双侧腓浅动脉纤细1例

男性尸体标本，年龄约50岁，身长170cm，双下肢无畸形及发育异常。解剖下肢时发现其双侧腓浅动脉起始于胫前动脉，起点距腓骨小下7．2cm，外径0．2mm。该血管沿趾长伸肌与腓骨长短肌之间下行，沿途发出3支外径约0．1mm的吻合支(附图)，与胫后动脉穿支吻合之后，进入皮下，彼此间吻合形成皮下动脉网。     

Schwannomatosis involving peripheral nerves: a case report

Schwannomatosis or neurilemmomatosis has been used to describe patients with multiple nonvestibular schwannomas with no other stigmata of neurofibromatosis type-2 (NF-2). In our case, schwannomatosis, multiple schwannomas were present in a 21-yr-old woman with no stigmata or family history of NF-1 or NF-2. She had no evidence of vestibular schwannoma or other intracranial tumors. Multiple peripheral tumors were found in the carotid space of the neck, and soft tissue of posterior shoulder, lower back, ankle and middle mediastinum. All of those tumors were completely limited to the right side of the body. All surgically removed tumor specimens in this patient proved to be schwannomas.     

Compressive neuropathy of the tibial nerve and peroneal nerve by a Baker's cyst: case report

We report a case of Baker's cyst that induced compression of both the tibial and common peroneal nerves. The patient presented with calf atrophy and foot drop over a 6-month period. These signs and symptoms could have been mistaken for those of spinal origin. Based on an electrodiagnostic study and magnetic resonance imaging, compression of nerves by an asymptomatic Baker's cyst measuring 6x4 cm was confirmed. This cyst communicated with the articular joint which was also associated with a medial meniscal lesion. We treated the patient arthroscopically by performing partial medial meniscectomy, and through the posterolateral and the posteromedial portal, decompression of the Baker's cyst was performed. Approximately 6 weeks after the arthroscopic decompression, the cyst recurred. Therefore open resection was performed. At 1-year follow-up, the patient had considerable improvement in motor as well as sensory function and showed no evidence of recurrence. Although the electrodiagnostic studies showed an improvement in symptoms, the patient continued to complain of lower leg weakness owing to delayed diagnosis and cyst decompression. We believe that Baker's cysts should also be considered in the differential diagnoses of patients who present with neuromuscular dysfunction in the calf and leg.     

Accessory peroneal nerves in the human

The Nervus peroneus profundus accessorius was described by Ruge (1878) in the lower mammals and for the first time identified by Bryce (1897) in man. It is an accessory terminal branch of the superficial peroneal (musculocutaneous) nerve which winds round the lateral malleolus beneath the tendons of the peronei muscles and reaches the dorsum of the foot; there it often supplies the lateral portion of the extensor digitorum brevis muscle. In further investigations this nerve has been traced in 21.2% of subjects resp. in 13.5% of legs. This nerve, however, is not the only accessory branch of the common peroneal nerve: In 14 out of 140 subjects (10%) resp. in 22 out of 280 legs (7.9%) a Nervus peroneus superficialis accessorius has been found. This nerve pierces the anterior crural intermuscular septum either in common with deep peroneal (anterior tibial) nerve or at a lower point. Then it descends in front of the septum rarely giving off muscular branches to the extensor digitorum longus and peroneus tertius muscles; in the lower half of the leg it pierces the crural fascia, passes in front of the ankle joint and becomes the medial cutaneous nerve of the dorsum of the foot. This accessory superficial peroneal nerve may be of importance in surgery of the leg and foot.     

双侧尺神经肘部走行异常1例

患者,男性,25岁,左手肌肉萎缩并环小指麻木半年就诊,查体:左环指尺侧半及左小指皮肤感觉减退,左手小鱼际肌,骨间肌萎缩,环小指呈爪状畸形,夹纸试验阳性,左肘尺神经沟处Tinel征阳性,左前臂内侧皮肤感觉无异常.诊断为"左肘管综合征(重度)[1]",入院拟行尺神经探查松解及前置术,术中探查见尺神经并未在尺神经沟内,而是在肱骨内侧髁的前侧走行,与尺侧上副动脉伴行(图1).神经沟的浅面未见明显的筋膜和韧带覆盖,而是被肌肉组织充填,尺神经在肱骨内侧髁近侧和远侧分别被增厚的腱膜(来源不明)和尺侧屈腕肌的筋膜压迫,卡压段神经变细,中间段神经水肿增粗,切开筋膜,松解神经外膜,然后切开内侧髁前面的深筋膜,将尺神经移位其内,缝合筋膜数针予以固定.     

