Brachial plexus injury | a nerve disorder

Brachial plexus injury

This type of injury was due to the breakage in network of nerves the nerves started to break the message towards the shoulder region or may be towards the region that convert message to the hands and arm.

Discovery of these nerves related to different types of regions specially that consist of cervical parts and these parts are differentiated into cervical 5th,6th,7th and 8th which were present in the cervical regions and other parts were present in the thoracic region, the name was given them to the T1 nerves .

some of the nerves split down and some of the nerves join together to form the junction and that junction plays their role in the message conveyor.

But this junction is sensitive when any kind of injury was made to this part abnormalities was present and these went to this type of disease.

The brachial name was given due to region in which these nerves were present and plexus was given due to the elements which were given to the nerves and these were roots which was 5 in numbers and trunks were 3 in number, divisions were 2 in numbers and cords was with 3 in numbers with some kind of terminal nerves.

Further the branches were classified and supraclavicular and infraclavicular branches were further named. 

Supraclaviculated branches.

This arises from the root region or may be from the trunk region as we described it following.

Rooted.

  1. Cervical 5 and cervical 6 which were elongated nerves and present in the thoracic region.
  2. Cervical 5 that was further rooted and made the scapular dorsal region of the nerve.
  3. Cervical 5 which was further rooted to the nerves which were phrenic. phrenic nerve
  4. Scalenated  and langouste nerves which regions were colic and further division was 5th,6th,7th and 8t

Trunk regions.

  1. Suprascapulated nerves with the division cervical 5th, and 6th.
  2. Subclavian region with the cervical 5th and 6th.

Infraclavicular branches.

Infraclavicular branches these were originated from the cord and their axons was reduced and these axons were reduced to the make the nerves that were arisen from the spinal cord.

Cord located at lateral.

  •         Obliqued that was present at the pectoral region and with the cerviculated part 5th, 6th and 7th.
  •         Musculocutanated with the cervical 5th, 6th and 7th.
  •         Obliqued rooted with the mediated cervical 5th, 6th, and 7th.

Cord located in the central region.

  •         This contains the cervical 8th and trunk 1st that present at the pectoral region in the central part.
  •         Central cutaneous of forearm c8,T1 This present at the cervical 8th and trunk 1st region with the cutaneous at the central position in the forearm.
  •         Central cutaneous of arm c8, T1 This was present in the arm and contained the cervical 8th and trunk 1st with the cutaneous in the central.
  •         It was present in the cervical 7th and 8th and in the trunk 1st.

Cord located at dorsal position.

  •         It was present in the cervical 5th and 6th region and present higher to subscapular region.
  •         It was present in the region at the dorsal position with thoracic region and cervical 6thand 7th.
  •         It was also identified under subscapular region with the cervical 5th and 6th.
  •         It was also present at the axillary endings of the cervical 5th and 6th.
  •         Radially presented at the cervical 5th, 6th and 8th.

Causes of Brachial Plexus Injury

Damaged the chest part, shoulders regions and arm. Innervate the chest, shoulder and arm. Resulted in the tumours formation and my shoulder could not make perfect movements and can cause injuries.

The patient felt someone is stinging their bodies and may be someone burning their arms, this is the minor stage of this injury. And major injuries may have occurred and this was due to some kind of accident which may be a motorcycle accident.

In these conditions the arm of the patient may be rendered working and fully paralyze the arm and no neural senses in the arm could be produced. The patient never felt any types of sensation and may have never felt something on his arm. 

These are also damaged due to some kind of cancerous cell growth into the tumour cells and these can damage the arms and cause this injury. And may be inflammations that can cause damage to these kinds of networks of nerves.

Some kind of syndrome can also cause the injury. And damaged the unions of these cells. There were several types of injuries that could have occurred in the unborn child. That was due to the injury to the mother which was pregnant and caught some kind of injuries.

In this condition the head of the child may be injured and brachial injury could take place. In the second condition the shoulder was injured and the injured shoulder had this disease and did not work properly. In third type may be injured by gunshot or may be some kind of violence can produce this injury.

Several kinds of injuries were studied.

  •       Avulsion

In this kind the damage did not present only the nerve was displaced from its original position. Nerves present in the spinal card slipped from its original position. The symptom was studied that the eyelid of the patient was hanged and these can produce this injury.

It was not a severe one; it can be cured easily but did not directly operate due to the less common disease. surgical treatment was made in which damaged cells were replaced  but these cells were not treated because they become abnormal.

If this can damage the diaphragm tissues, it would cause the breathing problems. The patient could cause suffocation and had problems breathing. This all can be presented in the child that was new born so can show their symptoms.

  •       Ruptured

These can be studied as the breakage in the nerves. These nerves did not displaced but these ruptured in the spinal cord so that nerves impulses could not be transferred. Resulted in the appearance of wounded structures outside of the spinal cord.

