Clinical and electrophysiological mapping of nerve root injury following trauma of brachial plexus: A retrospective study in 23 dogs and 42 cats

Bu çalışmanın amacı kedi ve köpeklerde brakial pleksus travmasını takiben oluşan sinir kökü hasarının klinik ve elektrofizyolojik muayene ile haritalanmasını bildirmektir. Çalışmada herhangi bir kırığa bağlı olmaksızın gelişen brakial pleksus yaralanması ile Haziran 2009 ve Ocak 2014 arasında kliniğimize başvuran 65 hastanın (23 köpek, 42 kedi) medikal kayıtları incelendi. Elektrofizyolojik olarak iğne elektromyografi, motor sinir iletimi ve/veya sensorik sinir iletimi ve somatosensorik uyandırılmış potansiyeller çalışıldı. Hasarlı bölge üç hastada (1 köpek, 2 kedi) nekropside, 11 hastada ise (4 köpek, 7 kedi) cerrahi girişim sırasında incelendi. Kutanöz innervasyon alanlarının değerlendirilmesi sonucunda 40 olguda (29 kedi, 11 köpek) kaudal ve 26 olguda (14 kedi, 12 köpek) total brakial pleksus yaralanması belirlendi. Ayrıca bütün olgularda denerve kutanöz alanlarda nosisepsiyon yoktu. On bir kedi ve 5 köpekte izole radial sinir köklerinin total avulziyonu belirlendi. Dört köpek ve 11 kedide izole radial sinir kökü hasarı tespit edildi. Geriye kalan vakalarda radial sinir ile birlikte diğer brakial pleksus sinirlerinin total avulziyonu (18 kedi, 14 köpek) ya da hasarı (3 kedi) belirlendi. Sonuç olarak, brachial pleksusu oluşturan sinirlerden radial sinir travmatik olarak en çok yaralanan olsa da diğer sinirlerin de yaralanması söz konusudur. Travmatik brakial pleksus lezyonlarının değerlendirilmesinde elektrofizyolojik muayene, lezyonun tipinin ve etkilenen sinirin belirlenmesi açısından yararlı bir tanı aracı olarak göz önünde bulundurulmalıdır.

Travmatik brakial pleksus yaralanmalarının klinik ve elektrofizyolojik olarak değerlendirilmesi: 23 köpek ve 42 kedide retrospektiv bir çalışma

Objective of this study is to report mapping of nerve root injury with clinical and electrophysiological examination in cats and dogs following trauma of brachial plexus (TBP). Medical record of 65 patients (23 dogs and 42 cats) with brachial plexus injury without any fracture between July 2009 and January 2014 were reviewed. Needle electromyography, motor nerve conduction and/or sensory nerve conduction and somatosensory evoked potentials (SEP) of the forelimb were studied. Injured area was examined at necropsy in 3 cases (1 dog, 2 cats), and in 11 cases (4 dogs, 7 cats) during surgery. Assessment of cutaneous zone innervation revealed caudal brachial plexus lesion in 40 cases (29 cat and 11 dogs) and complete brachial plexus lesions in 25 cases (13 cats, 12 dogs). Nociception was also absent at the denervated cutaneous zone in all cases. Complete avulsion of isolated radial nerve roots was diagnosed in 11 cats and 5 dogs, and injury of isolated radial nerve roots was diagnosed in 4 dogs and 11 cats. Rest of the cases had complete avulsion (17 cats, 14 dogs) or injury (3 cats) of radial nerve roots in addition to other nerves of the brachial plexus. In conclusion, Radial nerve roots prone to TBP, but other nerve roots of brachial plexus can also be afected. Electrophysiological assessment of TBP should be carried out as an ancillary diagnostic tool for determining afected nerves and type of lesion for radial nerve.

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