• 제목/요약/키워드: nerve compression syndrome

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압박성 신경병증 (Compression Neuropathy)

  • 김병성
    • 대한정형외과 초음파학회지
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    • 제1권2호
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    • pp.128-133
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    • 2008
  • 신경 압박의 원인은 외부로부터 가해지는 것도 있고, 신체 내부 병리가 발생하여 신경 주행에 따라 발생할 수 있다. 주관절 이하부에서 압박성 신경병증으로 정중 신경, 척골 신경, 요골신경병증이 있다. 정중 신경은 굴곡 지대부위에서 수근관 증후군이 대표적이며, 모든 신경 포착 증후군 가운데 가장 흔하다. 그 외 주관절 부위에서 스트러더스 인대, 상완 이두근 건막, 회내근, 천수지 굴근 기시부 그리고 비정상 근육들에 의한 회내근 증후군과 전 골간 신경 증후군이 있다. 척골 신경은 스트러더스 궁, 내측 상과 후방의 주관, 척수근 굴근 두 기시부 사이의 건막 등에서 눌리는 주관 증후군과, 수근부에서 결절종, 유구골 갈고리 골절 그리고 혈관성으로 오는 척골 관 증후군이 있다. 요골 신경의 심부 분지가 회외근속을 지나면서 만들어지는 부위에서 눌리는 경우 요골 관 증후군이라고 한다. 치료는 초기에는 소염제나 야간부목, 스테로이드 주사와 같은 보존적 치료를 시행할 수 있으며, 이에 호전되지 않을 경우 전기적 검사나 영상 검사에서 이상이 나타나면 수술적 감압술을 시행하여야 한다.

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상지의 압박성 신경병증의 초음파 검사 (Ultrasonographic Examination of Compression Neuropathy in the Upper Extremity)

  • 정양국;김배균
    • 대한정형외과 초음파학회지
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    • 제1권1호
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    • pp.64-72
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    • 2008
  • 주관절, 완관절 주변의 압박성 신경병증은 일상생활의 불편을 초래하는 상지에서의 흔한 신경병증의 하나로 이에 대한 초음파 검사 소견을 바르게 해석하는 데는 정상적인 신경의 구조와 압박성 신경병증의 병리적 변화를 이해하는 것이 중요하다. 압박성 신경병증에서는 특징적인 초음파 소견을 보이는데 압박부위의 신경은 눌려서 편평한 모양으로 나타나고 근위부에서는 고신호강도의 부종성 변화와 신경속 양상의 소실을 보인다. 기본적인 횡주사 및 종주사 영상 외에 관절이나 근육을 동적으로 움직이면서 시행한 초음파 검사는 척골신경이 주관절 굴곡시 삼두박건 내측두와 함께 내상과위로 아탈구 되는 탄발성 삼두박근 증후군이나 능동적 회내근의 수축시 신경압박이 일어나는 원형 회내근 증후군 등에서 신경의 아탈구나 압박소견을 보여준다. 수근관 증후군이나 주관 증후군 등에서는 신경 단면적의 정량적인 계측이나 압박비의 평가가 진단에 도움이 된다. 임상적 검사 및 전기생리적 검사와 병행하여 사용할 경우 초음파 영상은 상지에서의 압박성 신경병증을 진단하는데 있어 매우 유용한 검사방법의 하나이다.

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경근자법(經筋刺法)을 이용한 상지부(上肢部) 신경포착증후군에 대한 임상적 고찰 (Clinical Study about Meridian Tendino-musculature Acupuncture on Nerve Compression Syndrome of Upper Limbs)

  • 윤경진;최유진;이참결;이은용;노정두
    • Journal of Acupuncture Research
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    • 제29권1호
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    • pp.151-158
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    • 2012
  • Objectives : To broaden understanding about meridian tendino-musculature acupuncture on nerve compression syndrome of upper limbs and to evaluate the effect of meridian tendino-musculature acupuncture on nerve compression syndrome of upper limbs. Methods and Results : From June 1st to Oct. 31th, the patients were outpatients for treatment of nerve compression syndrome of upper limbs in department of acupuncture and moxibustion, traditional Korean medical hospital, Semyung University and treated with meridian tendino-musculature acupuncture. To evaluate the effect of meridian tendino-musculature acupuncture, thickness of muscle by medical skinfold caliper, coding result(arbitary values used to evaluate results) and VAS(Chief complain) were used. As a result, muscle atropy and symptoms are improved remarkably. Conslusions: Meridian tendino-musculature acupuncture was found to be helpful to patients who wish to recover from their muscle atropy and symptoms of upper limbs. In order to make this meridian tendino-musculature acupuncture more available, we should pay more attention to improving treatment appliance and acupuncture technique.

