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Chapter 26 - Peripheral Nerve Injury Response Mechanisms

from Section 2 - Clinical Neurosurgical Diseases

Published online by Cambridge University Press:  04 January 2024

By
Andrew S. Jack  and
Line Jacques
Edited by
Farhana Akter ,
Nigel Emptage ,
Florian Engert  and
Mitchel S. Berger
Farhana Akter
Affiliation:
Harvard University, Massachusetts
Nigel Emptage
Affiliation:
University of Oxford
Florian Engert
Affiliation:
Harvard University, Massachusetts
Mitchel S. Berger
Affiliation:
University of California, San Francisco
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Summary

The peripheral nervous system(PNS) comprises spinal and cranial nerves, which include motor, sensory, and autonomic nerves, as well as their roots, trunks, plexuses, ganglia, and accompanying supportive connective tissue distal to the brain and spinal cord. It is located peripheral to the central nervous system(CNS), and has very little in the way of protection from injury. In contrast to the CNS, it has a much higher innate capacity for repair and recovery after injury. Despite its physiological diversity, the PNS has a highly organized and choreographed injury response mechanism partially explaining its improved outcomes post-injury. In this chapter, we discuss the pathophysiology of peripheral nerve injury(PNI) and its ensuing reparative response. Before delving into PNIs and their classifications, it is important to review the basic anatomic organization of the PNS, its key cellular components, and supporting connective tissue.

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Chapter
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Neuroscience for Neurosurgeons , pp. 348 - 354
Publisher: Cambridge University Press
Print publication year: 2024

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References

Burden, SJ, Sargent, PB, McMahan, UJ. Acetylcholine receptors in regenerating muscle accumulate at original synaptic sites in the absence of the nerve. J Cell Biol 1979;82(2):412–25. https://doi.org/10.1083/jcb.82.2.412Google Scholar
Burnett, MG, Zager, EL. Pathophysiology of peripheral nerve injury: a brief review. Neurosurg Focus 2004;16(5):E1. https://doi.org/10.3171/foc.2004.16.5.2Google Scholar
Caillaud, M, Richard, L, Vallat, JM, Desmouliere, A, Billet, F. Peripheral nerve regeneration and intraneural revascularization. Neural Regen Res 2019;14(1):24–33. https://doi.org/10.4103/1673-5374.243699Google Scholar
Dodd, J, Jessell, TM. Axon guidance and the patterning of neuronal projections in vertebrates. Science 1988;242(4879):692–9. https://doi.org/10.1126/science.3055291Google Scholar
Gundersen, RW, Barrett, JN. Characterization of the turning response of dorsal root neurites toward nerve growth factor. J Cell Biol 1980;87(3 Pt 1):546–54. https://doi.org/10.1083/jcb.87.3.546Google Scholar
Jack, AS, Hurd, C, Forero, J, et al. Cortical electrical stimulation in female rats with a cervical spinal cord injury to promote axonal outgrowth. J Neurosci Res 2018;96(5):852–62. https://doi.org/10.1002/jnr.24209Google Scholar
Kurosinski, P, Gotz, J. Glial cells under physiologic and pathologic conditions. Arch Neurol 2002;59(10):1524–8. https://doi.org/10.1001/archneur.59.10.1524Google Scholar
Mackinnon, S, Dellon, A. Surgery of the Peripheral Nerve. New York: Thieme, 1988.Google Scholar
Mizisin, AP, Weerasuriya, A. Homeostatic regulation of the endoneurial microenvironment during development, aging and in response to trauma, disease and toxic insult. Acta Neuropathol 2011;121(3):291–312. https://doi.org/10.1007/s00401-010-0783-xGoogle Scholar
Pestronk, A, Drachman, DB. Motor nerve sprouting and acetylcholine receptors. Science 1978;199(4334):1223–5. https://doi.org/10.1126/science.204007Google Scholar
Pham, K, Gupta, R. Understanding the mechanisms of entrapment neuropathies. Neurosurg Focus 2009;26(2):E7. https://doi.org/10.3171/FOC.2009.26.2.E7CrossRefGoogle ScholarPubMed
Seddon, H. Three types of nerve injury. Brain 1943;66:237.Google Scholar
Sunderland, S. A classification of peripheral nerve injuries producing loss of function. Brain 1951;74(4):491–516. https://doi.org/10.1093/brain/74.4.491Google Scholar
Tassler, PL, Dellon, AL, Canoun, C. Identification of elastic fibres in the peripheral nerve. J Hand Surg Br 1994;19(1):48–54. https://doi.org/10.1016/0266-7681(94)90049-3Google Scholar
Topp, KS, Boyd, BS. Structure and biomechanics of peripheral nerves: nerve responses to physical stresses and implications for physical therapist practice. Phys Ther 2006;86(1):92–109. https://doi.org/10.1093/ptj/86.1.92CrossRefGoogle Scholar
Vallat, JM, Tazir, M, Calvo, J, Funalot, B. [Hereditary peripheral neuropathies]. Presse Med 2009;38(9):1325–34. https://doi.org/10.1016/j.lpm.2009.01.014Google Scholar
Weerasuriya, A, Mizisin, AP. The blood–nerve barrier: structure and functional significance. Methods Mol Biol 2011;686:149–73. https://doi.org/10.1007/978-1-60761-938-3_6Google Scholar

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