Brachial Plexus Variations in Human Fetuses

Neurosurgery - Tập 53 Số 3 - Trang 676-684 - 2003
İsmihan İlknur Uysal1,2,3,4, Muzaffer Şeker1,2,3,4, Ahmet Kağan Karabulut1,2,3,4, Mustafa Büyükmumcu1,2,3,4, Taner Ziylan1,2,3,4
1Accepted, April 23, 2003.
2Department of Anatomy, Meram Faculty of Medicine, Selçuk University, Konya, Turkey
3Received, December 13, 2002.
4Reprint requests:

Tóm tắt

AbstractOBJECTIVEWe examined the anatomic variations of the brachial plexus (BP) in human fetuses.METHODSThis study was performed with 200 BPs from spontaneously aborted fetuses without detectable malformations. The plexuses were dissected, and the normal position and/or morphological variations of the BP were determined and photographed.RESULTSThere were no variations in 93 plexuses, and 107 plexuses were observed to have different variations. Morphological variations were observed more frequently among female fetuses and right sides. The BPs were composed mostly of the C5, C6, C7, and C8 nerves and the T1 nerve (71.5%). A prefixed plexus was observed in 25.5% of cases, and a postfixed plexus was observed in 2.5% of cases. In one case (0.5%), the C4 and T2 nerves joined the formation. The inferior trunk was not formed in 9% of cases. The superior trunk was not formed in 1% of cases. In one plexus, the superior trunk was formed by the ventral rami of the C4 and C5 nerves. In one case, the inferior trunk was formed by the ventral rami of the T1 and T2 nerves. Division variations were observed most frequently. There were also variations in the terminal branches, such as the roots of the median nerve joining in the distal part of the arm (8.5%), the axillary nerve being separate from the posterior division of the superior trunk (2.5%), and a connection existing between the median and musculocutaneous nerves (1%).CONCLUSIONKnowledge of BP variations is important for surgeons who perform surgical procedures in the cervical and axillary regions.

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Tài liệu tham khảo

Allieu, 1988, Neurotization via the spinal accessory nerve in complete paralysis due to multiple avulsion injuries of the brachial plexus, Clin Orthop, 237, 67, 10.1097/00003086-198812000-00011

Alnot, 1988, Traumatic brachial plexus palsy in the adult: Retro- and infraclavicular lesions, Clin Orthop, 237, 9, 10.1097/00003086-198812000-00003

Berry, 1995, Nervous system, Gray's Anatomy, ed 38, 1266

Blair, 1987, Normal brachial plexus: MR imaging, Radiology, 165, 763, 10.1148/radiology.165.3.3685357

Brunelli, 1989, Brachial plexus injuries, The Practice of Hand Surgery, ed 2, 218

Chuang, 1993, Functional restoration of elbow flexion in brachial plexus injuries: Results in 167 patients (excluding obstetric brachial plexus injury), J Hand Surg [Am], 18A, 285, 10.1016/0363-5023(93)90363-8

Collins, 1995, The anatomy of the brachial plexus as displayed by magnetic resonance imaging: Technique and application, J Natl Med Assoc, 87, 489

Cooke, 1988, The anatomy and pathology of the brachial plexus as demonstrated by computed tomography, Clin Radiol, 39, 595, 10.1016/S0009-9260(88)80058-8

Cornish, 1997, Brachial plexus anatomy, Reg Anaesth, 22, 106, 10.1016/S1098-7339(06)80067-2

Dubuisson, 1993, Posterior subscapular approach to the brachial plexus, J Neurosurg, 79, 319, 10.3171/jns.1993.79.3.0319

Edwards, 1956, Vessels and nerves of the superior extremity,in Concise Anatomy, 157

Friedman, 1990, Nerve transposition for the restoration of elbow flexion following brachial plexus avulsion injuries, J Neurosurg, 72, 59, 10.3171/jns.1990.72.1.0059

Fuss, 1989, The lateral root of the ulnar nerve, Acta Anat (Basel), 134, 199, 10.1159/000146687

Gacek, 1990, Neck dissection injury of a brachial plexus anatomical variant, Arch Otolaryngol Head Neck Surg, 116, 356, 10.1001/archotol.1990.01870030120023

