Lyrtzis Christos, Stamati Athina, Stathopoulou Elvira, Paraskevas George
Anatomy and Surgical Anatomy, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Cureus. 2024 Aug 30;16(8):e68201. doi: 10.7759/cureus.68201. eCollection 2024 Aug.
Carpal tunnel syndrome (CTS) is a common neuropathy with various underlying causes, posing diagnostic and management challenges for healthcare providers. The condition is typically associated with repetitive strain, idiopathic factors, or anatomical variations, leading to the compression of the median nerve within the carpal tunnel. We describe a case of a 46-year-old male who presented with recurrent CTS symptoms one year after a successful carpal tunnel release surgery. The symptoms resurfaced following a minor wrist trauma, leading to pain, numbness, and hand weakness. Despite initial conservative management, including immobilization and NSAIDs, the symptoms persisted. Further investigation and exploratory surgery revealed a rare subepineural hematoma of the median nerve, which was subsequently drained, resulting in immediate and lasting symptom relief. This case demonstrates the importance of considering uncommon etiologies such as subepineural hematomas in patients with recurrent CTS and underscores the need for a thorough diagnostic approach to ensure effective treatment.
腕管综合征(CTS)是一种常见的神经病变,有多种潜在病因,给医疗服务提供者带来诊断和管理方面的挑战。这种病症通常与重复性劳损、特发性因素或解剖变异有关,导致腕管内正中神经受压。我们描述了一例46岁男性病例,该患者在成功进行腕管松解手术后一年出现复发性CTS症状。症状在一次轻微的手腕外伤后再次出现,导致疼痛、麻木和手部无力。尽管最初进行了包括固定和使用非甾体抗炎药在内的保守治疗,但症状仍持续存在。进一步的检查和探索性手术发现了一种罕见的正中神经皮下血肿,随后进行了引流,症状立即得到缓解且持久缓解。该病例表明,对于复发性CTS患者,考虑诸如皮下血肿等罕见病因的重要性,并强调了采用全面诊断方法以确保有效治疗的必要性。