Sequential injury: Delayed-onset axillary artery thrombosis following brachial plexus paralysis from a traumatic shoulder injury

Abstract

The association of brachial plexus nerve injury with arterial involvement in the context of shoulder trauma is well documented in the literature. However, the clinical presentation can vary significantly from case to case. In severe trauma cases, there may be a simultaneous occurrence of both types of injuries. An arterial injury can lead to the formation of a hematoma, causing compression of the nerves that innervate the upper limb. Additionally, avulsion or stretching of the roots of the brachial plexus may also generate a peri‑arterial hematoma, which can result in arterial thrombosis. These complex mechanisms underscore the importance of a multidisciplinary assessment in the management of these patients.