It could not be treated with the medicines but surgically replaced so repaired could be made by surgical treatment.

  •       Neuromated

There was a collection of many cells and collagen that surrounded the injured nerves. When a signal was transmitted but blockage was made due to these collections. So that nerves did not send signals and body proper function was not made. It can be treated but the treatment required the surgical replacement of the tendon. Resulted in the non-functioning of muscles.

  •       Neurapraxiated

In this type of disorder, the nerves size was extended and in this type nerves could not perform function well because collection of cells and collagen appeared on the site of extension. In this type no breakage was present. This was seen in the new-born child, this can be seen in the child with the age of three months.

Injuries that cause less damage.

This can occur in the person who was physically involved in some kind of physical work. Some examples were football players injured, or may be during wrestling, which was involved in the damaging of these types of cells.

Some of them had stressed their muscles or may have compressed these tissues. In these patients some of the effects were seen which were stinging and burning the affected part of the body.

  •         The person who was suffering this disorder can feel the sensation of being electric shocked or maybe they felt their arm was burning.
  •         Maybe their arm functioning was slow and they were weakened by movements of arms.

These remained in the person for a few minutes and a few days. Depend on how they physically damaged themselves. So that duration varied different in different person

Injuries that appeared more lethal

This was due to severe damage in the nerves roots. The nerves could be fully damaged from the root of the spinal cords. In these types the nerve impulse never passed from the spinal cord. Nerve impulse could not transmit to the muscles so this could be found lethal for the person who was suffering from this.

 These symptoms were identified in the infected patient.

 Person muscles may not function normally or may be the person shoulder lost working and could be slowed or may be paralysed completely.

  •         The patient did not feel their arms with their body so that he felt that he was without an arm and shoulder. And may be without a hand that nerves are damaged.
  •         In early stages he felt a lot of pain but later as paralyzed pain could be reduced.

Attribution of cause

Closely causes

Some kind of traction injury was seen in which the compression and may be reduction of muscles was seen. Some kind of radiation that can damage the nerves. These nerves were seen to be influenced by the many types of radiations.

 Also due to cells which have died and this death can stop the passage of nerves impulses. Maybe a wound which was so stuffed that caused the damages of nerves. Maybe during birth the child would bear the in-born damage to the child. Openly causes.

Blast injury that can be seen in which some kind of physical injuries were seen in which nerve get damaged so nerve could not pass. During surgeries the damage was done to nerves and caused these brachial injuries.

May be some kind of dislocation of nerves can also cause the damage to nerves. And nerves may be enlarged so that wound can be appeared so nerves impulse could not pass. May be collection of cells which blocked the passage of nerve impulses.

Many conditions were seen due to which injuries took place.

  •         Mainly motorcycle injuries were the main causes which noticed 70% on the large scale.
  •         Clavicular damage and axillary artery damage were seen about 20 %. These were less than the first one.
  •         Less than 5% were reported due to injury in the spinal cord.

Sign related to these Injuries:-

            These were some kinds of signs for this injury identified.

 The arm of the patent did not show any type of movement.

uscle movement could not be controlled by the person who was affected.

Wrist had no ability to control the muscle movements.

Person did not feel any sensation on the hand.

The arm of the person did not feel any kind of senses.

Nerve was compressed.

This injury could have occurred during the time of child birth.

Maybe the body had some kind of weakness due to which it caused the weak nervous response.

 Nerves root may be ruptured.

Most cases of bike accidents were the main reason for injuries.

Maybe nerves located at different places and that body part could be damaged.

Different kinds of effects were noticed.

The damage was related to the upper and lower nerves. If the upper nerves were damaged the shoulder could be stretched down and the neck may be stressed upward or may be the neck fell a side.

But if the lower nerves were damaged the arm would be forced above and your hand would present down. 

 These injuries can occur in certain ways, including:

  •       Contacted many sports.

During a football match the footballer was clashed and the nerves were damaged and they would feel the burning and stinging sensation that would remain for a few minutes in them.

  •       During the birth of a child.

During the childbirth if the child could not handle properly it would be affected by this disease. In this the shoulder or arm may be compressed or stretched and the weight of the child was transferred on the shoulder or arms. Resulting in the ruptures and dislocation of the nerves and nerves impulses could not transfer.

  •       Sudden crushes.

Some time it was seen that the person who caught a severe accident could find the death of these nerves and some of the nerve cells were damaged and these causes contain an accident or may be sudden fall of the person and maybe shot with the gun.

  •         Abnormal growth of cells and cancerous cells treatment.

Sometimes cells that abnormally grow and can cause the damage of the nerves due to extra pressure and may be rupturing these nerves. Size of these cells increased and put pressure on the brachial plexus and caused abnormality in transmission of nerves.

