Schwannoma of the median nerve (even outside the wrist) may mimic carpal tunnel syndrome

Padua, Luca; Pazzaglia, Costanza; Insola, Angelo; Aprile, Irene; Caliandro, Pietro; Rampoldi, Michele; Bertolini, Carlo; Tonali, P.

doi:10.1007/s10072-006-0527-9

Cited by 27 publications

(18 citation statements)

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“…However, no compatibility could be detected between the severity of these changes and complaints. This is in harmony with other examples reported in the literature (3,6,19,24,25).…”

Section: Discussionsupporting

confidence: 92%

The role of wrist MR imaging in the differential diagnosis of the carpal tunnel syndrome

Önen¹,

Kayalar²,

Ilbas³

et al. 2014

Turkish Neurosurgery

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AIm:The carpal tunnel syndrome (CTS) is the commonest compressive neuropathy. Electromyography (EMG) is accepted as gold standard in diagnosis of CTS. However, pathologies and variations that are associated with a various findings may lead to failure. sOnuÇ: Klinik ve EDT ile KTS tanısı alan hastalarda bilek MRİ eşlik eden patolojileri ortaya koyabilmektedir. Ek patolojiler uygulanacak cerrahi şeklini değiştirebileceği gibi, postoperatif başarısızlığı da azaltılacaktır. Özellikle belirgin predispozan faktörü olmayan, tek taraflı KTS öyküsü bulunan, kliniğinde şüpheli semptomları olan olgularla ve endoskopik cerrahi planlanan hastalara el bileği MRİ önerilir.

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“…However, no compatibility could be detected between the severity of these changes and complaints. This is in harmony with other examples reported in the literature (3,6,19,24,25).…”

Section: Discussionsupporting

confidence: 92%

The role of wrist MR imaging in the differential diagnosis of the carpal tunnel syndrome

Önen¹,

Kayalar²,

Ilbas³

et al. 2014

Turkish Neurosurgery

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“…These structures included traumatic neuromas, Schwannomas, lipofibromatous hamartomas, ganglion cysts, thrombosed persistent median arteries, an abscess, and compressive gouty tophus. [55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73] Conclusion. Based on Class II evidence, neuromuscular ultrasound of the wrist probably adds value to electrodiagnostic studies when assessing CTS as it can detect structural abnormalities.…”

Section: Analysis Of the Evidencementioning

confidence: 99%

Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome

et al. 2012

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“…Any process that causes an increase in the pressure in the carpal tunnel, such as space-occupying lesions (eg, lipoma and ganglion), tenosynovitis due to connective tissue diseases, gouty tophus, vascular anomalies (persistent median artery with or without an aneurysm), or malunited distal radial fractures, may lead to carpal tunnel syndrome. Benign neoplasms of the nerve, such as lipofibromatous hamartoma of the nerve 15 and schwannoma, 16 may also cause carpal tunnel syndrome when they occur in the carpal tunnel. Likewise, a bifid median nerve occurs relatively frequently in patients with carpal tunnel syndrome.…”

Section: Discussionmentioning

confidence: 99%

Bifid Median Nerve Causing Carpal Tunnel Syndrome: MRI and Surgical Correlation

Bagatur¹,

Yalçınkaya²,

Atça³

2013

Orthopedics

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Carpal tunnel syndrome can be secondary in some patients, and vascular anomalies (usually a persistent median artery), median nerve variations, or both are among the etiologic factors. High division of the median nerve proximal to the carpal tunnel (known as a bifid median nerve) is a median nerve anomaly that has an incidence rate of 2.8%. This rare entity is often associated with various abnormalities that are clinically relevant, such as vascular malformations (persistent median artery), aberrant muscles, and carpal tunnel syndrome. The bifid median nerve is one cause of carpal tunnel syndrome because of its relatively higher cross-sectional area compared with a nonbifid median nerve. Obtaining magnetic resonance imaging and ultrasounds of bifid median nerves has helped surgeons avoid potential surgical hazards.This article describes 3 men with 4 bifid median nerves associated with a persistent median artery. Mean patient age was 38 years (range, 37-40 years). Mean follow-up was 7 years (range, 3-11 years). Patients were diagnosed with carpal tunnel syndrome and underwent open carpal tunnel release. To reveal a morphological etiology in patients in whom it the possibility of having idiopathic carpal tunnel syndrome is unlikely, preoperative imaging studies should be obtained. Bifid median nerves associated with a persistent median artery in the carpal tunnel are important to understand for their clinical and surgical significance. A secondary nature should be suspected in patients with unilateral symptoms, especially those with a history of symptoms and when the symptomatic hand shows severe neurophysiologic impairment but the contralateral hand is neurophysiologically intact. Inadvertent injury to the median nerve during carpal tunnel surgery can be minimized if the variations of the median nerve are recognized.

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Schwannoma of the median nerve (even outside the wrist) may mimic carpal tunnel syndrome

Cited by 27 publications

References 0 publications

The role of wrist MR imaging in the differential diagnosis of the carpal tunnel syndrome

The role of wrist MR imaging in the differential diagnosis of the carpal tunnel syndrome

Evidence‐based guideline: Neuromuscular ultrasound for the diagnosis of carpal tunnel syndrome

Bifid Median Nerve Causing Carpal Tunnel Syndrome: MRI and Surgical Correlation

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