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Posterior Interosseous Neuropathy Caused by Torsion due to Leash of Henry: A Case Report

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초록

A 34-year-old man was referred for electrodiagnosis of left forearm and elbow pain with concurrent left wrist and finger extension weakness. Symptom developed abruptly, after waking up from sleep. After 11 days of onset, electromyography was performed. In nerve conduction study, the left radial motor response was unobtainable and in needle electromyography, abnormal spontaneous activities and no motor unit potential were noted in the left supinator, extensor digitorum communis, extensor carpi ulnaris and extensor indicis proprius muscles, suggesting left posterior interosseous neuropathy involving the supinator muscle and all the distal muscles to it. Subsequent ultrasonography of the left upper arm revealed multiple nerve torsions, and surgical exploration finally confirmed that the main torsion site was caused by the recurrent branch of radial artery, the Leash of Henry. We report an unusual case of spontaneous posterior interosseous nerve neuropathy due to nerve torsion caused by Leash of Henry.

Abstract

A 34-year-old man was referred for electrodiagnosis of left forearm and elbow pain with concurrent left wrist and finger extension weakness. Symptom developed abruptly, after waking up from sleep. After 11 days of onset, electromyography was performed. In nerve conduction study, the left radial motor response was unobtainable and in needle electromyography, abnormal spontaneous activities and no motor unit potential were noted in the left supinator, extensor digitorum communis, extensor carpi ulnaris and extensor indicis proprius muscles, suggesting left posterior interosseous neuropathy involving the supinator muscle and all the distal muscles to it. Subsequent ultrasonography of the left upper arm revealed multiple nerve torsions, and surgical exploration finally confirmed that the main torsion site was caused by the recurrent branch of radial artery, the Leash of Henry. We report an unusual case of spontaneous posterior interosseous nerve neuropathy due to nerve torsion caused by Leash of Henry.

참고문헌 (9)

  1. Anania P, "Posterior interosseous nerve entrapments: review of the literature. Is the entrapment distal to the arcade of Frohse a really rare condition?", Acta Neurochir (Wien), 160, pp.1857~1864 (2018)
  2. Bevelaqua AC, "Posterior interosseous neuropathy: electrodiagnostic evaluation", Hss j, 8, pp.184~189 (2012)
  3. Lawley AR, "Posterior interosseous neuropathy: the diagnostic benefits of a multimodal approach to investigation", Clin Case Rep, 4, pp.437~441 (2016)
  4. Dang AC, "Unusual compression neuropathies of the forearm, part I: radial nerve", J Hand Surg Am, 34, pp.1906~1914 (2009)
  5. Endo Y, "Spontaneous nerve torsion: unusual cause of radial nerve palsy", Skeletal Radiol, 44, pp.457~461 (2015)
  6. Fernandez E, "Radial nerve palsy caused by spontaneously occurring nerve torsion. Case report", J Neurosurg, 94, pp.627~629 (2001)
  7. Guerra WK, "Peripheral nerve palsy by torsional nerve injury", Neurosurgery, 68, pp.1018~1024 (2011)
  8. Kim DH, "Surgical treatment and outcomes in 45 cases of posterior interosseous nerve entrapments and injuries", J Neurosurg, 104, pp.766~777 (2006)
  9. Ochi K, "Surgical treatment of spontaneous posterior interosseous nerve palsy: a retrospective study of 50 cases", J Bone Joint Surg Br, 93, pp.217~222 (2011)

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