Cubital Tunnel Syndrome: An Entrapment Neuropathy Which May Arise from Vascular Malformation

Document Type : Case Report

Authors

1 Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Sciences, Rasht, Iran

2 Guilan Road Trauma Research Center, Poursina Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

3 Department of Pathology, Golsar Hospital, Rasht, Iran

4 Neuroscience Research Center, Department of Neurosurgery, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Vascular malformation as a cause of cubital tunnel syndrome has not yet been reported. Cubital tunnel syndrome (CuTS), the most common entrapment neuropathy of the ulnar nerve at elbow level, is also the second most common entrapment neuropathy in the upper extremity, regardless of carpal tunnel syndrome. Here, we report CuTS due to vascular malformation in a 63-year-old woman. The ulnar nerve at the distal part of tunnel was markedly compressed. There was no connection between the lesion and the ulnar nerve. The diagnosis was made by using histopathology, and thereafter the lesion was fully resected. Pain in her ring and little fingers disappeared one month after resection of the malformation.

Keywords


  1. Liu MT, Lee JT, Wang CH, Lin YC, Chou CH. Cubital Tunnel Syndrome Caused by Ulnar Nerve Schwannoma in a Patient with Diabetic Sensorimotor Polyneuropathy. Acta neurologica Taiwanica. 2016;25(2):60-4.
  2. Middleton SD, Anakwe RE. A 37-year-old man with numbness in the hand. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2015;187(8):593-5.
  3. Citisli V, Kocaoglu M, Gocmen S, Korucu M. Unusual presentation of multiple nerve entrapment: a case report. The Pan African medical journal. 2014;19:283.
  4. Emamhadi M, Emamhadi A, Andalib S. Intramuscular compared with subcutaneous transposition for surgery in cubital tunnel syndrome. The Annals of The Royal College of Surgeons of England. 2017;99(8):653-7.
  5. Uscetin I, Bingol D, Ozkaya O, Orman C, Akan M. Ulnar nerve compression at the elbow caused by the epitrochleoanconeus muscle: a case report and surgical approach. Turkish neurosurgery. 2014; 24(2):266-71.
  6. Illes JD, Johnson TL. Chiropractic management of a patient with ulnar nerve compression symptoms: a case report. Journal of Chiropractic Medicine. 2013;12(2):66-73.
  7. Bayrakli F, Kurtuncu M, Karaarslan E, Ozgen S. Perineural cyst presenting like cubital tunnel syndrome. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. 2012;21 Suppl 4:S387-9.
  8. Cutts S. Cubital tunnel syndrome. Postgraduate Medical Journal. 2007;83(975):28-31.
  9. Li M-x-l, He Q, Hu Z-l, Chen S-h, Lv Y-c, Liu Z-h, et al. Applied anatomical study of the vascularized ulnar nerve and its blood supply for cubital tunnel syndrome at the elbow region. Neural Regeneration Research. 2015;10(1):141-5.
  10. Tong J, Xu B, Dong Z, Liu J, Zhang C, Gu Y. Cubital tunnel syndrome caused by ganglion cysts: a review of 59 cases. Acta neurochirurgica. 2017;159(7):1265-71.
  11. Wojewnik B, Bindra R. Cubital tunnel syndrome — Review of current literature on causes, diagnosis and treatment. Journal of Hand and Microsurgery. 2009;1(2):76-81.
  12. Torre J. Ulnar artery aneurysm with digital ischemia. Vascular Medicine. 1999;4(3):143-5.
  13. O'Farrell DA, Cannon DP, Nunley JA. Digital ischemia associated with a thrombosed aneurysm of the dorsal interosseous artery. A case report. The Journal of bone and joint surgery American volume. 1997;79(3):441-3.
  14. Cassileth LB, Chang B. Vascular malformation within the flexor tendon sheath. The Journal of hand surgery. 2003;28(1):153-6.
  15. Hill FC, Yuen A, Ramakrishnan A. Vascular malformation of the flexor tendon presenting as tenosynovitis. Hand (New York, NY). 2012;7(2):200-3.
  16. Schonauer F, Nele G, La Rusca I. Thrombosed vascular malformation within the flexor tendon sheath of the index finger in the palm. Case reports in plastic surgery & hand surgery. 2015;2(3-4):60-2.
  17. Ek ET, Suh N, Carlson MG. Vascular anomalies of the hand and wrist. The Journal of the American Academy of Orthopaedic Surgeons. 2014;22(6):352-60.
  18. Waddell GF. A haemangioma involving tendons. The Journal of bone and joint surgery British volume. 1967;49(1):138-41.
  19. Prosperi L, Prosperi P. [Angioma of the sheath of the EDC and EPL tendons of the thumb (clinical and diagnostic considerations on a case)]. La Chirurgia degli organi di movimento. 1980;66(2):267-9.
  20. Rico AA, Holguin PH, Gonzalez IG, Coba JM. Flexor tendon synovial sheath haemangioma mimicking subacute tenosynovitis. Journal of hand surgery (Edinburgh, Scotland). 1994;19(6):704-5.