A novel classification of musculocutaneous nerve variations: The relationship between the communicating branch and transposed innervation of the brachial flexors to the median nerve

Hayashi, Mitsuhiro; Shionoya, Kento; Hayashi, Shunsuke; Hatayama, Naoyuki; Kawata, Sumio; Qu, Ning; Hirai, Shuichi; Miyaso, Hidenobu; Itoh, Masahiro

doi:10.1016/j.aanat.2016.08.004

Cited by 19 publications

(23 citation statements)

References 17 publications

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“…Carmeliet [1] points to the existence of common molecular signals and pathways during development of the blood vessels and nerves, which may explain the coexistence of anatomical variations of neurovascular structures. Combined anatomical variations of nerves and blood vessels, similar to those described in our report, may also constitute a potentially important clinical and surgical issue, especially during repair of the brachial plexus or its branches, as well as during surgical procedures performed within the upper limb [2, 5, 16]. …”

Section: Discussionsupporting

confidence: 57%

“…According to those authors “sensory and motor branches are not consistently reported in the brachial plexus descriptions in dissection studies and there is no agreement regarding the actual sequence of these branches along the nerve” [16]. In our case the muscular branches to the brachial flexors were distributed in the order described by Hayashi et al [5]; The most proximal was the branch to the coracobrachialis muscle, the second was the branch to the biceps brachii muscle and the most distal was the branch to the brachialis muscle. However, only the last branch arose directly from the musculocutaneous nerve.…”

Section: Discussionmentioning

confidence: 57%

“…The musculocutaneous and median nerves may be fused at some distance [5, 8]. The origin of the branch to the coracobrachialis muscle may be from the lateral cord of the brachial plexus [8, 16].…”

Section: Discussionmentioning

confidence: 99%

“…Such anastomosis is observed in 17.8–54.55% of cases and may be of great importance during radial artery catheterization [3, 7, 10, 11]. In the clinical context, it is also important to know possible anatomical variations of the median nerve and the musculocutaneous nerve [5, 8, 16]. In some cases, the coexistence of anatomical variations of the nerves and vessels can even be a source of conflict between individual structures, e.g., entrapment neuropathy of the median nerve due to the atypical (superficial to the nerve) course of the brachial artery [9].…”

Section: Introductionmentioning

confidence: 99%

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Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

et al. 2019

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The use of the term “brachioradial artery” was introduced for the high origin of the radial artery. Although the prevalence of the brachioradial artery reported by different authors varies from 4.67 to 15.6%, the presence of the hypoplastic brachial segment of the brachioradial artery is rare with an occurrence rate of 0.83%. Moreover, in just 0.6% of cases the loop of the median nerve may be placed near half of the length of the brachial artery, as in the case described in our report. A comprehensive understanding of anatomical variations of neurovascular structures in the upper limb is of great clinical significance. The presented case report illustrates a rare manifestation of persistent primitive developmental relationships in the arterial pattern of the upper limb (persistent, hypoplastic brachial segment of the superficial brachioradial artery), coexisting with atypical formation of the median and musculocutaneous nerves. Anatomical variations of vessels and nerves may coexist which should be taken into account when performing vascular, reconstructive or orthopedic surgery.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

et al. 2019

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“…carcinoma or melanoma operations. Trap neuropathies and injuries due to the unexpected origin, course, and distribution of the nerves are common in the presence of the variant nerves [1,6,[10][11][12].…”

Section: Bilateral Variations Of Median Nerve Formation and Endpoint mentioning

confidence: 99%

Bilateral variations of median nerve formation and endpoint variation of brachiales veins

Dıramali¹,

Kosif²,

Meyvaci³

et al. 2019

Int J Anat Var

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Prevalence of musculocutaneous nerve variations: Systematic review and meta‐analysis

et al. 2018

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We aimed to establish the prevalence of the musculocutaneous nerve (MCN) variations and the probability of the variation being pure or mixed in the same plexus. We applied the principles of evidence-based anatomy to find, appraise, and synthesize data through a meta-analysis of anatomical studies. The variations were grouped based on the presence and location of the communicating branch with the median nerve and the origin of branches to anterior arm muscles. Forty-three cadaveric studies met the inclusion criteria, providing data from 4124 plexuses. The overall pooled prevalence of plexuses with MCN variations was 20%. Based on the classification applied in our study, the pooled prevalence of variations was 17% in region 1A, 20% in region 1B, 36% in region 2 and 49% in region 3. Importantly, 64.58% of variations in region 1A and 74.14% of variations in region 1B were mixed, that is, associated with a variation in another region. The odds of finding another variation in the presence of a variation in region 2 or 3 were equal 0.37 and 0.52, respectively, demonstrating a significantly lower probability of finding mixed variations involving these regions, when compared with region 1A. Variations of the MCN are most common in the part distal to the exit from within or beneath the coracobrachialis muscle. Proximal variations are more often associated with another variation located along the nerve. These findings can assist health care professionals in the treatment of brachial plexus lesions. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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A novel classification of musculocutaneous nerve variations: The relationship between the communicating branch and transposed innervation of the brachial flexors to the median nerve

Cited by 19 publications

References 17 publications

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Hypoplastic superficial brachioradial artery coexisting with atypical formation of the median and musculocutaneous nerves: a rare combination of unusual topographical relationships

Bilateral variations of median nerve formation and endpoint variation of brachiales veins

Prevalence of musculocutaneous nerve variations: Systematic review and meta‐analysis

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