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13 March 2018 : Case report  China (mainland)

An Uncommon Cause of Contralateral Brachial Plexus Injury Following Jugular Venous Cannulation

Unusual clinical course, Unusual or unexpected effect of treatment, Patient complains / malpractice

Jinguo Wang1ABDEF, Feng Liu2BCDE, Shunshun Liu3ABDEF, Na Wang3ABCEF*

DOI: 10.12659/AJCR.908125

Am J Case Rep 2018; 19:289-291

Abstract

BACKGROUND: The complication rate of central venous catheterization ranges from 4% to 35%. Brachial plexus injury can occur, mostly on the same side as the catheterization, without affecting the contralateral brachial plexus.

CASE REPORT: A 71-year-old woman received placement of a vein hemodialysis catheter via right internal jugular vein. Five days after the cannulation, she complained of contralateral burning pain and numbness at the ulnar side of her left forearm. On the next day, the pain increased and extended to her left shoulder girdle and whole left arm, despite use of analgesics. When she passively tilted her head to the right side, ear to shoulder, the pain increased in the left arm. We found the patient had a tight suture with which the jugular catheter was fixed. The patient persistently turned her head to the right and slightly flexed her neck to loosen the suture to avoid discomfort. We removed the suture and the central venous catheter. Her pain in the left shoulder and arm was diminished the next day. Three days later, the symptoms had all disappeared completely.

CONCLUSIONS: Central venous catheterization may cause contralateral brachial plexus injury, which may result from a tight suture with which the jugular catheter is fixed.

Keywords: Arm Injuries, Catheterization, Central Venous, Jugular Veins

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923