Ultrasonography for nerve compression syndromes of the upper extremity

최수정,안재홍,류대식,강채훈,Seung Mun Jung,박만수,신동락 대한초음파의학회 2015 ULTRASONOGRAPHY Vol.34 No.4

Nerve compression syndromes commonly involve the nerves in the upper extremity. Highresolutionultrasonography (US) can satisfactorily assess these nerves and may detect themorphological changes of the nerves. US can also reveal the causes of nerve compression whenstructural abnormalities or space-occupying lesions are present. The most common US finding ofcompression neuropathy is nerve swelling proximal to the compression site. This article reviewsthe normal anatomic location and US appearances of the median, ulnar, and radial nerves. Common nerve compression syndromes in the upper extremity and their US findings are also reviewed.

제8뇌신경의 혈관성 신경압박증후군: 임상적 특징과 약물 치료

김동현,김형종,홍성광,이효정 대한이비인후과학회 2014 대한이비인후과학회지 두경부외과학 Vol.57 No.8

Background and Objectives Neurovascular compression syndrome of the eighth cranial nerve is characterized by recurrent auditory and vestibular symptoms. A detailed history and laboratory findings are important in the differential diagnosis of other diseases, such as Meniere’s disease, vestibular neuritis, or vestibular migraine. This study reviewed its clinical features and the efficacy of medical treatment. Subjects and Method The medical records of seven patients with a diagnosis of neurovascular compression syndrome of the eighth cranial nerve were reviewed retrospectively. Results Their ages at the time of disease onset ranged from 30 to 67 years. Six of the patients had unilateral typewriter tinnitus, like Morse code, and five had vertigo. The duration of these symptoms was up to 20 seconds. Three of the five patients with vertigo had canal paresis. All patients responded completely to carbamazepine or oxcarbazepine. Conclusion Medical treatment was very successful for treating the symptoms of neurovascular compression syndrome of the eighth cranial nerve. The characteristics of the audiovestibular symptom and laboratory results are important for differentiating other diseases. Korean J Otorhinolaryngol-Head Neck Surg 2014;57(8):518-25

제8뇌신경의 혈관성 신경압박증후군

이효정,김동현 대한이비인후과학회 2013 대한이비인후과학회지 두경부외과학 Vol.56 No.11

Neurovascular compression syndrome of the eighth cranial nerve is characterized by recurrent audiologic and vestibular symptoms. The clinical presentation is the most important for diagnosing neurovascular compression syndrome of the eighth cranial nerve. This review describes the pathophysiology, diagnosis and treatment of neurovascular compression syndrome of the eighth cranial nerve.

Ultrasonographic findings of posterior interosseous nerve syndrome

김유동,하두회,이상민 대한초음파의학회 2017 ULTRASONOGRAPHY Vol.36 No.4

Purpose: The purpose of this study was to evaluate the ultrasonographic findings associated with posterior interosseous nerve (PIN) syndrome. Methods: Approval from the Institutional Review Board was obtained. A retrospective review of 908 patients' sonographic images of the upper extremity from January 2001 to October 2010 revealed 10 patients suspicious for a PIN abnormality (7 male and 3 female patients; mean age of 51.8±13.1 years; age range, 32 to 79 years). The ultrasonographic findings of PIN syndrome, including changes in the PIN and adjacent secondary changes, were evaluated. The anteroposterior diameter of the pathologic PIN was measured in eight patients and the anteroposterior diameter of the contralateral asymptomatic PIN was measured in six patients, all at the level immediately proximal to the proximal supinator border. The size of the pathologic nerves and contralateral asymptomatic nerves was compared using the Mann-Whitney U test. Results: Swelling of the PIN proximal to the supinator canal by compression at the arcade of Fröhse was observed in four cases. Swelling of the PIN distal to the supinator canal was observed in one case. Loss of the perineural fat plane in the supinator canal was observed in one case. Four soft tissue masses were noted. Secondary denervation atrophy of the supinator and extensor muscles was observed in two cases. The mean anteroposterior diameter of the pathologic nerves (n=8, 1.79±0.43 mm) was significantly larger than that of the contralateral asymptomatic nerves (n=6, 1.02±0.22 mm) (P=0.003). Conclusion: Ultrasonography provides high-resolution images of the PIN and helps to diagnose PIN syndrome through visualization of its various causes and adjacent secondary changes

정중신경병증

홍석우,공현식 대한의사협회 2017 대한의사협회지 Vol.60 No.12

The median nerve is the most important nerve in the upper extremity, as it is responsible for most of the sensation of the hand, the fine motor functions of the thumb, and finger grasping. Median neuropathies most commonly occur as compressive neuropathy or entrapment neuropathy, but sometimes as neuritis without any compressive lesion. Carpal tunnel syndrome (CTS), anterior interosseous nerve syndrome, and pronator teres syndrome are the subtypes of median nerve neuropathies, of which CTS is the most common. Median neuropathies can be diagnosed clinically by careful history-taking and a physical examination. Typical symptoms of CTS include night pain (crying), a tingling sensation of the radial digits, numbness or paresthesia, clumsiness, and atrophy of the thenar muscles. Electrophysiologic testing can be used for confirmation of the diagnosis and for documentation before surgical treatment. Imaging modalities including ultrasonography or magnetic resonance imaging can be used to ensure diagnostic accuracy and to detect unusual causes of compression. Conservative treatments include rest, bracing, nerve stretching, non-steroidal anti-inflammatory drugs, and steroid injections. If nonsurgical approaches are unsatisfactory or the nerve damage is severe, surgical treatment should be considered. Carpal tunnel release for CTS is a relatively simple procedure that involves division of the transverse carpal ligament and decompression of the median nerve. Early diagnosis and proper management are important, as muscle atrophy and sensory loss may persist when surgical release is delayed in patients with advanced disease.

