Lipofibromatous hamartoma of the nerve is a benign tumor, which affects the major nerves and their branches in the human body. It is often found in the median nerve of the hand and is commonly associated with macrodactyly, but it is rarely found in the digital nerves at the peripheral level. This tumor is often found in young adults and may go through a self- limiting course. However, operation is indicated when the tumor size is large or when the associated nerve compressive symptoms are present. We have experienced a rare case of lipofibromatous hamartoma that symmetrically involved the volar digital nerves of both index fingers on the ulnar side. With the aid of a microscope, we dissected and removed the tumor as much as possible without sacrificing the nerve. No sensory change occurred in both fingers and no sign of recurrence was observed upon follow-up.
Adipose Tissue/pathology ; Adult ; Female ; Fingers/*innervation/pathology ; Hamartoma/complications/*pathology ; Humans ; Nerve Compression Syndromes/etiology/*pathology

Bilateral suprascapular nerve entrapment syndrome is very rare. It presents with shoulder pain, weakness and atrophy of the supraspinatus and infraspinatus muscles. We present a twenty-year old man having a history of bilateral shoulder pain associated with weakness. Electromyographic studies revealed signs of a lesion that caused a neupraxic state of the left suprascapular nerve, moderate axonal loss of the right suprascapular nerve and denervation of the right suprascapular muscle. The patient was treated with physical and medical therapy. Due to worsening of the symptoms, a surgical operation was performed by the excision of the transverse scapular ligaments bilaterally. His pain, weakness and atrophy had diminished on examination six weeks later. Suprascapular nerve entrapment should be considered in patients with shoulder pain, particularly those with weakness and atrophy of the supraspinatus and infraspinatus muscles.
Adult ; *Back ; Human ; Magnetic Resonance Imaging ; Male ; Muscle Weakness/etiology/*pathology ; Muscular Atrophy/etiology/*pathology ; Nerve Compression Syndromes/complications/*pathology ; Pain/etiology/pathology ; *Shoulder

Running through the infratemporal fossa is the lingual nerve (i.e. the third branch of the posterior trunk of the mandibular nerve). Due to its location, there are various anatomic structures that might entrap and potentially compress the lingual nerve. These anatomical sites of entrapment are: (a) the partially or completely ossified pterygospinous or pterygoalar ligaments; (b) the large lamina of the lateral plate of the pterygoid process; and (c) the medial fibers of the anterior region of the lateral pterygoid muscle. Due to the connection between these nerve and anatomic structures, a contraction of the lateral pterygoid muscle, for example, might cause a compression of the lingual nerve. Any variations in the course of the lingual nerve can be of clinical significance to surgeons and neurologists because of the significant complications that might occur. To name a few of such complications, lingual nerve entrapment can lead to: (a) numbness, hypoesthesia or even anesthesia of the tongue's mucous glands; (b) anesthesia and loss of taste in the anterior two-thirds of the tongue; (c) anesthesia of the lingual gums; and (d) pain related to speech articulation disorder. Dentists should, therefore, be alert to possible signs of neurovascular compression in regions where the lingual nerve is distributed.
Cranial Fossa, Middle ; Foramen Ovale ; pathology ; Humans ; Ligaments ; pathology ; Lingual Nerve ; pathology ; Nerve Compression Syndromes ; complications ; pathology ; Ossification, Heterotopic ; pathology ; Paresthesia ; etiology ; Pterygoid Muscles ; pathology ; Sphenoid Bone ; pathology ; Tongue ; innervation

BACKGROUNDSome studies indicated that cases of idiopathic oculomotor nerve palsy can be explained by vascular compression of the oculomotor nerve. Vascular contact with or compression to the cisternal segment of the oculomotor nerve has been reported frequently in asymptomatic individuals. In this study, we retrospectively analyzed the relationship between the oculomotor nerve's cisternal segment and adjacent arteries in asymptomatic patients and the prevalence of this occurrence via magnetic resonance imaging (MRI).

METHODMRI of bilateral oculomotor nerves in 93 asymptomatic patients were reviewed. The oculomotor nerve-artery relationship was evaluated and classified from levels 1 to 3, representing the degrees of contact on oblique transverse and oblique sagittal reconstructed MRI. Prevalence of the nerve-artery relationship at each level was described. The correlation between the nerve-vessel relationship (levels) and the age was analyzed by Spearman's rank correlation analysis.

RESULTSCisternal segment of the oculomotor nerve did not have contact with any artery (level 1) in 27.4% (51/186) nerves. One hundred nerves made contact with at least one artery (level 2), but their shapes or configurations were not changed; 35 nerves (18.8%) were displaced or distorted due to artery compression (level 3). The posterior cerebral artery had the greatest incidence of making contact with or compressing the cisternal segment of the oculomotor nerve (58.1%). No significant correlation between nerve-vessel relationship (levels) and the age was found in this study.

CONCLUSIONSWhether oculomotor nerve contact with or compression by one or more arteries is of high prevalence in asymptomatic individuals as evidenced by MRI examination. There is no correlation with individual age. Discretion should be used when making an etiological diagnosis of vascular compression for patients with oculomotor nerve palsy. Further investigation of other causes is warranted.

