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Traumatic spinal accessory nerve palsy

E Vandeweyer1, D Goldschmidt, S de Fontaine

  • 1Department of Plastic Surgery, University Hospital Erasme, Brussels, Belgium.

Journal of Reconstructive Microsurgery
|June 9, 1998
PubMed
Summary
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Spinal accessory nerve injuries from trauma are rare. A case of complete nerve section from a glass injury highlights the importance of early diagnosis and surgical repair for full functional recovery and pain relief.

Area of Science:

  • Neurology
  • Trauma Surgery
  • Anatomy

Background:

  • Spinal accessory nerve (SAN) injuries are uncommon, particularly those resulting from direct trauma.
  • Penetrating neck injuries, especially in the posterior triangle, pose a risk to the SAN.

Observation:

  • A rare case of total spinal accessory nerve section occurred following a glass-penetrating injury.
  • The initial lesion was missed, with diagnosis delayed until physical examination revealed scapula alata and shoulder dysfunction.

Findings:

  • Surgical exploration and direct nerve suturing were performed two months post-trauma.
  • Complete restoration of shoulder muscle function was achieved 12 months after surgery.
  • Preoperative pain, a significant symptom, resolved completely after functional recovery.

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Implications:

  • This case underscores the necessity of considering SAN lesions in penetrating neck trauma.
  • Prompt diagnosis and surgical intervention can lead to favorable outcomes in complete nerve sections.
  • Early management is crucial for preventing long-term disability and resolving associated pain.