The Department of Neurological Surgery leads the UCSF Nerve Injury Clinic, a multi-disciplinary clinic that includes members of the Departments of Neurological Surgery, Neurology, and Orthopedic Surgery. There is a parallel program for children. The clinic provides care for patients who have recent injuries that involve any aspect of the peripheral nervous system. Diagnoses are formed in conjunction with neuroradiologists using neurography and other investigations. Comprehensive evaluation and treatment are provided, including non-invasive and surgical management. Surgery may include nerve exploration and repair using intraoperative nerve studies and nerve grafting.
Nerve tumors anywhere in the body are evaluated and surgically managed in both adults and children. Microsurgical approaches are used along with intraoperative monitoring to achieve aggressive resection with minimal new neurological deficits. Malignant nerve sheath tumors are managed in conjunction with members of the Department of Orthopedics who specialize in orthopedic oncology.
Entrapment syndromes (also called entrapment neuropathies) are characterized by numbing in the body caused by compression of the peripheral nerves. The most common entrapment syndromes are carpal tunnel syndrome and ulnar neuropathy. Neurosurgeons at UCSF provide surgical nerve decompression to treat these disorders.
Pediatric Nerve Injury
Rarely, newborns can sustain injuries to the nerves that control the function of the arm and hand. Often, these injuries heal without treatment. Some patients, however, will require surgical treatment that can range from either removal of scar tissue from the damaged nerves or repair with nerve grafting. It is important that these patients be evaluated by the specialists in the Nerve Injury Clinic early as surgical repair should be performed by six months of age. This evaluation includes a direct examination, MR imaging, and electrical measurement of muscle and nerve function. In cases where the nerve injury is too extensive for direct repair of the nerves, specific procedures to help normal muscles take over some of the arm function can be done by our orthopedic surgeons, although these procedures are done between 3-5 years of age.