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The diagnostic utility og imaging techniques in injuries to the intramedullary and subarachnoid portions of the brachial plexus,with possibly complete avulsion of one or more nerve roots from the spinal cord and extramedullary meningocoele was compared in 18 patients studies by unenhanced computed tomography(CT),cervical myelography,myelographic CT (MCT)and megnetic resonance imaging(MRI).Emphasis was placed on the lesions of the subarchnoid roots.CM was the only diagnositc modality to show avulsion of 18 nerve roots and their levels in 8 patients(100%=gold standard),andto verify 2 incomplete avulsions.MCT reliably revealed 8 of 18(45%)and MRI 1 out of 18(6%)avulsions.Myelography with MCT showed intact subarachnoid nerveroots in 10 additional patients.MRI and MCT(16 out of10= 100%)were superior to myelography(14/16=18%)for demonstrating 16 traumatic meningocoeles in 8 patients;follow-up MRI(6-24 months)showed no increase in their size.We recomment a subsequent CT to rule out fracture to the spinal column;MRI should provide significant information concerning oedema or haemorrhage in the spinal cord.Myelography with segmental MCT is performed to differentiate pre-from post-ganglionic lesions,data which are essential for deciding whether exploration of the plexus or a motor substitution operation is indicated. |
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CAT scan
CAT scan,abnormal
CAT scan,myelogram with
CAT scan,spinal cord
meningocele
meningocele,traumatic
MRI
MRI,abnormal
MRI,CAT scan compared to
MRI,spinal cord
myelogram
root avulsion
root lesion,nerve
spinal cord
spinal cord,injury of
trauma
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