Post-traumatic brachial plexus MRI in practice.

Injuries are separated into spinal nerve root avulsions (pre-ganglionic lesions) and more distal rupture (post-ganglionic lesions). The lesions may be associated with different nerve root levels. Spinal MRI is used to diagnose pre-ganglionic lesions, which may be present in the absence of pseudomeningoceles. The other sequences described are used to diagnose post-ganglionic lesions, regardless of the type of lesion. Knowledge that a graftable C5 nerve root is present is important in the treatment strategy. Contrast enhancement in the scalene triangle does not predict the quality of the nerve root (continuous injury with response to peroperative stimulation or division of the root needing grafting). Understanding post-traumatic neuronal injuries to the brachial plexus. Knowing how to look for spinal MRI abnormalities and post-ganglionic abnormalities.