Variations of the Course of the Upper Trunk of the Brachial Plexus and their Clinical Significance for the Thoracic Outlet Syndrome: A Study on 93 Cadavers

Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Anastasopoulos, Nikolaos; Skandalakis, Panagiotis; Koebke, Juergen
February 2006
American Surgeon;Feb2006, Vol. 72 Issue 2, p188
Academic Journal
The aim of this study is the recording of the variations of the course of the upper trunk (UT) of the brachial plexus (BP) and their clinical significance for the thoracic outlet syndrome (TOS) and the anesthetic blockade of the BP. Five different anatomical variations of the course of the UT of the BP, in relation to the anterior scalene muscle (ASM), were observed in 24 out of the 186 sides of the 93 cadavers we studied (12.9%). The C5 root was passing anteriorly to the ASM in six cases. The UT was located anteriorly to the ASM in four cases and was perforating the ASM's belly in 12 cases. In one cadaver, the ASM was double and the UT was passing between the two bellies of the double ASM. Finally, in another cadaver, the C5 root was found to be anterior to the anterior scalene muscle, while the C6 root was perforating the ASM's belly. These variations are predisposing factors for the TOS; they cause specific symptomatology and require a different surgical approach in comparison with other causes of the syndrome. Moreover, knowledge of these is important during the performance of the anesthetic blockade of the BF.


Related Articles

  • Thoracic Outlet Syndrome. DeLaurentis, Dominic A.; Wolferth Jr., Charles C.; Friedman, Paul // Angiology;Sep1974, Vol. 25 Issue 8, p548 

    A patient with a thoracic outlet syndrome produced by a large intra-axillary lipoma is presented. Removal of this lipoma without removal of either the first rib or clavicle produced reversal of the patient's symptoms which were primarily neurologic. This report emphasizes the fact that although...

  • Essentials and Safeguards of Surgery for Thoracic Outlet Syndrome. Roos, David B. // Angiology;Mar1981, Vol. 32 Issue 3, p187 

    The article discusses essentials and safeguards of surgery for thoracic outlet syndrome. Symptoms that usually fail to respond to "conservatism" include sensory complaints of persistent coldness, paraesthesias, and intolerable pain; and the motor involvement of progressive weakness, fatigue, and...

  • New Concepts of Thoracic Outlet Syndrome That Explain Etiology, Symptoms, Diagnosis, and Treatment. Roos, David B. // Vascular Surgery;Sep/Oct1979, Vol. 13 Issue 5, p313 

    Presents a study which focused on new concepts of thoracic outlet syndrome. Etiology of the disease; Symptoms of the disease; Diagnosis and treatment of the disease.

  • Benign Anatomical Mistakes: The Thoracic Outlet Syndrome. Skandalakis, John E.; Mirilas, Petros // American Surgeon;Oct2001, Vol. 67 Issue 10, p1007 

    Focuses on thoracic outlet syndrome, the compression of the brachial plexus and the subclavian vessels at the upper opening of the thorax. Confusion in the anatomical nomenclature of the area; History and related literature; Redefinition of the thoracic outlet syndrome.

  • Thoracic Outlet Syndrome, Anatomical and Surgical Perspective. Ul Hassan, Ashfaq; Hamid, Sajad; Jeelani, Showkat; Rasool, Zahida; Hamid, Shahnawaz; Jan, Irfan // JK Science;Apr-Jun2011, Vol. 13 Issue 2, p57 

    A review of the article "Thoracic Outlet Syndrome, Anatomical and Surgical Perspective" by Ashfaq Ul Hassan, Sajad Hamid, Showkat Jeelani, Zahida Rasool, Shahnawaz Hamid and Irfan Jan, which appeared in the April-June 2011, is presented.

  • The Use of Saphenous Vein Bypass Grafting for Cervical Rib Axillary Brachial Artery Obstruction. Riester, Walter H. // Vascular Surgery;Jan/Feb1983, Vol. 17 Issue 1, p25 

    Interventional methods of treatment of arterial problems resulting from thoracic outlet obstruction include thrombectomy by Fogarty balloon catheter, cervical sympathectomy, resection of the stenotic aneurysmal segment of artery together with resection of the first and cervical rib. The...

  • Brachial plexus injury related to improper positioning during general anesthesia. Ngamprasertwong, Pornswan; Phupong, Vorapong; Uerpairojkit, Ketchada // Journal of Anesthesia;2004, Vol. 18 Issue 2, p132 

    Reports on a case of brachial plexus injury related to the improper perioperative positioning of a patient who underwent laparoscopic radical nephrectomy. Medical records of the patient; Discussion on brachial plexus injury; Recommendations in order to prevent or minimize the severity of...

  • Axillar Compression Syndrome: Anatomical and Clinical Study. Majerović, Mate; Jelinčić, Željko; Augustin, Goran // Collegium Antropologicum;Dec2004, Vol. 28 Issue 2, p809 

    In order to evaluate the possibility of compression of axillar artery by medial and lateral fascicle of brachial plexus, authors performed 26 axillar dissections on cadavers. Second part included analysis of 24 selective angiograms of axillar artery of patients with diagnosis of TOS. Third part...

  • Vascular Thoracic Outlet Syndrome World J. Surg. Vol. 27, No. 5, May 2003. Davidovic, Lazar B.; Kostic, Dusan M.; Jakovljevic, Nenad S.; Kuzmanovic, Ilija L.; Simic, Tijana M. // World Journal of Surgery;May2003, Vol. 27 Issue 5, p545 

    The surgical treatment of 30 cases of vascular thoracic outlet syndrome (TOS) in 25 patients is presented. Patients included 17 women and 8 men with average age of 26.1 years. The causes of compression were cervical rib (n = 16), soft tissue anomalies (n = 12), and scar tissue after clavicle...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics