Variation of the brachial artery emerging through an opening in the median nerve: a case report.
Anatomical variation
Brachial artery
Brachial plexus
Cadaveric study
Median nerve
Vascular surgery
Journal
Surgical and radiologic anatomy : SRA
ISSN: 1279-8517
Titre abrégé: Surg Radiol Anat
Pays: Germany
ID NLM: 8608029
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
03
05
2023
accepted:
29
07
2023
medline:
22
9
2023
pubmed:
8
8
2023
entrez:
8
8
2023
Statut:
ppublish
Résumé
The median nerve maintains a close relationship with the brachial artery in the upper limb. Variability in the formation and distribution of upper extremity vessels is frequently encountered during donor body dissections or surgical procedures. This case presents a rare anatomical variation of the brachial artery emerging through an opening in the median nerve. The median nerve formed a small opening without the contribution from additional nerve roots and the remaining vasculature of the upper limb was otherwise normal. An abnormal arrangement of a neurovascular bundle in the arm can cause sensory and motor issues, as well as vascular implications. This variation has clinical significance in surgical interventions and potentially daily functioning. To our knowledge, this is the first report of a small median nerve opening pierced by the brachial artery.
Identifiants
pubmed: 37552268
doi: 10.1007/s00276-023-03227-3
pii: 10.1007/s00276-023-03227-3
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1135-1138Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Al-Qattan MM, Yang Y, Kozin SH (2009) Embryology of the upper limb. J Hand Surg Am 34(7):1340–1350. https://doi.org/10.1016/j.jhsa.2009.06.013
doi: 10.1016/j.jhsa.2009.06.013
pubmed: 19700076
Bhat KM, Gowda S, Potu BK (2009) Nerve loop around the axillary vessels by the roots of the median nerve a rare variation in a south Indian male cadaver: a case report. Cases J 2:179. https://doi.org/10.1186/1757-1626-2-179
doi: 10.1186/1757-1626-2-179
pubmed: 19946489
pmcid: 2783134
Chou HC, Jeng H, Ko TL, Pai MH, Chang CY, Wu CH (2001) Variant palmaris profundus enclosed by an unusual loop of the median nerve. J Anat 199(4):499–500. https://doi.org/10.1046/j.1469-7580.2001.19940499.x
doi: 10.1046/j.1469-7580.2001.19940499.x
pubmed: 11693311
pmcid: 1468361
Ghosh B, Dilkash MNA, Prasad S, Sinha SK (2022) Anatomical variation of median nerve: cadaveric study in brachial plexus. Anat Cell Biol 55(2):130–134. https://doi.org/10.5115/acb.22.022
doi: 10.5115/acb.22.022
pubmed: 35718802
pmcid: 9256496
Kim DH, Hudson AR, Kline DG (2013) Atlas of peripheral nerve surgery, 2nd edn. Saunders, Philadelphia
Konarik M, Musil V, Baca V, Kachlik D (2020) Upper limb principal arteries variations: a cadaveric study with terminological implication. Bosn J Basic Med Sci 20(4):502–513. https://doi.org/10.17305/bjbms.2020.4643
doi: 10.17305/bjbms.2020.4643
pubmed: 32343941
pmcid: 7664784
Mat Taib CN, Hassan SN, Esa N, Mohd Moklas MA, San AA (2017) Anatomical variations of median nerve formation, distribution and possible communication with other nerves in preserved human cadavers. Folia Morphol (Warsz) 76(1):38–43. https://doi.org/10.5603/FM.a2016.0045
doi: 10.5603/FM.a2016.0045
pubmed: 27665953
Nulle K, Jaudzema A (2021) Ultrasonographic evaluation of the median nerve: normal and variant anatomy and appearance. J Ultrason 21(87):e318–e325. https://doi.org/10.15557/JoU.2021.0053
doi: 10.15557/JoU.2021.0053
pubmed: 34970443
pmcid: 8678701
Paraskevas G, Lazaridis N, Piagkou M, Natsis K (2018) Superficial brachial artery traversing a median nerve loop in the arm associated with other vascular and muscular anomalies: case report and clinical implications. Ital J Anat Embryol 123(1):17–22. https://doi.org/10.13128/IJAE-23006
doi: 10.13128/IJAE-23006
Paraskevas GK, Varnalidis I, Koutsouflianiotis K (2017) Median nerve’s loop in the arm penetrated by a superficial brachial artery: case report and neurosurgical considerations. Int J Res Med Sci 3(8):2123–2125
Pavlovsky E, Kistner G, Loomis M (2023) A persistent median artery piercing the median nerve: a review and clinical implications. Bull Natl Res Cent. https://doi.org/10.1186/s42269-023-01057-2
doi: 10.1186/s42269-023-01057-2
Rodríguez-Niedenführ M, Burton GJ, Deu J, Sañudo JR (2001) Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat 199:407–417. https://doi.org/10.1046/j.1469-7580.2001.19940407.x
doi: 10.1046/j.1469-7580.2001.19940407.x
pubmed: 11693301
pmcid: 1468351
Roy TS (2003) Median nerve penetration by a muscular branch of the brachial artery. Clin Anat 16(4):335–339. https://doi.org/10.1002/ca.10080
doi: 10.1002/ca.10080
pubmed: 12794918
Saenz C, Rahimi OB, Kar R (2022) Cadaveric study of division of the median nerve by the persistent median artery. Surg Radiol Anat 44:1455–1460. https://doi.org/10.1007/s00276-022-03035-1
doi: 10.1007/s00276-022-03035-1
pubmed: 36280597
Standring S, Gray H (2021) Gray’s anatomy: the anatomical basis of clinical practice, 42nd edn. Elsevier, Amsterdam
Sthapak E, Pasricha N, Bhatnagar R (2019) Relation of median nerve with brachial artery: a cadaveric study. J Anat Science 27:10–14