J Korean Orthop Assoc.  2019 Oct;54(5):452-456. 10.4055/jkoa.2019.54.5.452.

Carpal Tunnel Syndrome Caused by Persistent Median Artery and Bifid Median Nerve in an Adolescent

• Lee SU
• Lee HW
• Joo SY

• KMID: 2461236
• DOI: http://doi.org/10.4055/jkoa.2019.54.5.452

Abstract

Carpal tunnel syndrome is rare in children. When it does occur in children, the most common causes reported are mucopolysaccharidosis and mucolipidosis. The median artery is a transitory vessel that develops from the axillary artery in early embryonic life and does not normally survive until postfetal life. In a small percentage of individuals, however, it persists into adulthood and is frequently accompanied by a bifid median nerve. A persistent median artery can be a cause of carpal tunnel syndrome in adults, but it is extremely rare in children and adolescents. This paper reports a case of a carpal tunnel syndrome caused by a persistent median artery and bifid median nerve in a 13-year-old girl.

Keyword

carpal tunnel syndrome; arteries; median nerve; adolescent

MeSH Terms

Adolescent*
Adult
Arteries*
Axillary Artery
Carpal Tunnel Syndrome*
Child
Female
Humans
Median Nerve*
Mucolipidoses
Mucopolysaccharidoses

Figure

• 

  Figure 1 Photograph of both hands demonstrate thenar muscle atrophy of the right hand.

• 

  Figure 2 (A) Sonography of the right wrist shows bifid median nerve (solid arrows) and persistent median artery (open arrow). (B) Axial T2-weighted magnetic resonance imaging shows the ulnar trunk (open arrow) and radial trunk (open arrow) of the bifid median nerve and persistent median artery (solid arrow).

• 

  Figure 3 (A) Intraoperative photograph of the volar wrist shows transverse carpal ligament. (B) After carpal tunnel release, the bifid median nerves and associated median vessels were apparent.

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