Abstract
The median nerve maintains a close relationship with the brachial artery in the upper limb. Variability in the formation and distribution of upper extremity vessels is frequently encountered during donor body dissections or surgical procedures. This case presents a rare anatomical variation of the brachial artery emerging through an opening in the median nerve. The median nerve formed a small opening without the contribution from additional nerve roots and the remaining vasculature of the upper limb was otherwise normal. An abnormal arrangement of a neurovascular bundle in the arm can cause sensory and motor issues, as well as vascular implications. This variation has clinical significance in surgical interventions and potentially daily functioning. To our knowledge, this is the first report of a small median nerve opening pierced by the brachial artery.
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Acknowledgements
The authors thank those who generously donated their bodies to medical science. Anatomical research has the potential to expand our collective knowledge and ultimately improve patient care. Therefore, these donors and their families deserve our upmost gratitude. The authors would also like to thank the medical students that participated in the main dissection of this donor body: William Rutkowski, Allyssa Thomas, Alex Velaoras, Anastasia Kapitonava, Annika Kim, Danny Quraishi, Juliette van Heerden, Kian Robinson, Prachi Gaddam, and Tessa Palisoc.
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Both authors contributed to the study conception and design, material preparation, data collection and analysis. The first draft of the manuscript was written by William E. Rutkowski and both authors contributed to edits on additional versions of the manuscript. Both authors read and approved the final manuscript.
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The human donor body used in this study was obtained from the Humanity Gifts Registry, a nonprofit agency of the Commonwealth of Pennsylvania. The donor provided premortem informed consent to anatomy education and research. The Drexel University Institutional Review Board Committee confirmed that no additional ethical approval is required.
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Rutkowski, W.E., Howe, C.A. Variation of the brachial artery emerging through an opening in the median nerve: a case report. Surg Radiol Anat 45, 1135–1138 (2023). https://doi.org/10.1007/s00276-023-03227-3
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DOI: https://doi.org/10.1007/s00276-023-03227-3