An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy

Marie Noëlle Hébert-Blouin, Shakeel A. Chowdhry, Peter H. Abrahams, Robert J. Spinner

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Contralateral upper extremity weakness following resection of a frontal tumor is not unusual to neurosurgeons. The differential diagnosis is broad and includes postoperative brachial plexopathy, which is usually secondary to malpositioning. We report the first known case of postoperative brachial plexopathy secondary to sialadenitis. A 53-year-old woman who had undergone an uncomplicated right frontal craniotomy for resection of a right frontal metastatic lesion developed left upper extremity weakness as well as extensive left neck edema immediately postoperatively. The edema, tracking along the fascial plane of the neck, caused compression of the upper (more superficial) elements of the brachial plexus and ensuing plexopathy. The cause of the neck edema was found to be sialadenitis of the submandibular gland. With medical treatment, the edema slowly resolved and the patient regained full function of her left upper extremity within weeks. This unusual case represents a new etiology of postoperative brachial plexopathy, illustrates the clinical relevance of the anatomy of the neck fasciae, and broadens the differential diagnosis of contralateral weakness following craniotomy for resection of a brain tumor.

Original languageEnglish (US)
Pages (from-to)840-845
Number of pages6
JournalClinical Anatomy
Volume22
Issue number7
DOIs
StatePublished - Oct 2009

Fingerprint

Craniotomy
Brachial Plexus Neuropathies
Upper Extremity
Edema
Neck
Sialadenitis
Differential Diagnosis
Brachial Plexus
Submandibular Gland
Fascia
Brain Neoplasms
Anatomy
Neoplasms
Therapeutics

Keywords

  • Brachial plexopathy
  • Neck swelling
  • Postoperative complication
  • Sialadenitis

ASJC Scopus subject areas

  • Anatomy
  • Histology

Cite this

Hébert-Blouin, M. N., Chowdhry, S. A., Abrahams, P. H., & Spinner, R. J. (2009). An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy. Clinical Anatomy, 22(7), 840-845. https://doi.org/10.1002/ca.20853

An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy. / Hébert-Blouin, Marie Noëlle; Chowdhry, Shakeel A.; Abrahams, Peter H.; Spinner, Robert J.

In: Clinical Anatomy, Vol. 22, No. 7, 10.2009, p. 840-845.

Research output: Contribution to journalArticle

Hébert-Blouin, MN, Chowdhry, SA, Abrahams, PH & Spinner, RJ 2009, 'An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy', Clinical Anatomy, vol. 22, no. 7, pp. 840-845. https://doi.org/10.1002/ca.20853
Hébert-Blouin, Marie Noëlle ; Chowdhry, Shakeel A. ; Abrahams, Peter H. ; Spinner, Robert J. / An unusual anatomical explanation for contralateral upper extremity weakness after frontal craniotomy. In: Clinical Anatomy. 2009 ; Vol. 22, No. 7. pp. 840-845.
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