Carpal tunnel syndrome in a patient with a Cimino-Brescia fistula.

A case of a carpal tunnel syndrome in a patient with chronic renal insufficiency undergoing hemodialysis by means of a Cimino-Brescia arteriovenous fistula is reported. Surgical decompression of the median nerve at the wrist was followed by the immediate and complete relief of the patient's symptoms. Ischemia related to a vascular 'steal' phenomenon or increased venous pressure have been proposed as primary alterations which can cause a damage of the median nerve at the wrist. In our case, we found symptoms relating to both of these pathogenetic hypotheses.