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The Sheath of the Brachial Plexus? A Matter of Life and Death/Reply to Dr. Cornish
- Article from:
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Regional Anesthesia and Pain Medicine
- Article date:
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July 1, 2008
- Author:
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Copyright informationCopyright Churchill Livingstone Inc., Medical Publishers Jul/Aug 2008. Provided by ProQuest LLC. (Hide copyright information)
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To the Editor:
I write in reference to an article by Franco et al.,1 which purported to demonstrate the brachial plexus sheath. At least part of the stimulus for their work seems to have been an article we published,2 in which we concluded that the rigid anatomy surrounding the neurovascular bundle was the important factor for containment and spread, rather than an "encasing and enveloping connective tissue sheath." A subsequent paper described this arrangement in detail.3
As far as evidence questioning existence of the sheath, there are some interesting examples. Gray's Anatomy comments that the connective tissue surrounding the nerves rapidly changes character and diminishes beyond the ...