Ultrasound of the cervical roots and brachial plexus in neonates

Abstract

Introduction: In this exploratory study we investigated whether ultrasound can visualize the neonatal cervical roots and brachial plexus. Methods: In 12 healthy neonates <2 days old, the neck region was studied unilaterally with ultrasound using a small-footprint 15-7-MHz transducer. Results: The C5-C8 nerve roots and brachial plexus could be imaged with sufficient delineation of the root exits to assess their integrity. The brachial plexus was more difficult to discern from the surrounding area in neonates compared with adults, especially in the interscalene region because of the smaller amount of connective tissue in and surrounding muscles and nerves. In addition, the large deposits of brown fat make for a different ultrasound appearance of the neonatal neck compared with adults. Conclusions: Ultrasound of the neonatal cervical nerve roots is feasible and may be used as a non-invasive screening technique to assess nerve root integrity in obstetric brachial plexus injury.