Bilateral anatomic variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle

• Autorzy: Radunovic M. , Vukcevic R. , Abramovic M. , Vukcevic N. , Radojevic N. , Vuksanovic-Bozaric A.
• Języki publikacji: EN

Abstrakty

EN

The brachial plexus represents a field of many anatomical variations with important clinical implications, especially in the diagnosis and treatment of the thoracic outlet syndrome (TOS). The case described in this paper presented a novel bilateral variation in the relation of the upper trunk of the brachial plexus to the anterior scalene muscle. The ventral rami of the C5 and C6 spinal nerves perforated the anterior scalene muscle simultaneously through a common opening, and joined to form the upper trunk. Previous literature reports described variations of the brachial plexus and the scalene muscles, as well as the embryological basis for their presence. The case reported herein helps to improve the comprehension of the TOS, as well as the diagnostic and therapeutical approach to this syndrome. (Folia Morphol 2019; 78, 1: 195–198)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2019
• Tom: 78
• Numer: 1
• Opis fizyczny: p.195–198,fig.,ref.

Twórcy

autor

Radunovic M.

• Faculty of Medicine, University of Montenegro, Ljubljanska 1, 20000 Podgorica, Montenegro

autor

Vukcevic R.

• Faculty of Medicine, University of Montenegro, Ljubljanska 1, 20000 Podgorica, Montenegro

autor

Abramovic M.

• Faculty of Medicine, University of Montenegro, Ljubljanska 1, 20000 Podgorica, Montenegro

autor

Vukcevic N.

• Faculty of Medicine, University of Montenegro, Ljubljanska 1, 20000 Podgorica, Montenegro

autor

Radojevic N.

• Department of Forensic Medicine, Clinical Centre of Montenegro, Podgorica, Montenegro

autor

Vuksanovic-Bozaric A.

• Faculty of Medicine, University of Montenegro, Ljubljanska 1, 20000 Podgorica, Montenegro

