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At least 19 recordsLinked to original sources

Nerves in a pinch: imaging of nerve compression syndromes.

Nerve compression is a common entity that can result in considerable disability. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although the appropriate diagnosis is often determined by clinical examination, the diagnosis may be more difficult when the presentation is atypical, or when anatomic and technical limitations intervene. In these instances, imaging can have an important role in helping to define the site and etiology of nerve compression or in establishing an alternative diagnosis. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. For both modalities, the use of high-resolution techniques is important. Bony abnormalities contributing to nerve compression are best assessed by radiographs or CT. For the radiologist, knowledge of the anatomy of the fibro-osseous tunnels, familiarity with the causes of nerve compression, and an understanding of specialized imaging techniques are important for successful diagnosis of nerve compression.

Carpal Tunnel Syndrome↗

[Tarsal tunnel syndrome. Nerve compression syndrome in the foot].

Pathological changes in sensation over the sole of the foot do not always correspond to the full area of distribution of the posterior tibial nerve. Some neurologists advise separate examination of the tibial nerve, the medial and lateral plantar nerves, in order to ascertain whether either or both might be affected. 60 preparations of cadaveric feet in the Department of Anatomy were examined. Using a measuring grid, the position and size of the nerves in the tarsal tunnel were assessed and the facial band which define and divide the osteofibrous canal delineated. The corners of the measuring grid were the tip of the medial malleolus (A), the tip of the calcaneal tubercle at its greatest distance from the medial malleolus (B) and the tuberosity of the navicular bone (C). These points can also be clearly identified clinically. They define a triangle whose sides A-B and B-C are of constant equal length and whose base A-C varies little. The operative approach includes a T-shaped incision of the retinaculum. The vertical line of the T lies underneath the skin incision. The horizontal line corresponds with the upper border of the abductor hallucis muscle. The upper border of the abductor hallucis is defined and the muscle retracted medially to expose the deep fascia. This layer is removed together with the connective tissue bridge which stretches between the fascia and the calcaneus. The plantar nerves are discovered and run to the sole of the foot without further obstruction.

Diagnosis, Differential↗

Management of nerve compression syndrome in musicians.

Nerve compression syndromes are common in the general population, and they are also common in musicians. As many as 30% of musicians who have a recognized musculoskeletal disorder are diagnosed with a nerve compression syndrome. Thus, it is important to consider the diagnosis of nerve compression syndromes in all musicians who present with musculoskeletal complaints. Proper management of these problems is essential if one is to avoid significant morbidity.

Humans↗

Cochleovestibular nerve compression syndrome. II. Vestibular nerve histopathology and theory of pathophysiology.

The present study was undertaken to systematically examine and characterize pathological changes in vestibular nerve specimens obtained at surgery in patients with symptomatic cochleovestibular nerve compression syndrome (CNCS). Vestibular nerves were obtained in six cases of CNCS and were intermingled with vestibular nerves obtained in cases of Meniere's disease. All of the nerve specimens were coded and reviewed microscopically in a blind-study fashion by the neuropathologist. The vestibular nerves obtained from CNCS cases showed significant endoneurial fibrosis, compared to controls (specimens from patients with Meniere's disease). Based on observations in this study, as well as the clinical symptoms and audiovestibular test findings in these patients, a theory of pathophysiology in CNCS of the cochleovestibular nerve is proposed. The implications of this theory are discussed with respect to the diagnosis of CNCS.

Axons↗

Uncommon nerve compression syndromes of the upper extremity.

Nerve compression syndromes are a common cause of pain, sensory disturbance, and motor weakness in both the upper and the lower extremities. Although carpal tunnel syndrome is frequently diagnosed and treated surgically with success, other compression syndromes are less common and are often best treated nonsurgically. Understanding the anatomy of the major peripheral nerves with respect to intermuscular septa, fibrous bands, muscle margins, and internervous planes is crucial to understanding how and where peripheral nerve compression can occur. Some conditions, such as anterior interosseous nerve syndrome, respond well to nonoperative treatment; others, such as posterior interosseous nerve syndrome, are better treated by surgical intervention. The authors discuss the anatomic and pathologic causes for compression syndromes, as well as guidelines for treatment and outcomes.

Arm↗

[Cochleovestibular nerve compression syndrome. A case report].

Cochleovestibular nerve compression syndrome is a term used to describe a group of audiovestibular symptoms produced by vascular compression of the cochleovestibular nerve. The most frequent abnormalities are sensorineural hearing loss, asymmetry of the wave I-III and III-V interval in the auditory brainstem response, and changes in electronystagmography. The clinical presentation varies and symptoms include recurrent vertigo, tinnitus, instability, and motion intolerance. A case is reported of cochleovestibular nerve compression syndrome in a 40-year-old woman with right ear hearing loss and occasional dizziness and tinnitus. Clinical exploration disclosed no relevant findings, but the auditory brainstem response showed an increase in the wave I-V interval. Contrasted magnetic resonance imaging identified a vascular loop near the cochleovestibular nerve. The differential diagnosis and treatment of this rare syndrome are discussed.

Adult↗

[Post-traumatic painful ulnar nerve compression syndrome treated by wrapping the nerve with the vein: preliminary report].

Three cases of post-traumatic painful ulnar nerve compression syndrome are presented. Previous treatment both conservative and surgical (neurolysis) proved unsatisfactory. The method described-wrapping of the nerve with the saphenous vein graft in the area of scarification-gave satisfactory outcome in 2 of 3 operated patients (significant resolution of pain and improvement of sensation) in one year follow-up. In one patient surgery failed. The method presented might be considered in refractory cases of painful nerve compression syndrome due to its entrapment within scarred tissue after injury or previous surgery.

