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Radiographic evaluation of brachial plexopathy.

W G Armington, H R Harnsberger, A G Osborn

    AJNR. American Journal of Neuroradiology
    |March 1, 1987
    PubMed
    Summary
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    Diagnosing brachial plexopathy requires tailored imaging. Trauma patients benefit from cervical myelography first, while non-trauma cases depend on clinical localization for initial CT or myelography.

    Area of Science:

    • Radiology
    • Neurology
    • Medical Imaging

    Background:

    • Brachial plexopathy diagnosis is challenging due to subtle or confusing neurologic signs.
    • Accurate localization of brachial plexus disease is difficult.
    • Optimal radiographic approaches are needed for diagnosis and anatomical delineation.

    Purpose of the Study:

    • To determine the most direct radiographic approach for diagnosing brachial plexopathy.
    • To anatomically delineate the causes of brachial plexopathy.
    • To compare imaging efficacy in traumatic versus non-traumatic cases.

    Main Methods:

    • Retrospective review of clinical and radiographic records of 43 patients with brachial plexus symptoms.
    • Analysis of patients who underwent CT and/or myelography.

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  • Division of patients into traumatic and non-traumatic groups.

    • Main Results:

    • Deficiencies in CT evaluation were noted in 35% of non-traumatic cases, delaying diagnosis.
    • Trauma patients presenting with brachial plexus symptoms should undergo cervical myelography before CT.
    • Non-traumatic patients require clinical classification (central vs. peripheral) to guide initial imaging (myelography for central, CT for peripheral).

    Conclusions:

    • Imaging strategy for brachial plexopathy should be tailored based on trauma history and clinical presentation.
    • Cervical myelography is recommended as the initial imaging modality for traumatic brachial plexopathy.
    • CT protocols should include contrast enhancement for improved visualization of vascular structures.