橈骨動脈の走行異常による正中神経障害の1例

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  • A Case of Median Nerve Disorder Due to Anomalous Course of the Radial Artery

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Neurovascular variations in the hand are common and have been well documented. Muscle anomalies and median artery may cause median nerve compression. We report median nerve compression due to an aberrant course of the radial artery within the carpal tunnel. A 23-year-old right-handed woman had felt palpable string and pain in the right palm. She had also experienced weakness of her right hand upon working. Tinel’s sign and Phalen’s test were negative and electrophysiological examinations revealed no abnormality of median nerve conduction. Magnetic resonance imaging and CT angiography revealed an aberrant course of the radial artery in the palm. <br>Surgical exploration was performed under brachial plexus block. The superficial palmar arch of the radial artery ran over the flexor retinaculum and passed deep between the two recurrent motor branches of the median nerve. Traction applied to a proximal branch was thought to have caused her symptoms. Microsurgical reconstruction was performed by transposition of the course of the radial artery. The patient’s symptoms resolved completely and she returned to her job two months after surgery.

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