Superficial Radial Nerve and Cephalic Vein: An Anatomic Study by Cadaver Dissection

OBJECTIVE: To acquire normal anatomy of superficial radial nerve and cephalic vein and identify the optimal site for venipuncture of cephalic vein at wrist to decrease the damage of superficial radial nerve. METHOD: We examined anatomic relationships of the superficial radial nerve, cephalic vein, and styloid process of radius in 14 hands from 10 cadavers. The distances were measured from the styloid process of radius to the point at which the superficial radial nerve pierced fascia, and to the crossing point of superficial radial nerve with cephalic vein. RESULTS: The mean distance from the styloid process of radius to the point at which the superficial radial nerve pierced fascia was 79.9+/-9.84 (60~93) mm and from the styloid process of radius to the crossing point of superficial radial nerve with cephalic vein was 29.5+/-15.24 (13~55) mm. CONCLUSION: The most optimal injection site for venipuncture of cephalic vein at wrist was located 55 mm more proximal area from styloid process.

Superior Mesenteric Artery Syndrome in Traumatic Brain Injury: A case report

Superior mesenteric artery syndrome (SMAS) is a rare cause of proximal duodenal obstruction resulting from compression of the duodenum by the SMA against the aorta. Risk factors associated with SMAS are prolonged supine position, weight loss and decreased abdominal wall muscle tone; all of which are frequently accompanied with traumatic brain injury (TBI). The following case report describes a patient who developed SMAS in the setting of TBI. This report presents a 16 year old male with TBI who had postprandial epigastric pain, vomiting and weight loss. Computed tomography and upper gastrointestinal series demonstrated the existence of SMAS. The patient was managed conservatively with total parenteral nutrition to obtain a positive nitrogen balance. Physician should consider SMAS in the differential diagnosis of patients presenting with abdominal pain and vomiting.