Rare variant of median nerve compression: compression by brachial artery false aneurysm combined with carpal tunnel syndrome. Case report and literature review.

BACKGROUND

The authors present severe compression of the median nerve by iatrogenic false aneurysm of the brachial artery combined with carpal tunnel syndrome.

MATERIAL AND

METHODS

An 81-year-old woman developed acute anesthesia of fingers I-III of the left hand, impaired flexion of the thumb and forefinger, swelling of the hand and forearm, local pain in postoperative period after angiography. The patient was previously followed-up for transient numbness in both hands for 2 years with a diagnosis of carpal tunnel syndrome. Electroneuromyography and ultrasound of the median nerve at the level of shoulder and forearm were carried out. We visualized a pulsatile lesion with Tinel's sign within the elbow (false aneurysm of the brachial artery).

RESULTS

Resection of brachial artery aneurysm and neurolysis of the left median nerve were followed by regression of pain syndrome and improvement of motor function of the hand.

CONCLUSION

This case demonstrates a rare variant of acute high compression of the median nerve after diagnostic angiography. This situation should be considered in differential diagnosis with classical carpal tunnel syndrome.