Inflammatory pseudotumor of the peroneal nerve: case report and literature review

Inflammatory pseudotumors (IPTs) are a group of lesions of obscure etiology. Although they are presumably reactive, their exact pathogenesis is unknown. Inflammatory pseudotumors are identified in different organs; however, IPTs of the peripheral nerves have been rarely reported in the English literature. We report a 44-year-old woman who presented with left foot drop. Examination revealed a thickening in the posterolateral aspect of the popliteal fossa and features consistent with peroneal nerve palsy. Magnetic resonance imaging revealed a mass that may represent a Baker cyst or perineural sheath mass that was excised. After pathological examination, the case was diagnosed as IPT of peroneal nerve, and the patient received no further therapy. Inflammatory pseudotumors of the peripheral nerves, although rare, should always be of consideration in the differential diagnosis of peripheral nerve nodular mass lesions. They can mimic neoplastic nerve sheath lesions, clinically and radiologically. However, they are amenable to surgical cure with nerve-sparing surgery. Thus, despite their rarity, on dealing with neural S100 negative lesion, their inclusion is mandatory to avoid an unnecessary and a rather aggressive surgery.     

CTA发现单侧腓动脉胫后动脉变异1例

<正>腓动脉是小腿的重要血管之一,腓动脉穿支皮瓣已在临床上被广泛运用。CT血管造影(CTA,CT angiography)检查被证实是术前设计皮瓣的可靠方法之一~([1,2])。在1例患者的双下肢CTA检查中,发现其左侧腓动脉及胫后动脉发生变异,现报道如下。本例患者,男,38岁,主因"右手机器伤清创术后3天"入院。入院诊断:右手背皮肤缺损并肌腱外露。拟行游离腓动脉穿支皮瓣移植修复术。为保证     

Neural fibrolipoma of the superficial peroneal nerve in the ankle: a case report with immunohistochemical analysis

This report presents a case of neural fibrolipoma arising from the superficial peroneal nerve in the ankle. A 28-year-old woman was referred with a soft tissue mass in the anterior aspect of the right ankle, which had been gradually enlarging for the past 10 years. Magnetic resonance imaging showed a mass lesion, measuring approximately 8 x 3 x 2 cm, with high to partially low signal intensity on both T1- and T2-weighted images. A band of low signal intensity within the lesion, which is indicative of coexistence with the tumor and the superficial peroneal nerve, could be detected on both T1- and T2-weighted images. The patient underwent an excisional biopsy. The specimen microscopically consisted of nerve bundles and fibro-fatty proliferation with abundant collagen fibers. Immunoreactivity for CD34 antigen antibody was detected in fibrous spindle cells. This is the first report to present an immunohistochemical profile of neural fibrolipoma. Neural fibrolipoma should be considered as a differential diagnosis when a lipomatous lesion is encountered in the foot or ankle as well as in the upper extremities.     

髂腹下神经、髂腹股沟神经和生殖股神经变异1例

国内外文献中关于髂腹下神经、髂腹股沟神经或生殖股神经的变异包括起源、行程、数目、分支分布等诸多情况[1～4].作者在解剖1具青年女性尸体时,发现其髂腹下神经、髂腹股沟神经和生殖股神经分支或分布都有异常.该变异尚未见文献报道.     

Unilateral common peroneal nerve palsy following renal transplantation: a case report of tacrolimus neurotoxicity

Neurologic complications are not uncommon in renal transplant recipients. Acute femoral neuropathy, lumbosacral plexopathy, and sciatic neuropathy have been reported after kidney transplantation probably due to perioperative nerve compression and ischemia. To the best of our knowledge, common peroneal nerve (CPN) palsy has not been described in the early postoperative period following renal transplantation. Also, mononeuropathy due to tacrolimus (TAC) therapy has not been described so far. We report a case of isolated CPN palsy presenting as unilateral foot drop following renal transplantation and that improved only after replacing TAC with cyclosporine.     

