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Wheeless' Textbook of Orthopaedics

Peripheral nerve injuries in the adult with traumatic brain injury


Stone-L; Keenan-MA Adult Head Trauma Service, Rancho Los Amigos Medical Center, Downey, California 90242. Clin-Orthop. 1988 Aug(233): 136-44 Fifty adult patients who sustained a traumatic brain injury (TBI) were screened for the presence of a peripheral nerve injury (PNI). All suspected patients had diagnostic electromyography performed in order to confirm the clinical findings. The incidence of PNI with TBI was 34%. A variety of nerve injuries were seen, the most frequent of which were ulnar nerve entrapment at the elbow (10%) and brachial plexus injuries (10%). No patient initiated a complaint that led to the diagnosis. In addition, all the neuropathies were missed prior to admission. The neuropathies commonly were found in the neurologically impaired extremity and associated with spasticity. The results of this study suggest that patients sustaining a TBI have a significant and higher incidence of PNI as a complication than previously reported.



Original Text by Clifford R. Wheeless, III, MD.