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[正中开胸术后双侧臂丛神经病变1例]

[A case of bilateral brachial plexopathy after median sternotomy].

作者信息

Nagata T, Hara H, Shigeto H, Yamada T, Nishimura Y, Kira J

机构信息

Department of Neurology, Faculty of Medicine, Kyushu University.

出版信息

Rinsho Shinkeigaku. 1999 Feb-Mar;39(2-3):343-6.

Abstract

A 53-year-old man with bilateral brachial plexopathy after median sternotomy for cardiac surgery was described. When he was awakened six days after cardiac surgery, he experienced weakness and paresthesia of both upper limbs. Neurological examination revealed moderate to severe atrophy and weakness of right biceps, brachioradialis, left triceps, and distal muscles of both upper limbs, and paresthesia around the right thumb and the left hypothenar. Deep tendon reflex of the right biceps, triceps, brachioradialis and left triceps was absent. In addition, he showed Horner's syndrome at the left side. The results of needle EMG and nerve conduction study indicated the damage of the right upper trunk and left middle and lower trunks of the brachial plexus. Although brachial plexopathy following median sternotomy has previously been reported in Western literatures, there is only a single report of unilateral brachial plexopathy in Japan. This is the first report in Japan of the bilateral brachial plexopathy following median sternotomy, and suggests that brachial plexopathy should be recognized as a complication of median sternotomy.

摘要

本文描述了一名53岁男性,在心脏手术正中开胸术后出现双侧臂丛神经病变。心脏手术后六天他苏醒时,感到双上肢无力和感觉异常。神经系统检查发现,右肱二头肌、肱桡肌、左三头肌以及双上肢远端肌肉有中度至重度萎缩和无力,右拇指周围和左小鱼际有感觉异常。右肱二头肌、三头肌、肱桡肌以及左三头肌的腱反射消失。此外,他左侧出现霍纳综合征。针极肌电图和神经传导研究结果表明,臂丛神经右上肢上干以及左上肢中干和下干受损。虽然西方文献中此前已有正中开胸术后臂丛神经病变的报道,但日本仅有一例单侧臂丛神经病变的报道。本文是日本首例正中开胸术后双侧臂丛神经病变的报道,提示臂丛神经病变应被视为正中开胸术的一种并发症。

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