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Neurological picture
Sunderland's median nerve fascicular anatomy revisited by ultrasound
  1. Giampietro Zanette1,
  2. Matteo Francesco Lauriola1,
  3. Stefano Tamburin2
  1. 1Neurology Unit, Pederzoli Hospital, Peschiera del Garda, Italy
  2. 2Department of Neurological and Movement Sciences, University of Verona, Verona, Italy
  1. Correspondence to Dr Stefano Tamburin, Department of Neurological and Movement Sciences, University of Verona, Piazzale Scuro 10, Verona I-37134, Italy; stefano.tamburin{at}univr.it

https://doi.org/10.1136/jnnp-2014-310043

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    The internal anatomy of the upper-limb nerves was investigated with microdissection by the seminal work of Sunderland.1 More recent autopsy studies further explored the fascicular anatomy of the median nerve (MN) and confirmed a radial-to-ulnar sensory and motor arrangement of nerve fascicles at the wrist.2 ,3

    We report two patients with partial MN damage, in whom sensory neurography and ultrasound (US) documented asymmetrical involvement of the nerve involving its ulnar and radial sectors, respectively.

    Case reports

    Patient 1 was a 22-year-old man with a penetrating lesion of the wrist because of a glass fragment. He reported sensory loss and paraesthesia involving the ulnar side of the index, middle and radial side of the ring finger with no motor symptoms. Median sensory neurography showed markedly reduced ring finger sensory nerve action potential (SNAP), absent middle finger SNAP and slightly reduced, but still in …

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    Footnotes

    • Contributors GZ was involved in the design and conceptualisation of the study, analysis and interpretation of the data, revising the manuscript for intellectual content; MFL was involved in the analysis and interpretation of the data, revising the manuscript for intellectual content; ST was involved in the conceptualisation of the study, analysis and interpretation of the data, drafting the manuscript. All authors were involved in the final approval of the version to be published.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.