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Brachial Plexus Injuries

Apr 20, 2020

The brachial plexus is a group of nerves that run from the spinal cord in the neck down the arms. These nerves control movement and sensation in the arms and hands, so they are essential to help you complete many different tasks. Injuries to the brachial plexus range in severity and duration and is typically caused by trauma to those nerve roots, from motor vehicle accidents, construction accidents and falls. Improper medical care can also cause brachial plexus injury.  As infants are particularly vulnerable, many brachial plexus injuries are caused to babies by excessive force used in their delivery. At Raynes Lawn Hehmeyer, we understand the seriousness of brachial plexus injuries and the many legal issues that come with fighting for victims who have suffered brachial plexus injury. If you or a family member has suffered a brachial plexus injury because of someone’s negligence we will fully investigate the circumstances and fight to hold the appropriate parties responsible for causing this devastating injury.

What Is Brachial Plexus Birth Injury?

Brachial plexus is the name given to the bundle of connected nerves that come off the spinal cord near the neck. These nerves branch out into the shoulders, arms and hands. An important job for this cluster of nerves is to control movement in the arms, wrists, and hands. The brachial plexus nerves also allow you to feel or sense sensations in the arms, wrists and hands.

When brachial plexus injuries occur, the connection, or communication, between the spinal cord and the arm, wrist, and hand is interrupted or cut off.  That connection, or pathway, is how the brain passes signals back and forth to the arms and hands. When that pathway is damaged or broken, the brain cannot properly communicate with the arm or hand, resulting in loss of movement and sensation in the areas controlled by those nerves.

Trauma to this area of the head and neck can cause brachial plexus injury. That trauma can be from a significant impact as seen in a motor vehicle accident, or a direct cutting of the nerves during surgery. However, stretching of the nerves from the spinal cord can also cause permanent brachial plexus injury. This is particularly true for infants.  Too much stretching, force or pressure – sometimes also called “traction”- to the infant’s head and neck during delivery is a frequent cause of brachial plexus injuries.  This would be a brachial plexus, birth injury.

Shoulder Dystocia and brachial plexus injury at delivery:

Sometimes during a mother’s labor and vaginal delivery of her child, the child’s head will come out of the birth canal, but the body gets stuck. This happens when the child’s shoulder gets stuck behind the mother’s pubic bone; a condition known as “shoulder dystocia”.  While shoulder dystocia is considered an obstetrical emergency, all doctors and midwives are taught various techniques to safely deliver the child from a shoulder dystocia. Each of these techniques or maneuvers were designed to safely free the baby’s shoulder and complete the delivery without excessive force or stretching on the baby’s brachial plexus.

Doctors are taught how to deliver in a way to reduce the risk of a brachial plexus injury because these injuries can have devastating effects on a child for a lifetime. Brachial plexus injuries vary in severity depending on the nature and extent of trauma to the nerves. Some extremities will return to normal function and feeling over time with no treatment, others may respond with therapy, others may need surgery, and some never improve despite surgical and non-surgical treatment.  Babies who suffer a severe brachial plexus injury will have lifelong disabilities due to their inability to fully use, move and feel their arms, wrists and or hands.

What Are the Types of Brachial Plexus Injuries?

There are four types of injuries to the nerves that make up the brachial plexus:

Avulsion: This injury occurs when the nerve roots are torn away from their spinal cord attachment point. Most of these injuries occur right at the spinal cord. These are severe injuries and are reported to be approximately 10 to 20 percent of brachial plexus injury cases. This type of nerve damage cannot be surgically repaired. Depending on their location, avulsion can cause issues with the diaphragm and affect breathing in the injured party.

Neuropraxia: This is the type of injury to nerves that comes from stretching. The nerves are stretched but do not tear. Most of these injuries occur along the nerve outside of the spinal cord. It is the most common form of brachial plexus birth injuries. Many of these injuries will recover on their own, with most babies regaining normal function within several months.

Rupture:  These occur when the nerve is torn, but not in the area where it attaches to the spine. Many of these injuries will require the nerves to be surgically repaired.

Neuroma: This is the scar tissue which has formed after a nerve has been injured and tries to heal. The scar tissue now presses against the nerve and interrupts the nerve signals to the muscles. In many cases, neuroma will have to be surgically treated.

Conditions arising from Brachial Plexus Injuries

Several conditions are the result of brachial plexus injuries, and they include:

Erb’s palsy: This is weakness in the biceps and shoulders as a result of injury to the upper brachial plexus nerves. Erb’s palsy causes problems with arm and shoulder movement. However, the hand functions may still be healthy.

Klumpke’s palsy: The term given to the palsy that arises from injury to the lower portion of the brachial plexus, affecting the muscles of the hand and fingers. This nerve damage can cause a loss of motion in the hand and wrist.

Global palsy:  The palsy resulting from severe injury to the lower and upper nerves of the brachial plexus interfering with movement and sensation in the shoulder, arms and hands.

Horner’s syndrome: This injury arises from disruption of the nerve pathway coming from the spinal cord to one side of the face. This can cause patients to have one pupil smaller than the other, have a drooping eyelid and even diminished sweat production in the face. This condition can be caused in children by injury to their neck and shoulder during delivery and therefore can be seen with severe cases of brachial plexus birth injury.

Has Your Infant Suffered a Brachial Plexus Injury?

If your child suffered a birth related brachial plexus injury due to medical negligence, he or she may be entitled to financial compensation.  The law provides for money damages to compensate your child for their pain, disfigurement, disability and medical expenses.  Not all brachial plexus injuries are a result of negligence. These cases are very complex.  Proving that negligence was the cause of your child’s injuries will require dedicated attorneys experienced at investigating and pursuing justice for children hurt by medical error.

The attorneys at Raynes Lawn Hehmeyer are here to help protect your rights, and the rights of your injured child. If you need to schedule a consultation, make sure to fill out the contact form.

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