CT myelography to determine the root status—not Adult brachial plexus done now but was the gold standard a few years ago. Sunderland's[ 19 ] well-known classification is useful Adult brachial plexus understand the nature of the injury. Etiology and pathophysiology In the majority of cases treated by the author as also elsewhere in the world, the main etiology remains vehicular accident typically on a two wheeler. Dry skin is a give away for affected dermatomes due to loss of sudomotor function. In mammals too the glia come in at the site of an injury but currently appear to remain static there and in fact hinder regeneration to some extent. Iatrogenic injury, either deliberate as in tumor surgery involving nerve roots or accidental while operating in the posterior triangle of the neck. The main frustration of brachial plexus surgeons is the patient with avulsed roots—no usable proximal Adult brachial plexus axons.