Vakhshori Venus, Alluri Ram K, Mahajan Anuj, Ghiassi Alidad
Department of Orthopaedic Surgery, Keck Medical Center of University of Southern California, Los Angeles, California.
Department of Vascular Surgery, Keck Medical Center of University of Southern California, Los Angeles, California.
J Wrist Surg. 2018 Jul;7(3):258-261. doi: 10.1055/s-0037-1607422. Epub 2017 Oct 27.
Arteriovenous malformations (AVMs) are commonly treated using endovascular techniques. Previous nerve palsies after embolization have been reported as isolated case reports, none of which affected the forearm. A case of acute, transient neuropathy of the radial nerve following embolization of a forearm AVM is described. The patient, an otherwise healthy 27-year-old man, began having symptoms of superficial radial nerve (SRN) and posterior interosseous nerve (PIN) palsies immediately following endovascular embolization. He underwent decompression of the radial nerve within 5 days and was found to have direct compression of the PIN and SRN. The patient recovered completely at the time of his 7-month follow-up. Few cases of nerve palsy after endovascular embolization have been reported in the literature. Many are intracranial, but rare instances of peripheral nerve palsy have been reported, including two sciatic nerve and four digital nerve palsies after endovascular embolization. No cases of peripheral nerve palsy in the forearm have been reported. We recommend careful consideration of surrounding neural elements at risk for palsy prior to endovascular embolization and detailed discussion with the patient during the informed consent process.
动静脉畸形（AVM）通常采用血管内技术进行治疗。既往栓塞后出现神经麻痹的情况仅有个别病例报告，且均未累及前臂。本文描述了1例前臂AVM栓塞后出现桡神经急性、短暂性神经病变的病例。该患者为一名27岁的健康男性，在血管内栓塞后立即出现桡神经浅支（SRN）和骨间后神经（PIN）麻痹的症状。他在5天内接受了桡神经减压手术，术中发现PIN和SRN受到直接压迫。患者在7个月随访时完全康复。文献中报道的血管内栓塞后神经麻痹病例较少。多数为颅内病例，但也有外周神经麻痹的罕见报道，包括血管内栓塞后出现的2例坐骨神经麻痹和4例指神经麻痹。尚未见前臂外周神经麻痹的病例报道。我们建议在血管内栓塞前仔细考虑周围有麻痹风险的神经结构，并在知情同意过程中与患者进行详细讨论。
