Mohammadreza Emamhadi - Department of Neurosurgery, Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Science, Rasht, Iran
Shahrokh Yousefzadeh Chabok - Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
Fariborz Samini - Orthopedic Research Center, Mashhad University of Medical Science, Department of Neurosurgery, Mashhad, Iran
babak Alijani - Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
Hamid Behzadnia - Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
Fariborz Ayati Firozabadi - Legal Medicine Organization, Rasht, Iran
Zoheir Reihanian - Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran

  Background: Variations of the brachial plexus are common and a better awareness of the variations is of crucial importance to achieve successful results in its surgical procedures. The aim of the present study was to evaluate the anatomical variations of the brachial plexus in adult cadavers.   Methods: Bilateral upper limbs of ۳۲ fresh cadavers (۲۱ males and ۱۱ females) consecutively referred to Guilan legal medicine organization from November ۲۰۱۱ to September ۲۰۱۴, were dissected and the trunks, cords and terminal nerves were evaluated. Results: Six plexuses were prefixed in origin. The long thoracic nerve pierced the middle scalene muscle in ۶ cases in the supra clavicular zone. The suprascapular nerve in ۷ plexuses was formed from posterior division of the superior trunk. Five cadavers showed anastomosis between medial brachial cutaneous nerve and T۱ root in the infra clavicular zone. Terminal branches variations were the highest wherein the ulnar nerve received a communicating branch from the lateral cord in ۳ cases. The median nerve was formed by ۲ lateral roots from lateral cord and ۱ medial root from the medial cord in ۶ cadavers. Some fibers from C۷ root came to the musculocutaneous nerve in ۸ cadavers. Conclusion: The correlation analysis between the variations and the demographic features was impossible due to the small sample size. The findings of the present study suggest a meta-analysis to assess the whole reported variations to obtain a proper approach for neurosurgeons.

Anatomical variations, Brachial Plexus, Cords, Peripheral nerves, Trunks