Abstract

DE-LA-RUBIA-NAVARRO, Marta; SANCHIS-GARCIA, Juan Manuel; ORTIZ-SANJUAN, Francisco  and  ROMAN IVORRA, José Andrés. Median nerve compression at elbow level by a proximal cubital artery pseudoaneurysm: a case report. Rev.Colomb.Reumatol. [online]. 2023, vol.30, n.1, pp.63-66.  Epub Aug 18, 2023. ISSN 0121-8123.  https://doi.org/10.1016/j.rcreu.2021.04.005.

We describe the case of an 82-year-old man who had recently undergone cardiac surgery (quadruple coronary bypass), who consulted due to the appearance of a necrotic eschar on the thumb of the right index finger, together with paraesthesia and hypoaesthesia in the first 3 fingers of the same hand. An ultrasound scan of the right elbow was performed to rule out involvement of the median nerve and an anechoic, thick-walled mass was found, dependent on the wall of the proximal ulnar artery, compatible with a pseudoaneurysm of the same, compressing the nerve. Electromyography showed an acute lesion of the proximal median nerve and angio-CT confirmed the diagnosis of pseudoaneurysm of the proximal ulnar artery. Pseudoaneurysm is a dilatation by rupture of the arterial wall, which does not involve all three layers of the arterial wall and communicates with the vascular lumen. Its development after vascular manipulation is very rare, and it is uncommon for it to act by compressing a nerve structure. In our case, together with vascular surgery, treatment with intralesional thrombin was decided, with good evolution.

Keywords : Pseudoaneurysm; Median nerve; Cubital artery; Vascular manipulation.

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