A brachial plexus is a group of nerves that supplies the upper limbs of your body. This plexus is connected to the spinal cord; any injury in the nerves can result in reversible or irreversible paralysis of the muscles of the arms or hands.
Reversible Nerve Damage
When the blood supply to the nerves of the brachial plexus is cut off, transient paralysis could happen. This can occur when you’re lying in a certain position that compresses the plexus in your shoulder. Reversible nerve damage can also occur in direct trauma, vehicular accidents or penetrating injuries.
Irreversible Nerve Damage
When the nerve roots of the brachial plexus are completely avulsed from the spinal cord or when the nerves get ruptured through and through, irreversible paralysis of the affected muscle can occur. There will also be a loss of sensation over the area of the nerve supply, and the paralysis of the muscles will cause them to become flaccid.
In these types of severe injuries, recovery is difficult; however, there can be an improvement. Generally, it is presumed that if there is no visible improvement in three months, the prognosis is likely to be disappointing.
Brachial Plexus Injuries in a Newborn
Newborns can have brachial plexus injuries at the time of their birth if unprofessional manoeuvres are taken to assist the delivery of the baby. Manual pulling of the arm of the baby during the delivery can cause the nerve roots of the plexus to stretch and become avulsed.
Newborn children with high birth weight are also more prone to brachial plexus injuries.
Fortunately, most babies will recover within a few months on their own. A small percentage will require surgery.
Surgery for Brachial Plexus Injuries
The only treatment for these types of nerve injuries is surgical intervention. Brachial plexus surgery is a complicated procedure that involves the repair of damaged nerves and nerve roots. Sometimes the surgeons will perform a nerve transfer to innervate the muscle with a nearby nerve instead. These ‘donor’ nerves are usually the radial nerve, the ulnar nerve or the intercostal nerves.
Proper post-op care is pivotal for a smooth recovery. Patients will usually notice an improvement in function in a couple of months to a year.
Other surgical options include a complete muscle transfer to restore function and movement. The recovery period for this type of surgery is usually prolonged and may take up to several years.