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The majority of the mastery course for the

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brachial plexus has concentrated on the

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larger components of the brachial plexus.

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So, remember, the brachial plexus is

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comprised of the roots, the trunks, the

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divisions, the cords, and the branches.

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So, the majority of the times when you'll

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be imaging, especially in adults, you'll

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be looking specifically for the divisions

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and the cords of the brachial plexus.

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But remember, we have to look at the

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proximal components of the brachial

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plexus; it's two, which are the roots

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of the brachial plexus, because that can

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also result in a brachial plexopathy.

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So, this is a newborn that presented with a

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left-sided brachial plexopathy after birth.

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So, when we look at the axial T2-weighted images

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on the left and we scroll down, we see this

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well-defined fluid collection that's involving

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the lateral aspect of the spinal canal and

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is likely extending into the epidural space

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and extending into the left neural foramen.

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And as we extend down more, even

0:59

further, we see a second well-defined

1:02

fluid collection, the cystic collection.

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And given the history of birth trauma

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and a left-sided brachial plexopathy,

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these are consistent with nerve root

1:11

avulsions resulting in pseudomeningoceles.

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When we look at this image on the left-hand

1:17

side, the sagittal images, we can see the normal

1:20

nerve roots exiting through the neural foramen.

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But as we scroll through, and we get to

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the level of the meningoceles, notice

1:28

how we do not see the target sign.

1:30

So, just below it here, we can see the

1:32

nerve roots surrounded by the regular fat.

1:34

And as we get to the level of the

1:36

pseudomeningoceles, we can see the

1:38

cystic areas that involve the lateral

1:41

aspect of the spinal canal, extending

1:42

into the proximal neural foramen.

1:44

But notice how we don't have those

1:46

nerve roots that are visualized.

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So, that indicates that there has

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been avulsion of the nerve roots.

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So, this case demonstrates the appearance

1:55

of multiple pseudomeningoceles that are post-

1:57

traumatic, emphasizing the fact that you can

2:01

have brachial plexopathies that involve the

2:04

proximal exiting nerve roots from the cords.

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So, not only do we have to look at the anterior,

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the middle scalene, and the subclavian

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artery, but always remember to follow the

2:14

nerve roots back to the central canal,

2:17

because we can have brachial plexopathies

2:19

resulting from nerve root avulsions.