• Journal of Korean Neurosurgical Society
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• 제37권4호
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• pp.293-295
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• 2005

Posterior interosseous nerve(PIN) syndrome is an entrapment of the deep branch of the radial nerve just distal to the elbow joint. It is caused by acute trauma or masses compressing the nerve. We report an unusual case of PIN syndrome with wrist drop caused by compression of the nerve by anomalous vascular leash. The patient has recovered with the surgical decompression of the offending vessels and arcade of Frohse.

• Clinics in Shoulder and Elbow
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• 제16권2호
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• pp.148-152
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• 2013

관절 관절경으로 수술적 치료를 시행한 후 전방 및 후방 골간 신경 증후군이 동시에 발생한 1예를 보고하고자 한다. 45세 남자 환자가 좌측 견관절의 불안정성으로 견관절 관절경 수술을 시행받았다. 전신 마취하 우측 측와위 자세에서 전완부를 신전한 상태에서 견인 장치를 부착한 상태로 2시간 동안 수술을 시행하였다. 1주일 후 환자는 좌측 전완부 동통, 수지의 신전력 및 무지와 인지의 심수지 굴근력의 저하로 외래를 방문하였다. 경과 관찰하였으나 증상이 지속되어 전방 골간 신경에 대해서는 신경 탐색술을 시행하였고 후방 골간 신경에서는 모래 시계 모양의 협착 소견이 발견되어 병변 절제 후 신경 외막 봉합술을 시행하였다. 수술 후 약 5개월간 외래에서 경과 관찰하였다. 신경 탐색술을 시행하고 3개월 후 총수지 신근의 기능이 회복하기 시작하였으며, 점차 회복하여 신경 탐색술 후 5개월째 증상이 완전히 회복되었다. 견관절 관절경 수술 후 전방 및 후방 골간 신경 증후군의 발생은 드물지만 견인 장치 및 수술 중 자세에 의해 유발될 수 있다. 따라서 견인 장치 부착 및 수술 자세에 대해 술자의 주의가 필요하다고 생각한다.

• Journal of Korean Neurosurgical Society
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• 제58권5호
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• pp.491-493
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• 2015

The upper trunk of the brachial plexus is the most common area affected by neuralgic amyotrophy (NA), and paresis of the shoulder girdle muscle is the most prevalent manifestation. Posterior interosseous nerve palsy is a rare presentation in patients with NA. It results in dropped finger on the affected side and may be misdiagnosed as entrapment syndrome or compressive neuropathy. We report an unusual case of NA manifested as PIN palsy and suggest that knowledge of clinical NA phenotypes is crucial for early diagnosis of peripheral nerve palsies.

• Korean Journal of Radiology
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• 제25권5호
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• pp.449-458
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• 2024

Selective fascicular involvement of the median nerve trunk above the elbow leading to anterior interosseous nerve (AIN) syndrome is a rare form of peripheral neuropathy. This condition has recently garnered increased attention within the medical community owing to advancements in imaging techniques and a growing number of reported cases. In this article, we explore the topographical anatomy of the median nerve trunk and the clinical features associated with AIN palsy. Our focus extends to unique manifestations captured through MRI and ultrasonography (US) studies, highlighting noteworthy findings, such as nerve fascicle swelling, incomplete constrictions, hourglass-like constrictions, and torsions, particularly in the posterior/posteromedial region of the median nerve. Surgical observations have further enhanced the understanding of this complex neuropathic condition. High-resolution MRI not only reveals denervation changes in the AIN and median nerve territories but also illuminates these alterations without the presence of compressing structures. The pivotal roles of high-resolution MRI and US in diagnosing this condition and guiding the formulation of an optimal treatment strategy are emphasized.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.135-141
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• 2024

The use of ultrasound (US)-guided interventions has rapidly increased in Korean medicine (KM) to ensure the safety and accuracy of invasive procedures, such as pharmacopuncture and acupotomy. Although hands-on training is important for the acquisition of skills, it requires considerable time and cost. A detailed guide on the procedure and treatment regions is needed to ensure hygiene and safety during US-guided procedures in KM practice. In this study, we present the overall procedure, target structures, and treatment approaches of US-guided pharmacopuncture and acupotomy for nerve entrapment in the upper extremities of the cubital and radial tunnel, posterior interosseous nerve, carpal tunnel, and Guyon's canal syndrome. We believe that the findings of our study will serve as a foundation for future clinical research, practice, and education on US-guided KM procedures. Further research involving US-guided interventions should specify target structures in three-dimension to delineate the treatment areas.

• Journal of Korean Neurosurgical Society
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• 제55권3호
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• pp.148-151
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• 2014

Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.