Anatomical Variations Of Median Nerve Research Articles

The anatomical variations of median nerve in Shiraz, Iran.

The origin and distribution of median nerve varies among the different individuals. The median nerve variations in axillary region were reported by many authors previously. Understanding of these variations is especially necessary for clinicians to prevent iatrogenic nerve damage. The current work aimed to evaluate the possible anatomical variations of median nerve in the axillary region in a sample of the Iranian cadavers (Shiraz, Fars). We dissected 26 upper limbs from 13 male cadavers to investigate the different variations of median and musculocutaneous nerves according to Venieratos and Anagnostopoulou classification. In 23.07% of specimens (n=6), the medial root united with 2 lateral roots and formed the median nerve proximal to the coracobrachialis muscle. In one case, a communicating branch separated from the musculocutaneous nerve distal to the coracobrachialis and connected to the median nerve in upper arm. Our results suggest that there are anatomical variations of the median nerve in terms of its origin and its communication with the musculocutaneous nerve in the population of southern Iran. The anatomical knowledge of the median nerve variations is important for clinicians to improve patient health outcome. Theses variations of the median nerve should be considered during surgical procedures of the axillary region and nerve block of the infra clavicular part of the brachial plexus.

TH-263. Prevalence of anatomic variations of median nerve at the wrist using high frequency ultrasound in Brazilian individuals

TH-263. Prevalence of anatomic variations of median nerve at the wrist using high frequency ultrasound in Brazilian individuals

A study of anatomical variations of median nerve in human cadavers

Comprehensive knowledge pertaining to anatomical variations of median nerve is extremely important in clinical and surgical procedures so as to avoid injury to it. The objectives of the study were to know about the variations of median nerve in its formation, course, and distribution in arm. Dissection method was employed and 50 upper limbs were studied for anatomical variations of median nerve obtained from the department of Anatomy. Median nerve was formed by two roots in 37(74%) and by three roots in 13 (26%) specimens. It was formed in axilla in 32(64%), in upper third of arm in 10 (20%), middle third of arm in 6 (12%) and lower third of arm in 2 (4%) specimens. In one specimen high division of brachial artery in the middle third of the arm was observed along with formation of median nerve at the same level. Formation of median nerve was lateral to axillary artery in 42 (84%), anterior to axillary artery in 5 (10%), medial to axillary artery in 3 (6%) specimens. Median nerve coursed lateral to brachial artery in 47 (94%), medial to brachial artery in 3 (6%) specimens Median nerve was supplying flexor muscles of arm in 6 (12%) specimens. In two of these six specimens there were concomitant neurovascular variations as well. The present study may provide additional information as such neurovascular variations encountered here are important to be noted during surgical procedures as these are more prone to iatrogenic injuries.

Coexistence of trifid and bifid median nerve in a patient with bilateral carpal tunnel syndrome

Carpal tunnel syndrome is the most common upper extremity neuropathy in the wrist that may be associated with anatomic variations of median nerve. Trifurcation of the median nerve has been very rarely reported in the literature. We report coexistence of bilateral median nerve variation in the wrist and its radiological features. Ultrasonography and magnetic resonance imaging was performed to the patient after Tinel and Phalen tests. There was bifurcation and trifurcation of the median nerve in right and left wrists respectively. Bilateral carpal tunnel syndrome was caused by bilateral median nerve variation in the present case. When a median nerve variation is detected in one wrist, a possible variation at the other side should be kept in mind and hence should be evaluated. A thorough knowledge of the variations of the median nerve is essential in order to avoid surgical complications and to ensure optimal patient outcome. US is an easy and cheap radiological method for diagnosis and it should be the first chosen radiological technique to evaluate median nerve variations in idiopathic CTS patients.