Woźniak Jowita, Kędzia Alicja, Dudek Krzysztof
Department of Normal Anatomy, Medical University of Wroclaw, Wroclaw, Poland.
Anat Sci Int. 2012 Dec;87(4):223-33. doi: 10.1007/s12565-012-0150-1. Epub 2012 Sep 4.
The brachial plexus is an important nervous system structure. It can be injured during the perinatal period and by postnatal damage. The goal of this study was to assess human fetal brachial plexus variability. A total of 220 brachial plexuses were surgically prepared from 110 human fetuses aged 14-32 weeks of fetal life (50 females and 60 males) ranging in CRL from 80 to 233 mm. The study incorporated the following methods: dissectional and anthropological, digital image acquisition, digital image processing using Image J and GIMP software, and statistical methods (Statistica 9.0). Symmetry and sexual dimorphism were examined. Anomalies of the brachial plexuses were observed in 117 (53.18 %) cases. No sexual dimorphism was found. It was observed that cord variations occurred more often on the left side. Division variants (33.64 %) occurred most often, but also cords (18.18 %) as well as root nerves and terminal ramifications (15.90 %) were found. Trunk anomalies were rare and occurred in only 5.45 % of plexuses. Three height types of median nerve roots in combination with the nerve were distinguished. In one-third of cases, median nerve root connections were found below the axillary fossa and even half in the proximal part of the humerus. In conclusion, the brachial plexus was characterized for anatomical structural variability. Most often division and cord variations were observed. Anomalies occurred regardless of sex or body side except for cord variants. Brachial plexus variation recognition is significant from the neurosurgical and traumatological point of view.
臂丛神经是一种重要的神经系统结构。它在围产期和出生后都可能受到损伤。本研究的目的是评估人类胎儿臂丛神经的变异性。从110例孕龄14 - 32周的人类胎儿（50例女性和60例男性）中手术制备了220个臂丛神经，其头臀长在80至233毫米之间。该研究采用了以下方法：解剖学和人类学方法、数字图像采集、使用Image J和GIMP软件进行数字图像处理以及统计方法（Statistica 9.0）。对对称性和性别差异进行了检查。在117例（53.18%）病例中观察到臂丛神经异常。未发现性别差异。观察到索变异在左侧更常见。分支变异（33.64%）最常见，但也发现了索（18.18%）以及神经根和终末分支（15.90%）。干异常很少见，仅在5.45%的神经丛中出现。区分了三种高度类型的正中神经根与神经的组合。在三分之一的病例中，正中神经根连接在腋窝下方被发现，甚至在肱骨近端有一半病例如此。总之，臂丛神经的特点是解剖结构存在变异性。最常观察到的是分支和索的变异。除了索变异外，异常的发生与性别或身体侧别无关。从神经外科和创伤学角度来看，识别臂丛神经变异具有重要意义。
