Hitting A Nerve: T1 Nerve Root Injury Secondary to Open Heart Surgery
Nicole Varda1, Jacob A Saunders, Thomas C Varkey
1Department of Neurology, The University of Arizona, College of Medicine-Phoenix, Phoenix, AZ.
The Neurologist
|June 1, 2026
Summary
This study highlights a rare complication of cardiothoracic surgery: brachial plexus injury. Prompt diagnosis and management are key for recovery from this nerve injury, which can cause significant upper extremity weakness.
Area of Science:
- Neurology
- Surgery
- Orthopedics
Background:
- Cardiothoracic surgery, particularly sternotomy, carries risks of cardiovascular complications.
- A less common but significant complication is peripheral nerve injury due to prolonged physical tension during surgery.
Purpose of the Study:
- To present a case of brachial plexus injury following open-heart surgery.
- To emphasize the importance of considering nerve injuries in postoperative neurological deficits.
Main Methods:
- A case report of a 72-year-old woman with acute left upper extremity weakness post-surgery.
- Diagnostic workup included advanced imaging and physical examination to rule out stroke and identify brachial plexus injury, specifically T1 nerve root involvement.
Main Results:
- Imaging confirmed a brachial plexus injury, not a stroke, as the cause of weakness.
- The patient experienced gradual improvement with supportive care and physical therapy.
Conclusions:
- Brachial plexus injuries should be considered in the differential diagnosis of postoperative weakness after cardiothoracic surgery.
- Advanced imaging and electromyography are crucial for diagnosing iatrogenic brachial plexopathy.
- Early recognition and management are vital for patient recovery.
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