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Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications.

Chhabra A, Ahlawat S, Belzberg A, Andreseik G - Indian J Radiol Imaging (2014)

Bottom Line: The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment.While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene.With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA.

ABSTRACT
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.

No MeSH data available.


Related in: MedlinePlus

Peripheral nerve anatomy. Illustration shows various layers of the nerve demonstrated along its cross section
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Figure 1: Peripheral nerve anatomy. Illustration shows various layers of the nerve demonstrated along its cross section

Mentions: A peripheral nerve is a cord-like collection of axons (nerve fibers) that are long and slender tail-like projections from the neuron cell bodies. The connective tissue sheath around the axon is called the endoneurium. A bundle of axons are covered together in another connective tissue layer referred to as the perineurium. The perineurium along with the endoneurium forms the blood-nerve barrier as it encircles the cable-like structure called the fascicle. The fascicles are finally bundled together by a thick connective tissue layer called the epineurium. There are outer and inner epineurial layers [Figure 1]. The inner epineurium contains the vessels supplying and coursing through the nerve and small amount of adipose tissue.[9] The fascicles vary from 1 to 3 in number in the small sensory nerves to about 200 in the large nerves, such as the sciatic nerve. There is also predictable topographical anatomical arrangement of the fascicles in a particular nerve, for example, in the ulnar nerve in the forearm, the sensory, motor, and dorsal cutaneous fascicles are organized from lateral to medial.[11] The peripheral nerves are divided into motor, sensory, or mixed from a functional perspective.


Peripheral nerve injury grading simplified on MR neurography: As referenced to Seddon and Sunderland classifications.

Chhabra A, Ahlawat S, Belzberg A, Andreseik G - Indian J Radiol Imaging (2014)

Peripheral nerve anatomy. Illustration shows various layers of the nerve demonstrated along its cross section
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126136&req=5

Figure 1: Peripheral nerve anatomy. Illustration shows various layers of the nerve demonstrated along its cross section
Mentions: A peripheral nerve is a cord-like collection of axons (nerve fibers) that are long and slender tail-like projections from the neuron cell bodies. The connective tissue sheath around the axon is called the endoneurium. A bundle of axons are covered together in another connective tissue layer referred to as the perineurium. The perineurium along with the endoneurium forms the blood-nerve barrier as it encircles the cable-like structure called the fascicle. The fascicles are finally bundled together by a thick connective tissue layer called the epineurium. There are outer and inner epineurial layers [Figure 1]. The inner epineurium contains the vessels supplying and coursing through the nerve and small amount of adipose tissue.[9] The fascicles vary from 1 to 3 in number in the small sensory nerves to about 200 in the large nerves, such as the sciatic nerve. There is also predictable topographical anatomical arrangement of the fascicles in a particular nerve, for example, in the ulnar nerve in the forearm, the sensory, motor, and dorsal cutaneous fascicles are organized from lateral to medial.[11] The peripheral nerves are divided into motor, sensory, or mixed from a functional perspective.

Bottom Line: The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment.While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene.With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Orthopaedic Surgery, University of Texas Southwestern Medical Center, Baltimore, MD, USA.

ABSTRACT
The Seddon and Sunderland classifications have been used by physicians for peripheral nerve injury grading and treatment. While Seddon classification is simpler to follow and more relevant to electrophysiologists, the Sunderland grading is more often used by surgeons to decide when and how to intervene. With increasing availability of high-resolution and high soft-tissue contrast imaging provided by MR neurography, the surgical treatment can be guided following the above-described grading systems. The article discusses peripheral nerve anatomy, pathophysiology of nerve injury, traditional grading systems for classifying the severity of nerve injury, and the role of MR neurography in this domain, with respective clinical and surgical correlations, as one follows the anatomic paths of various nerve injury grading systems.

No MeSH data available.


Related in: MedlinePlus