Brachial Plexopathy Due to Upper-Extremity Deep Vein Thrombosis: A Case Report

Abstract

Upper-extremity deep vein thrombosis (DVT) accounts for 1% to 4% of DVT cases. Brachial plexus injury can result from venous distention due to thrombosis in the upper extremity, leading to neurologic deficits. We report a patient diagnosed with brachial plexopathy caused by venous thrombosis in the upper extremity. A 66-year-old female patient with a medical history of Parkinson disease and dementia presented to the emergency department with drowsy mental status. She was diagnosed with pre-renal acute kidney injury with multi-organ dysfunction. On the second hospital day, right upper extremity edema and muscle weakness were observed. On the sixth hospital day, the patient’s overall medical condition improved after conservative treatment, but severe edema was noticed, and muscle weakness did not show significant improvement in the right upper extremity. Computed tomography showed multifocal pulmonary thromboembolism and DVT in the pulmonary arteries, superior vena cava, and popliteal veins. After anticoagulant administration, the swelling subsided, but the weakness in the entire right upper extremity did not improve. Electromyography demonstrated right brachial pan-plexopathy involving the upper, middle, and lower trunks. A follow-up examination showed no significant improvement of muscle strength and function in the right upper extremity at 3 months after the first hospital day.