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Stroke and brachial plexus injury: a difficult problem

P E Kaplan, J Meridith, G Taft

    Archives of Physical Medicine and Rehabilitation
    |September 1, 1977
    PubMed
    Summary
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    Stroke patients with brachial plexus injury face prolonged upper extremity rehabilitation. Electromyography (EMG) confirmed nerve damage, with recovery taking 8-12 months for some, impacting overall recovery timelines.

    Area of Science:

    • Neurology
    • Physical Medicine and Rehabilitation

    Background:

    • Middle cerebral artery syndrome can lead to contralateral hemiplegia.
    • Brachial plexus neuropathy may coexist with stroke, complicating upper extremity recovery.

    Observation:

    • Five patients with middle cerebral artery syndrome and hemiplegia presented with electromyographic (EMG) evidence of brachial plexus neuropathy.
    • Intensive rehabilitation involving range of motion, strengthening, and coordination exercises was administered to all patients.

    Findings:

    • Three patients showed EMG evidence of shoulder girdle muscle reinnervation after 8+ months of rehabilitation.
    • Two patients did not regain shoulder girdle muscle control, with EMG evidence of brachial plexus injury resolving in 8-12 months for those who did reinnervate.

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    Implications:

    • Concurrent brachial plexus injury significantly complicates and prolongs upper extremity rehabilitation in stroke patients.
    • Early identification and management of brachial plexus neuropathy are crucial for optimizing stroke rehabilitation outcomes.