Highup Division of Median Nerve with Vascular Malformations: A case report

Abstract

On the left side, after a cleaned dissection of axillary region for brachial plexus, two roots of median nerve have been found and in between two roots there is presence of axillary artery. Musculocutaneous nerve is emerging from lateral cord of brachial plexus. Branches of this nerve are supplying corachobrachialis muscle on the upper end after piercing it. Lateral root is dividing into two branches .Medial branch is uniting with the medial root to form the main trunk of median nerve and lateral branch is uniting with the main trunk in the lower third of arm and then the reunited nerve passes between two heads of pronator teres. There are arteriovenous malformations over cubital fossa like tangles and arteriovenous fistulas at the lower end of forearm between cephalic vein and radial artery. Bluish   discolouration was noted on fingernails of hand. Similar to the left side after a cleaned dissection of the axillary region for brachial plexus on right side, two roots of median nerve have been found. Lateral root is dividing into two branches, lateral & medial. Medial branch is joining the medial root of median nerve and lateral branch joins the main trunk in the middle of the arm to continue as main nerve trunk in the middle of the arm which then passes between two heads of pronator teres muscle, gives branches before piercing. There are no arteriovenous malformations or arteriovenous fistula on the right side which is present on the left side.