Median nerve penetration by a muscular branch of the brachial artery

Brachial artery pseudoaneurysms (BAPs) are rare but could lead to complications of high morbidity. We report a case of a BAP presenting with hand ischemia and median nerve neuropathy nearly a decade after the inciting iatrogenic trauma, successfully treated with excision and direct repair. This report highlights that untreated pseudoaneurysms can be indolent and present late with both symptoms of embolization and local compression.

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The superficial ulnar artery: development and clinical significance

Jornal Vascular Brasileiro ◽

10.1590/s1677-54492007000300013 ◽

2007 ◽

Vol 6 (3) ◽

pp. 284-287

Author(s):

Srinivasulu Reddy ◽

Venkata Ramana Vollala

Keyword(s):

Clinical Significance ◽

Upper Limb ◽

Brachial Artery ◽

Biceps Brachii ◽

Ulnar Artery ◽

Wide Range ◽

Male Cadaver ◽

Median Cubital Vein ◽

Muscular Branch ◽

Superficial Ulnar Artery

The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.

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A RARE CASE OF TENDINOUS INSERTION OF CORACOBRACHIALIS ASSOCIATED WITH VARIANT MUSCULOCUTANEOUS NERVE

Revista Argentina de Anatomía Clínica ◽

10.31051/1852.8023.v12.n2.28694 ◽

2020 ◽

Vol 12 (2) ◽

pp. 98-101

Author(s):

Khizer H. A. Mookane ◽

Sangeeta Muralidharan

Keyword(s):

Median Nerve ◽

Brachial Artery ◽

Rare Case ◽

Musculocutaneous Nerve ◽

Surgical Reconstruction ◽

The Novel ◽

Medial Border ◽

Brachialis Muscle

We report a rare case of the tendinous insertion of coracobrachialis muscle which has not been reported in the literature. The insertion of the novel coraco-brachialis muscle is usually into the medial border of the humerus in a 3-5cm impression at the mid-shaft level. Contrary to this, in the present case, it was seen getting inserted as a sharp slender tendon in the middle of the medial border of the humerus. Variable insertion of coracobrachialis muscle may be responsible for the causation of compression of surrounding structures like median nerve, musculocutaneous nerve, and brachial artery. This article aims to point out a rare case of the unusual tendinous insertion of coracobrachialis and its association with musculocutaneous nerve, providing necessary information to surgeons performing surgical reconstruction using coracobrachialis.

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Abnormal Division of Axillary Artery - A Case Report

National Journal of Clinical Anatomy ◽

10.1055/s-0039-3401660 ◽

2012 ◽

Vol 01 (01) ◽

pp. 044-047

Author(s):

N Ratnakar Rao

Keyword(s):

Median Nerve ◽

Radial Artery ◽

Brachial Artery ◽

Axillary Artery ◽

Practical Importance ◽

Lateral Side ◽

Superficial Branch ◽

Collateral Artery ◽

Male Cadaver ◽

The Right

AbstractA case of the abnormal branching of the right Axillary artery in a 60 year old male cadaver is presented here. The axillary artery divided into two trunks, a lateral and medial from the second part only in this case. The lateral branch was superficial running between two roots of median nerve, which here is referred to as superficial branch. The other was a medial trunk, running deep to median nerve on the medial, hence it is referred as deep brachial artery. The superficial branch had a similar course as radial artery coursing on the lateral side of cubital fossa, fore arm, anatomical snuff box and hand, hence it was considered as equivalent to radial artery. The deep brachial artery gave rise to anterior and posterior circumflex humeral arteries and the superior ulnar collateral artery. This variation is rare and the incidence quoted as around 0.12 - 3.2% in the available literature. The normal and abnormal anatomy of the axillary artery is having practical importance for the radiologists during angiography and surgeons for accurate diagnostic interpretation.

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Posttraumatic pseudoaneurysm of the brachial artery and postsurgical retraction of median nerve: description of a case and ultrasonography findings

Emergency Radiology ◽

10.1007/s10140-006-0549-x ◽

2006 ◽

Vol 13 (5) ◽

pp. 269-272 ◽

Cited By ~ 12

Author(s):

Marta Pelaz Esteban ◽

Sara Beltrán de Otálora ◽

Rosa M. Landeras ◽

Elena Gallardo ◽

María Antonia Fernández Echevarría ◽

...

Keyword(s):

Median Nerve ◽

Brachial Artery

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Median nerve compression by an iatrogenic pseudoaneurysm of brachial artery

European Journal of Radiology Extra ◽

10.1016/j.ejrex.2004.03.004 ◽

2004 ◽

Vol 50 (3) ◽

pp. 75-76

Author(s):

Fernando Ruiz Santiago ◽

Pilar Jiménez Villares ◽

Juan Miguel Tristán Fernández ◽

Fabiola Muñoz Parra

Keyword(s):

Median Nerve ◽

Brachial Artery ◽

Nerve Compression ◽

Median Nerve Compression ◽

Iatrogenic Pseudoaneurysm

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Variant insertion of coracobrachialis muscle-morphological significance, embryological basis and clinical importance

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v6i2.3616 ◽

1970 ◽

Vol 6 (2) ◽

pp. 42-46 ◽

Cited By ~ 4

Author(s):

R Guha ◽

N Satyanarayana ◽

CK Reddy ◽

N Jayasri ◽

V Nitin ◽

...

Keyword(s):

Median Nerve ◽

Ulnar Nerve ◽

Brachial Artery ◽

Clinical Importance ◽

Proximal Part ◽

Medial Epicondyle ◽

Medical Sciences ◽

Medial Border ◽

Male Cadaver ◽

Anomalous Insertion

The coracobrachialis muscle in the arm is morphologically the sole representative of adductor group muscle in the arm, but such function during the process of evolution became insignificant in man. It is more important morphologically than functionally. Variant insertion of the coracobrachialis muscle was found during routine dissection of an adult male cadaver in the Department of Anatomy, College of Medical Sciences, and Bharatpur, Nepal. Normally the coracobrachialis muscle is inserted into the middle of the medial border of the humerus. In the present case an additional slender tendon passed inferiorly, crossing anterior to the median nerve and brachial artery, before attaching to the medial epicondyle of the humerus. Most of the proximal part of the tendon gave rise to an aponeurotic expansion that inserted into the distal medial border of the humerus. The tendinous insertion and aponeurotic expansion may represent a variant of the coracobrachialis longus (Wood's) muscle and the internal brachial ligament or the ligament of Struthers. The ulnar nerve was found to be traversing below the aponeurotic expansion. This type of anomalous insertion of coracobrachialis muscle may lead to compression of median nerve, brachial artery and ulnar nerve. Key words: Coracobrachialis muscle; ligament of Struthers; median nerve; brachial artery; ulnar nerve. DOI: 10.3126/jcmsn.v6i2.3616 Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 42-46

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