Brachial Plexus Avulsion—自験例およびその診断について

BRACHIAL PLEXUS AVULSION: CLINICAL CASES AND DIAGNOSTIC PROCEDURES

Ｉ．はじめに

　近年交通事故や災害事故の増加にともないBrachialPlexus Avulsion （頸神経根の引きぬき損傷）に遭遇する機会が多くなった。

　しかし本症は頭部外傷や四肢骨折などを伴いやすく，また解剖学的複雑さも加味して比較的看過されやすく，その損傷部位や損傷程度にいたる系統的診断を欠くことが多い。

Two cases of brachial plexus avulsion with com-plete clinical course and results of neurological examinations were reported. The one was left C-5, 6 brachial plexus avulsion without posterior nerve roots involvement, and the others was left C-5, - Th-1 brachial plexus avulsion with Homer's sign. Clinical evidences consisted of dorsal scaplar nerve palsy, long thoracic nerve palsy, upper limb paraly-sis and abscence of deep tendon reflexs. Axon re-flexes were normal. E. M. G. showed fibrillation voltage. Myelography revealed meningocele at the affected nerve roots.

The mechanism and charactericity of brachial plexus avulsion and various myelographic findings at the levels of lesion were discussed under the pathogenetic point of view with review of other cases.

We would like to stress the careful neurological examinations and diagnostic procedures such as axon reflex examination, E. M. G and myelography are necessary to determine the levels of nerve roots avulsion in the diagnosis of brachial plexus avul-sion.