title: Tardy spinal cord tumor following avulsive brachial plexus injury: coincidental or causal?
abstract: OBJECTIVE
  Late neurologic deterioration after brachial plexus injury (BPI) is uncommon and may be caused by multiple etiologies. An unusual, previously unreported, case of late neurologic deterioration after BPI is presented.
  
  
  METHODS
  A pediatric patient previously treated for a traumatic preganglionic BPI and presenting with neurologic deterioration 5 years after his injury is reviewed.
  
  
  RESULTS
  Magnetic resonance imaging and computed tomography myelogram revealed spinal cord herniation at the same level of the previous nerve root avulsions. Surgical open biopsy demonstrated a spinal cord anaplastic astrocytoma. Despite craniospinal radiotherapy and different regimens of chemotherapy, he died 4 years later from leptomeningeal spread.
  
  
  CONCLUSIONS
  This case illustrates a previously unreported cause of late neurologic deterioration following BPI. The probable coincidental versus possible causal interrelationship of these two processes (BPI and spinal cord tumor) is discussed, but no conclusions can be reached.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Hébert-Blouin
authors.forename: Allen T
authors.initials: AT
authors.lastname: Bishop
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Shin
authors.forename: Cynthia
authors.initials: C
authors.lastname: Wetmore
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D001254:Astrocytoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery; D002648:Child; D003131:Combined Modality Therapy; D003606:Dacarbazine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017809:Fatal Outcome; D006732:Horner Syndrome / Q000150:complications; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008588:Meningocele / Q000473:pathology; D018908:Muscle Weakness / Q000209:etiology; D019635:Neurosurgical Procedures; D015541:Off-Road Motor Vehicles; D019651:Plastic Surgery Procedures; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013131:Spine / Q000473:pathology; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide