Cervical myelopathy caused by retrograde intraneural dissection of anesthetic solution.
Brachial plexus block is a generally safe procedure for postoperative analgesia following shoulder surgery. This report describes brachial plexus block complicated by intraneural dissection of anesthetic solution, resulting in severe damage to the upper spinal cord. Other investigators have hypothesized that this rare complication is caused by accidental needle placement within the substance of the cord. This case demonstrates that the complication can occur despite a peripherally located needle.
Cochrane
Thomas I
TI
Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Tower 5D EMG, Boston, Massachusetts 02115, USA. tcochrane@partners.org
D000328:Adult; D001917:Brachial Plexus; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D012782:Shoulder / Q000601:surgery; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology