Page Paul Samuel, Paige Stewart, Hanna Amgad
Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States.
Surg Neurol Int. 2021 May 17;12:224. doi: 10.25259/SNI_75_2021. eCollection 2021.
Vascular compression is an extremely rare cause of mononeuropathy and compression of selective tibial nerve branches is an additionally a rare finding and makes diagnosis difficult.
Here within, we describe the case of a 41-year-old male who presented with isolated mononeuropathy of the medial gastrocnemius (MG) branch of the tibial nerve presented as persistent fasciculations and atrophy. After electromyography and clinical evaluation, surgical exploration was recommended. A vascular bundle was found to be compressing the MG branch of the tibial nerve and thus was ligated to decompress the nerve. Postoperatively, all fasciculations improved and muscle atrophied improved.
Vascular compression resulting in mononeuropathy of the peripheral nerves is a rare clinical entity. Clinicians should include these etiologies on their differential when considering surgical exploration of mononeuropathies.
血管压迫是单神经病极为罕见的病因,而选择性胫神经分支受压更是罕见情况,这使得诊断困难。
在此,我们描述一名41岁男性病例,该患者表现为胫神经腓肠肌内侧头(MG)分支孤立性单神经病,症状为持续性肌束震颤和萎缩。经肌电图和临床评估后,建议进行手术探查。发现一束血管压迫胫神经的MG分支,遂予以结扎以减压神经。术后,所有肌束震颤和肌肉萎缩均有所改善。
血管压迫导致周围神经单神经病是一种罕见的临床病症。临床医生在考虑对单神经病进行手术探查时,应将这些病因列入鉴别诊断范围。