The Austrian Flag — Severe Carpal Tunnel Syndrome: A Case Report

2018 ◽  
Vol 23 (03) ◽  
pp. 412-414
Author(s):  
Konrad Mende ◽  
Michael A. Tonkin
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Axonal Degeneration ◽  
Amyloid Deposits ◽  
Tunnel Syndrome

In severe carpal tunnel syndrome a continuum of neural changes takes place depending on the degree and duration of the compression, beginning with breakdown of the blood-nerve barrier, followed by endoneurial oedema and, subsequently, perineurial thickening and ischemia. Persisting chronic compression will eventually result in axonal degeneration. We report a case of longstanding carpal tunnel syndrome with amyloid deposits and the unusual intraoperative ‘Austrian flag’ sign.

scholarly journals Axonal degeneration in association with carpal tunnel syndrome

2003 ◽  
Vol 61 (1) ◽  
pp. 48-50 ◽  
Author(s):  
Marcelo Ribeiro Caetano
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Axonal Degeneration ◽  
Conduction Block ◽  
Sensory Nerve ◽  
Normal Subjects ◽  
Segmental Demyelination ◽  
Sensory Nerve Action ◽  
Tunnel Syndrome ◽  
Worse Prognosis

Median nerve entrapment in the palm to wrist segment is known as carpal tunnel syndrome (CTS). Electromyography is the best evaluation test to confirm the disease, as it shows a median reduced conduction velocity and/or conduction block; however, the usual CTS electrodiagnostic tests do not separate segmental demyelination alone from segmental demyelination plus secondary axonal degeneration. We studied 100 hands from CTS patients (classified as mild, moderate, and severe), and 50 hands from normal subjects. The median palmar sensory nerve action potential (SNAP) amplitude was measured and compared between the two groups. It would be expected that SNAP was normal if no axonal degeneration had occurred. The results showed that in mild CTS group and part of moderate CTS group SNAP amplitude was normal, whereas in severe CTS group, and part of moderate group SNAP amplitude was reduced, proving that axonal degeneration was involved. As it is well stated that axonal lesions have worse prognosis than segmental demyelinating ones, this simple test may help to preditic the CTS outcome and treatment.

scholarly journals Amyloidotic muscle pseudohypertrophy: case report

2001 ◽  
Vol 59 (3A) ◽  
pp. 582-586 ◽  
Author(s):  
Rosana Herminia Scola ◽  
Lineu Cesar Werneck ◽  
Cássio Slompo Ramos ◽  
Ricardo Pasquini ◽  
Hans Graf ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Case Report ◽  
Bone Marrow Transplantation ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Muscle Hypertrophy ◽  
Type I ◽  
Subjective Improvement ◽  
Tunnel Syndrome ◽  
Bilateral Carpal Tunnel Syndrome

The authors report one case of amyloidosis associated with muscular pseudohypertrophy in a 46-year-old woman, who developed weakness, macroglossia and muscle hypertrophy associated with primary systemic amyloidosis. Electromyography showed a myopathic pattern and bilateral carpal tunnel syndrome. The muscle biopsy presented with a type I and II fiber hypertrophy and infiltration of amyloid material in the interstitious space and artery walls. She underwent bone marrow transplantation with stabilization and subjective improvement of the clinical picture.

Snapping wrist after surgery for carpal tunnel syndrome and trigger digit: a case report

2004 ◽  
Vol 29 (3) ◽  
pp. 384-386 ◽  
Author(s):  
Toshirou Itsubo ◽  
Shigeharu Uchiyama ◽  
Kenji Takahara ◽  
Hiroyuki Nakagawa ◽  
Mikio Kamimura ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Tunnel Syndrome

scholarly journals Incidental finding of a persistent median artery (palmar type) during a routine carpal tunnel decompression: a case report

2017 ◽  
Vol 99 (7) ◽  
pp. e204-e205
Author(s):  
J Butt ◽  
AK Ahluwalia ◽  
A Dutta
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Incidental Finding ◽  
Surgical Decompression ◽  
Iatrogenic Injury ◽  
Palmar Fascia ◽  
Tunnel Syndrome ◽  
Median Artery

Carpal tunnel syndrome is characterised by compression of the median nerve. The mainstay of treatment is surgical decompression. This case report highlights the occurrence of a persistent median artery, which could complicate surgery. A 55-year-old woman underwent carpal tunnel decompression. An incidental finding of a large-calibre persistent median artery, which was superficial to the flexor sheath, could have been damaged. This was carefully retracted and the procedure was completed, without any complications. Several studies have shown the prevalence of persistent median artery to range from 1.1–27.1%. It is usually found deep to the flexor retinaculum but in this case it was found to be just beneath the palmar fascia. There is increased chance of iatrogenic injury with this particular variant. Surgeons performing the procedure should be mindful of this variation, because accidental damage could result in devastating consequences to the hand.

scholarly journals Carpal Tunnel Syndrome due to Lipoma: A Case Report

2019 ◽  
Vol 24 (2) ◽  
pp. 197 ◽  
Author(s):  
Kyu Bum Seo ◽  
Sang Rim Kim ◽  
Kwang Woo Nam ◽  
Sungwook Choi ◽  
Jun Young Seo ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Tunnel Syndrome
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