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Brachial Plexus Overview
What is the brachial plexus, and how are brachial plexus birth injury symptoms identified and treated?
According to the Mayo Clinic, the brachial plexus is a group of nerves that branch out of the spinal cord in the neck and are responsible for sending communication from the brain to the arms, hands, and fingers.
In the worst case scenarios, these nerves can be dissected from the spinal cord with disastrous results such as arm paralysis and numbness.
These “worst case scenarios” are more common in adults that have been in accidents involving motorcycles and vehicles and are rarely the situation with brachial plexus birth injury.
More common in brachial plexus birth injury and sports injury are situations in which the shoulder is forced down while the neck is stretched in the opposite direction. If the arm is forced above the head, injury to the lower group of these nerves versus the upper group is more likely.
Brachial plexus birth injury symptoms are often seen after extended labor, fetal breech presentation, higher fetal birth weight with respect to pelvic size, or any other birthing situation in which the infant’s shoulders might get trapped in the birth canal. Forceps delivery or any pulling of the baby’s head while the rest of its body is still within the vagina can cause injuries of this type and often result in an injury called Erb’s Palsy, which affects the upper group of brachial nerves.
Other causes of brachial plexus injury symptoms may be malignant or non-malignant tumors growing in and around the region, damage via cancer treatments such as radiation, accidents like falls and bullet wounds.
According to the American Society for Surgery for the Hand, physical and occupational therapy are critical recovery tools for those that have experienced brachial plexus injury of any kind, whatever the source.
If muscle movement fluidity is able to be restored, but the closest joint has become stiffened over time due to inactivity, they may act like a rusty hinge and retard recovery.
Treatments for Brachial Plexus Birth Injury Symptoms
Early identification of birth injury symptoms is the most important part of securing treatment for a brachial plexus birth injury. Some infants will get better on their own without the need for surgery if a home exercise routine is carried out by the parents and followed up on with physical and occupational therapy.
According to the Children’s Hospital of Philadelphia, an infant with this type of injury will likely hold their elbow in a straightened manner, turning their forearm and hand inward toward their body.
If a complete diagnostic workup is conducted involving CT scan, Magnetic Resonance Imaging (MRI), and X-rays, it may be determined that surgery is the best option. Investigative surgery may be undertaken and nerves freed from scar tissue.
Other options include nerve grafting a healthy, functioning nerve from elsewhere in the body to fill a gap after a malfunctioning area is removed and nerve transfers. Nerve transfers use working nerve tissue to stimulate an unresponsive area.
