Brachial plexopathy due to massive swelling of the neck associated with craniotomy in the park bench position

Surgical Neurology
Satoru ShimizuKiyotaka Fujii

Abstract

During prolonged neurosurgical procedures, anesthetized patients are at risk for position-related complications. We report a rare combination of neck swelling and brachial plexopathy as operative position-related complications. This 56-year-old woman was placed in the left park bench position for removal of a tentorial meningioma in the right posterior fossa. At 2 hours after the 10-hour procedure, her left neck began to swell with progression during the next 10 hours to involve the face on the same side and the face and neck on the opposite side. Computed tomography showed swelling of the muscles and deep soft tissue primarily on the left. No brain edema was observed. She was conservatively treated with orotracheal intubation, placed in the head-up position, and received anticoagulants. Her swelling subsided by the 20th postoperative day; however, she manifested weakness in the proximal muscles of the left upper extremity. Magnetic resonance imaging revealed swelling of the brachial plexus on the left; electrophysiologic studies were compatible with damage to the upper trunk of the brachial plexus. She was discharged 2 months after surgery with improved weakness. Possible pathologic mechanisms are kinking of the jugular vein d...Continue Reading

References

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Citations

Aug 31, 2012·Case Reports in Neurological Medicine·Hiroyuki KoizumiKiyotaka Fujii
Sep 1, 2009·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Marie-Noëlle Hébert-BlouinRobert J Spinner
Jun 4, 2016·Journal of Neurosurgery. Pediatrics·Aditya VedantamSandi Lam
Apr 2, 2020·Frontiers in Surgery·Ana Mavarez-MartinezSergio D Bergese
Jul 22, 2019·Acta neurochirurgica·Giannantonio SpenaGianluca Grimod
Nov 3, 2021·British Journal of Neurosurgery·Alessandro De CassaiMarina Munari

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