Traumatic nerve injury
General or Other | General Practice | Traumatic nerve injury (Disease)
Description
Considering major nerves controlling strength and sensation are present throughout the body, trauma can commonly damage these structures. Nerve injury causes pain, weakness, and numbness. Although some nerve injuries recovery spontaneously, other do not.
For example, if a nerve is cut, stretched apart, or has excessive scar tissue in or compressing the injured nerve, then recovery may not be possible without surgery. Nerve injuries can be classified as sharp transections, blunt transections, and uncertain.
Causes and Risk factors
Lesions produced by the action of nerve structure factors at various stages of alteration made trauma of axons and myelin sheaths. Lesions are classified into three types: neural-praxia (functional interrupt nerve transmission, usually perfect remitting), intrathecal anatomical disruption of axonal and myelinated structures, which require a much longer recovery nerve and neurotmezis (complete interruption of nerve structures, which require continuity chrirurgical nerve recovery after removal of damaged tissue lesion focus).
Diagnosis and Treatment
Surgery is both diagnostic and therapeutic. The nerve is inspected both with a microscope and direct electrical testing. Cut nerves are repaired. Uncut, but scarred nerves that have no electrical response are also repaired, usually by removing the damaged nerve segment and replacing it with a nerve graft (see technology and techniques available section). If electrical function is present, then the nerve is only cleared of scar tissue to allow further recovery. Surgery only optimizes the anatomical situation so that nerve regeneration can occur. Therefore, immediately after surgery your neurological deficit should be the same, however, with regeneration movement and sensation should start to return in 3 to 12 months, depending on the nerve repaired.
Nerve regeneration is not perfect, however, with some patients having only a partial recovery, or even no recovery of function. Some nerves recover better than others. For example the radial and tibial nerves recover exceptionally well, while the peroneal and ulnar nerves do not. Furthermore, as the distance between the injury and the muscle or skin to be reinnervated increases, the chance of a good recovery decreases. Therefore, proximal arm and leg nerve injuries are more problematic. Neuropathic pain usually resolves as reinnervation occurs, but once again, this can take many months. The chance of neurological recovery also depends on the timing of surgery: sooner a nerve is repaired, the better. The usually timing of surgery is 3 to 6 months for uncertain injuries. If you wait longer than one year, then the chances of recovery are minimized. ...