Bilateral median nerve compression at the level of Struthers' ligament

2000 ◽  
Vol 92 (4) ◽  
pp. 693-696 ◽  
Author(s):  
Atif Aydinlioglu ◽  
Bayram Cirak ◽  
Fuat Akpinar ◽  
Nihat Tosun ◽  
Ali Dogan
Keyword(s):  
Median Nerve ◽  
Motor Function ◽  
Surgical Decompression ◽  
Nerve Entrapment ◽  
Nerve Compression ◽  
Sensory Disturbance ◽  
Content Type ◽  
Median Nerve Compression ◽  
Function Loss ◽  
Fine Print

✓ Struthers' ligament syndrome is a rare cause of median nerve entrapment. Bilateral compression of the median nerve is even more rare. It presents with pain, sensory disturbance, and/or motor function loss at the median nerve's dermatomal area. The authors present the case of a 21-year-old woman with bilateral median nerve compression caused by Struthers' ligament. She underwent surgical decompression of the nerve on both sides. To the authors' knowledge, this case is the first reported bilateral compression of the median nerve caused by Struthers' ligament. The presentation and symptomatology of Struthers' ligament syndrome must be differentiated from median nerve compression arising from other causes.

Struthers ligament: a source of median nerve compression above the elbow

1973 ◽  
Vol 38 (6) ◽  
pp. 778-779 ◽  
Author(s):  
Richard V. Smith ◽  
Robert G. Fisher
Keyword(s):  
Median Nerve ◽  
Surgical Procedure ◽  
Nerve Entrapment ◽  
Nerve Compression ◽  
Historical Background ◽  
Complete Relief ◽  
Content Type ◽  
Median Nerve Compression ◽  
Supracondylar Process ◽  
Fine Print

✓ A case of median nerve entrapment at the elbow by a non-osseous fibrous ligament (Struthers) is presented. A relatively simple surgical procedure with ligament division afforded complete relief of symptoms. The existence of Struthers' ligament without a bony supracondylar process is reaffirmed, and the historical background of its identification outlined.

Bilateral anomalous course of the ulnar nerve at the wrist causing ulnar and median nerve compression syndrome

1987 ◽  
Vol 67 (5) ◽  
pp. 754-756 ◽  
Author(s):  
Renato J. Galzio ◽  
Vincenzo Magliani ◽  
Danilo Lucantoni ◽  
Corrado D'Arrigo
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Nerve Compression ◽  
Content Type ◽  
Nerve Compression Syndrome ◽  
Median Nerve Compression ◽  
Compression Syndrome ◽  
Fine Print

✓ The case of a patient with a bilateral compression syndrome of the ulnar and median nerves at the wrist is described. Both ulnar nerves, which were surgically explored at different times, followed an anomalous course and passed into the canalis carpi side by side with the median nerve. This variation in the course of the ulnar nerve is extremely rare and causes a unique syndrome with characteristic electromyographic patterns.

Magnetic resonance neurography studies of the median nerve before and after carpal tunnel decompression

2002 ◽  
Vol 96 (6) ◽  
pp. 1046-1051 ◽  
Author(s):  
Simon A. Cudlip ◽  
Franklyn A. Howe ◽  
Andrew Clifton ◽  
Martin S. Schwartz ◽  
B. Anthony Bell
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Surgical Decompression ◽  
Mr Neurography ◽  
Magnetic Resonance Neurography ◽  
Content Type ◽  
Before And After ◽  
Tunnel Syndrome ◽  
Fine Print

