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Clinical and Experimental Aspects of Injection Injuries of Peripheral Nerves

Published online by Cambridge University Press:  18 September 2015

Fred Gentili ,
Alan R. Hudson  and
Daniel Hunter
Fred Gentili
Affiliation:
Division of Neurosurgery, University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada
Alan R. Hudson*
Affiliation:
Division of Neurosurgery, University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada
Daniel Hunter
Affiliation:
Division of Neurosurgery, University of Toronto and St. Michael's Hospital, Toronto, Ontario, Canada
*
38 Shuter Street, Toronto, Ontario, Canada M5B 1A6
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Injury to peripheral nerves complicating deep intramuscular injections of antibiotic and other agents is well recognized and can result in significant permanent neurological deficit. The purpose of this paper is to review the subject of nerve injection injuries, and report on a series of recent experimental studies carried out in this laboratory designed to improve our understanding of the pathophysiology of this condition and help provide a rational basis for its treatment. A wide variety of chemotherapeutic, prophylactic, and local anaesthetic agents in common use were injected into the sciatic nerve of the adult Wistar rat. Both intrafascicular and extrafascicular injections were examined. Results revealed that the site of injection was the most crucial factor in determining the degree of nerve fiber injury. Following intrafascicular injection, the degree of injury varied significantly, depending upon the specific agent injected. The most severe injuries were associated with wide-spread axonal and myelin degeneration. Pathological alterations in the nerve were evident as early as 30 minutes following injection injury. Regeneration was a constant finding in nerve damage by injection of the various agents. The mechanism of injury appeared to be a direct toxic effect of the injected compound on neural tissue, with an associated break down of the bloodnerve barrier.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 7 , Issue 2 , May 1980 , pp. 143 - 151
Copyright
Copyright © Canadian Neurological Sciences Federation 1980

References

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