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Superficial brachial artery: a possible cause for idiopathic median nerve entrapment neuropathy
Affiliations- Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, Gauteng, South Africa, South Africa
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Abstract
Nerve entrapment syndromes occur because of anatomic constraints at specific locations in both upper and lower limbs. Anatomical locations prone to nerve entrapment syndromes include sites where a nerve courses through fibro-osseous or fibromuscular tunnels or penetrates a muscle. The median nerve (MN) can be entrapped by the ligament of Struthers; thickened biceps aponeurosis; between the superficial and deep heads of the pronator teres muscle and by a thickened proximal edge of flexor digitorum superficialis muscle. A few cases of MN neuropathies encountered are reported to be idiopathic. The superficial branchial artery (SBA) is defined as the artery running superficial to MN or its roots. This divergence from normal anatomy may be the possible explanation for idiopathic MN entrapment neuropathy.
This study presents three cases with unilateral presence of the SBA encountered during routine undergraduate dissection at the University of Johannesburg. Case 1 — SBA divided into radial and ulnar arteries. Brachial artery (BA) terminated as deep brachial artery. Case 2 — SBA continued as radial artery (RA). BA terminated as ulnar artery (UA), anterior and posterior interosseous arteries. Case 3 — SBA continued as UA. BA divided into radial and common interosseous arteries.
Arteries that take an unusual course are more vulnerable to iatrogenic injury during surgical procedures and may disturb the evaluation of angiographic images during diagnosis. In particular, the presence of SBA may be acourse of idiopathic neuropathies.
Abstract
Nerve entrapment syndromes occur because of anatomic constraints at specific locations in both upper and lower limbs. Anatomical locations prone to nerve entrapment syndromes include sites where a nerve courses through fibro-osseous or fibromuscular tunnels or penetrates a muscle. The median nerve (MN) can be entrapped by the ligament of Struthers; thickened biceps aponeurosis; between the superficial and deep heads of the pronator teres muscle and by a thickened proximal edge of flexor digitorum superficialis muscle. A few cases of MN neuropathies encountered are reported to be idiopathic. The superficial branchial artery (SBA) is defined as the artery running superficial to MN or its roots. This divergence from normal anatomy may be the possible explanation for idiopathic MN entrapment neuropathy.
This study presents three cases with unilateral presence of the SBA encountered during routine undergraduate dissection at the University of Johannesburg. Case 1 — SBA divided into radial and ulnar arteries. Brachial artery (BA) terminated as deep brachial artery. Case 2 — SBA continued as radial artery (RA). BA terminated as ulnar artery (UA), anterior and posterior interosseous arteries. Case 3 — SBA continued as UA. BA divided into radial and common interosseous arteries.
Arteries that take an unusual course are more vulnerable to iatrogenic injury during surgical procedures and may disturb the evaluation of angiographic images during diagnosis. In particular, the presence of SBA may be acourse of idiopathic neuropathies.
Keywords
superficial brachial artery, median nerve entrapment, entrapment neuropathies
About this articleTitle
Superficial brachial artery: a possible cause for idiopathic median nerve entrapment neuropathy
Journal
Issue
Article type
Case report
Pages
527-531
Published online
2017-02-10
Page views
1827
Article views/downloads
1289
DOI
Pubmed
Bibliographic record
Folia Morphol 2017;76(3):527-531.
Keywords
superficial brachial artery
median nerve entrapment
entrapment neuropathies
Authors
P. Nkomozepi
N. Xhakaza
E. Swanepoel
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