Elevated intraneural vascularization of the median nerve proximal to the arteriovenous fistula in hemodialysis patients suspected of carpal tunnel syndrome: A case series

Author:

Bagge Carina N.1,Lindhard Kristine1,Liem Ylian S.2,Lindquist Janus Kaufmann345,Balazs‐Becsi Eszter6,Wolfram Nils345

Affiliation:

1. Department of Nephrology Herlev Hospital Herlev Denmark

2. Department of Nephrology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark

3. Department of Clinical Neurophysiology Rigshospitalet Copenhagen University Hospital Copenhagen Denmark

4. Department of Clinical Neurophysiology Rigshospitalet Glostrup, Copenhagen University Hospital Glostrup Denmark

5. Department of Neurology Zealand University Hospital Roskilde Denmark

6. Department of Clinical Neurophysiology Filadelfia Epilepsy Hospital Dianalund Denmark

Abstract

AbstractPatients with end‐stage kidney disease may require creation of an arteriovenous fistula in order to receive hemodialysis treatment. The creation may result in several complications, including carpal tunnel syndrome. Early diagnosis and treatment are essential to relieve symptoms, prevent permanent nerve damage, and improve quality of life. However, the sensory and motor disturbances resembling carpal tunnel syndrome could be related to other etiologies than external compression of the median nerve underneath the transverse ligament. This case report presents eight patients with a radiocephalic arteriovenous fistula, who all had symptoms of carpal tunnel syndrome. Ultrasonographic examination showed a segmental intraneural hypervascularization of a large vessel inside the median nerve proximal to the wrist and arteriovenous fistula anastomosis with garland‐like course as well as multiple flow velocities. The neurophysiological findings showed a significant decreased velocity in the ipsilateral forearm to the arteriovenous fistula.

Publisher

Wiley

Subject

Nephrology,Hematology

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