Canis ISSN: 2398-2942

Brachial plexus: avulsion

Synonym(s): Brachial plexopathy

Contributor(s): Kyle Braund, Prof Mark Rochat

Introduction

  • See brachial plexus root avulsion Brachial plexus: root avulsion.
  • Clinical signs more severe than partial avulsions.
  • Cause: result of trauma, usually road traffic accidents (RTA).
  • Signs: neurological deficits apparent immediately following injury.
  • Neurogenic muscle atrophy takes 7-10 days to develop.
  • Prognosis: for recovery poor.

Pathogenesis

Etiology

  • Traumatic traction of spinal nerve roots at their origin inside the dura mater.

Predisposing factors

General
  • Lack of leash laws and/or irresponsible pet ownership.
  • Intact dog.
  • Bitch in heat.
Environmental
  • Dog lives on busy road or in city.
Management
  • Dog allowed to exercise unsupervised.
  • Old or faulty extending lead.
  • Dog exercised off the lead.

Pathophysiology

  • Traumatic.
  • Limb forcibly abducted or rotated at its attachment to the body → traumatic traction on the spinal nerve roots at their origin inside the dura mater → disruption of the neural elements → interruption of spinal reflexes. Ventral roots are especially susceptible.
  • Skin desensitization → decrease in muscle tone → onset of neurogenic muscle atrophy.
  • Some shrinkage of the areas of skin desensitization as nerves grow in from neighboring innervated areas.

Timecourse

  • Neurological deficits apparent immediately after injury.
  • Neurogenic muscle atrophy from 7-10 days after injury.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

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