Variation Of Roots In The Formation Of Median Nerve

Background: Median nerve formation exhibits several variations in the form of additional roots and /orcommunications which are relevant to the surgical explorations of shoulder, axilla and arm.Aim: To study the variations in the formation of median nerve and its communications with musculocutaneousnerve in cadaveric upper limbs.Materials and Methods: The study was done in 34 formalin fixed cadavers (68 upper limbs) and 10 isolatedlimbs. All cadavers were conventionally dissected and observed for median nerve formation and dissected up tocubital fossa for presence of any communications.Observations: Out of the 78 upper limbs dissected, 12 limbs (15.38%) showed two lateral roots and one medialroot contributing to the formation of median nerve. One case of bilateral presence of extra lateral root wasfound. The extra lateral root or communication from the musculocutaneous nerve was arising distal tocoracobrachialis in 2 cases and proximal to the muscle in 10 cases. In three cases, absence of musculocutaneousnerve was observed and median nerve was supplying either all or some muscles of the flexor compartment. Oneof the cases of absent musculocutaneous nerve had two medial roots and one lateral root that is a very rarecombination of variation not reported in the literature. In all cases of two lateral roots, the median nerve wasformed medial or anterior to axillary artery. So we observed median nerve variation in 16 upper limbs [20.51%]Conclusion: Thorough understanding of variations in the formation and communications of median nerve and itsvascular relations is important for successful surgical outcome and clinical interpretation of lesions of thenerve.

Bilateral anterior ischaemic optic neuropathy in Takayasu arteritis.

This report describes a case of a young male with bilateral, asymmetrical AION. He was subsequently diagnosed with Takayasu's disease.