Arm Injuries↗

Nerve compression syndromes of the lower extremity.

Nerve compression syndromes of the lower extremity present a challenge in differential diagnosis. Compression of the common peroneal nerve occurs relatively frequently; compression of the sciatic nerve occurs infrequently. The pattern of weakness helps distinguish lumbar root entrapment from peripheral compression syndromes. Compression syndromes must also be differentiated from diabetic, alcoholic or vasculitic neuropathy. Recovery correlates with the degree and duration of nerve injury. Thus, early diagnosis and treatment are important.

Diagnosis, Differential↗

[Oligofascicular median nerve compression syndrome].

The anterior interosseous nerve syndrome is described as a compression of this nerve by a fibrous band in the region of the pronator teres or the flexor digitorum superficialis muscle. We report a case which appeared clinically as an anterior interosseous nerve syndrome but on exploration no fibrous band was present. The compression involved exclusively the fascicles in the main trunk of the median merve which form more distally the anterior interosseous nerve. The damage fascicles were resected and interfascicular nerve grafting was performed. After 16 months motor function has recovered well. Recently a similar case was observed.

Adult↗

[Postpartum obturator nerve syndrome: case report and review of the nerve compression syndrome during pregnancy and delivery].

Compression of a peripheral nerve or nerve trunk can occur during pregnancy and delivery. The injury may be caused by the fetal head, the application of forceps, trauma or hematoma due to cesarean section, or improper positioning in leg holders. Often, no cause of the injury is found. The most common nerve compression syndromes during pregnancy and delivery are carpal tunnel syndrome, femoral neuropathy, and post partal foot drop. Obturator neuropathy, meralgia paraesthetica, tarsal tunnel syndrome, and syndrome of the rectus abdominis muscle occur less frequently. Symptoms, such as paraesthesia, pain and palsies not always attract the immediate attention of the physician. Sometimes they are misinterpreted as nervous complaints. Often, remission is reached at delivery. A case of obturator neuropathy after delivery is reported, and literature on clinical, pathophysiological and electrophysiological findings in maternal obstetric palsies is reviewed.

Adult↗

[The ulnar nerve compression syndrome].

The ulnar nerve has to bear a large amount of compression, especially in the cubital tunnel, which can be deducted from the topographic relation of this nerve to the elbow. Apart from tightness of the tunnel, intraarticular changes can also cause compression of the nerve. A further narrow tunnel in the course of the ulnar nerve is the "loge de GUYON", situated in the hypothenar region. A careful neurological examination of sensory and motor signs as well as an accurate electromyographical examination differentiate compression syndromes from other neuropathies. Two unusual cases of a functional cubital tunnel syndrome are demonstrated: their cause was primarily a chondromatosis of the elbow joint in one case a functional vasal compression in the other case.

Elbow↗

Suprascapular nerve compression syndrome.

Five patients suffering from suprascapular nerve compression syndrome were treated by surgical decompression of the nerve. The syndrome is described and the surgical treatment is outlined. The diagnostic necessity for electromyography is stressed as is the intraoperative evaluation of the conductive obstacle by use of electrostimulation.

Adolescent↗

[Nerve compression syndromes of the elbow and hand].

The importance of nerve compression syndrome in the upper extremity for making a diagnosis or differential diagnosis in orthopedics, surgery, especially hand surgery, and neurology is evident. We review the characteristics of this entity, demonstrate the pathophysiological findings, and stress their importance on the diagnosis, therapy, indications for operation, and operative techniques in our patients. With special regard to the topographic anatomy each of these nerve compression syndromes of the elbow and the wrist region is demonstrated systematically and consequences are discussed for surgical therapy.

Carpal Tunnel Syndrome↗

Nerve compression syndromes as models for research on osteopathic manipulative treatment.

Experimental and clinical studies of nerve compression syndromes show that ischemia or edema, singly or combined, causes responses in nerves that lead to alterations in impulse conduction and to commonly observed clinical signs. Because osteopathic manipulative treatment (OMT) is thought to affect microcirculation and anatomic positioning of structures, nerve compression syndromes appear ideal as models for studying how OMT accomplishes results. We recommend that researchers develop experimental protocols or clinical studies of nerve compression syndromes that will use anatomic, histologic, and physiologic criteria to monitor the effects of OMT. Techniques such as soft tissue, muscle energy, counterstrain, or myofascial release are appropriate for study in nerve compression syndromes. Such studies are necessary to understand the biologic basis of OMT.

Animals↗

[Surgical treatment of suprascapular nerve compression syndrome through posterior approach].

OBJECTIVE: To discuss the optimal approach to treat suprascapular nerve compression syndrome. METHODS: From January 2000 to June 2003, 8 cases of suprascapular nerve compression syndrome were treated by surgical intervention to cut the transverse scapular ligament through posterior approach. Of the 8 patients, there were 2 males and 6 females (age ranged from 21 to 53) with duration of 6 months to 3 years. The change of symptom, muscle power, and muscle atrophy after operation were observed. RESULTS: One week after operation, pain around the scapular disappeared, muscle power of supraspinatus and infraspinatus muscles recovered to normal. One, 6, 12 and 16 months after the operation, the patients were followed up. No recurrence was observed. Muscle atrophy didn't recover. CONCLUSION: To treat suprascapular nerve compression syndrome with operation through posterior approach is easy to operate. When the suprascapular nerve is entrapped in scapular notch, this approach is a good choice.

Adult↗