Plexopathie brachiale, complication grave d’une plaie pénétrante du cou par arme à feu : aspects clinique et neurophysiologique

Abstract

English Title: Brachial plexopathy, serious complication of a penetrant wound neck with firearm: clinical and neurophysiological aspects

English Abstract

Background: Brachial plexus paralysis following cervical trauma by firearm is a rare complication in our current practice.

Case report: We report the observation of a 31-year-old soldier who was a victim oh a shooting with open trauma of the left cervical region. On examination, there is a penetrating wound of the left neck with motor deficit of the predominantly proximal left upper limb without sensory involvement. Biological examinations showed a surinfection of the traumatic wound. Radiological examinations are normal showing multiple lead bullets at the point of impact. The diagnosis of brachial plexus palsy is suspected before clinical examination and confirmed by neurophysiological investigations. Medical management consisted of antibiotic therapy targeted towards the isolated germ associated with daily dressings. Surgical treatment is underway to repair nerve damage associated with physiotherapy.

Conclusion: In the event of any penetrating wound in the neck by a firearm, a initial thorough examination must be carried out urgently in search of signs of severity; Any motor deficit of the upper limb in this context must make suspect a brachial plexus injury.

Keywords: Brachial plexus, firearm, neurophysiology