Bibliografia

• 1. Abe M, Ichinohe K, Nishida J. Diagnosis, treatment, and complications of thoracic outlet syndrome. J Orthop Sci. 1999; 4(1): 66–69, indexed in Pubmed: 9914431.
• 2. Beheiry EE. Anatomical variations of the median nerve distribution and communication in the arm. Folia Morphol. 2004; 63(3): 313–318, indexed in Pubmed: 15478107.
• 3. Falyar CR, Shaffer KM, Perera RA. Localization of the brachial plexus: Sonography versus anatomic landmarks. J Clin Ultrasound. 2016; 44(7): 411–415, doi: 10.1002/jcu.22354, indexed in Pubmed: 27028598.
• 4. Fetty LK, Shea J, Toussaint CP, et al. A quantitative analysis of variability in brachial plexus anatomy. Clin Anat. 2010; 23(2): 210–215, doi: 10.1002/ca.20927, indexed in Pubmed: 20069647.
• 5. Harry WG, Bennett JD, Guha SC. Scalene muscles and the brachial plexus: anatomical variations and their clinical significance. Clin Anat. 1997; 10(4): 250–252, doi: 10.1002/(SICI)1098-2353(1997)10:4<250::AID-CA6>3.0.CO;2-W, indexed in Pubmed: 9213042.
• 6. Kattan AE, Borschel GH. Anatomy of the brachial plexus. J Pediatr Rehabil Med. 2011; 4(2): 107–111, doi: 10.3233/PRM-2011-0163, indexed in Pubmed: 21955968.
• 7. Kirazlı Ö, Tatarlı N, Ceylan D, et al. A variation of the cords of the brachial plexus on the right and a communication between the musculocutaneous and median nerves on the left upper limb: a unique case. J Neurol Surg A Cent Eur Neurosurg. 2013; 74 Suppl 1: e176–e179, doi: 10.1055/s0032-1333416, indexed in Pubmed: 23444130.
• 8. Kuhn JE, Lebus V GF, Bible JE. Thoracic outlet syndrome. J Am Acad Orthop Surg. 2015; 23(4): 222–232, doi: 10.5435/JAAOS-D-13-00215, indexed in Pubmed: 25808686.
• 9. Leonhard V, Smith R, Caldwell G, et al. Anatomical variations in the brachial plexus roots: implications for diagnosis of neurogenic thoracic outlet syndrome. Ann Anat. 2016; 206: 21–26, doi: 10.1016/j.aanat.2016.03.011, indexed in Pubmed: 27133185.
• 10. Leung S, Zlotolow DA, Kozin SH, et al. Surgical anatomy of the supraclavicular brachial plexus. J Bone Joint Surg Am. 2015; 97(13): 1067–1073, doi: 10.2106/JBJS.N.00706, indexed in Pubmed: 26135073.
• 11. Lewis W. The development of the arm in man. Am J Anat. 1902; 1(2): 145–183, doi: 10.1002/aja.1000010204.
• 12. Makhoul RG, Machleder HI. Developmental anomalies at the thoracic outlet: an analysis of 200 consecutive cases. J Vasc Surg. 1992; 16(4): 534–42; discussion 542, doi: 10.1016/0741-5214(92)90161-z, indexed in Pubmed: 1404675.
• 13. Milliez PY, Sakka M. [Ontogenic basis of human predisposition to thoracic outlet syndrome. Cervicothoracic reconstruction of a 2.5 cm embryo]. Ann Chir Plast Esthet. 1993; 38(5): 573–583, indexed in Pubmed: 7944233.
• 14. Natsis K, Totlis T, Tsikaras P, et al. Variations of the course of the upper trunk of the brachial plexus and their clinical significance for the thoracic outlet syndrome: a study on 93 cadavers. Am Surg. 2006; 72(2): 188–192, indexed in Pubmed: 16536255.
• 15. Radunovic M, Vukasanovic-Bozaric A, Radojevic N, et al. A new anatomical variation of the musculocutaneous and the median nerve anastomosis. Folia Morphol. 2013; 72(2): 176–179, doi: 10.5603/fm.2013.0030, indexed in Pubmed: 23740508.
• 16. Roos DB. The place for scalenectomy and first-rib resection in thoracic outlet syndrome. Surgery. 1982; 92(6): 1077–1085, indexed in Pubmed: 7147186.
• 17. Sadowski M, Tułaza B, Lysenko L. Renaissance of supraclavicular brachial plexus block. Anaesthesiol Intensive Ther. 2014; 46(1): 37–41, doi: 10.5603/AIT.2014.0008, indexed in Pubmed: 24643926.
• 18. Sakamoto Y. Spatial relationships between the morphologies and innervations of the scalene and anterior vertebral muscles. Ann Anat. 2012; 194(4): 381–388, doi: 10.1016/j.aanat.2011.11.004, indexed in Pubmed: 22209543.
• 19. Shinohara H, Naora H, Hashimoto R, et al. Development of the innervation pattern in the upper limb of staged human embryos. Acta Anat (Basel). 1990; 138(3): 265–269, doi: 10.1159/000146950, indexed in Pubmed: 2389673.
• 20. Som PM, Laitman JT. Embryology, variations, and innervations of the human neck muscles. Neurographics. 2017; 7(3): 215–242, doi: 10.3174/ng.3170206.
• 21. Takafuji T, Sato Y. Study on the subclavian artery and its branches in Japanese adults. Okajimas Folia Anat Jpn. 1991; 68(2-3): 171–185, doi: 10.2535/ofaj1936.68.2-3_171, indexed in Pubmed: 1758682.
• 22. Uemura M, Takemura A, Suwa F. Bilateral subclavian arteries passing in front of the scalenus anterior muscles. Anat Sci Int. 2007; 82(3): 180–185, doi: 10.1111/j.1447-073X.2006.00162.x, indexed in Pubmed: 17867345.
• 23. Woźniak J, Kędzia A, Dudek K. Brachial plexus variations during the fetal period. Anat Sci Int. 2012; 87(4): 223–233, doi: 10.1007/s12565-012-0150-1, indexed in Pubmed: 22945314.
• 24. Xu S, Wang X, Lou X, et al. Novel double-superior-trunk injury of the brachial plexus: a case report. J Int Med Res. 2008; 36(3): 594–598, doi: 10.1177/147323000803600327, indexed in Pubmed: 18534144.
• 25. Yildiz S, Cömert A, Ozan H. A case of connected superior and middle trunks of the brachial plexus or with abnormal upper trunk. Rom J Morphol Embryol. 2011; 52(3 Suppl): 1157–1159, indexed in Pubmed: 22119842.

Identyfikatory

DOI

10.5603/FM.a2018.0056