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Peripheral nerve lesions associated with missile-induced pseudoaneurysms
Zoran Roganović1, Sidor Misović, Goran Kronja
1Department of Neurosurgery, Military Medical Academy, Belgrade, Serbia. roganovic@yubc.net
Journal of Neurosurgery
|October 17, 2007
Summary
Missile-induced pseudoaneurysms can cause severe nerve damage, especially if surgical intervention is delayed over 3.5 days. Prompt surgical treatment of these traumatic nerve injuries and associated pseudoaneurysms leads to good outcomes.
Area of Science:
- Traumatology
- Vascular Surgery
- Neurosurgery
Background:
- Traumatic pseudoaneurysms linked to nerve compression are infrequently documented, with limited focus on the nerve damage.
- Understanding the clinical course and outcomes of these specific injuries is crucial for effective management.
Purpose of the Study:
- To prospectively evaluate the clinical presentation, surgical management, and treatment outcomes of nerve injuries associated with pseudoaneurysms.
- To identify factors influencing the recognition and severity of nerve damage in these cases.
Main Methods:
- A prospective study of 22 patients with missile-induced nerve injury and pseudoaneurysm treated surgically between 1991 and 1995.
- Surgical repair of both artery and involved nerves, with assessment of sensorimotor deficits and pain intensity.
Main Results:
- Pulsatile mass occurrence was location-dependent and significantly correlated with preoperative diagnosis.
- Nerve recovery depended on the extent of nerve damage and surgical procedure (neurolysis or grafting).
- Delay in surgery beyond 3.5 days significantly increased the risk of severe nerve damage from neurapraxia.
Conclusions:
- Preoperative recognition of missile-induced pseudoaneurysms depends on location and presentation.
- Nerve lesions are typically in continuity, but damage can be severe if surgical repair is delayed.
- Appropriate surgical techniques guided by intraoperative nerve action potentials yield successful outcomes.
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