[Localized hypertrophic neuropathy (LHN) of the brachial plexus: diagnosis and presurgical evaluation with MRI].
The authors report a case of localized hypertrophic neuropathy diagnosed by MRI. This 10-year-old girl presented with painless progressive deltoid atrophy. Electrodiagnostic studies demonstrated chronic denervation. An MRI performed with T1, T2, T1 with gadolinium and fat saturation sequences showed a linear 5-cm long segment of hypertrophic brachial plexus cord, with moderate high T2, intermediate T1 signal, and marked post-Gadolinium enhancement. Progressive improvement followed surgical resection with nerve graft repair. Histological study confirmed LHN (perineurial cell proliferation), a rare cause of peripheral neurological deficit. MRI findings may suggest LHN, that should be suspected as well as peripheral nerve compression or tumor; inflammatory neuritis and idiopathic lesion (with normal MRI findings) remain a diagnosis of exclusion. MR aids in the precise localization of the lesion before surgery.
Saguintaah
M
M
Service de Radiologie Pédiatrique, Hôpital Arnaud de Villeneuve, 34295 Montpellier Cedex 5, France.
Veyrac
C
C
Baud
C
C
Couture
A
A
D001706:Biopsy; D020516:Brachial Plexus Neuropathies / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D004576:Electromyography; D005260:Female; D005682:Gadolinium; D006801:Humans; D006984:Hypertrophy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009133:Muscular Atrophy / Q000209:etiology; D016067:Nerve Transfer / Q000379:methods; D011300:Preoperative Care / Q000379:methods*; D011868:Radioisotopes; D020127:Recovery of Function; D012782:Shoulder; D016896:Treatment Outcome
D011868:Radioisotopes; D005682:Gadolinium