PEDIATRIC NEUROSURGERY

Brachial plexus and peripheral nerve injuries

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The brachial plexus is a network of nerves that conducts signals from the spinal cord, which is housed in the spinal canal of the vertebral column (or spine), to the shoulder, arm and hand. These nerves innervate the muscles and skin of the chest, shoulder, arm and hand. Brachial plexus injuries, or lesions, are caused by damage to those nerves. Lesions can lead to severe functional impairment.

Many brachial plexus injuries happen during birth: the baby's shoulders may become impacted during the birth process causing the brachial plexus nerves to stretch or tear. Obstetric injuries may occur from mechanical injury involving shoulder dystocia during difficult childbirth, the most common of which result from injurious stretching of the child's brachial plexus during birth, mostly vaginal, but occasionally Caesarean section. The excessive stretch results in incomplete sensory and/or motor function of the injured nerve.

Signs and symptoms may include a limp or paralyzed arm, lack of muscle control in the arm, hand, or wrist, and lack of feeling or sensation in the arm or hand. Although several mechanisms account for brachial plexus injuries, the most common is nerve compression or stretch. Infants, in particular, may suffer brachial plexus injuries during delivery and these present with typical patterns of weakness, depending on which portion of the brachial plexus is involved. The most severe form of injury is nerve root avulsion, which results in complete weakness in corresponding muscles.

Please contact NSPC (631) 983-8400 for more information or to schedule an appointment.