Unique variation in the course of maxillary artery in infratemporal fossa: a case report

Maxillary artery is one of the key contents of the infratemporal fossa. Mandibular nerve and its branches form a clinically important relation of maxillary artery in this region. A comprehensive knowledge of variations of maxillary artery in the fossa is of special relevance in oral maxillofacial surgeries, management of epistaxis, intractable neuralgias or headaches. We found a unique variation of maxillary artery, presenting bilaterally, in relation to branches of mandibular nerve. During routine dissection in a 55-year-old male cadaver, maxillary artery was seen passing deep to lateral pterygoid muscle and crossed through the nerve loop formed between two roots of auriculotemporal nerve and posterior division of mandibular nerve. Further course of maxillary artery was medial to the posterior division of mandibular nerve. Maxillary artery gave its middle meningeal artery branch as it traversed through the nerve loop. A tortuous course taken by maxillary artery can lead to its entrapment causing headaches or nerve irritation presenting with neuralgia.     

The communicating branches between the sural and superficial peroneal nerves in the foot: a review of 55 cases

The rich sensory innervation of the ankle and foot is manifest through the numerous communicating branches linking the neural trunks, particularly the superficial peroneal and sural nerves on the anterolateral aspect of the hindfoot. The 35 communicating branches seen in 55 dissections (58%) were proximal in half of the cases, lying in the malleolar and lateral tarsal regions, and distal in the other half, in the metatarsal region. The communicating branch was straight in 25 cases and curved in 11. The average distances of the communicating branch from the crest of the lateral malleolus and the tubercle of the 5th metatarsal was 4.7 and 4.1 cm, but there was a wide range of values. We believe that stretching of the proximal communicating branch during forced inversion of the ankle and/or foot or during fractures of the calcaneus or direct injury in surgical approaches or arthroscopy of the ankle may lead to unexplained pre- and submalleolar pain. Advances in modern imaging may allow recognition of these branches and guidance of infiltration and even neurolysis in cases of failure of conservative treatment.     

Model-based ankle joint angle tracing by cuff electrode recordings of peroneal and tibial nerves

The main goal of the present study was to estimate the ankle joint angle from the peroneal and tibial electroneurography (ENG) recordings. Two single-channel cuff electrodes for recording ENG were placed on the proximal part of rabbit peroneal and tibial nerves respectively and static positioning and ramp-and-hold stretches were performed to characterize the static and dynamic ENG responses. An ENG model, consisting of static and dynamic parts, was constructed to relate ENG to ankle angle trajectory and an inverse ENG model was derived to predict ankle angle. The results showed that the new model could accurately estimate large-range ankle angles during and after ramp-and-hold movements. Our study provides a basis for implementing joint angle tracing without using artificial angle sensors.     

Unique expression pattern of viral proteins in human herpesvirus 8-positive plasmablastic lymphoma: a case report

Background: Human herpesvirus 8 (HHV8)-positive plasmablastic lymphoma is a disease which correlates with acquired immunodeficiency syndrome (AIDS). Little is known about the pathogenesis of the disease due to its rarity. We report an autopsy case about AIDS related HHV-8-positive plasmablastic lymphoma and presents an examination about HHV8 related proteins for the disease by using immunohistochemical techniques. Case presentation: Two kinds of tumors complicated the male AIDS patient: one was HHV-8-positive plasmablastic lymphoma and the other was Kaposi’s sarcoma (KS). Immunohistochemically, the lymphoma cells were positive for HHV8-associated lytic early proteins as well as HHV8 latency-associated nuclear antigen 1 (LANA-1), and, on the other hand, the lymphoma cells were negative for lytic immediately early proteins. KS was positive for only LANA-1. Conclusion: These findings indicate that the lymphoma cells acquired an ability to proliferate without de novo HHV8 replication. Moreover, the onset mechanisms of HHV-8-positive plasmablastic lymphoma may be different from those of KS.     

右侧肌皮神经分支分布异常1例

根据《中国人解剖数据》统计，肌皮神经分支分布于鱼际肌及拇、示指皮肤罕见。在标本制作中，发现右侧肌皮神经此类变异1例，报道如下：