Search

Purpose: Secondary to peripheral nerve injuries, involvement of sympathetic fibers complications such as Complex Regional Pain Syndrome (CRPS) have been reported. There are no reports available in the distribution of the sympathetic fibers/areas of sensory nerves in the forearm., Materials and Methods: The present study aim is an attempt to find the distribution of sympathetic fibers in the anterior branch of medial antebrachial cutaneous nerve of forearm (AMACN), lateral antebrachial cutaneous nerve of forearm (LACN) and superficial branch of radial nerve (SBRN) at cubital fossae. We have studied on 17 fresh human cadaveric AMACN, LACN and SRBN samples. Frozen sections of these nerves were processed by immunohistochemical (tyrosine hydroxylase) method for sympathetic fibers., Results: Sympathetic fibers area (Asym) was found to be more in SBRN when compared to AMACN and LACN. The comparison of the sympathetic index (SI = sympathetic fibers area / total fascicular area of the nerve) between AMACN and LACN (p-value < 0.001), AMACN and SBRN (p-value <0.001), LACN and SBRN (p-value < 0.001) were statistically significant. Sympathetic index (SI) for SBRN was more when compared to AMACN and LACN. SBRN had maximum percentage (5.16%) of Asym when compared with LACN and AMACN., Conclusions: Sympathetic fibers area (Asym), sympathetic index (SI) and percentage of sympathetic fibers area (Asym %) were found to be more in SBRN when compared with AMACN and LACN. These results of the study might help to explain sympathetic system-related diseases in the area of distribution of AMACN, LACN and SBRN.

Purpose: The superficial branch of radial nerve (SBRN) is one of the cutaneous nevus biopsied for diagnosis of peripheral neuropathy. The purpose of this study is to find out the cross sectional microanatomy of the (SBRN) at antecubital fossa for changes in the fascicular, non-fascicular components with respect to age and also to find cross sectional area of SBRN in healthy volunteers., Materials and Methods: Sixty SBRN were harvested bilaterally from 30 fresh human bodies (25 males and five females) with ages of 37 to 88 years. Samples were divided into three age groups (G1, 37-55 years; G2, 55-70 years; G3, ≥ 71 years) and studied at different magnifications after histological processing for morphometric analysis - total cross-sectional (Asc), fascicular (Af), and non-fascicular area (Anonf). Fifteen volunteers SBRN cross sectional area was measured by ultrasonography (US)., Results: The SBRN was found to have 2-6 fascicles. The differences in the adipose tissue (FAT) areas, between G1 and G2 (p=0.233) and between G2 and G3 (p=0.458) were not statistically significant. However, a significant difference was seen between G3 and G1 (p=0.021). The differences in the non-adipose tissue (FAT) areas, between G1 and G2 (p=0.110), between G2 and G3 (p=0.950) and between G3 and G1 (p=0.210) were not statistically significant. The amount of adipose tissue (FAT) in the epifascicular and interfascicular region increased in elderly individuals (age ≥ 71 years). Ultrasonographic cross-sectional area ranged from 2 to 3 mm²., Conclusions: Our study revealed comparatively more adipose tissue in human SBRN with advanced age (≥ 71 years). Findings may help to explain poor prognosis with advancing age following repair. SBRN ultrasonographical Asc was comparable to histological Asc in ages between 37-55 years.

Purpose of Study: Changes in peripheral nerve anatomy with age may be the cause for poor prognosis after nerve repair in elderly cases. The aim of the present study is to find out and compare the cross-sectional microanatomy as well as age-related changes in the non-fascicular components of superficial branch of radial nerve at cubital fossa (SBRN-1) and above wrist (SBRN-2)., Methods: Thirty-eight fresh human (14 male and five female) cadaveric SBRN-1 and SBRN-2 were collected from both sides of 19 cadavers and study has been performed at different magnifications after routine histological (Masson's trichrome stain) processing was done for morphometric analysis (total cross-sectional area [Asc], fascicular area [Af], non-Af [Anonf], adipose [FAT] area and non-adipose area [nFAT])., Results: SBRN-1 and SBRN-2 belonged to polyfascicular type and showed difference in amount of connective and adipose tissues in Anonf. The number of fascicles in SBRN-1 ranged from 2 to 6 (3.66±0.21, mean±SEM) and in SBRN-2 ranged from 7.5 to 11.5 (9.24±0.26). On comparing the percentage level of adipose tissue (FAT) in total cross-section area (Asc) and in Anonf of SBRN-1 and SBRN-2, the level of adipose tissue was increased with age., Conclusions: The amount of adipose tissue in SBRN-1 and SBRN-2 Anonf was found to be high in most of the elderly cases. On comparison, there was not much difference between SBRN-1 and SBRN-2, but, the fascicle count was found to be increasing gradually from proximal to distal part of the SBRN., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

Introduction: The aim of this study was to document the morphological and topographical anatomy of the infraorbital foramen (IOF) in relation to the infraorbital rim (IOR), which is necessary in clinical situations that require regional nerve blocks., Methods: A total of 80 dry South Indian adult human skulls of unknown age and gender were studied. In each skull, the IOF on both sides was measured using a metal casing digital vernier caliper, with the IOR as the reference point. The IOF's location and its transverse and vertical diameters were measured. The shape, size, orientation and accessory foramens of the IOF were also documented., Results: The majority of IOF among the skulls were oval-shaped on both the right (55 percent) and left (51.25 percent) sides. The majority were directed inferomedially on both the right (55 percent) and left (52.50 percent) sides. The overall combined distance between the IOR and IOF was 4.1 to 11.5 (6.57 +/- 1.28) mm. The overall combined vertical diameter was 1.2 to 4.7 (2.82 +/- 0.79) mm. The overall combined transverse diameter was 1 to 5.1 (2.87 +/- 0.78) mm. Accessory foramens of IOF were found in 13 (16.25 percent) skulls., Conclusion: Knowledge of the anatomical characteristics of IOF locations, diameters, shapes, directions and its accessory foramens may have important implications on blocking the infraorbital nerve for surgical and local anaesthetic planning. Information on the shape of the foramens obtained from this study may provide additional guidance to surgeons when introducing needles in anaesthetic procedures.

Purpose: Poor prognosis of nerve repair in patients may be due to changes in intraneural anatomy with age. Also, chances of Complex Regional Pain Syndrome-Type I (CRPS-I) secondary to peripheral nerve injury are comparatively high. The present study is to find the fascicular pattern of the anterior branch of the medial antebrachial cutaneous nerve of forearm (MACN) (at antecubital fossa), microanatomic morphometric characteristics of its connective tissue components (adipose tissue) and changes with age and study of intraneural sympathetic fiber content., Material and Methods: Sixty six human (37-88-year-old) cadaveric anterior branch of MACN have been collected from antecubital fossa and the study has been performed at magnifications (5x, 10x, 20x, and 40x objective) after routine histological (Hematoxylin & Eosin stain, Masson's trichrome stain) processing was done for morphometric analysis (total cross-sectional, fascicular and non-fascicular area) and immunohistochemical (tyrosine hydroxylase) processing for sympathetic fibers., Results and Conclusions: The anterior branch of the MACN's average total cross section area was 1.150 mm(2) on right side and 1.156 mm(2) on left side. There was significant increase in non-fascicular connective tissue area. In non-fascicular area, there was very less amount of adipose tissue in 86.37% of cases and more adipose tissue in 13.63% (elderly) cases. The average sympathetic fiber area is 0.0109 mm(2) without definite relationship with age. Our study makes an attempt to build a normal data base for MACN which might be helpful during the application of diagnostic and surgical nerve graft procedures.