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Samuel J. Brendler

. The most complete discussion of the subject is a monograph by Wichmann 7 in which human case reports are reviewed along with experimental animal data. Ferrier and Yeo 3 electrically stimulated the cervical and lumbosacral anterior roots in monkeys, and observed the muscle contractions and movements of joints of the limbs. Forgue 4 repeated this work in dogs and monkeys. Herringham 6 reported the results of his dissection of human fetal and adult brachial plexuses. This was the first attempt to study human cervical nerve roots and brachial plexuses in a

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H. Verbiest

. We had occasion to perform this operation for a spontaneous vertebral arteriovenous fistula, following Henry's procedure. The vertebral artery was lifted from its bed by means of tapes applied above and below the lesion, and the abnormal communications could be occluded while the artery remained patent. 21 As we viewed the operative exposure, it occurred to us that this procedure provided excellent access to the lateral aspects of the cervical vertebral bodies, the intervertebral foramina, and the portion of the anterior rami of the brachial plexus lying in the

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Brachial Plexus Avulsion

A Review of Diagnostic Procedures and Report of Six Cases

Juvencio Robles

I n 1947, Murphey and his coworkers 9 accidentally discovered the value of cervical myelography in the diagnosis of avulsion of the brachial plexus while performing a myelogram in an attempt to rule out a herniated cervical disc in a patient with symptoms in his left arm. They found a defect which they called “traumatic meningocele.” Since that time this finding has been considered pathognomonic of spinal root avulsion. Bonney 1 introduced the axon reflex test in the differential diagnosis of avulsion and peripheral lesions of the brachial plexus. During

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William F. Bouzarth Tetsuo Tatsumi May 1968 28 5 417 428 10.3171/jns.1968.28.5.0417 Inappropriate Secretion of ADH Caused by Obstruction of Ventriculoatrial Shunts Burton L. Wise May 1968 28 5 429 433 10.3171/jns.1968.28.5.0429 Brachial Plexus Avulsion Juvencio Robles May 1968 28 5 434 438 10.3171/jns.1968.28.5.0434 Nerve Root Conduction Studies During Lumbar Disc Surgery Carl V. Granger Stevenson Flanigan May 1968 28 5 439 444 10.3171/jns.1968.28.5.0439 Erosion of the Petrous Temporal Bone by Neurilemmoma Philip V. Best May 1968 28 5 445

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David M. Leivy, Davit Tovi and Erich G. Krueger

lumbar nerve roots was subsequently confirmed by Gruss 7 and Wrete, 21–23 who also found them in the lower roots of the brachial plexus. It was felt at that time that the intermediate ganglia had not migrated far enough from the neural crest and that their postganglionic fibers passed through the white rami to the ganglionic chain to join the main postganglionic fibers in their usual course through the gray rami communicantes. 16 Alexander, et al. , 1 found the intermediate sympathetic ganglia in human material next to or imbedded in the white and gray rami, or

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Fred C. Kriss, Donald R. Kahn and Richard C. Schneider

, were resected. The esophagus, trachea, and common carotid artery were dissected free of tumor. The internal jugular vein and thoracic duct were ligated and sectioned. The phrenic nerve was involved in tumor and had to be resected. The subclavian artery and innominate vein, vertebral artery, and thyrocervical trunk were all involved in neoplasm and were sacrificed to obtain a wide margin beyond the tumor. The residual mass was then removed from the superior mediastinum. There was tumor directly invading the posterior trunk of the brachial plexus. A 6 cm length of No

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Blaine S. Nashold Jr., William P. Wilson and D. Graham Slaughter

persons suffered from central pain or dysesthesia. The selection of this latter group of patients was based on Riddoch's definition of central pain as “spontaneous pain and painful over-reaction to objective stimulation resulting from lesions confined to the substance of the central nervous system, including dysesthesia of any kind.” 10 TABLE 1 Clinical etiologic basis for pain Case No. Etiology Site of Pathology Type of Pain Electrode Implants No. Site 1 Traumatic avulsion of arm Brachial plexus Phantom pain

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The Results of Anterior Interbody Fusion of the Cervical Spine

Review of Ninety-Three Consecutive Cases

Lee H. Riley Jr., Robert A. Robinson, Kenneth A. Johnson and A. Earl Walker

times it has been used as a diagnostic test because pain of brachial plexus compression in the thoracic outlet is generally intensified rather than relieved by cervical traction. Pain is a subjective phenomenon, and the degree of incapacitation that results is a function not only of the mechanical lesion in the neck producing the nervous stimuli interpreted as pain, but also of the emotional make-up of the patient, which influences that interpretation. Therefore, the history should include an evaluation of emotional and environmental factors that may be present

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Blaine S. Nashold Jr., W. P. Wilson and D. G. Slaughter

suicide and required hospitalization. Severe depressions had occurred in 50% of these persons. TABLE 1 Etiology of pain and results of therapeutic lesions Case No. Age Etiology Pathologic Site Type of Pain and Duration Response to Therapeutic Lesions Follow-Up (mos) 1 62 traumatic avulsion of arm brachial plexus phantom pain 2 yrs relief alive 24 2 29 traumatic avulsion of brachial plexus plexus and spinal roots in cord phantom pain 2 yrs relief alive 24 3 68 traumatic avulsion

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Thomas B. Ducker, Ludwig G. Kempe and George J. Hayes

neurorrhaphy. 72 For the moderate size nerves such as the median, ulnar, radial, peroneal, and tibial, these guidelines hold true. For large nerve trunks, such as the sciatic nerve or brachial plexus, regardless of the timing of a repair, the outlook remains poor. For the smaller digital nerves, any delay appears unnecessary, and the prognosis after repair is generally very good. Thus, previously defined rules concerned with timing of a nerve repair possessed both usefulness and shortcomings. Method of Study The metabolic background or base for these observations has