Increased nerve vascularization detected by color doppler sonography in patients with ulnar neuropathy at the elbow indicates axonal damage

Frijlink, Daphne W.; Brekelmans, G. J. F.; Visser, Leo H.

doi:10.1002/mus.23505

Cited by 45 publications

(59 citation statements)

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“…A common finding is the presence of detectable intraneural blood flow (INBF), which often correlates with nerve size and electrophysiological severity. Detectable INBF has also been shown to be associated with axonal loss . Of interest, none of these studies reported the detection of INBF in healthy subjects, suggesting that the presence of nerve hypervascularity may be pathological.…”

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confidence: 99%

Effects of hemodialysis on intraneural blood flow in end‐stage kidney disease

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Effects of hemodialysis on intraneural blood flow in end‐stage kidney disease

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“…Intraneural hypervascularization in penetrating nerve injury seems to be a more robust and consistent phenomenon in comparison to other peripheral nerve conditions, such as entrapment neuropathies or inflammatory neuropathies, resembling the intensity and extension seen in peripheral nerve sheath tumors, such as schwannomas . A direct comparison is, however, hampered by methodological issues, as either no quantification of flow signals was performed, or a different method was used in these studies.…”

Section: Discussionmentioning

confidence: 88%

“…Presently, the demonstration of any intraneural blood flow is usually considered to be hypervascularization of the nerve and a pathological sign in conditions such as carpal tunnel syndrome, ulnar neuropathy at the elbow, chronic inflammatory demyelinating polyneuropathy, leprosy, and certain peripheral nerve sheath tumors . However, no ultrasonographic data are available concerning vascularity and nerve regeneration following nerve trauma, where the development of vasculature has been shown to be a crucial element in animal models .…”

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Ultrasonographic demonstration of intraneural neovascularization after penetrating nerve injury

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“…Assessment of intraneural vascular flow is based on Doppler and power Doppler techniques (the latter being particularly effective to show small vessel flow), which enable depiction of the nerve circulatory system 26 . In healthy nerves, vascularization cannot be detected, whereas increased intraneural vascularization can be seen in entrapment 27 , inflammatory neuro pathies 22 and neurolymphomatosis 28 . The clinical value of intraneural vascular flow is currently under debate.…”

Section: Ultrasonographymentioning

confidence: 99%

New technologies for the assessment of neuropathies

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Peripheral neuropathies are among the most common neurological disorders 1 . In routine clinical practice, diagnosis of peripheral neuropathies is typically based on clinical assessment, nerve conduction studies and needle electromyography, which can determine whether symptoms are caused by primary axonal damage or demyelinating damage. This distinction is often relevant to therapeutic choices and to prognosis, as axonal damage typically reflects an inflammatory (for example, vasculitic) or degenerative (for example, hereditary or idiopathic) process that correlates with disability, whereas demyelinating damage can reflect a hereditary neuro pathy, but more often reflects an acquired immunemediated neuropathy. Besides metabolic, inflammatory or primary degenerative neuropathies, peripheral nerves can also be damaged by compression from adjacent tissue structures, such as tendons, cysts or haematomas. In this case, proper identification of the site, nature and degree of the lesion might be challenging, but is relevant to treatment and prognosis. Moreover, some patients present with symptoms that suggest damage to small nerve fibres, which nerve conduction studies cannot be used to detect.In the past 15 years, several techniques have become available to investigate focal and diffuse peripheral neuropathies, and their reliability has widened the spectrum of diagnostic tools for clinicians and improved assessment of neuropathies. In this Review, we provide an overview of these new and emerging technologies. We first discuss peripheral nerve imaging with MRI and ultrasonography, which can provide information about the precise localization of neuro pathies and the pathological processes involved in large-fibre neuropathies, and can complement clinical and electrophysiological evaluation. We then consider techniques that can provide diagnostic information when the pathological process is restricted to small nerve fibres and is consequently not detectable with nerve conduction studies or neuroimaging. These include skin biopsy, which is established in clinical practice, and the emerging techniques of corneal confocal microscopy, laser-evoked potentials and heat-related and pain-related evoked potentials, and microneurography.Nerve imaging technology Advances in imaging techniques have made it possible to gain great insight into nerve pathology with magnetic resonance and ultrasound. Each approach offers distinct advantages, and can provide different information about damage to large myelinated fibres. Abstract | Technical advances are rapidly changing the clinical and instrumental approach to peripheral nerve diseases. Magnetic resonance neurography, diffusion tensor imaging and nerve ultrasonography are increasingly entering the diagnostic workup of peripheral neuropathies as tools that complement neurophysiology and enable investigation of proximal structures, such as plexuses and roots. Progress in the design of magnetic resonance scanners and sequences, and the development of high-frequency ultrasound probes mean th...

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Increased nerve vascularization detected by color doppler sonography in patients with ulnar neuropathy at the elbow indicates axonal damage

Abstract: IVUS in the ulnar nerve can be detected in patients with UNE and is associated with nerve enlargement and clinical and electrodiagnostic severity. In addition, IVUS is associated with axonal damage.

Cited by 45 publications

References 18 publications

Effects of hemodialysis on intraneural blood flow in end‐stage kidney disease

Effects of hemodialysis on intraneural blood flow in end‐stage kidney disease

Ultrasonographic demonstration of intraneural neovascularization after penetrating nerve injury

New technologies for the assessment of neuropathies

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