Resection of a benign brachial plexus nerve sheath tumor using intraoperative electrophysiological monitoring.
OBJECTIVE
Benign peripheral nerve sheath tumors arising from the brachial plexus are rare. Neurosurgeons often lack the clinical and surgical experience to optimize the management of these uncommon tumors. We filmed a video depicting the surgical resection of a benign peripheral nerve sheath tumor involving the brachial plexus.


METHODS
An illustrative case was used to demonstrate the proper management of a brachial plexus nerve sheath tumor including the important role of intraoperative electrophysiological neuromonitoring during tumor resection.


RESULTS
Using an illustrative case, we describe a systematic approach in the evaluation and surgical management of patients with a brachial plexus nerve sheath tumor. The importance of taking a thorough clinical history, performing a thorough physical examination, applying high-resolution magnetic resonance imaging techniques to visualize the pathology, and using intraoperative electrophysiological neuromonitoring during surgical exposure and resection of the tumor are stressed. Combined with appropriate postoperative treatment, these techniques minimize the risks and increase the likelihood of achieving a good clinical outcome.


CONCLUSIONS
Brachial plexus nerve sheath tumors are challenging mass lesions that should be evaluated and surgically resected by an experienced team of physicians to optimize clinical outcome.
Kwok
Keith
K
Department of Neurosurgery, University of California at Davis, Sacramento, California 95825, USA. keithkwok2004@yahoo.com
Davis
Brooke
B
Kliot
Michel
M
D001917:Brachial Plexus / Q000473:pathology / Q000601:surgery*; D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D004558:Electric Stimulation; D004594:Electrophysiology; D005260:Female; D006801:Humans; D020407:Internet; D008488:Medical Illustration; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D018317:Nerve Sheath Neoplasms / Q000601:surgery*; D009442:Neurilemmoma / Q000601:surgery*; D010524:Peripheral Nervous System Neoplasms / Q000601:surgery*; D011300:Preoperative Care; D014741:Video Recording