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In brachial plexus lesions and their revision, evaluation of nerve stumps is very important for the reconstructive strategy. We intraoperatively perform cryostat sections, Haematoxilin-Eosin (HE) stained, and compare the clinical appearance of the nerves to the microscopic results. Toluidine blue staining is later used to validate the structural details. Intraneural fibrosis can be traced safely with both staining methods, in root avulsions a histology is helpful, too. For more proximal, intraforaminal lesions semithin section stained with toluidine-blue are less informative than are HE-stained cryostat sections. In these lesions the clinical control by electrical stimulation and evoked potentials is superior.

Neurosurgery does not claim to have improved surgery of the brachial plexus. But achievements in microsurgery have advanced surgical possibilities in several faculties. Neurosurgery for example has introduced considerable improvements concerning the assessment of intraforaminal or intraspinal root injuries. Intraoperative inspections of roots via hemi-laminectomy allowed to determine specificity and sensitivity of modern radiological imaging by correlating intraoperative findings with the results of the radiological imaging. Using determined axial MRI with thin sections, we showed root avulsion in a very high quantity. These findings led us to modify our surgical concept. Operations with long exploration were reduced and preoperative planning of neurotisation was improved due to the preoperative diagnostics.

Paresis of the hindlimb in piglets after intramuscular injection of various therapeutics in the caudal thigh muscles were observed. The injection was followed by inflammatory changes of the muscle tissue at the injection site. The tibial and fibular nerve were enclosed in the alterations and showed a distinct to complete loss of nerve fibers resulting in clinical signs of paresis. The affected hindlimb was dragged on the dorsal digital surface. The piglet showed an extended consecutive swelling and ulceration below the hock and loss of the claws. These findings strongly demonstrate the necessity of a correct intramuscular injection in piglets, which should be done in the lateral neck muscles.