Adolescent ; Adult ; Age Factors ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Nerve Compression Syndromes ; complications ; pathology ; Oculomotor Nerve ; pathology ; Oculomotor Nerve Diseases ; etiology ; pathology ; Young Adult

OBJECTIVE: To explore the clinical characteristics, pathological mechanism, diagnose, differential diagnosis and the treatment of vascular compressive vestibular neuropathy. METHOD: The authors retrospectively studied 2 cases of vascular compressive vestibular neuropathy about clinical characteristics, auditory tests, vestibular tests and imaging examine results, pharmacotherapy results and reviewed the related documents. RESULT: There were some common clinical characteristics: (1) Vertigo and disequilibrium could be elicited by any physical activity and head movement and abated with complete bed rest; (2) Symptoms and signs can't be improved by vestibular suppressant medications; (3) When taken Dix-Hallpike test, true vertigo or a spinning sensation appeared during head movement, when head skilled at any position,the symptoms disappeared; (4) The suffering lateral often showed high frequency sensorineural hearing loss ,the ABR of the suffering lateral showed prolonged inter wave latency of I-III wave; (5) Vestibular tests showed central lesion; (6) Occupying lesion can be ruled out by CT and MRI, MRI showed neurovascular compression of vestibular nerve; (7) Taking carbamazepine plus baclofen or only Tegretol orally can alleviate symptoms. A great deal of surgeries confirmed neurovascular compression of cranial nerve U as a disease entity, the offending artery mainly anterior inferior cerebellar artery. Microvascular decompression of cranial nerve VIII can successfully relieve vertigo. CONCLUSION Neurovascular compression of cranial nerve VIII is a disease entity beyond question. It's major characters were vertigo and disequilibrium which elicited by any physical activity and head movement, magnetic resonance tomographic angiography can give valuable information for diagnosis and treatment. Microvascular decompression can effectively relieve vertigo.
Adult ; Decompression, Surgical ; Female ; Humans ; Microsurgery ; Middle Aged ; Nerve Compression Syndromes ; complications ; diagnosis ; surgery ; Retrospective Studies ; Vertigo ; etiology ; Vestibular Nerve ; pathology ; Vestibular Neuronitis ; diagnosis ; pathology ; surgery ; Vestibulocochlear Nerve ; pathology

A 61-year-old female presented with 4 years history of left-sided hemifacial spasm. Head MRI and angiography indicated left vertebral artery dissecting aneurysm which compressed ipsilateral cranial nerves Ⅶ and Ⅷ. Microvascular decompression was performed. The dissecting aneurysm was pushed apart and the distal part of the parent artery was adhered to the dura on the petrosum. The compressed nerves were totally decompressed. The symptom of facial spasm was completely resolved immediately after surgery and did not recur during 6 months of follow up.
Cerebral Angiography ; Facial Nerve ; pathology ; Female ; Hemifacial Spasm ; surgery ; Humans ; Magnetic Resonance Imaging ; Microvascular Decompression Surgery ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; etiology ; surgery ; Vertebral Artery Dissection ; diagnostic imaging ; surgery ; Vestibulocochlear Nerve ; pathology

INTRODUCTIONSuprascapular nerve neuropathy secondary to ganglion cyst impingement has increasingly been found to be a cause of shoulder pain.

CLINICAL PICTUREWe present 2 patients who complained of dull, poorly localised shoulder pain, which worsened with overhead activities. Magnetic resonance imaging showed ganglion cysts in the spinoglenoid notch.

TREATMENTBoth patients failed conservative management with physiotherapy and underwent shoulder arthroscopy. One patient underwent arthroscopic decompression of the cyst and the other had open excision of the cyst.

OUTCOMEBoth patients experienced resolution of symptoms within 6 months of surgery.

CONCLUSIONWith appropriate treatment, suprascapular nerve neuropathy secondary to ganglion cyst impingement is a treatable condition with potentially good results.

Adult ; Female ; Ganglion Cysts ; complications ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; surgery ; Peripheral Nervous System Diseases ; etiology ; surgery ; Risk Factors ; Scapula ; Shoulder Impingement Syndrome ; etiology ; surgery ; Shoulder Pain ; etiology ; surgery

OBJECTIVETo observe the pinching action to the nerve root by the lumbar disc herniation and facet or lamina (ligamentum flavum) and evaluate its clinical meaning.

METHODSSeventy-one patients were divided into 3 groups according to the size of distance between protrusion of nuclear and facet or lamina (ligamentum flavum). The degree of the straight leg raising of the affected side (SLR) and the sagittal index (SI) of lumbar disk herniation were measured and analyzed among them.

RESULTSThere was no corelation between the affected degree of SLR and sex, age and SI of patient (P > 0.05). The coefficient between distance group and the affected degree of SLR is-0.878 7 (P < 0.01).

CONCLUSIONThe degree of the surrounding compression by the protrusion of nuclear and facet or lamina (ligamentum flavum) reflects the injuried severity of the nerve root.

Adolescent ; Adult ; Female ; Humans ; Intervertebral Disc Displacement ; complications ; diagnostic imaging ; pathology ; Ligamentum Flavum ; pathology ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Nerve Compression Syndromes ; etiology ; Spinal Nerve Roots ; injuries ; Tomography, X-Ray Computed