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Title: Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia

Abstract

Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication.

Authors:
; ; ;  [1];  [2];  [3]
  1. Brigham and Women's Hospital, Department of Radiology (United States)
  2. Brigham and Women's Hospital, Department of Anesthesia (United States)
  3. Brigham and Women's Hospital, Department of Surgery (United States)
Publication Date:
OSTI Identifier:
21091344
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 28; Journal Issue: 5; Other Information: DOI: 10.1007/s00270-004-0282-3; Copyright (c) 2005 Springer Science+Business Media, Inc.; www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABLATION; ANESTHESIA; ARMS; CHEST; HEAD; IMAGE PROCESSING; INJURIES; PATIENTS; POSITIONING; RADIOWAVE RADIATION; SURGERY

Citation Formats

Shankar, Sridhar, E-mail: shankars@ummhc.org, Sonnenberg, Eric van, Silverman, Stuart G., Tuncali, Kemal, Flanagan, Hugh L., and Whang, Edward E. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia. United States: N. p., 2005. Web. doi:10.1007/S00270-004-0282-3.
Shankar, Sridhar, E-mail: shankars@ummhc.org, Sonnenberg, Eric van, Silverman, Stuart G., Tuncali, Kemal, Flanagan, Hugh L., & Whang, Edward E. Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia. United States. doi:10.1007/S00270-004-0282-3.
Shankar, Sridhar, E-mail: shankars@ummhc.org, Sonnenberg, Eric van, Silverman, Stuart G., Tuncali, Kemal, Flanagan, Hugh L., and Whang, Edward E. Wed . "Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia". United States. doi:10.1007/S00270-004-0282-3.
@article{osti_21091344,
title = {Brachial Plexus Injury from CT-Guided RF Ablation Under General Anesthesia},
author = {Shankar, Sridhar, E-mail: shankars@ummhc.org and Sonnenberg, Eric van and Silverman, Stuart G. and Tuncali, Kemal and Flanagan, Hugh L. and Whang, Edward E.},
abstractNote = {Brachial plexus injury in a patient under general anesthesia (GA) is not uncommon, despite careful positioning and, particularly, awareness of the possibility. The mechanism of injury is stretching and compression of the brachial plexus over a prolonged period. Positioning the patient within the computed tomography (CT) gantry for abdominal or chest procedures can simulate a surgical procedure, particularly when GA is used. The potential for brachial plexus injury is increased if the case is prolonged and the patient's arms are raised above the head to avoid CT image degradation from streak artifacts. We report a case of profound brachial plexus palsy following a CT-guided radiofrequency ablation procedure under GA. Fortunately, the patient recovered completely. We emphasize the mechanism of injury and detail measures to combat this problem, such that radiologists are aware of this potentially serious complication.},
doi = {10.1007/S00270-004-0282-3},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 28,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2005},
month = {Wed Jun 15 00:00:00 EDT 2005}
}