Case Report: A rare mimicker of traumatic brachial plexopathy: intramuscular venous malformation of the subscapularis muscle

Abstract

Venous malformations (VMs) involving the brachial plexus are rare clinical entities that can mimic traumatic brachial plexus injuries. A 27-year-old male presented with progressive right upper limb weakness and numbness following an occupational fall with overhanging limb suggesting a traumatic tractional brachial plexus injury. However, magnetic resonance imaging (MRI) revealed an intramuscular VM in the subscapularis muscle which was compressing the cords of the brachial plexus. In view of difficult surgical access for removal associated with high risks of iatrogenic neurological injury, fluoroscopy-guided percutaneous bleomycin sclerotherapy was performed. Significant neurological recovery was observed post-intervention in conjunction with intensive rehabilitation. This case report outlines the diagnostic clues, management challenges, and functional outcomes of a right subscapularis intramuscular VM causing secondary compressive brachial plexopathy.