فلج و بررسي عصب مديان MEDIAN در اثر آنوريسم تراماتيك TRAUMATIC شريان ULNAR

Isolated arterial injury without concomitant nerve injury is uncommon. Failure to repair a partial arterial laceration may result in false aneurysm formation and delayed nerve dysfunction attributable to compression. We present a 30-year-old man who suffered from 1-centimeter traumatic knife wound on dorsoulnar aspect of proximal of the left forearm. He has complained of paresthesia and motor disturbances in the distribution of the median nerve that was began a few days after injury. An exploratory surgical procedure revealed a voluminous 8*10*8-centimeter pseudo aneurysm from partial longitudinal laceration of the ulnar artery that injecting the epineural sheath of median nerve and compressing its fascicles. Excision of pseudo aneurysm and decompression of median nerve was performed and the ulnar artery was ligated. The postoperative evolution was very satisfactory with almost full clinical and electrophysiological recovery 3 months later. Careful surgical exploration of every wound suspected of arterial injury after penetrating trauma is essential. Failure to recognize and correct the arterial injury may result in delayed nerve damage by the expansion of a false aneurysm.