Introduction: Among factors affecting the outcome in brachial plexus injuries, delay to referral and surgery, cerebral plasticity, as well as cognitive possibilities in the rehabilitation stage are of utmost importance. These factors can be modified by a simultaneous brain injury, but few reports have focused on this specific issue.
Methods: From our traumatic brain injury database, we performed an observational study on the 22 patients who sustained a combined brain and brachial plexus injury over a 12-year period (2000- 2011).
Results: Average initial GCS was 11,3, age 40,5 years, 82% of males. Glasgow Outcome Scale was favorable in all but one patient. Time from trauma to referral and brachial plexus surgery, brain imaging findings and neuropsychological assessment were studied. Outcome concerning the limb function was compared to a control population of brachial plexus injury.Cerebral radiological findings related to brachial plexus injury are reviewed. Cognitive changes and cerebral plasticity are discussed as possible causes of hindered rehabilitation.
Conclusions: The presence of a concomittant brain injury may adversely affect the delay for treatment, the participation to rehabilitation program and the functionnal outcome of these patients, especially when there is pronounced neuropsychological dysfunction.
Patient Care: Quantification of this potential prognostic factor, and understanding of the additionnal issues involved in concomitent traumatic brain injury.
Learning Objectives: By the conclusion of this session, participants should be able to
-discuss about epidemiology of traumatic brain injury associated to brachial plexus injury.
-discuss about radiological and neuropsychological assessment of these patients, focused on the rehabilitation stage.
-Discuss about cerebral radiological changes related to brachial plexus injury.