deformations: a risk factor for obstetrical brachial plexus palsy? Pediatr Neurol 2006;35(4):246–249.
Alfonso I , Alfonso DT, Price AE, Grossman JAI. Cortical dysplasia and obstetrical brachial plexus palsy. J Child Neurol 2008 (in press).
Gurewitsch ED. Optimizing shoulder dystocia management to prevent birth injury. Clin Obstet Gynecol 2007;50:592–606.
Gurewitsch ED, Johnson E, Hamzehzadeh S, Allen RH. Risk factors for brachial plexus injury with and without shoulder dystocia. Am J Obstet Gynecol 2006;194:486–492.
Hudic I, Fatusic Z, Sinanovic O, Skokic F. Etiological risk factors for brachial plexus palsy. J Matern Fetal Neonatal Med 2006;19:655–661.
Medina LS, Yaylali I, Zurakowski D, Ruiz J, Altman NR, Grossman JA. Diagnostic performance of MRI and MR myelography in infants with a brachial plexus birth injury. Pediatr Radiol 2006;6:1295–1299.
Abbott R, Abbott M, Alzate J, Lefton D. Magnetic resonance imaging of obstetrical brachial plexus injuries. Childs Nerv Syst 2004;20:720–725.
Birchansky S, Altman N. Imaging the brachial plexus and peripheral nerves in infants and children. Semin Pediatr Neurol 2000;7:15–25.
Francel PC, Koby M, Park TS, et al. Fast spin-echo magnetic resonance imaging for radiological assessment of neonatal brachial plexus injury. J Neurosurg 1995;83:461–466.
Bahm J, Wein B, Alhares G, Dogan C, Radermacher K, Schuind F. Assessment and treatment of glenohumeral joint deformities in children suffering from upper obstetric brachial plexus palsy. J Pediatr Orthop Br 2007;16:243–251.
Chen L, Gao SC, Gu YD, Hu SN, Xu L, Huang YG. Histopthologuc study of the neuroma-in-continuity in obstetric brachial plexux palsy. Plast Reconstr Surg 2008;121:2046–2054.
Acknowledgments
The authors acknowledge Ilker Yaylali, MD, PhD, for assistance in data retrieval and analysis and Herbert Valencia, RN, for preparation of intraoperative figures.
Author information
Authors and Affiliations
Editor information
Rights and permissions
Copyright information
© 2009 Humana Press, a part of Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Russell, S.M., Alfonso, I., Grossman, J.A. (2009). Observations on the Etiology of Brachial Plexus Birth Palsy Based on Radiographic, Intraoperative, and Histologic Findings. In: O'Leary, J. (eds) Shoulder Dystocia and Birth Injury. Humana Press. https://doi.org/10.1007/978-1-59745-473-5_21
Download citation
DOI: https://doi.org/10.1007/978-1-59745-473-5_21
Published:
Publisher Name: Humana Press
Print ISBN: 978-1-934115-28-2
Online ISBN: 978-1-59745-473-5
eBook Packages: MedicineMedicine (R0)