Persistent Median Artery in the Carpal Tunnel

Gassner, Eva; Schocke, Michael; Peer, Siegfried; Schwabegger, Anton H.; Jaschke, Werner; Bodner, Gerd

doi:10.7863/jum.2002.21.4.455

Cited by 111 publications

(30 citation statements)

References 25 publications

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“…Both magnetic resonance imaging (MRI) and ultrasonography are used to detect median nerve anomalies, and the use of ultrasonography and MRI to detect carpal tunnel has been recently reported 8-10. Ultrasonography is recognized as a useful imaging method to visualize internal body structures, including tendons, muscles, nerves, joints, vessels and internal organs for potential pathology.…”

Section: Discussionmentioning

confidence: 99%

“…The practice of dynamically examining the musculoskeletal system using ultrasound in real time is widely used. The use of sonography at high frequencies has been demonstrated to be a useful diagnostic tool in patients with CTS 10-12. The small structures of a bifid median nerve and the relationship of this structure to a persistent median artery can be observed more clearly using an 18-MHz high-frequency transducer.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, a persistent median artery could be an independent risk factor for CTS when enlarged to 3 mm in diameter in some pathological conditions, including internal thrombus, aneurysm, and calcified plaque formation 15-17. Thus, the early detection of the thrombosed median artery using ultrasonography can result in prompt anticoagulant therapy, thus preventing the need for any surgery or thrombolytic therapy 10. Although Pierre-Jerome, et al observed that the PMA was more frequently observed on the left side 9, no significant differences between the left and right side of the wrists were observed in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals

Chen

Chen²,

Hu³

et al. 2017

Clinics

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OBJECTIVE:The aim of this study was to investigate the prevalence of anatomic variations of the bifid median nerve, persistent median artery and persistent median vein in Chinese individuals and their relationship with carpal tunnel syndrome.METHODS:One hundred and sixty median nerves were examined using ultrasonography and colour Doppler ultrasonography. The location, shape, and size of the bifid median nerve, persistent median artery and persistent median vein were recorded. The cross-sectional area of the bifid median nerve (two trunks) was measured at the level of the pisiform.RESULTS:Among the 160 wrists examined, a bifid median nerve was observed in 15 (9.4%) wrists, and a persistent median artery was observed in 12 (7.5%) wrists. These two variations either coexisted or were observed independently, and the probability of coexistence (6.3%) was higher than the probability of existing independently (bifid median nerve only 3.1%, persistent median artery only 1.3%). The cross-sectional area of the radial trunk was greater than (13 in 15, 86.7%) the cross-sectional area of the ulnaris trunk. Persistent median vein was observed in 9 wrists (5.6%).CONCLUSIONS:The persistent median artery and bifid median nerve tend to coexist, and the persistent median vein sometimes runs parallel to the persistent median artery. Their positional relationship in carpal tunnel is uncertain, and thus, preoperative ultrasound is necessary. These three variations do not present any additional risk for the development of carpal tunnel syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals

Chen

Chen²,

Hu³

et al. 2017

Clinics

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“…They conclude that a PMA has a superficial course close to the transverse carpal ligament; pre-operative diagnosis of this anatomic variation may be of clinical importance. [16]…”

Section: Discussionmentioning

confidence: 99%

Cadaveric study of anatomical variations of the median nerve and persistent median artery at wrist

Agarwal¹,

Gupta²,

Yadav³

et al. 2014

Indian J Plast Surg

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Background:Awareness of anatomical variations of the median nerve at wrist is important in repair of traumatic injuries and treatments of compression syndrome because in these situations precise dissection of the nerve is mandatory and such variations are not infrequent.Materials and Methods:In this study, 52 hands of 52 fresh cadavers were dissected and median nerve anatomy along with the presence of persistent median artery (PMA) was noted.Results:A total of 26 hands (50%) had the deviation from the standard text book anatomy of the median nerve. There was early division of the median nerve into the medial and lateral branches in 11.53% hands. There was early branching of the 2nd common digital nerve in 9.6% hands. The transligamentous motor branch to the thenar muscle was most prevalent (42.3% hands). The single motor branch to the thenar muscles was found in the majority of hands (84.6%). The PMA was present in 11.53% hands and it was associated with variations in the median nerve anatomy in all cases.Conclusions:This study shows a high percentage of deviation from standard anatomy as well as a high percentage of transligamentous thenar muscle motor branch. The presence of PMA was associated with variations in the median nerve anatomy in all cases. Therefore if PMA is present there are very high chances of associated median nerve anomalies.

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“…Gassner et al ., in a study of 50 asymptomatic volunteers, found a persistent median artery in 16 of 100 (16%) wrists. In 10 of these 16 wrists, there was an associated high division or bifid nerve 13 . Wong et al .…”

Section: Discussionmentioning

confidence: 99%

Review of the dimensions of the median nerve and carpal tunnel using sonography in asymptomatic adults

2011

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The normal range at two SDs of the CSA of the median nerve at the inlet was 5.2-9.6 mm(2) . The upper limit of volar bowing of the flexor retinaculum was 0.8 mm. The FR overlaps with values obtained in other studies of patients with carpal tunnel syndrome. The mean AP diameter of the CT was 10.4 mm (SD 1.1). To the best of our knowledge, this is the largest study performed in an asymptomatic population assessing the different sonological parameters related to the CT.

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Persistent Median Artery in the Carpal Tunnel

Cited by 111 publications

References 25 publications

Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals

Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals

Cadaveric study of anatomical variations of the median nerve and persistent median artery at wrist

Review of the dimensions of the median nerve and carpal tunnel using sonography in asymptomatic adults

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