Homolateral Hourglass-Like Constrictions of the Axillary and Suprascapular Nerves: Case Report

Ultrasonographic identification of nerve pathology in neuralgic amyotrophy: Enlargement, constriction, fascicular entwinement, and torsion

“…The possible causes of this unfavorable outcome have not been addressed previously. On the other hand, for over 40 years, hand surgeons and neurosurgeons have been publishing case reports of patients with the peculiar surgical finding of non‐traumatic, non‐compressive, hourglass‐like constriction on upper limb nerves, sometimes associated with nerve torsion . Ochi et al .…”

“…The cause of the incomplete or absent nerve regeneration in some patients is unknown; however, a clue may have been provided by recent studies reporting a peculiar surgical finding of “hourglass‐like fascicular constriction” of the upper extremity nerves in a large series of patients with typical symptoms of neuralgic amyotrophy and no spontaneous recovery . Since 1966, the “hourglass‐like constriction” of nerves or nerve fascicles has been described in numerous case reports as a surgical finding on various nerves, including the posterior interosseous nerve (PIN), the median and anterior interosseous nerves (AINs), the main trunk of the radial nerve, the musculocutaneous nerve, and the suprascapular and axillary nerves . When available, histology showed inflammatory signs.…”

Typical Brachial Neuritis (Parsonage-Turner Syndrome) With Hourglass-Like Constrictions in the Affected Nerves

“…The involved nerves have included the main trunk of the radial nerve and posterior interosseous nerve, 4 -9 the main trunk of the median nerve and anterior interosseous nerve, 9 -12 the axillary nerve, 13,14 and the suprascapular nerve. 14 Most of these reported cases presented as an involve-FIGURE 1: Finding at surgery in case 1.…”

“…ment of an isolated peripheral nerve, and to the best of our knowledge, only 3 cases published in the English literature had multiple nerve involvement. 9,14,15 It is well accepted that this phenomenon is not caused by external compression. However, the etiology of this phenomenon is still unclear.…”

Prospective clinical and sonographic observation of the patient with hourglass-like focal radial nerve constriction

“…В 1966 г. опубликовано наблюдение с описанием слу-чайной находки фокальной констрикции перифери-ческого нерва (ФКПН) по типу «песочных часов» у пациента, направленного на хирургическое лечение по поводу острой нейропатии лучевого нерва [1]. В по-следующем случаи ФКПН были описаны и другими хирургами [2][3][4][5][6][7][8], а также представлены результаты сопоставления операционных находок с результатами изменения нерва по данным ультразвукового исследо-вания (УЗИ) и магнитно-резонансной томографии на том же уровне [9][10][11][12][13], при этом не проводилось системной оценки обнаруженных изменений. Вопрос о структурных и функциональных нарушениях пери-ферического нерва при острых мононейропатиях до сих пор остается открытым.…”