Kübra ERDOĞAN, KEMAL EMRE ÖZEN, Burhan YARAR, GİZEM ÇİZMECİ, GONCA AY KESELİK, MEHMET ALİ MALAS

Nervus Medianus ve Nervus Ulnaris’i Aynı Seviyede Oluşan Postfiks Plexus Brachialis

Derin boyun diseksiyonu gerektiren cerrahi müdahaleler ve rejyonel anestezi uygulamaları gibi pek çok girişimsel işlemde plexus brachialis anatomisinin bilinmesi oldukça önemlidir. Bu olgu sunumunda, nadir bir plexus brachialis varyasyonunun tanıtılması amaçlanmıştır. Laboratuvarımızdaki rutin diseksiyonlar esnasında 61 yaşında bir erkek kadavranın sağ plexus brachialis’indeki truncus ve fasciculus oluşumlarında varyasyonlar gözlemledik. Çeşitli travmatik ve cerrahi süreçlerde zedelenme riski yüksek olan plexus brachialis’in anatomisinin ve varyasyonlarının göz önünde bulundurulması tanı ve tedavi açısından klinisyenlere yol gösterici olabilir.

Postfix Brachial Plexus Whose Median Nerve and Ulnar Nerve Expose the Same Level

Knowledge of brachial plexus anatomy is quite important for numerous invasive treatments such as surgical operations requiring deep neck dissection and regional anesthesia applications. In this case report, it is aimed to demonstrate a rare brachial plexus variation. During routine dissection in our laboratory we observed variations in the formation of trunks and cords on the right brachial plexus of embalmed 61 years old male cadaver. The awareness of anatomy and variations of the brachial plexus which is vulnerable to traumas and surgical procedures, would be beneficial to physicians during diagnostic and treatment steps.

PDF

___

Tytherleigh-Strong G. Pectoral girdle, shoulder region and axilla. In: Standring S (Editor). Gray's Anatomy E-Book: The Anatomical Basis of Clinical Practice. 40. Baskı, Spain: Elsevier Health Sciences 2015: 818.
Kerr AT. The brachial plexus of nerves in man, the variations in its formation and branches. Dev Dyn 1918; 23: 285-395.
Lee HY, Chung IH, Sir SW, et al. Variations of the ventral rami of the brachial plexus. J Korean Med Sci 1992; 7: 19-24.
Uysal İİ, Şeker M, Karabulut AK, Büyükmumcu M, Ziylan T. Brachial plexus variations in human fetuses. Neurosurgery 2003; 53: 676-84.
Villamere J, Goodwin S, Hincke M, Jalali A. A brachial plexus variation characterized by the absence of the superior trunk. Neuroanatomy 2009; 8: 4-6.
Mahan MA, Spinner RJ. Nerves of the upper extremity. In: Tubbs RS, Loukas M, Shoja MM (Editors). Bergman's Comprehensive Encyclopedia of Human Anatomic Variation. 1. Baskı, New Jersey: John Wiley & Sons 2016: 1068-112.
Aragão JA, Melo LO, Barreto ATF, Da Silva Leal AT, Reis FP. Variations in the formation of the trunks of brachial plexus. J Morphol Sci 2014; 31: 48-50.
Emamhadi M, Chabok SY, Samini F et al. Anatomical variations of brachial plexus in adult cadavers; a descriptive study. Arch Bone Jt Surg 2016; 4: 253-8.
Johnson EO, Vekris M, Demesticha T, Soucacos PN. Neuroanatomy of the brachial plexus: normal and variant anatomy of its formation. Surg Radiol Anat 2010; 32: 291-7.
Cunningham DJ. Note on a connecting twig between the anterior divisions of the first and second dorsal nerves. J Anat Physiol 1877; 11: 539-40.
Aggarwal A, Puri N, Aggarwal AK, Harjeet K, Sahni D. Anatomical variation in formation of brachial plexus and its branching. Surg Radiol Anat 2010; 32: 891-4.
Chaudhary P, Singla R, Kalsey G, Arora K. A four trunked brachial plexus and a post fixed brachial plexus: a conjunction or a co‐incidence? Rep
Babu BP, Kumar J, Singh G. Brachial plexus with two trunks and double axillary veins: applied importance and clinical implications. Fırat Tıp Dergisi 2006; 11: 210-2.
Matejcik V. Aberrant formation and clinical picture of brachial plexus from the point of view of a neurosurgeon. Bratisl Lek Listy 2003; 104: 291- 9.
Fazan VPS, Amadeu AS, Caleffi AL, Rodrigues Filho OA. Brachial plexus variations in its formation and main branches. Acta Cir Bras 2003; 18: 14-8.