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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What does the MRI scan findings of my brachial plexus below indicate?

Respected Sir,

I Biswajit Bhattacharjee residing at Ichapur goalapara S.C.ghosh street ,Post-Nawabganj,Dist-24Pgs(North) (West Bengal), (Mobile no- 0000 ) have been suffering for a road traffic accident Right Pan Brachial Plexus Injury since 9 years (8/7/2005). Then I admitted at “Peerless Hospital ” at Kolkata (West Bengal) for 46 days and this time there doctor suggest to me take a “MRI OF BRACHIAL PLEXUS” of my right hand and this “MRI” report was below -



HISTORY -

Road traffic accident followed by injury to right side of neck & mono paresis of right upper limb .



PARAMETERS- FSE T1,T2, STIR & gradient echo T2 weighted images of the brachial plexus in coronal , sagittal & transverse planes with slice thickness of 3mm. & 4mm.



FINDINGS- Diffuse oedema is noted in the soft tissue along the course of trunk & cords of right brachial plexus from the supraclavicular to right axillary region . There is oedema in right anterior & middle scalne muscles, pectoralis muscles, trapezius supraspinatus, infraspinatus & subscapularis muscles with evidence of fracture in right scapula . Continuity of the trunks & cords of right brahical plexus is not appreciated & may be obscured by the adjoining soft tissue changes . There is also evidence of pseudo-meningocele in the right lateral recess & neural foramina at C5-C6 & C6-C7 levels of the cervical spine . Cervical cord shows normal signals . Left brachial plexus is normal.Right sided pleural thickening is noted .



IMPRESSION - The above findings are suggestive of effects of trauma in right brachial plexus with pseudo-meningocele at C5-C6 & C6-C7 levels consistent with avulsion of right C6 & C7 nerve roots . There is also evidence of diffuse oedema along the course of trunks & cords of right brachial plexus suggesting possibility ntusion or laceration of the nerves in these region . Evidence of fracture is noted in right scapula with diffuse oedema in adjoining soft tissue . Suggested clinical correlation and further investigations if clinically indicated . Then I also taken treatment under Prof. V. S. Mehta,(DELHI AIMS) he was operation at Paras Hospital on 23rd July, 2006 and suggest me physiotheraphy continously but till now no improvement.



PARAS HOSPITALS ( GURGAON HARYANA)



DEPARTMENT OF NEUROSURGERY

DISCHARGE SUMMARY AFTER OPERATION IN “PARAS HOSPITAL” is below- HISTORY OF PRESENT(23RD JULY,2006) ILLNESS :

About 1yr back, patient suffered a road traffic accident during which he sustained multiple injuries.

He sustained injury to the head with multiple fractures involving right clavicle, right femur. right distal ratio & Pattellar fracture.

Patient was under intensive care following unconsciousness and regained consciousness after 15 days.



After regaining consciousness, there was complete loss of movement & sensations of the right upper limb.

For the last 1yr, there is no change in the neurological state of the right upper limb. There is history of episodes of hyperaesthesia on the affected side.



GENERAL & SYSTEMIC EXAMINATION : Within normal limits.



NEUROLOGICAL EXAMINATION

Higher Function : Normal.

Cranial nerves : Normal.

Cerebellum : Normal.



RIGHT UPPER LIMB

Attitude : Adducted & Pronated.



MOTOR SYSTEM

Bulk : Ateophy of right upper limb.

Tone : Normal. Power : 0/5 in all muscle groups.

Reflexes : Absent

SENSORY SYSTEM : Absent sensations in C5-T1 segment.

Distal pulsations : Present

Left upper limb,Right & Left Lower limb :Normal.



Now, I went to Apolo Hospital in Kolkata (West Bengal) for see to Dr. Sughran Banerjee (artho) and he suggest me for treatment by stem cell therapy.I want to recover my this problem , I visit with you as early as possible . Sir kindly give me your suggestion as early as possible and I will be grateful you.



PLEASE PLEASE PLEASE .

Yours faithfully,

Biswajit Bhattacharya .

Mobile : 0000.



Mon, 13 Oct 2014
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General & Family Physician 's  Response
Welcome to health care magic.

1.Sorry for what you are going through. The MRI report suggest there is a evidence of injury at the level of C5-6,C6-7.
2.The description says there is spinal chord / meningocele - meningothelial elements displaced into the skin and subcutaneous tissues.
3.There is nerve root compression at the level of C6-C7 level probably disc causing pressure effect.
4.These procedures are very sensitive - at times you might feel good and the post operative site might shows any inflammatory / infective changes will again be symptomatic.
5.In this case what i would recommend is get a repeat MRI done and see the present condition and treat accordingly.
6.I would think generally it need a constant workup with spine exercises and physiotherapy.

Good luck.
Hope i have answered your query,
any thing to ask ? do not hesitate to ask.
http://doctor.healthcaremagic.com/doctors/dr-ganesh/62888
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