Brachial Plexus Injury-Pediatric

Specialty Area: Pediatric Neurosurgery

The brachial plexus is a network of nerves in the shoulder that carries signals from the spinal cord to the arms and hands. It allows people to control movements and feel sensations in the arms and hands.

Injury to the brachial plexus is fairly common during the birthing process, occurring in one to two births per 1,000. Larger babies in difficult deliveries are particularly prone to this injury. The brachial plexus can also be injured when nerves are stretched by a blow to the shoulder or when bones around them are broken.

Children and babies with brachial plexus injuries will typically have a number of the following symptoms:

• Unable to lift their arm above their head
• Unable to bring objects to their mouth
• Unable to move their fingers
• Unable to feel things in their arm, hand or fingers
• Tingling or pain in their arm, hand or fingers

Hopkins Treatment
Early diagnosis and treatment can seriously improve long-term outcomes for these injuries. The seriousness of these injuries can vary widely. Many children will regain all or most function through occupational therapy. If no improvement is seen after three months, however, a pediatric neurologist and pediatric neurosurgeon should determine if the child can benefit from other interventions or surgery. One in 10 babies with brachial plexus injury will require some level of surgery. If the injury occurred during the birthing process, the best age for surgery is between four and nine months, as waiting more than a year can result in long-term damage.