Object. Recently developed novel MR protocols called MR neurography, which feature conspicuity for nerve, have been shown to demonstrate signal change and altered median nerve configuration in patients with median nerve compression. The postoperative course following median nerve decompression can be problematic, with persistent symptoms and abnormal results on electrophysiological studies for some months, despite successful surgical decompression. The authors undertook a prospective study in patients with carpal tunnel syndrome, correlating the clinical, electrophysiological, and MR neurography findings before and 3 months after surgery. Methods. Thirty patients and eight control volunteers were recruited to the study. The MR neurography consisted of axial and sagittal images (TR = 2000 msec, TE = 60 msec) obtained using a temporomandibular surface coil, fat saturation, and flow suppression. Maximum intensity projection images were used to follow the median nerve through the carpal tunnel in the sagittal plane. Magnetic resonance neurography in patients with carpal tunnel syndrome demonstrated proximal swelling (p < 0.001) and high signal change in the nerve, together with increased flattening ratios (p < 0.001) and loss of nerve signal in the distal carpal tunnel (p < 0.05). Sagittal images were very effective in precisely demonstrating the site and severity of nerve compression. After surgery, division of the flexor retinaculum could be demonstrated in all cases. Changes in nerve configuration, including increased cross-sectional area, and reduced flattening ratios (p < 0.001) were seen in all patients. In many cases restoration of the T2 signal intensity toward that of controls was seen in the median nerve in the distal carpal tunnel. Sagittal images were excellent in demonstrating expansion of the nerve at the site of surgical decompression. Conclusions. In this study the authors suggest that MR neurography is an effective means of both confirming compression of the median nerve and its successful surgical decompression in patients with carpal tunnel syndrome. This modality may prove useful in the assessment of unconfirmed or complex cases of carpal tunnel syndrome both before and after surgery.

Carpal tunnel syndrome in pediatric mucopolysaccharidoses

1975 ◽  
Vol 43 (1) ◽  
pp. 102-103 ◽  
Author(s):  
Michael E. Miner ◽  
R. Neil Schimke
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Clinical Examination ◽  
Carpal Tunnel ◽  
Pediatric Patients ◽  
Surgical Decompression ◽  
Content Type ◽  
Careful Clinical Examination ◽  
Tunnel Syndrome ◽  
Fine Print

✓ Four pediatric patients with mucopolysaccharidoses and an associated carpal tunnel syndrome are presented. Findings in these cases were typical of the adult form of median nerve compression at the wrist, but the patients had minimal symptoms in view of these findings. The importance of careful clinical examination and early surgical decompression is emphasized.

MEDIAN NERVE COMPRESSION SECONDARY TO LIPOMA ARISING FROM FLEXOR TENOSYNOVIUM: A CASE REPORT

Hand Surgery ◽  
2007 ◽  
Vol 12 (02) ◽  
pp. 83-86 ◽  
Author(s):  
Marios D. Vekris ◽  
Marios G. Lykissas ◽  
Alexandros E. Beris
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Nerve Compression ◽  
Complete Relief ◽  
Sensory Disturbance ◽  
Neurologic Symptoms ◽  
Median Nerve Compression

Lipomas are space-occupying lesions that may rarely be responsible for compression neuropathies. Here we report a case of a lipoma arising from flexor tenosynovium that was responsible for a sensory disturbance resulting from the compression of the median nerve in the carpal tunnel. The patient had complete relief from the neurologic symptoms six months after lipoma excision.

Suprascapular nerve entrapment: experience with 28 cases

1996 ◽  
Vol 85 (6) ◽  
pp. 1020-1025 ◽  
Author(s):  
Gregor Antoniadis ◽  
Hans-Peter Richter ◽  
Stefan Rath ◽  
Veit Braun ◽  
Gerald Moese
Keyword(s):  
Motor Function ◽  
Suprascapular Nerve ◽  
Nerve Entrapment ◽  
Nerve Lesion ◽  
Posterior Portion ◽  
Suprascapular Notch ◽  
Content Type ◽  
Suprascapular Nerve Entrapment ◽  
Athletic Activities ◽  
Fine Print

✓ Suprascapular nerve entrapment (SNE) in the suprascapular notch is a rare entity that must be considered in the differential diagnosis of radicular pain, as well as that of shoulder discomfort. Over a period of 10 years (1985–1995), the authors treated 28 cases of SNE in 27 patients by surgical decompression of the nerve. One patient underwent operation bilaterally within 5 years. Five patients presented with a history of trauma to the shoulder region. In three patients, a ganglion cyst was the origin of the nerve lesion. In 16 patients, the nerve problem was primarily related to athletic activities. Eight of these patients were professional volleyball players. In the remaining three patients, there was no relationship between the nerve lesion and trauma or athletic activities. Twenty-one patients (22 cases) complained of pain located over the suprascapular notch. Seventeen patients had paresis and atrophy of both the supraspinatus (SS) and infraspinatus (IS) muscles. In 10 patients only the IS muscle was involved. One patient exhibited a sensory deficit over the posterior portion of the shoulder. Electromyography was performed in all cases. The mean follow-up period in the 25 cases (24 patients) that could be evaluated was 20.8 months (range 3–70 months). Nineteen of 22 cases with preoperative pain could be evaluated. Sixteen of these patients were completely free of pain after surgery and three patients found their pain had improved. Motor function in the SS muscle improved in 86.7% and motor function in the IS muscle in 70.8% of cases. Atrophy of the SS muscle resolved in 80.7% and atrophy of the IS muscle in 50% of cases. Surgical treatment of SNE is indicated after failed conservative treatment and in cases of atrophy of the SS and IS muscles. The authors recommend the posterior approach, which minimizes risks and complications and produces good postoperative results.