  1. Nerves which were ruptured could cause pain in the forearm of the person.
  2. Due to the damage in the nerve of ulnar the grip of the parson becomes weak.
  3. Fingers of the person were without sensation.
  4. Felt pain in the limbs.
  5. Nerves roots that were covered become thin due to damage.
  6. Nerves matter can change its colour and damage can be seen.
  7. During the birth of a child it was also observed.
  8. If the shoulder of the baby was damaged. It could be in these injuries.
  9. If the nerves fibres were injured it can also cause this type of injury.
  10. If the clavicle which was damaged and dislocated resulted in this injury.
  11. Some kind of damage related with bike injury or other can lead to this injury.
  12. If the lateral side of the scapula got damaged it would make possible this disorder.
  13. If a person fell at a great height and head injury can be made and weight of the person transferred to shoulder could be exemplified this disorder.
  14. During delivery if the child was so much forced this would lead to damage of brachial injuries.
  15. If a person fell by the tree, if he did not completely grasp the tree the lower kind of brachial injuries was seen. 
  16. The fingers and wrist muscles were paralysed due to some kind of syndrome.
  17. If the weight was lifted up to more than the capacity of the person so it can stress the nerves and cause injury.

Epidemic studied.

These were found in both children and adults. When we studied the differences were observed. B

  1. a) Adult person:

In the people that were at the age of above 15 it was seen more commonly and above the age of 34 half of the people were suffering from it. Males were more affected as compared to the females.

  1. b) Children:

In children the baby that caught some kind of injury during the abnormal delivery would fall into this disease. One baby out of thousand could lead to this disorder.

In adults it was seen that the person who was physically injured had a great chance of this disorder. Mainly the bike riders and snow bike riders.

Treatments of this disorder

Naturally recovered:

Brachial plexus was naturally healed when the nerves or cervical spines were damaged but if the root of the spinal cord was damaged the natural recovery was slightly impossible. The physical exercises were required, in which the hands and neck were given properly. 1 to 3 months required to heal. If the dislocation was there it could be easily healed by the physiotherapy. If small damage to nerves it could also be treated without surgery.

Surgical treatment:

The surgical treatment was done with a few chances to recover from this disorder. In the treatment, the damage cells could be replaced and can change. The chances of survival were less due to the ruptured nerves could not treated. The patient needs more time, 18 month required to recover from this disorder. Microsurgical could resume working in 3 months to 6 months.

Methods includes:

Neurolysis of the scar tissue.

If the collections of the cells were present on the nerves, the growth of these wounds could be prohibited. Some kind of surgical treatment was required to remove these collections of cells.The nerves that were present and nerves sheath which was present, the wound which was present surgically removed.

Neuroma excision

When the size of the nerves was increased, the extra size was removed by surgical treatment neuroma. This could be done due to removal of one or may be separating each of the nerves.

Nerves can be grafted.

Sometimes the space between the nerve endings enlarged, this space was adjusted by the surgical method. For this reason may be the donor nerve was transferred to the damaged part or may be at the nerve ended part so that the space which was adjusted according to thepassage of the nerves impulse. Grafting technique was experimented on the person as the idea was taken from the plant tissues grafting, so that nerves can also be replaced.

 Neuroticism of nerves.

In these processes the damaged and ruptured nerve was replaced by the donor nerves so that it started to perform their function. In this root cannot be replaced only the nerves that arise from the roots of the spinal cord are replaced. The nerves could be planted inside and may be also external endings. 

 Nerves could be transferred in an isolated form.

  •         The age of the person must be more than 12 years for the replacement of nerves in the isolated form by surgical treatment.
  •         A nerve which was destroyed can also replace, this replacement was done by the combination of many nerves which was transferred.

 Other kinds of treatments were also done, by which this disorder was cured.

Steps involved:

  •         In which the surgery was done that can replace the nerves.
  •         Maybe the tendon was replaced.
  •         Muscles were also transported.
  •         The rebuilding of the shoulder muscles was done.
  •         The skeleton parts could be moved.
  •         Elbow of the patient was rebuilt.

 

            These were further treated by these methods.

  1. These injuries were treated by mean therapy of physical involvement.
  2. Some of these were naturally treated without any treatment.
  3. Some of them could be treated with surgery with the duration of 6 months but some needed more time.
  4. Maybe emotional treatment was also done by the parents.
  5. The tumours that caused this injury, may be removed.
  6. Nerves could be replaced.
  7. These injuries required rehabilitation of the nerves that could be made that took many years.
  8. Nerves could be grafted.
  9. Decompressed surgery was made.
  10. Nerves could be transferred.

          11   Therapy with physical exercises.

  1. Therapy of occupation was done.
  2. Medicines may be used for treatment.
  3. Electrical shocks may be given for the treatment.

 

 

 

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