• The Korean Journal of Pain
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• v.19 no.2
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• pp.241-243
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• 2006

Central pain is defined as pain associated with lesions of the central nervous system, and is among the most intractable of chronic pain syndromes. A 47 year-old-female, who had right arm and shoulder pain, was diagnosed with syringomyelia of the Arnold Chiari malformation type I and received foramen magnum decompression and a syringo-subarachnoid shunt. After the operation, the evoked pain was improved, but she complained of a continuous burning pain, coupled with cold and tactile allodynia. This symptom failed to fully subside on administration of oral medicine; therefore, brachial plexus block was performed, which relieved her pain transiently. Through repeated trials, a gradual decrease in the pain intensity and frequency was found. However, the way in which brachial plexus block improves spinal central pain is not completely known.

• Archives of Hand and Microsurgery
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• v.22 no.3
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• pp.137-146
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• 2017

Brachial plexus injury is regarded as one of the most devastating injuries of the upper extremity. Accurate diagnosis is important to obtain the successful results. Basic preoperative evaluation includes simple radiography, cervical myelography. Magnetic resonance imaging, angiography, electrophysiologic studies and intraoperative studies. Furthermore, proper timing of surgery, surgical indication, plan and sufficient understanding of patients about the prognosis are the key for the satisfactory outcomes. This article provides an overview of the evaluation, diagnosis, intraoperative monitoring, and proper surgical planning for the treatment of posttraumatic brachial plexus injuries.

• Archives of Reconstructive Microsurgery
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• v.6 no.1
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• pp.73-79
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• 1997

Complete denervation after severe brachial plexus injury make significant muscle atrophy with loss of proper function. It is much helpful to reconstruct the essential function of the elbow flexion movement in patient with total loss of elbow flexion motion after brachial plexus lesion which was not recovered with nerve surgery or long term conservative treatment from onset. In whole arm type brachial plexus injury, if there were no response to neurotization or neglected from injury, the volume of the denervated muscle is significantely reduced month by month. About 18 months most of the muscle fibers change to fibrous tissues and markedly atrophied irreversibly, further waiting is no more meaningful from that period. Authors performed 14 cases of functioning gracilis muscle transfer from 1981 to 1995 with microneurovascular technique, neuromusculocutaneous free flaps were performed for reconstruction of lost elbow flexion function. Average follow-up period was 5 years and 6 months. We used couple of intercostal nerves as a recipient nerve which were anastomosed to muscular nerve from obturator nerve in all cases. Recipient vessels were three deep brachial artery and eleven brachial artery which were anastomosed to medial femoral circumflex artery with end to end or end to side fashion. Average resting length of the transplanted gracilis were 24 cm. We can get average 54 degree flexion range of elbow with fair muscle power from flail elbow. There were one case of muscle necrosis with lately developed thrombosis of microvascular anastomosed site which comes from insufficient recipient arterial condition, 3 cases of partial marginal necrosis of distal skin of the transplanted part which were not significant problem with spontaneously solved with time goes by gracilis muscle has constant neurovascular pattern with relatively easy harvesting donor with minimal donor morbidity. Especially it has similar length and shape with biceps brachii muscle of upper arm and longer nerve pedicle which can neurorrhaphy with intercostal nerve without nerve graft if sufficient mobilization of the nerves from both sides of gracilis and intercostal region. Authors can propose gracilis muscle transplantation with intercostal nerves neurotization is helpful method with minimal donor morbidity for neglected brachial plexus palsy patients.

• Journal of Acupuncture Research
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• v.29 no.2
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• pp.99-106
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• 2012

Objectives : The purpose on this study is to report clinical effects of oriental medicine for traumatic brachial plexus injury. Methods : The patient was treated using acupuncture, electroacupuncture, beevenom acupuncture treatment, herbal medication, moxibustion and physical treatment. And the effects for traumatic brachial plexus injury have measured in VAS, sthenometry and dermatome of upper limb. Results : 1. VAS of upper limb pain was changed to go down at less than half. 2. Sthenometry was improved slowly than VAS. 3. Dermatome of upper limb were improved gradually. Conclusions : Oriental medical treatment showed positive effect on traumatic brachial plexus injury.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.249-252
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• 2005

