A Rare Case of Superficial Brachioradial Artery and Median Nerve Within the Pronator Arch Above the Hueter’s Line—a Case Report

Abstract

The brachial artery divides at the level of the neck of the radius in the elbow into its terminal branches, the radial, and ulnar arteries. If the brachial artery divides at a higher level, the branches are termed brachioradial and brachioulnar arteries. The brachioradial and brachioulnar arteries usually follow the ordinary course of the radial and ulnar arteries. We report a case of the brachial artery along with median nerve passing through a fibromuscular tunnel formed by the extra head of origin of pronator teres (pronator arch) from the medial intermuscular septum in the arm. Further, we observed a higher division of the brachial artery into brachioradial and brachioulnar arteries. The brachioradial artery followed an unconventionally superficial course in the forearm. We believe such a unique variation will be of interest to cardiologists during cardiac catheterization where the artery is prone to iatrogenic injury due to its course below the fibromuscular pronator arch and a concomitant compression of the median nerve.