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1/3. arteritis and brachial plexus neuropathy as delayed complications of radiation therapy.

    radiation-induced arteritis of large vessels and brachial plexus neuropathy are uncommon delayed complications of local radiation therapy. We describe a 66-year-old woman with right arm discomfort, weakness, and acrocyanosis that developed 21 years after local radiation for breast adenocarcinoma. Arteriography revealed arteritis, with ulcerated plaque formation at the subclavian-axillary artery junction, consistent with radiation-induced disease, and diffuse irregularity of the axillary artery. electromyography showed a chronic brachial plexopathy. The patient's acrocyanosis, thought to be due to digital embolization from her vascular disease, improved with antiplatelet therapy. The concurrent combination of radiation-induced arteritis and brachial plexopathy is uncommon but should be considered in patients presenting with upper extremity pain or weakness after radiation therapy.
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ranking = 1
keywords = radiation-induced
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2/3. radiation-induced conduction block: resolution following anticoagulant therapy.

    Neurophysiologic studies documented proximal conduction blocks in a patient harboring a delayed radiation-induced brachial plexopathy. Since anticoagulants have been reported to be beneficial in radiation-induced neuropathies, the patient was started on acenocumarol. After 3 months of treatment there was significant improvement of clinical deficits, which correlated with resolution of conduction blocks. This observation suggests that ischemic nerve injury leading to disruption of the conduction properties of motor axons contributes to the pathogenesis of delayed radiation-induced peripheral nerve injuries.
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ranking = 1.5
keywords = radiation-induced
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3/3. Imaging the anatomy of the brachial plexus: review and self-assessment module.

    OBJECTIVE: The educational objectives of this continuing medical education activity are to describe the normal anatomy of the brachial plexus, to name the most common symptoms associated with a brachial plexopathy, to describe the most common imaging findings resulting from trauma to the brachial plexus, to describe the imaging manifestations of common neoplasias affecting the brachial plexus, and to also describe the imaging findings and symptoms related to irradiation-induced brachial plexopathies. CONCLUSION: In this article, I have illustrated and described the normal anatomy of the brachial plexus; the most common symptoms related to brachial plexopathy; and imaging findings related to trauma, tumors, and irradiation affecting the brachial plexus.
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ranking = 0.5
keywords = radiation-induced
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