Spontaneous brachial plexus hemorrhage - Case report

A. Chris Heller, Todd Kuether, Stanley L. Barnwell, Gary Nesbit, Kim A. Wayson

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4 Scopus citations

Abstract

BACKGROUND. Shoulder hemorrhage resulting in brachial plexus neuropathy is a rare occurrence most often seen in cases of traumatic injury or anticoagulation therapy. We report a unique case of spontaneous brachial plexus hemorrhage. CASE DESCRIPTION. This is the first report of a spontaneous shoulder hemorrhage in which a 48-year-old jackhammer operator presented to the emergency department with a sudden onset of right shoulder pain and upper extremity pain and numbness. Imaging studies revealed a hematoma in the right axilla and chest wall. Without evidence of active bleeding or worsening neurologic deficit, this patient was treated conservatively with pain control and observation and eventually experienced a full recovery. Had there been persistent neurologic deficit, however, surgical evacuation would have been indicated. CONCLUSIONS. Cases of nerve compression caused by a hematoma should be analyzed on the basis of the severity of the neurologic deficit and not on the underlying cause of bleeding. Conservative treatment may be indicated in cases of mild or improving neurologic deficit, but regardless of its etiology, a hematoma that results in severe or worsening neurologic symptoms must be surgically evacuated to prevent permanent nerve damage. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)356-359
Number of pages4
JournalSurgical Neurology
Volume53
Issue number4
DOIs
Publication statusPublished - Apr 2000

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Keywords

  • Brachial plexus
  • Hematoma
  • Hemorrhage
  • Neuropathy
  • Shoulder
  • Spontaneous hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Heller, A. C., Kuether, T., Barnwell, S. L., Nesbit, G., & Wayson, K. A. (2000). Spontaneous brachial plexus hemorrhage - Case report. Surgical Neurology, 53(4), 356-359. https://doi.org/10.1016/S0090-3019(00)00175-0