Granata Giuseppe, Tomasello Fabiola, Sciarrone Maria Ausilia, Stifano Vito, Lauretti Liverana, Luigetti Marco
Dipartimento di Neuroscienze, Organi di Senso e Torace, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Dipartimento di Neuroscienze, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Brain Sci. 2024 Jan 10;14(1):67. doi: 10.3390/brainsci14010067.
Neuralgic amyotrophy, also called Parsonage-Turner syndrome, in its classic presentation is a brachial plexopathy or a multifocal neuropathy, involving mainly motor nerves of the upper limb with a monophasic course. Recently, a new radiological entity was described, the hourglass constriction, which is characterized by a very focal constriction of a nerve, or part of it, usually associated with nerve thickening proximally and distally to the constriction. Another condition, which is similar from a radiological point of view to hourglass constriction, is nerve torsion. The pathophysiology of neuralgic amyotrophy, hourglass constriction and nerve torsion is still poorly understood, and a generic role of inflammation is proposed for all these conditions. It is now widely accepted that nerve imaging is necessary in identifying hourglass constrictions/nerve torsion pre-surgically in patients with an acute mononeuropathy/plexopathy. Ultrasound and MRI are useful tools for diagnosis, and they are consistent with intraoperative findings. The prognosis is generally favorable after surgery, with a high rate of good motor recovery.
神经性肌萎缩，也称为帕森热-特纳综合征，其典型表现为臂丛神经病或多灶性神经病，主要累及上肢运动神经，病程呈单相性。最近，一种新的影像学表现被描述出来，即沙漏样狭窄，其特征是神经或其一部分出现非常局限性的狭窄，通常在狭窄近端和远端伴有神经增粗。另一种在影像学上与沙漏样狭窄相似的情况是神经扭转。神经性肌萎缩、沙漏样狭窄和神经扭转的病理生理学仍知之甚少，目前认为炎症在所有这些情况中都起到了一定作用。现在人们普遍认为，对于急性单神经病/丛神经病患者，术前进行神经成像以识别沙漏样狭窄/神经扭转是必要的。超声和磁共振成像（MRI）是诊断的有用工具，且与术中发现一致。手术后预后通常良好，运动功能恢复良好率较高。
