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腘静脉动脉瘤压迫腓总神经

Common peroneal nerve compression by a popliteal venous aneurysm.

作者信息

Jang Seong Ho, Lee Honggi, Han Seung Hoon

机构信息

Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Kyunggi, Republic of Korea.

出版信息

Am J Phys Med Rehabil. 2009 Nov;88(11):947-50. doi: 10.1097/PHM.0b013e3181b331d8.

Abstract

A 58-yr-old man with a right foot drop and a sensory change in the right calf and foot, which developed after a bladder operation, was referred to our clinic for an electrodiagnostic evaluation. Neurologic examination showed grade 1 weakness of the right ankle in dorsiflexion, great toe in dorsiflexion, and ankle in eversion. In addition, the patient complained of pain and a tingling sensation in the right calf and foot. Electrodiagnostic findings were consistent with right common peroneal nerve palsy at the level of the fibula head. In addition, duplex ultrasonography, computed tomography angiography, and magnetic resonance imaging revealed a right popliteal venous aneurysm and impingement of the right common peroneal nerve between the aneurysm and the belly of the biceps femoris muscle. After resection of the aneurysm, his sensory symptoms and motor strength of the right foot and calf gradually improved. This case suggests that compression by the venous system should be considered when there is clinical evidence of focal neuropathy but no abnormal findings at common entrapment sites.

摘要

一名58岁男性,在膀胱手术后出现右脚下垂以及右小腿和足部感觉改变,遂转诊至我院进行电诊断评估。神经系统检查显示右踝关节背屈、拇趾背屈及踝关节外翻肌力为1级。此外,患者主诉右小腿和足部疼痛及刺痛感。电诊断结果符合腓骨头水平右侧腓总神经麻痹。此外,双功超声、计算机断层血管造影和磁共振成像显示右腘静脉瘤以及右腓总神经在动脉瘤与股二头肌肌腹之间受到压迫。切除动脉瘤后,其右脚和小腿的感觉症状及运动力量逐渐改善。该病例提示,当存在局灶性神经病变的临床证据但常见卡压部位无异常发现时,应考虑静脉系统压迫的可能性。

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