Prevalência de variações anatômicas encontradas em pacientes com síndrome do túnel do carpo submetidos a liberação cirúrgica por via aberta clássica

Pimentel, Victor Spirandelli; Artoni, Bruna Borsari; Faloppa, Flávio; Belloti, João Carlos; Tamaoki, Marcel Jun Sugawara; Pimentel, Benedito Felipe Rabay

doi:10.1055/s-0041-1731361

Cited by 4 publications

(11 citation statements)

References 27 publications

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“…16,[19][20][21] A persistent median artery was associated with the BMN in 76% of the cases, compared to other studies that presented about 63% of correlation. 12,18 Regarding the mean diameter of this artery, it was similar to that found by the same author, being 1.4 mm (0.9-4.0) against 1.3 mm (0.8-2.5 mm). 3,7 Despite the results presented, our study has few cases, and they were not submitted to decompression in the same period since the beginning of the symptoms.…”

Section: Sexsupporting

confidence: 87%

“…O torniquete provoca esvaziamento dos vasos ou danos, aumentando o risco de sequelas e recidiva do quadro. [15][16][17][18][19] Gassner et al 16 descreveram uma classificação da artéria mediana persistente e do nervo mediano como normal, em divisão alta e NMB. Esta divisão correlaciona a localização da artéria mediana persistente ao nervo mediano no túnel do carpo (ulnar, radial ou intermediário).…”

Section: Discussionunclassified

“…16,[19][20][21] A artéria mediana persistente foi associada ao NMB em 76% dos casos, enquanto outros estudos apresentaram cerca de 63% de correlação. 12,18 O diâmetro médio desta artéria foi semelhante ao encontrado pelo mesmo autor, sendo de 1,4 mm (0,9-4,0) contra 1,3 mm (0,8-2,5 mm). 3,7 Apesar dos resultados apresentados, nosso estudo possui poucos casos, que não foram submetidos à descompressão no mesmo período desde o início dos sintomas.…”

Section: Discussionunclassified

“…The tourniquet leads to the emptying of the vessels or damage, increasing the risk of sequelae and recurrence of the condition. [15][16][17][18][19] Gassner et al 16 described a classification of the persistent median artery and the median nerve as normal, high division, and BMN. This division correlates the localization of the persistent median artery to the median nerve in the carpal tunnel (ulnar, radial, or intermediary).…”

Section: Sexmentioning

confidence: 99%

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Artéria mediana persistente e síndrome do túnel do carpo: Um estudo retrospectivo

Felix,

Pistilli,

Rezende

et al. 2024

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Este é um estudo retrospectivo acerca da persistência da artéria mediana associada à síndrome do túnel do carpo (STC). Métodos Este é um estudo retrospectivo da persistência da artéria mediana e STC. Os critérios de exclusão foram pacientes que não apresentavam artéria mediana persistente, aqueles que eram diabéticos ou reumatoides e os que decidiram não realizar a cirurgia. Apenas 25 pacientes foram elegíveis para este estudo retrospectivo. Resultados A trombose da artéria mediana apresentou diferenças estatísticas considerando as variáveis sexo (p = 0,009), achados eletroneuromiográficos (p = 0,021), profissão (p = 0,066) e “duração total desde o início dos sintomas” (p = 0,055). A atrofia da musculatura tenar não apresentou diferenças estatísticas à comparação das variáveis. O nervo mediano bífido apresentou diferenças estatísticas em comparação aos testes provocativos (p = 0,013), frequência dos sintomas (p = 0,001) e idade (p = 0,028). Conclusão Embora incomum, a persistência da artéria mediana deve ser considerada um diagnóstico diferencial da STC. A ultrassonografia é um método confiável para prever a anatomia do túnel do carpo. O início tardio e os sintomas podem influenciar a trombose arterial e piorar os sintomas.

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Section: Sexsupporting

confidence: 87%

Section: Discussionunclassified

Section: Sexmentioning

confidence: 99%

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Artéria mediana persistente e síndrome do túnel do carpo: Um estudo retrospectivo

Felix,

Pistilli,

Rezende

et al. 2024

Rev Bras Ortop (Sao Paulo)

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“…CTS is a common orthopaedic issue, mainly treated surgically with the MN release. This routine procedure may be complicated from the possible variants in the area, as their total prevalence in patients suffering from CTS is 63.5% (PMA, bi d MN, a transverse carpal muscle and a subligamentous recurrent branch of MN) [13]. The PMA causing CTS may be related to an aneurysmal or a thrombotic part of the vessel, resulting in paresthesia and pain in the area innervated by MN [8,20].…”

Section: Discussionmentioning

confidence: 99%

Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

Piagkou

Tsakotos

Triantafyllou

et al. 2023

Preprint

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Purpose The current report describes the bilateral coexistence of a persistent median artery (PMA) of ulnar origin and asymmetrical termination, with a bifid median nerve (MN) and an interconnection of the median with the ulnar nerve (MN-UN). Unilaterally the “reverse” interconnection (MN-UN) was identified. Emphasis was given to the artery’s developmental background. Methods The PMA was identified in an 80-year-old formalin-embalmed male cadaver, derived from a body donation program after a signed informed consent. Results In the right forearm, the PMA of antebrachial type, terminated at the wrist, posterior to the palmar aponeurosis. Two neural communications (-) were identified: the UN-MN deep branch, at the forearm’s upper third, and the MN deep stem-UN palmar cutaneous branch, at the lower third (9.7cm distally to the 1st communication). In the left forearm, the PMA of palmar type, ended in the palm giving off the 3rd and 4th proper palmar digital arteries. An incomplete superficial palmar arch was identified by the PMA, radial and ulnar arteries’ contribution. After MN bifurcation into superficial and deep branches, the deep branches formed a loop, through which coursed the PMA. The MN deep branch communicated with the UN palmar cutaneous branch. Conclusions The PMA should be evaluated, as a causative factor of carpal tunnel syndrome. The modified Allen's test, and the Doppler ultrasound may detect the arterial flow and the angiography may depict the vessel thrombosis in complex cases. PMA could also be a "salvage" vessel for the hand supply, in radial and ulnar artery trauma.

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The role of variant anatomy in neurosurgery

Shnyakin,

Rudenko,

Gasimova

2024

Nejrohirurgiâ (Mosk.)

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Variants of atypical structure and location of anatomical structures always complicate the course of surgical access and admission and are often the causes of surgical errors and complications. This article presents an overview of some features of variant anatomy in areas of interest to neurosurgeons, including those leading to the development of intraoperative problems and postoperative neurological deficits.The main message of the article is not only that neurosurgeons should plan surgery taking into account individual anatomical variability starting with the shape of the skull, but also that in cases of adverse perioperative events, atypical anatomy should be taken into account as an objective risk factor and have a mitigating value in the evaluation of the neurosurgeon’s performance.The aim of this paper is to present and analyse scientific publications on variant anatomy, determining its role in the development of surgical errors and complications in neurosurgery.

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Prevalência de variações anatômicas encontradas em pacientes com síndrome do túnel do carpo submetidos a liberação cirúrgica por via aberta clássica

Cited by 4 publications

References 27 publications

Artéria mediana persistente e síndrome do túnel do carpo: Um estudo retrospectivo

Artéria mediana persistente e síndrome do túnel do carpo: Um estudo retrospectivo

Median artery bilateral persistence in coexistence with a bifid median nerve and a communication with the ulnar nerve and vice-versa

The role of variant anatomy in neurosurgery

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