de Barros Laura Mendes, de Oliveira Adilson Jose Manuel, Santos Alan de Souza, Lima Flávio Leão, Valente Rodolfo Silva
Hospital de Base do Distrito Federal, Department of Neurosurgery. Brasília, DF, Brazil.
Universidade de São Paulo (USP), Hospital das Clínicas, Faculty of Medicine, Department of Neurosurgery. São Paulo, SP, Brazil.
Autops Case Rep. 2020 May 6;10(2):e2020153. doi: 10.4322/acr.2020.153.
Compressive syndromes of peripheral nerves both in the upper and lower limbs are part of daily clinical practice; however, the etiological diagnosis can be challenging and impact on the outcome of the patient. We report five cases with rare etiologies of nerve entrapments: one in the lower limb and four in the upper limbs with the final diagnosis made only during the operation. The patients evolved without post-operative complications and had good outcomes. This series includes the first report of sciatic compression by a lipoma in the popliteal fossa, two lipomas one with compression of infraclavicular brachial plexus and another with compressing the posterior interosseous nerve, and two reports of vascular lesions due to blunt traumas, which are also uncommon. This series adds to the literature more hypotheses of differential diagnoses in nerve entrapments, which is fundamental to surgical decisions and pre-operative planning-and perhaps most importantly prevents wrong diagnosis of idiopathic compressions, which would lead to a completely wrong approach and unfavorable outcomes.
上肢和下肢周围神经的压迫综合征是日常临床实践的一部分；然而，病因诊断可能具有挑战性，并会影响患者的治疗结果。我们报告了5例病因罕见的神经卡压病例：1例发生在下肢，4例发生在上肢，最终诊断仅在手术中做出。患者术后未出现并发症，预后良好。该系列病例包括首例关于腘窝脂肪瘤压迫坐骨神经的报告、两例脂肪瘤，其中一例压迫锁骨下臂丛神经，另一例压迫骨间后神经，以及两例钝性创伤导致的血管病变报告，这些情况也并不常见。该系列病例为神经卡压的鉴别诊断增添了更多假设，这对手术决策和术前规划至关重要，也许最重要的是可防止对特发性压迫的错误诊断，否则将导致完全错误的治疗方法和不良后果。
