[Neurological complication after a vertical infraclavicular brachial plexus block. Case report of possible differential diagnoses of a neurological deficit].
A 72-year-old man with an obliteration of the brachial artery received a vertical infraclavicular block (VIP) for vascular surgery but 20 h after the operation a complete paresis of the affected extremity occurred. A new vascular obliteration could be excluded. During the diagnostic examination the patient noticed a snapping noise in the cervical column when moving his head and an abrupt recovery of the neurological deficits occurred. The radiological diagnostic provided no indication of cerebral ischemia or lesions of the brachial plexus. An additional diagnostic finding was a profound herniated vertebral disc with compression of the myelon. Fortunately, the neurological deficits completely returned to normal.
Ehrenberg
R
R
Klinik für Anästhesiologie, Universität Regensburg, Regensburg. raminehrenberg@yahoo.com
Bucher
M
M
Graf
B
B
D000368:Aged; D001917:Brachial Plexus; D002574:Cervical Vertebrae / Q000473:pathology; D003937:Diagnosis, Differential; D017128:Embolectomy; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D010291:Paresis / Q000139:chemically induced; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology