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持续性正中动脉血栓形成所致正中神经病变

Median Nerve Neuropathy Caused by Persistent Median Artery Thrombosis.

作者信息

Miyashima Yusuke, Gotani Hiroyuki, Okamoto Kotaro, Yagi Hirohisa, Tanaka Yoshitaka

机构信息

From the Department of Orthopedic Surgery, Japan Seafarers Relief Association Osaka Ekisaikai Hospital, Osaka, Japan.

出版信息

Plast Reconstr Surg Glob Open. 2023 Apr 10;11(4):e4916. doi: 10.1097/GOX.0000000000004916. eCollection 2023 Apr.

Abstract

Persistent median artery thrombosis mimicking carpal tunnel syndrome is rare. Here, we report the pathological, ultrasonography, and intraoperative findings of a case of persistent median artery thrombosis mimicking carpal tunnel syndrome. A 34-year-old man reported to our clinic with a complaint of numbness in his left thumb, index finger, and middle finger, which are innervated by the left median nerve. He also reported that he felt pain in his left wrist and distal forearm while working. Although findings of the usual provocative tests and nerve conduction studies were normal, ultrasonography revealed arterial thrombosis at the carpal tunnel level, whereas magnetic imaging showed persistent median artery thrombosis in the carpal tunnel. Three months after surgical resection of the thrombosed section of the artery, the patient fully recovered with no residual pain or limitations in the use of the affected arm. His patient-reported outcomes improved as well. It is important to investigate the existence of persistent median artery thrombosis if a patient presents with atypical symptoms of carpal tunnel syndrome. Ultrasonography is useful for the diagnosis of persistent median artery thrombosis. Surgical resection of a thrombosed persistent median artery in patients with carpal tunnel syndrome yields good results.

摘要

模仿腕管综合征的持续性正中动脉血栓形成罕见。在此,我们报告一例模仿腕管综合征的持续性正中动脉血栓形成的病理、超声及术中所见。一名34岁男性因左拇指、示指和中指(由左正中神经支配)麻木前来我院就诊。他还报告称工作时左腕和前臂远端疼痛。尽管常规激发试验和神经传导研究结果正常,但超声显示腕管水平动脉血栓形成,而磁共振成像显示腕管内持续性正中动脉血栓形成。动脉血栓形成段手术切除3个月后,患者完全康复,患侧手臂无残留疼痛或使用受限。患者报告的结局也有所改善。如果患者出现非典型腕管综合征症状,调查持续性正中动脉血栓形成的存在情况很重要。超声对诊断持续性正中动脉血栓形成有用。对腕管综合征患者行血栓形成的持续性正中动脉手术切除效果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb0/10287125/1262dbceba51/gox-11-e4916-g001.jpg

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