Postoperative edema after vascular access causing nerve compression secondary to the presence of a perineuronal lipoma: case report.

Abstract:

OBJECTIVE AND IMPORTANCE:Median nerve neuropathy can be clinically devastating to a patient. It can be caused by compression of the median nerve anywhere along its course. We present the case of delayed median nerve neuropathy after the placement of a vascular graft in the arm. CLINICAL PRESENTATION:An arm shunt was placed in the nondominant upper extremity in a 60-year-old man with end-stage renal disease. Twelve hours postoperatively, the patient developed neurapraxia in the median nerve distribution in the hand. INTERVENTION:Exploration of the arm revealed a lipoma coursing along and deep to the median nerve. Resection of the lipoma decompressed the nerve. CONCLUSION:In this patient, median nerve neuropathy was caused by a lipoma and postoperative swelling from placement of the vascular graft. The swelling that occurred after the shunt placement unmasked subclinical compression of the nerve by a lipoma deep to the median nerve. To our knowledge, this report is unique in documenting damage to the median nerve after vascular graft placement as a result of an occult mass.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Goldstein LJ,Helfend LK,Kordestani RK

doi

10.1097/00006123-200202000-00035

keywords:

subject

Has Abstract

pub_date

2002-02-01 00:00:00

pages

412-3; discussion 414

issue

2

eissn

0148-396X

issn

1524-4040

journal_volume

50

pub_type

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