Is brachial plexopathy most common in younger males between 15-25 years old?

Brachial Plexopathy Demographics

No, brachial plexopathy is not most commonly seen in younger males between 15-25 years old; it is most commonly seen in young adult males with a mean age of 28.4 years, primarily due to motorcycle accidents. 1

Epidemiology and Demographics

• Brachial plexopathy predominantly affects young adult males, with studies showing 94.6% of surgical cases being male patients 1
• The average age of patients with traumatic brachial plexus injuries is 28.38 years, slightly older than the 15-25 year range suggested in the question 1
• Motorcycle accidents account for approximately 79% of traumatic brachial plexus injuries, making them the leading cause in large metropolitan areas 1
• The high incidence of brachial plexopathies reflects the vulnerability of this complex nerve network to trauma 2

Etiologies of Brachial Plexopathy

• Traumatic causes are the most common and include:

  • High-energy motorcycle accidents (predominant cause) 1
  • Other motor vehicle accidents 3
  • Falls and sports-related injuries 4
  • Penetrating injuries such as gunshot wounds 4

• Non-traumatic causes include:

  • Inflammatory conditions like Parsonage-Turner syndrome (neuralgic amyotrophy) 3
  • Neoplastic involvement (primary tumors or metastatic disease) 4
  • Radiation-induced plexopathy 3
  • Thoracic outlet syndrome 3

Clinical Presentation and Associated Injuries

• Complete brachial plexus lesions occur in 46.1% of cases, with partial injuries affecting specific root levels in the remainder 1

• Common associated injuries include:

  • Head trauma (34.2% of cases) 1
  • Long bone fractures (38.8%) 1
  • Clavicle fractures (25.9%) 1
  • Thoracic trauma (12.9%) 1

• Persistent pain is reported in 76% of patients with traumatic brachial plexus injuries 5

Diagnostic Considerations

• MRI of the brachial plexus is the gold standard for evaluation due to superior soft-tissue contrast 3
• For traumatic cases, imaging should be delayed until approximately 1 month after injury to allow for resolution of hemorrhage and edema 4
• Electrodiagnostic testing plays an important role in confirming plexopathy and defining localization, pathophysiology, and severity 6

Prognosis and Outcomes

• Despite severe injuries, 60% of patients with traumatic brachial plexus injuries are able to return to employment 5
• Complete nerve ruptures generally have worse outcomes and often require early operative management 3
• Penetrating and open injuries typically require early surgical exploration, while blunt injuries may be managed operatively or non-operatively based on severity 3