Gebarski, 1982, Brachial plexus: Anatomic, radiologic and pathologic correlation using computed tomography, J Comput Assist Tomogr, 6, 1058, 10.1097/00004728-198212000-00002

Harry, 1997, Scalene muscles and the brachial plexus: Anatomical variations and their clinical significance, Clin Anat, 10, 250, 10.1002/(SICI)1098-2353(1997)10:4<250::AID-CA6>3.0.CO;2-W

Hensinger, 1992, Standards and measurements: Fetus and neonate, Fetal and Neonatal Physiology, vol 1, 1687

Hollinshead, 1982, Anatomy for Surgeons, vol 3, 220

Jahnke, 1991, Persistent brachial plexus birth palsies, J Pediatr Orthop, 11, 533, 10.1097/01241398-199107000-00022

Kawai, 1988, Nerve repairs for traumatic brachial plexus palsy with root avulsion, Clin Orthop, 237, 75, 10.1097/00003086-198812000-00012

Kerr, 1918, The brachial plexus of nerves in man: The variations in its formation and branches, Am J Anat, 23, 285, 10.1002/aja.1000230205

Kline, 1989, Civilian gunshot wounds to the brachial plexus, J Neurosurg, 70, 166, 10.3171/jns.1989.70.2.0166

Laurent, 1993, Neurosurgical correction of upper brachial plexus birth injuries, J Neurosurg, 79, 197, 10.3171/jns.1993.79.2.0197

Lee, 1992, Variation of the ventral rami of the brachial plexus, J Korean Med Sci, 7, 19, 10.3346/jkms.1992.7.1.19

Mangar, 1991, Brachial plexus compression from a malpositioned chest tube after thoracotomy, Anesthesiology, 74, 780, 10.1097/00000542-199104000-00023

Millesi, 1988, Brachial plexus injuries: Nerve grafting, Clin Orthop, 237, 36, 10.1097/00003086-198812000-00007

Narakas, 1988, Neurotization in brachial plexus injuries, Clin Orthop, 237, 43, 10.1097/00003086-198812000-00008

Ransford, 1977, Complete brachial plexus lesions, J Bone Joint Surg Br, 59B, 417, 10.1302/0301-620X.59B4.925052

Reede, 1993, Magnetic resonance imaging of the brachial plexus, Magn Reson Imaging Clin N Am, 1, 185, 10.1016/S1064-9689(21)00296-8

Roger, 1988, Imaging of posttraumatic brachial plexus injury, Clin Orthop, 237, 57, 10.1097/00003086-198812000-00009

Samardzic, 1992, Nerve transfer in brachial plexus traction injuries, J Neurosurg, 76, 191, 10.3171/jns.1992.76.2.0191

Sarsılmaz, 1993, Some variations of the brachial plexus in man, Turk J Med Res, 4, 161

Senecail, 1979, Morphologic and biometric data on the constitution of the brachial plexus in man, Bull Assoc Anat (Nancy), 63, 513

Snell, 1995, Clinical Anatomy for Medical Students, ed 5, 393

Tachdjıan, 1990, The neuromuscular system, Pediatric Orthopedics, vol 3, 2009

Urabe, 1991, MR imaging of birth brachial palsy in a two month old infant, Brain Dev, 13, 130, 10.1016/S0387-7604(12)80121-5

Üstün, 2001, Neurotization as an alternative for restoring finger and wrist extension, J Neurosurg, 94, 795, 10.3171/jns.2001.94.5.0795

Üstün, 2001, Selective restoration of motor function in the ulnar nerve by transfer of the anterior interosseous nerve: An anatomical feasibility study, J Bone Joint Surg Am, 83A, 549, 10.2106/00004623-200104000-00009

Üstün, 2001, An alternative method for restoring opposition after median nerve injury: An anatomical feasibility study for the use of neurotization, J Anat, 198, 635, 10.1017/S0021878201007622

Vahl, 1991, Brachial plexus injury after cardiac surgery, J Thorac Cardiovasc Surg, 102, 724, 10.1016/S0022-5223(19)36865-5

Yamada, 1991, Coaptation of the anterior rami of C3 and C4 to the upper trunk of the brachial plexus for cervical nerve root avulsion, J Neurosurg, 74, 171, 10.3171/jns.1991.74.2.0171

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Neurosurgery

Tập 53 Số 3

676-684

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