Acute Carpal Tunnel Syndrome in Hansen’s Disease

Gaur, Sonia; Kulshreshtha, K.K.; Swarup, S.

doi:10.1016/0266-7681(94)90071-x

Cited by 17 publications

(8 citation statements)

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“…Etiologies include bleeding secondary to chronic lymphatic leukemia, hemophilia, Colles' fracture of the wrist, epiphyseal fracture (Salter II) of the distal radius, bleeding secondary to giant cell tumour of the tendon sheath, unstable distal radioulnar joint, displaced intra-articular fracture of the distal radius, rheumatoid synovitis and vasculitis, Hansen's disease and trans-scaphoid perilunar fracture dislocation of the wrist. Other causes include gout, pseudogout, foreign body within the carpal tunnel and acute thrombosis of persistent median artery (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Balakrishnan¹,

Jarrahnejad²,

Balakrishnan³

2008

J Plastic Surgery

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Acute carpal tunnel syndrome is the most common compression neuropathy of the upper extremity following trauma. A rare occurence of spontaneous bleeding into the carpal tunnel, presenting as acute carpal tunnel syndrome, is presented.Key Words: Carpal tunnel syndrome; Spontaneous bleeding Syndrome du tunnel carpien aigu consécutif à une hémorragie spontanée Le syndrome du tunnel carpien est la neuropathie par compression la plus fréquente à survenir au niveau des membres supérieurs par suite de traumatismes. On présente ici un cas rare d'hémorragie spontanée au niveau du tunnel carpien ayant donné lieu à un syndrome aigu du tunnel carpien. C lassic carpal tunnel syndrome (CTS) occurs most often in women, and manifests as hypoesthesia and tingling in the median nerve distribution distal to the wrist joint. In acute CTS (ACTS), the intracarpal interstitial pressure rises above the threshold, and capillary blood flow is reduced below the level of median nerve viability. This leads to ischemia of the muscles and nerves, resulting in the clinical signs and symptoms. ACTS due to spontaneous bleeding into the carpal tunnel is rare. We report a patient who developed ACTS from spontaneous bleeding into the carpal tunnel following strenuous exercise. CASE PRESENTATIONA 51-year-old man presented to the emergency department with acute pain and swelling of the right hand following a workout at a gym. He had no history of serious illness in the past. Medications included acetylsalicylic acid (81 mg/day) and vitamin E once per day. His pain started after his workout and increased over a 2 h period. There was no history of trauma. His hematological work-up was negative. He complained of tingling and paresthesia of the median nerve distribution.On examination, there was swelling of the hand with slight bluish discolouration (Figure 1). The wrist was maintained in a flexed position. The signs and symptoms were those of acute tenosynovitis originating in the common flexor synovial sheath at the wrist with associated paresthesia in the distribution area of the median nerve in the hand.X-rays of the wrist and hand were negative. A clinical diagnosis of ACTS was made. He underwent decompression of the carpal tunnel under general anesthesia. At exploration, blood was seen inside the carpal tunnel (Figure 2). The carpal tunnel was decompressed. His symptoms improved following decompression and at six weeks he had full function of the hand.

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Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Balakrishnan¹,

Jarrahnejad²,

Balakrishnan³

2008

J Plastic Surgery

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“…Hamartomas involving the peripheral nerves were first described in 1953 by Mason,1 mostly involving the median nerve in the forearm and wrist and usually presenting as chronic CTS. Acute CTS may occur consecutive to hamate and triquetral fractures,2 acute metacarpal osteomyelitis3 compression by anomalous flexor digitorum superficialis,4 after internal fixation of scaphoid,4 secondary to pyogenic infections,5 classical hemophilia,6 von Willebrand's disease7 oral anticoagulant therapy,8 distal radial fractures,9 filarial infections,10 thrombosed persistent median artery,11 idiopathic tumoral calcinosis,12 decompression sickness,13 Hansen's disease,14 peritendinitis calcarea,15 pseudogout,16 scaphoid pseudoarthroses 17. Bilateral cases may occur due to human parvovirus B19 infection 18…”

Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome due to a hemangioma of the median nerve

Meena¹,

Sharma²,

Sharma³

et al. 2007

Indian J Orthop

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Hemangioma of the median nerve presenting as acute carpal tunnel syndrome is unusual A-18- year old male presented with severe incapacitating pain of sudden onset of left forearm and hand after manual field work. There was swelling on volar aspect of forearm, with hyperalgesia in the median nerve distribution. The fingers and wrist were inmarked flexion and the patient did not allow wrist and finger extension. X-rays were within normal limits. An emergency volar carpal ligament release revealed, haematoma about 100 ml with numerous vessels encircling the median nerve. Histopathology of lesion turned out to be a cavernous hemangioma. Post operatively patient had full recovery.

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“…Phalen (1) contributed much to the present understanding of the etiology, diagnosis and management of this syndrome. Other etiologies for carpal tunnel syndrome include acute pyogenic infection, spontaneous hemorrhage in patients who take anticoagulants, thrombosis of a persistent median artery and pseudogout (2)(3)(4)(5)(6)(7)(8). When interstitial pressure in the intracarpal canal rises above a critical threshold, capillary blood flow is reduced below the level that is required for median nerve viability.…”

Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome from a foreign body in the carpal tunnel

et al. 2002

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A case of acute carpal tunnel syndrome as the result of a foreign body in the carpal tunnel is reported. The diagnosis was based on the patient's symptoms and radiographs. Early recognition and decompression of the carpal tunnel with removal of the foreign body led to a full recovery. Key words: Acute carpal tunnel syndromeSyndrome aigu du tunnel carpien déclenché par la présence d'un corps étranger RÉSUMÉ : Le présent rapport porte sur un cas de syndrome aigu du tunnel carpien déclenché par la présence d'un corps étranger. Ce diagnostic a été posé sur la base des symptômes de la patiente et de ses radiographies. La reconnaissance précoce du problème et la décompression du tunnel carpien par extraction du corps étranger ont permis une récupération complète.

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Acute Carpal Tunnel Syndrome in Hansen’s Disease

Abstract: Two cases of acute carpal tunnel syndrome due to median nerve abscess as a consequence of Hansen's disease are reported. Nerve abscess as a cause of acute carpal tunnel syndrome is rare.

Cited by 17 publications

References 1 publication

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Acute carpal tunnel syndrome due to a hemangioma of the median nerve

Acute carpal tunnel syndrome from a foreign body in the carpal tunnel

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