외측 심부 비골신경 포착 증후군의 증례 보고 (Rare Disease Entity of Dorsolateral Foot Pain: Lateral Branch of Deep Peroneal Nerve Entrapment Syndrome)

  • 나윤주;여승미;박진호;황지혜
    • Clinical Pain
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    • 제20권2호
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    • pp.122-126
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    • 2021
  • When a patient represents pain in foot, physician can easily overlook compression neuropathy of peripheral nerve as it is uncommon. Among nerve entrapment syndrome encountered in the foot, selective compression in lateral branch of deep peroneal nerve (DPN) is rare. We report a case of a patient with pain and dysesthesia in dorsolateral foot which turned out as lateral branch of deep peroneal nerve entrapment syndrome caused by talonavicular joint effusion. We would like to share diagnostic work up flow and conservative treatment courses. This case manifests the importance of the deep peroneal nerve and its branches in clinical setting of pain and ankle instability.

Pudendal nerve entrapment syndrome caused by ganglion cysts along the pudendal nerve

  • Kim, Young Je;Kim, Du Hwan
    • Journal of Yeungnam Medical Science
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    • 제38권2호
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    • pp.148-151
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    • 2021
  • Pudendal nerve entrapment (PNE) syndrome refers to the condition in which the pudendal nerve is entrapped or compressed. Reported cases of PNE associated with ganglion cysts are rare. Deep gluteal syndrome (DGS) is defined as compression of the sciatic or pudendal nerve due to a non-discogenic pelvic lesion. We report a case of PNE caused by compression from ganglion cysts and treated with steroid injection; we discuss this case in the context of DGS. A 77-year-old woman presented with a 3-month history of tingling and burning sensations in the left buttock and perineal area. Ultrasonography showed ganglion cystic lesions at the subgluteal space. Magnetic resonance imaging revealed cystic lesions along the pudendal nerve from below the piriformis to the Alcock's canal and a full-thickness tear of the proximal hamstring tendon. Aspiration of the cysts did not yield any material. We then injected steroid into the cysts, which resolved her symptoms. Steroid injection into a ganglion cyst should be considered as a treatment option for PNE caused by ganglion cysts.

Ultrasound Diagnosis of Double Crush Syndrome of the Ulnar Nerve by the Anconeus Epitrochlearis and a Ganglion

  • Lee, Sang-Uk;Kim, Min-Wook;Kim, Jae Min
    • Journal of Korean Neurosurgical Society
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    • 제59권1호
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    • pp.75-77
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    • 2016
  • Double compression of the ulnar nerve, including Guyon's canal syndrome associated with cubital tunnel syndrome caused by the anconeus epitrochlearis muscle, is a very rare condition. We present a case of double crush syndrome of the ulnar nerve at the wrist and elbow in a 55-year-old man, as well as a brief review of the literature. Although electrodiagnostic findings were consistent with an ulnar nerve lesion only at the elbow, ultrasonography revealed a ganglion compressing the ulnar nerve at the hypothenar area and the anconeus epitrochlearis muscle lying in the cubital tunnel. Careful physical examination and ultrasound assessment of the elbow and wrist confirmed the clinical diagnosis prior to surgery.

외족장신경 제1분지의 신경초종에 의해 발생된 족장터널증후군 (Tarsal Tunnel Syndrome secondary to the Neurilemoma of first branch of the Lateral Plantar Nerve)

  • 이경태;탁상보
    • 대한족부족관절학회지
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    • 제2권1호
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    • pp.52-55
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    • 1998
  • Tarsal tunnel syndrome is a complex of symptoms resulting from the compression of the posterior tibial nerve or its branches, Many disease have been previously reported in the literatures as etiological agents in tarsal tunnel syndrome. We reported a case of tarsal tunnel syndrome secondary to neurilemoma of the first branch of lateral plantar nerve. The symptoms were similar with the entrapment syndrome of the first branch of the lateral plantar nerve. Symptoms were completely relieved after operation.