Compressive Neuropathy of the Posterior Tibial Nerve at the Lower Calf Caused by a Ruptured Intramuscular Baker Cyst

문석호,임선,박근영,문수진,박혜정,최현숙,조일련 대한재활의학회 2013 Annals of Rehabilitation Medicine Vol.37 No.4

Baker cyst is an enlargement of the gastrocnemius-semimembranosus bursa. Neuropathy can occur due to either direct compression from the cyst itself or indirectly after cyst rupture. We report a unique case of a 49-year-old man with left sole pain and paresthesia who was diagnosed with posterior tibial neuropathy at the lower calf area, which was found to be caused by a ruptured Baker cyst. The patient’s symptoms resembled those of lumbosacral radiculopathy and tarsal tunnel syndrome. Posterior tibial neuropathy from direct pressure of ruptured Baker cyst at the calf level has not been previously reported. Ruptured Baker cyst with resultant compression of the posterior tibial nerve at the lower leg should be included in the differential diagnosis of patients who complain of calf and sole pain. Electrodiagnostic examination and imaging studies such as ultrasonography or magnetic resonance imaging should be considered in the differential diagnosis of isolated paresthesia of the lower leg.

Tarsal Tunnel Syndrome: A Narrative Review

Kim Jahyung,Cho Jaeho 대한말초신경학회 2024 The Nerve Vol.10 No.1

Tarsal tunnel syndrome is a compressive neuropathy of the posterior tibial nerve beneath the flexor retinaculum on the medial ankle. Several intrinsic or extrinsic factors may contribute to pain over the medial plantar aspect of the foot that is aggravated by activities. In the presence of suggestive clinical features, appropriate use of radiographic and electrodiagnostic tests can be helpful. Surgical management is considered in patients who do not respond to non-operative treatment or those who have a space-occupying lesion within the tarsal tunnel. Along with surgical decompression of the posterior tibial nerve, complete removal of the causative space-occupying lesion is needed to prevent recurrence.

Thoracic Outlet Syndrome Induced by Huge Lipoma: A Case Report

설정훈,임정욱,강신광,최승원,권현조,염진영 대한신경손상학회 2019 Korean Journal of Neurotrauma Vol.15 No.1

Thoracic outlet syndrome is a relatively well known disease. Other than trauma, this diseaseis mostly caused by anatomical structures that cause vascular or neural compression. Thecause of thoracic outlet syndrome is diverse; however, there are only few reports of thoracicoutlet syndrome caused by lipoma in the pectoralis minor space. We report a case ofcompression of the lower trunk of brachial plexus in which a large lipoma that developed inthe pectoral minor space grew into the subclavicular space, along with a review of literature.

추골동맥과 후하소뇌동맥 굴곡에 의해 발생한 설하신경 압박 견인 및 혀인두신경통 증례

박효진,이우진,윤창호,박성호 대한신경과학회 2023 대한신경과학회지 Vol.41 No.4

Glossopharyngeal neuralgia is a condition characterized by lancinating pain in the tongue, soft palate, and pharynx. This condition can be caused by the combination of traction and compression of the glossopharyngeal nerve by tortuous vertebral and posterior inferior cerebellar arteries, which tug down and exert pressure on the nerve. Medical treatments including carbamazepine and gabapentin have been found to effectively manage glossopharyngeal neuralgia, even in cases with overt compression and traction of the nerve.

Diagnosis of Pure Ulnar Sensory Neuropathy Around the Hypothenar Area Using Orthodromic Inching Sensory Nerve Conduction Study: A Case Report

김민제,강종우,김구영,임성규,김기훈,박병규,김동휘 대한재활의학회 2018 Annals of Rehabilitation Medicine Vol.42 No.3

Ulnar neuropathy at the wrist is an uncommon disease and pure ulnar sensory neuropathy at the wrist is even rarer. It is difficult to diagnose pure ulnar sensory neuropathy at the wrist by conventional methods. We report a case of pure ulnar sensory neuropathy at the hypothenar area. The lesion was localized between 3 cm and 5 cm distal to pisiform using orthodromic inching test of ulnar sensory nerve to stimulate at three points around the hypothenar area. Ultrasonographic examination confirmed compression of superficial sensory branch of the ulnar nerve. Further, surgical exploration reconfirmed compression of the ulnar nerve. This case report demonstrates the utility of orthodromic ulnar sensory inching test.