Abstract
The use of the term “brachioradial artery” was introduced for the high origin of the radial artery. Although the prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6%, the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate of 0.83%. Moreover, in just 0.6% of cases the loop of the median nerve may be placed near half of the length of the brachial artery, as in the case described in our report. A comprehensive understanding of anatomical variations of neurovascular structures in the upper limb is of great clinical significance. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (persistent, hypoplastic brachial segment of the superficial brachioradial artery), coexisting with atypical formation of the median and musculocutaneous nerves. Anatomical variations of vessels and nerves may coexist which should be taken into account when performing vascular, reconstructive or orthopedic surgery.
Highlights
The radial artery demonstrates a high variability in regard to its origin, course, diverse arrangements of radial recurrent artery and its contribution to vascularization of the hand [3, 7, 12,13,14, 18]
The prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6% [3, 7, 12, 14], the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate from 0.67% [7] to 0.83% [3]
The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb, coexisting with an atypical formation of the median and musculocutaneous nerves
Summary
The radial artery demonstrates a high variability in regard to its origin, course, diverse arrangements of radial recurrent artery and its contribution to vascularization of the hand [3, 7, 12,13,14, 18]. Rodríguez-Niedenführ et al [14] proposed the term “brachioradial artery” to be used for the high origin of the radial artery In such a case, the accessory artery is observed in the medial bicipital sulcus, running superficially to the median nerve. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (i.e., persistent, hypoplastic brachial segment of the radial artery), coexisting with an atypical formation of the median and musculocutaneous nerves. Within the proximal third of the medial bicipital sulcus, the hypoplastic brachial segment of the superficial brachioradial artery took a superficial course to both the roots of the median nerve (Fig. 1). No other anatomical variations were observed on the examined specimen
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