Fact-sheet: Radicular avulsion


Updated on 04/19/2018 at 6:50 PM

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Definition

Avulsion or tearing of the spinal nerve roots due to stretching during trauma.

Clinical features

Two-wheeler accidents in young men.

Obstetric trauma.

Total or partial paralysis of the affected limb, neuropathic pain.

MRI

Objective: determine the lesion topography, pre- or post-ganglionic

Pre-ganglionic lesion:

  • direct sign: discontinuity
  • indirect signs: pseudomeningocele,
  • spinal cord edema,
  • lateral displacement of the spinal cord,
  • syringomyelia,
  • intracanal hematoma,
  • acute (STIR hyperintense edema of denervated muscles) or chronic (muscle amyotrophy and fatty degeneration) secondary denervation.

Post-ganglionic lesion (supra- or infra-clavicular): thickening of the nerve root with T2 hyperintensity.

Management

Spontaneous favorable outcome possible, otherwise nerve graft (do not wait more than 2 months).

Differential diagnosis

Compression of the branches of the Brachial plexus