tailieunhanh - Hội chứng thần kinh nén

Hội chứng thần kinh nén là một nguyên nhân phổ biến của đau, rối loạn cảm giác, và động cơ yếu trong cả hai phần trên và chi dưới. Mặc dù hội chứng ống cổ tay thường chẩn đoán và xử lý IS phẫu thuật thành công | Uncommon Nerve Compression Syndromes of the Upper Extremity John D. Lubahn MD and Mary Beth Cermak MD Abstract Nerve compression syndromes are a common cause of pain sensory disturbance and motor weakness in both the upper and the lower extremities. Although carpal tunnel syndrome is frequently diagnosed and treated surgically with success other compression syndromes are less common and are often best treated nonsurgically. Understanding the anatomy of the major peripheral nerves with respect to intermuscular septa fibrous bands muscle margins and internervous planes is crucial to understanding how and where peripheral nerve compression can occur. Some conditions such as anterior interosseous nerve syndrome respond well to nonoperative treatment others such as posterior interosseous nerve syndrome are better treated by surgical intervention. The authors discuss the anatomic and pathologic causes for compression syndromes as well as guidelines for treatment and outcomes. J Am Acad Orthop Surg 1998 6 378-386 Compression syndromes of peripheral nerves have a number of possible causes. Pressure on a nerve may disrupt either the local blood flow or the axoplasmic flow to the nerve. Low blood pressure may diminish the blood supply of peripheral nerves and cause the familiar dysesthesias paresthesias and occasional motor weakness about which patients frequently complain. Direct pressure of 500 mm Hg or more may cause internal disruption of the Epineurial scarring may spontaneously form in peripheral nerves with resultant symptoms of partial or complete compression Fig. 1 .2 3 Motor nerves such as the posterior interosseous branch of the radial nerve and the anterior interosseous branch of the median nerve contain stretch receptors sensory fibers and motor fibers. Therefore pressure on a motor nerve may be interpreted as a painful stimulus by the brain. To describe the extent of compression and or injury to a nerve classification systems have been developed by .