Peroneal sensory neuropathy entrapment syndrome.
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Compression of the axillary nerve in the quadrangular space is an unusual cause of pain and paresthesia of the upper extremity. In this report, the authors present a patient with a 1-year history of an undiagnosed axillary nerve compression associated with radial sensory neuropathy who improved after surgical decompression of the quadrangular space.
Neck pain is common in the elderly. An outline of the relevant anatomy and pathological conditions which affect the cervical spine and an approach to diagnosis are presented. Intrinsic causes of pain arise in the vertebral column itself--arthritis, discogenic disorders, trauma, tumors, and infection; in the cervical musculature--myofascial pain syndrome, torticollis, and whiplash; and in the spinal cord from tumors. Differentiation of these causes from extrinsic causes of neck pain will enable the appropriate management protocols to be implemented. Many of these problems can be treated effectively at the primary care level. Guidelines for specialist referral are suggested.
The Author refer about a pain syndrome of the wrist, characterized by nerve interosseous radial compression at carpal. A surgical enervation gives in all patients treated, a total remissione of pain.
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Peripheral nerve trunks are well-vascularized structures where a well-developed collateral system may compensate for local vascular damage. Interference with intraneural blood flow is reflected rapidly in disturbances in nerve function. In compression lesions and nerve entrapments, the microvascular factor plays an important pathophysiologic role for development of symptoms. Although endoneurial capillaries normally constitute a BNB helping to optimize endoneurial environment, damage to the vessels may induce a miniature closed compartment syndrome by increasing the permeability, thereby contributing to increased endoneurial fluid pressure and development of an intrafascicular edema. Surgeons, performing intraneural dissections, should be aware of the potential risks associated with intraneural bleedings, edema, and intraneural fibrosis.
Neurologic syndromes may be caused by mechanical vascular compression of cranial nerves in the posterior fossa. The clinical expression is variable and can be divided into two main groups. Isolated cranial nerve involvement is most frequently associated with tortuous, elongated vertebral and basilar arteries as well as redundant loops of the anteroinferior cerebellar artery. Pseudotumoral manifestations of cranial nerve involvement at the level of the cerebellopontine angle are more frequently related to aneurysms of the vertebral and basilar arteries.
Conventional electromyographic and nerve-conduction studies usually do not show abnormalities in patients who have a clinical diagnosis of radial tunnel syndrome. Therefore, posterior interosseous nerve-conduction measurements were performed during forced supination in patients who had this syndrome. Only one of sixteen patients had a major increase in latency. Our data do not support the hypothesis that the signs and symptoms in most patients who have a diagnosis of radial tunnel syndrome are caused by compression of the posterior interosseous nerve.
A rare case of cubital tunnel syndrome caused by the snapping of the medial head of the triceps brachii muscle in a 20-year-old man was reported. The ulnar nerve was compressed by the medial head of the triceps, which snapped from the back, and was constricted at the tendinous arch of origin of the flexor carpi ulnaris. Medial epicondylectomy with division of tendinous arch was carried out, and the postoperative course was satisfactory. Our case is compared with four cases reported previously.
Three patients exhibited variable weakness of toe extensors after trivial injuries. The first patient suffered an acute, partial anterior compartment syndrome during a prolonged motorbike ride; the second a traction injury of the deep peroneal nerve while slipping during a racquetball game. The third patient developed a compression injury of the peroneal nerve on the basis of a generalized demyelinating polyneuropathy. The major clues for diagnosis and management came from electromyographic (EMG) examination.