Myelographic Demonstration of Brachial Plexus Root Avulsion

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Abstract
Introduction Stretch injuries to the brachial plexus with permanent residual disability are relatively infrequent. However, each case usually results in severe functional impairment for the patient and represents a difficult problem in management for the physician. Stretch injuries of the brachial plexus are classically divided into three types: Erb-Duchenne upper type, Klumpke's lower type, and the combined type. The Erb-Duchenne type, involving the fibers derived from C-5 and C-6, usually occurs when the head is forcibly separated from the shoulder. The Klumpke type, involving C-8 and T-1 fibers, usually results from forcible hyperabduction of the upper extremity at the shoulder. The combined type may range from complete plexus involvement to the simple addition of C-7 to either of the first two types. The term "avulsion of the brachial plexus" applies to actual separation of the nerve rootlets from the spinal cord. A presumptive diagnosis of avulsion of the brachial plexus

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