Neurogenic tumors of the brachial plexus region are relatively rare. We report a recent experience of schwannoma of the right brachial plexus in the inferior trunk, which was successfully treated by microsurgical resection. A 38-year- old man presented a dysesthetic pain in the supraclavicular area and the right forearm of C6, 7 dermatome. Rubbery hard mass was palpated in the right supraclavicular area and magnetic resonance imaging showed a well circumscribed, well enhanced ovoid mass with cystic degeneration on the right brachial plexus portion. The patient underwent complete removal of the mass through the anterior cervicothoracic (modified Dartevelle) approach. At the postoperative 3 months, there is no neurologic deficit.

• Journal of Korean Neurosurgical Society
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• v.40 no.3
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• pp.143-147
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• 2006

Objective : Brachial plexus injury can produce a intractable chronic neuropathic pain. This study was undertaken to assess the long term outcome of microsurgical dorsal root entry zonotomy[MDT]. Methods : Between October 1997 and December 2002, 21 patients received MDT because of a intractable pain resulting from brachial plexus injury. Of these, 19 patients were followed for more than 2 years. Fourteen of 19 patients were male and patient ages ranged from 22 to 69 years. Mean pain duration was 36.8 months and all patients had severe pain of $9{\sim}10$ visual analogue scale. To achieve complete destruction of abnormal dorsal horns, thermocoagulation of the posterolateral sulcus were performed and careful gluing was done to prevent postoperative adhesion and pain recurrence. Results : Of the 19 patients, 15 patients had excellent [>75% reduction in pain] and good [$51{\sim}75%$ pain relief] results in a average postoperative period of 4.1 years. One patient had a poor [less than 25% pain relief] result. Three patients were considered to have a fair result [$26{\sim}50%$ pain relief]. Postoperative complications were 2 transient ipsilateral ataxia and 1 CSF fistula that resolved without surgical revision. Conclusion : These results indicate that MDT provides excellent long-term pain relief in medically intractable chronic neuropathic pain following brachial plexus injury without significant complications.

• Journal of Acupuncture Research
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• v.37 no.4
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• pp.270-274
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• 2020

This study aimed to show the effects of Korean medicine treatment (particularly bee-venom pharmacopunture) on a patient with brachial plexus palsy. A 64-year-old woman was diagnosed with brachial plexus palsy on the right upper extremity and was treated with Korean and Western medicine from September 30^th to November 6^th, 2019. Improvement of the patient's symptoms was evaluated using the Manual Muscle Test, Range of Motion and visual analogue scale. After treatment, the patient's Manual Muscle Test grade and Range of Motion were improved, and the Visual Analogue Scale score indicated the intensity of her right hand numbness had decreased. These results suggested that improper use of crutches can result in brachial plexus palsy and a Korean-Western medicine treatment regimen primarily focused on bee-venom pharmacopunture, may be effective in reducing the symptoms of brachial plexus palsy.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.128-131
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• 1998

Fracture of the clavicle and dislocation of the acromioclavicular joint occur commonly as separate injuries. However, complete acromioclavicular dislocation with an ipsilateral clavicle fracture is quite rare. We experienced a case of acromioclavicular joint dislocation associated with fracture of clavicle and brachial plexus injury treated by open reduction and internal fixation.

• The Korean Journal of Pain
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• v.28 no.4
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• pp.287-289
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• 2015

Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim$^{(R)}$.

• Archives of Reconstructive Microsurgery
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• v.4 no.1
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• pp.52-57
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• 1995

The authors have reviewed 19 patients of brachial plexus injury who treated by operative methods at Department of Orthopedic Surgery, Korea University Hospital during the period from January 1989 to February 1994. All of these patients were followed up more than one year and following results were obtained. 1. The whole arm type injury was most common(7 of 19 patient) and supraclavicular lesion(15 of 19 patient) was more dominant than infraclavicular lesion(4 of 19 patients). 2. The neurorrhaphy, nurolysis, nerve grafting, and neurotization were performed for the primary neural surgery and secondary reconstructive procedure consist of musculotendinous transfer and free muscle transfer with neurotization. 3. The followed up period was from one year to four years and six months, average being two years and five months. 4. We have obtained satisfactory results in 12 patients among 19 patients.