Pseudogout of the Wrist Presenting as Acute Median Nerve Compression

1985 ◽  
Vol 10 (2) ◽  
pp. 261-262
Author(s):  
D. R. A. GOODWIN ◽  
R. ARBEL
Keyword(s):  
Median Nerve ◽  
Upper Limb ◽  
Calcium Pyrophosphate ◽  
Nerve Compression ◽  
Median Nerve Compression ◽  
Septic Condition

Two cases are reported of acute median nerve compression due to calcium pyrophosphate deposition in the wrist, masquerading as a septic condition. There have been recent reports in the literature of the effects of calcium pyrophosphate in joints of the upper limb (Resnick 1983 and Hensley, 1983) These conditions are uncommon and the presentation and initial symptomatology of our case led in the first patient to misdiagnosis and an unnecessary operation, which was avoided in the second case.

Median nerve compression caused by a venous aneurysm

2001 ◽  
Vol 94 (4) ◽  
pp. 624-626 ◽  
Author(s):  
Gerhard Marquardt ◽  
Soledad M. Barduzal Angles ◽  
Fouad D. Leheta ◽  
Volker Seifert
Keyword(s):  
Median Nerve ◽  
Rare Case ◽  
Venous Malformation ◽  
Correct Diagnosis ◽  
Nerve Compression ◽  
Venous Aneurysm ◽  
Complete Relief ◽  
Upper Arm ◽  
Content Type ◽  
Different Levels

✓ A rare case of peripheral-nerve compression in the upper arm caused by a spontaneous venous aneurysm is reported. The apparent dysfunction of the median nerve led to various vain surgical explorations of the nerve at different levels. The real localization of nerve entrapment was identified by a thorough clinical examination, and sonography yielded a correct diagnosis. Surgical resection of the venous aneurysm resulted in complete relief of pain. To the authors' knowledge, this is the first report of a spontaneous venous malformation in the upper arm causing focal neuropathy.

Median nerve compression by a large cephalic vein aneurysm—a case report

2016 ◽  
Vol 32 (2) ◽  
pp. 152-155
Author(s):  
Sayyed Ehtesham Hussain Naqvi ◽  
Azam Haseen ◽  
Mohammed Haneef Beg ◽  
Eram Ali ◽  
Mohammed Arshad
Keyword(s):  
Case Report ◽  
Median Nerve ◽  
Cephalic Vein ◽  
Nerve Compression ◽  
Median Nerve Compression

Axillary nerve entrapment in the quadrilateral space

1987 ◽  
Vol 66 (6) ◽  
pp. 932-934 ◽  
Author(s):  
H. Carson McKowen ◽  
Rand M. Voorhies
Keyword(s):  
Upper Extremity ◽  
Shoulder Pain ◽  
Posterior Approach ◽  
Axillary Nerve ◽  
Nerve Entrapment ◽  
Neutral Position ◽  
Circumflex Artery ◽  
Content Type ◽  
Radiographic Features ◽  
Fine Print

✓ The quadrilateral space syndrome is a recently established entity with seemingly consistent pathological and radiographic features. An example of this syndrome is reported. In this patient, entrapment of the axillary nerve by fibrous bands in the quadrilateral space caused shoulder pain with paresthesias in the upper extremity. Subclavian angiography provided the diagnosis by demonstrating that the posterior humeral circumflex artery, which was normal when the arm was in a neutral position, was occluded when the arm was abducted and externally rotated. Axillary neurolysis through a posterior approach resulted in relief of symptoms.

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