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We report a case of superior trunk brachial plexus injury following a right mini-thoracotomy mitral valve repair. A 45-year-old woman with systemic lupus erythematosus, who was on steroids and immunosuppressive drugs, underwent mitral valve repair via right mini-thoracotomy. The patient was positioned in the left semisagittal position with the right upper arm elevated. Postoperatively, she exhibited focal motor and sensory deficits in the right upper extremity, and a superior trunk brachial plexus injury on the right side was diagnosed through brachial plexus MRI and electrophysiological examination. The nerve injury was likely due to excessive left lateral flexion of the head during the procedure. Sensation returned to normal 4 weeks postoperatively, and muscle strength fully recovered 3 months postoperatively. Careful attention to positioning during minimally invasive cardiac surgery is crucial to prevent nerve compression in superficial areas and excessive lateral flexion of the head.
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http://dx.doi.org/10.1093/icvts/ivae190 | DOI Listing |
Plast Reconstr Surg
September 2025
Department of Surgery, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
Background: Poor recovery of active glenohumeral external rotation (aGHER) after brachial plexus birth injury (BPBI) is common. Late spinal accessory nerve to infraspinatus motor branch (SAN-IS) transfer has been reported as effective. We investigated its efficacy in children over 4 years with BPBI.
View Article and Find Full Text PDFPaediatr Anaesth
October 2025
Human Anatomy and Embryology Unit, Faculty of Medicine and Health Sciences, Universitat of Barcelona, Barcelona, Spain.
The costoclavicular brachial plexus block has gained relevance as a safe and effective regional anesthesia technique for upper limb orthopedic surgery in adults, but data in pediatric populations remain limited. This study aimed to evaluate the incidence of phrenic nerve palsy associated with CBPB in pediatric patients. We conducted a descriptive observational study in 30 children undergoing upper limb orthopedic surgery.
View Article and Find Full Text PDFPsychophysiology
September 2025
Psychological Neuroscience Laboratory (PNL), Research Center in Psychology (CIPsi), School of Psychology, Universidade do Minho, Braga, Portugal.
Touch has an affective dimension, conveyed through low-threshold mechanoreceptors known as C-tactile (CT) afferents, which are activated by gentle, caress-like contact. While there is evidence that these fibers modulate nociceptive input, their influence on the processing of other somatosensory afferent activity remains largely unknown. In this study, we explored how slow brushing (CT-optimal stimulation) modulates somatosensory evoked potentials (SEPs) elicited by electrical stimulation of the median nerve (occurring at 0.
View Article and Find Full Text PDFRev Esp Anestesiol Reanim (Engl Ed)
September 2025
Instituto Nacional de Rehabilitación, Ciudad de México, Mexico.
Brachial plexus block at the interscalene level is a regional anesthetic technique widely used to provide analgesia in shoulder and upper extremity surgery; However, it is associated with a high incidence of phrenic nerve block with diaphragmatic paralysis which has clinical implications in patients with underlying respiratory disease, showing respiratory difficulty symptoms. As consequence, it has been contraindicated in certain population groups. Once diaphragmatic paralysis and respiratory symptoms are established, management is supportive and expectant.
View Article and Find Full Text PDFJ Neurophysiol
September 2025
Shirley Ryan AbilityLab, Chicago, IL.
Spasticity results from upper motor neuron lesions and can create a deforming force, pain, and is often accompanied by contracture. While the origin of spasticity is neural, there is ample evidence of secondary muscle changes. Here we use direct measurement of the force-frequency relationship (FFR) to characterize human muscle's physiological properties.
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