Permanent pain and brachial plexus injury after coronary bypass grafting: Case report and reviwing the literature

Neurological complications of cardiac surgery is known for almost a century. Brachial plexus injury after coronary artery bypass grafting is not a rare complication, but the frequency of reporting is less because these are temporary and often symptoms requiring treatment. in a few cases peripheral neuropathy findings are permanent and causes of disability. Diagnosis is based on symptoms, imaging and electrophysiological studies and it is important that both treatments for both medical and legal liability. Here in 63-year-old male patient was diagnosed brachial plexus injury lasting neuropathic pain the left upper limb after uneventful coronary artery bypass surgery presented and causes and consequences were discussed with literature.

Koroner bypass sonrası oluşan kalıcı ağrı ve brakial pleksus hasarı: Olgu sunumu ve literatür gözden geçirme

Kardiak cerrahinin nörolojik komplikasyonları neredeyse bir yüzyıldır bilinmektedir. Koroner arter bypass graftlemesi sonrası brakial pleksus yaralanmaları nadir bir komplikasyon değildir, fakat sıklıkla bulgular geçici olduğu ve tedavi gerektirmediğinden tanınma ve raporlanma sıklığı azdır. Çok nadir olguda periferik nöropati bulguları kalıcıdır ve özürlülüğe neden olur. Tanı semptomlar, görüntüleme ve elektrofizyolojik çalışmalara dayanır ve bu hem tedavi hem de medikal ve yasal sorumluluk için önemlidir. Burada sorunsuz koroner arter bypass cerrahisi sonrası sol üst ekstremitesinde kalıcı nöropatik ağrı ve brakila pleksus hasarı saptanan 63 yaşında erkek hasta sunuldu ve literatür eşliğinde sebep ve sonuçları gözden geçirildi.

Kaynakça

Shaw PJ, Bates D, Cartlidge NE, Heaviside D, Julian DG, Shaw DA. Early neurological complications of coronary artery bypass surgery. Br Med J (Clin Res Ed) 1985;291(6506):1384– 7.

Fox HM, Rizzo ND, Gifford S. Psychological observations of patients undergoing mitral surgery; a study of stress. Psychosom Med 1954;16(3):186–208.

Uribe JS, Kolla J, Omar H, Dakwar E, Abel N, Mangar D, et al. Brachial plexus injury following spinal surgery. J Neurosurg Spine 2010;13(4):552–8.

Webster K. Peripheral nerve injuries and positioning for general anesthesia. Anaesthesia Tutorial of the Week 258. 7th May 2012.

Chong AY, Clarke CE, Dimitri WR, Lip GY. Brachial plexus injury as an unusual complication of coronary artery bypass graft surgery. Postgrad Med J 2003;79(928):84–6.

Vander Salm TJ, Cereda JM, Cutler BS. Brachial plexus injury following median sternotomy. J Thorac Cardiovasc Surg 1980;80(3):447–52.

Sharma AD, Parmley CL, Sreeram G, Grocott HP. Peripheral nerve injuries during cardiac surgery: risk factors, diagnosis, prognosis, and prevention. Anesth Analg 2000;91(6):1358–69.

Warner MA, Warner ME, Martin JT. Ulnar neuropathy. Incidence, outcome, and risk factors in sedated or anesthetized patients. Anesthesiology 1994;81(6):1332–40.

Vahl CF, Carl I, Müller-Vahl H, Struck E. Brachial plexus injury after cardiac surgery. The role of internal mammary artery preparation: a prospective study on 1000 consecutive patients. J Thorac Cardiovasc Surg 1991;102(5):724–9.

Tomlinson DL, Hirsch IA, Kodali SV, Slogoff S. Protecting the brachial plexus during median sternotomy. J Thorac Cardiovasc Surg 1987;94(2):297–301.

Kaynak Göster

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