Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2020; 30(02): 229-232
DOI: 10.4103/ijri.IJRI_423_19
Case Report

A rare cause of median neuropathy at the carpal tunnel: Thrombosis of the persistent median artery

Richa D Jain
Departments of Radiodiagnosis, Aster CMI Hospital, Bengaluru, Karnataka
,
Lokesh Bathala
Departments of Neurology, Aster CMI Hospital, Bengaluru, Karnataka
,
H K Anuradha
Departments of Neurology, Aster CMI Hospital, Bengaluru, Karnataka
,
Sudhir K Kale
Departments of Radiodiagnosis, Aster CMI Hospital, Bengaluru, Karnataka
,
Guruprasad S Pujar
Departments of Neurology, Aster CMI Hospital, Bengaluru, Karnataka
,
Man M Mehndiratta
Department of Neurology, Janakpuri Super Speciality Hospital, New Delhi, India
,
Leo H Visser
Department of Neurology and Clinical Neurophysiology, St. Elisabeth Hospital, Tilburg, Netherland
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Carpal tunnel syndrome is a common peripheral nerve entrapment neuropathy caused due to compression of the median nerve at the level of the wrist joint. Bifid median nerve associated with a persistent median artery is a rare entity and in itself asymptomatic anatomical variant. However, distension of the persistent median artery due to a thrombus can be symptomatic due to compression on the median nerve and can compromise the blood flow to the palm. We report a case of persistent median artery thrombosis in a young female patient who presented with symptoms of carpal tunnel syndrome diagnosed on the ultrasonography and confirmed on the MRI with subsequent improvement post anticoagulation therapy.

Keywords

Carpal tunnel - MR Angiogram - persistent median artery - thrombosis - ultrasound


Publication History

Received: 15 October 2019

Accepted: 05 March 2020

Article published online:
19 July 2021

© 2020. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Mitchell R, Chesney A, Seal S, McKnight L, Thoma A. Anatomical variation of the carpal tunnel structures. Can J Plast Surg 2009; 17: 3-7
    CrossrefSearch in Google Scholar
  • 2 Srivastava A, Sharma P, Pillay S. Persistent median artery thrombosis: A rare cause of carpal tunnel syndrome. Australas J Ultrasound Med 2015; 18: 82-5
    CrossrefPubMedSearch in Google Scholar
  • 3 Eid N, Shibata MA, Otsuki Y. Persistant median artery: Cadaveric study and review of literature. J Clin Anat 2011; 00: 1-7
    Search in Google Scholar
  • 4 Rodríguez-Niedenführ M, Sañudo JR, Vázquez T, Nearn L, Logan B, Parkin I. Median artery revisited. J Anat 1991; 195: 57-63
    CrossrefSearch in Google Scholar
  • 5 Kele H, Verheggen R, Reimers CD. Carpal tunnel syndrome caused by thrombosis of the median artery: The importance of high-resolution ultrasonography for diagnosis. J Neurosurg 2002; 97: 471-3
    CrossrefPubMedSearch in Google Scholar
  • 6 Vag T, Koch M, Waldt K. Acute carpal tunnel syndrome from dissected and thrombosed persistent median artery diagnosed at magnetic resonance imaging. Rofo 2012; 184: 829-30
    Thieme ConnectPubMedSearch in Google Scholar
  • 7 Fumière E, Dugardeyn C, Roquet ME, Delcour C. US demonstration of a thrombosed persistant median artery in carpal tunnel syndrome. JBR-BTR 2002; 85: 1-3
    PubMedSearch in Google Scholar
  • 8 Barfred T, Hojlund AP, Bertheussen K. Median artery in carpal tunnel syndrome. J Hand Surg [Br] 1985; 10A: 864-68
    CrossrefPubMedSearch in Google Scholar
  • 9 Bilgin SS, Olcay SE, Derincek A, Adiyaman S, Demirtas AM. Can simple release relieve symptoms of carpal tunnel syndrome caused by a persistent median artery?. Arch Orthop Trauma Surg 2004; 124: 154-6
    CrossrefPubMedSearch in Google Scholar
  • 10 Lisanti M, Rosati M, Pardi A. Persistent median artery in carpal tunnel syndrome. Acta Orthop Belg 1995; 61: 315-8
    PubMedSearch in Google Scholar
  • 11 Salter M, Sinha N, Szmigielski W. Thrombosed persistent median artery causing carpal tunnel syndrome associated with bifurcated median nerve: A case report. Polish J Radiol 2011; 76: 46-8
    Search in Google Scholar