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기욘씨관 압박 증후군에서의 척골 동맥의 폐색 (Ulnar Artery Obstruction in Guyon Canal Compression Syndrome)

  • 안희창;김종도;이장현;최승석
    • Archives of Plastic Surgery
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    • 제37권6호
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    • pp.783-787
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    • 2010
  • Purpose: There are many articles describing about Guyon canal compression syndrome. Until recently, most of these articles have been presented about the symptoms of ulnar nerve compression, but there have been no reports about ulnar artery compression. In this article, besides the nerve compression symptoms in the Guyon's canal, we represented the symptoms and treatments based on the ulnar artery obstruction. Methods: Guyon canal is composed of the hamate and pisiform, and the ligaments which connect them. The course of the ulnar nerve and artery, which passes through this narrow canal, is affected by the anatomical structure of the base of the canal. Out of 14 patients (21 cases) were retrospectively reviewed in this study from 2006 to 2009. Of 14 patients, there were 5 men and 9 women with ages between 21 to 61 years old. The symptoms had volar sensory loss of ulnar sided digits, with muscular atrophy of hypothenar muscles. Prior to surgery, most of these patients had vascular disorders which was diagnosed definitively by angiography and electromyogram. Results: The release of Guyon canal and interposition graft of the obstructed arteries was carried out to 11 patients (15 cases) who had artery (vascular) occlusive disorder, and. 12 cases had sympathectomy and interposition graft after resection of obstructed ulnar artery. Six cases had release of carpal tunnel performed simultaneously. There were no major complications after surgery. The circulation of the ulnar artery was improved along with the patients' symptoms. Conclusion: The pre-existing articles about Guyon canal compression syndrome were mainly focused on ulnar nerve compression. This study, which was carried out by our department, showed that most of these patients had ulnar artery obstruction or stenosis simultaneously with ulnar nerve compression. The vascular disorder was corrected by interposition graft after the resection of the site of ulnar artery occlusion. And to conclude, When we resolve the ulnar nerve compression, the proper diagnosis & treatment of impaired ulnar artery circulation should be carried out concomitantly.

Posterior Interosseous Nerve(PIN) Syndrome Caused by Anomalous Vascular Leash

  • Cho, Tae-Koo;Kim, Jae-Min;Bak, Koang-Hum;Kim, Choong-Hyun
    • 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.

A Case of Hemifacial Spasm Caused by an Artery Passing Through the Facial Nerve

  • Oh, Chang Hyun;Shim, Yu Shik;Park, Hyeonseon;Kim, Eun-Young
    • Journal of Korean Neurosurgical Society
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    • 제57권3호
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    • pp.221-224
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    • 2015
  • Hemifacial spasm (HFS) is a clinical syndrome characterized by unilateral facial nerve dysfunction. The usual cause involves vascular compression of the seventh cranial nerve, but compression by an artery passing through the facial nerve is very unusual. A 20-year-old man presented with left facial spasm that had persisted for 4 years. Compression of the left facial nerve root exit zone by the anterior inferior cerebellar artery (AICA) was revealed on magnetic resonance angiography. During microvascular decompression surgery, penetration of the distal portion of the facial nerve root exit zone by the AICA was observed. At the penetrating site, the artery was found to have compressed the facial nerve and to be immobilized. The penetrated seventh cranial nerve was longitudinally split about 2 mm. The compressing artery was moved away from the penetrating site and the decompression was secured by inserting Teflon at the operative site. Although the facial spasm disappeared in the immediate postoperative period, the patient continued to show moderate facial weakness. At postoperative 12 months, the facial weakness had improved to a mild degree. Prior to performing microvascular decompression of HFS, surgeons should be aware of a possibility for rare complex anatomy, such as compression by an artery passing through the facial nerve, which cannot be observed by modern imaging techniques.