Brachial Plexopathy with Shoulder Subluxation in a Subacute Stroke Patient

Abstract

Brachial plexus injury is a rare complication of shoulder dislocation or subluxation. A 60-year-old man was diagnosed with brachial plexopathy following a stroke. The patient reported sudden-onset left-sided weakness and was diagnosed with middle cerebral artery infarction. He was admitted to Seoul Medical Center for comprehensive rehabilitation and then was transferred to another facility after 6 weeks. Although upper limb function improved, left shoulder subluxation persisted with no meaningful symptomatic relief. Six weeks after transfer from our facility, the patient visited the outpatient department with aggravated weakness of the left upper limb. Electrodiagnostic results, along with brain and brachial plexus magnetic resonance imaging and cervical spine computed tomography, suggested a high likelihood of brachial plexopathy with evidence of a lesion affecting the whole trunk. An extended arm sling was recommended for corrective alignment, and at the 6-week follow-up visit, the patient reported moderate symptomatic relief in the upper limb. Although plexopathy is challenging to diagnose in patients with stroke, timely diagnosis and appropriate management are critical for functional recovery.