Nerve sheath ganglion of the ulnar nerve

We report a case of a nerve sheath ganglion of the ulnar nerve at the canal of Guyon. This case involved a ganglion which was confined to the epineurium of the ulnar nerve. and it was completely excised without any damage to the nerve fiber. A nerve-sheath ganglion is rare, but it should be considered in the differential diagnosis of any tumor which is causing neural disturbance.     

Ganglion in the ulnar nerve groove (author's transl)]

Two cases of a rare localisation of ganglion is reported in this paper. A ganglion in the ulnar nerve presented by complete loss in ulnar nerve function. Attention is drawn to the importance of early diagnosis, and to the fact, that in cases of ulnar nerve lesions of unknown origin tumors in the ulnar groove must be considered.     

Distal ulnar neuropathy from carpal ganglia: a clinical and electrophysiological study

The clinical and electrophysiological observations in two cases of distal ulnar neuropathy from carpal ganglia are reported. In the first case, the ganglion was compressing the ulnar nerve just proximal to its division; in the second case, the ganglion was compressing the deep branch of the ulnar nerve just at its origin. In both cases, both axonal degeneration and segmental demyelination were present. A clinical classification of the compression syndromes of the deep ulnar branch is proposed.     

Intraneural ganglion cyst of the ulnar nerve causing cubital tunnel syndrome masquerading a peripheral nerve abscess of a neuritic leprosy

Cubital tunnel syndrome is a common entrapment neuropathy affecting the ulnar nerve. Intraneural ganglion cyst and nerve abscess due to leprosy can cause cubital tunnel syndrome. In this article, we are presenting a case of cubital tunnel syndrome caused due to an intraneural ganglion cyst in a 48-year-old lady. It had produced some diagnostic confusion due to its clinical similarity with nerve abscess. This is the first report of a case of an intraneural ganglion cyst of the ulnar nerve masquerading the diagnosis of a nerve abscess.     

Ulnar Nerve Compression in the Cubital Tunnel by an Epineural Ganglion: A Case Report

Epineural ganglia are considered to be a usual cause of peripheral nerve compression. In this report, we present a rare case of ulnar nerve compression by an epineural ganglion in the cubital tunnel. A 28-year-old right-handed female secretary developed progressive pain, numbness, and weakness in her right elbow, forearm, and hand for 6 months. Atrophy of the adductor pollicis and the first dorsal interosseous muscles was apparent. Clinical examination revealed a cystic mass at the posterior side of the elbow. Magnetic resonance imaging identified a ganglion while electrophysiologic studies revealed a severe conduction block of the ulnar nerve at the elbow. During surgery a 2-cm diameter epineural ganglion was identified compressing the ulnar nerve and was excised using microsurgery techniques. Two months postoperatively, the clinical recovery of the patient was very satisfactory, although the postoperative electrophysiologic studies demonstrated a less dramatic improvement.     

Compression of the Deep Palmar Branch of the Ulnar Nerve by a Ganglion

A ganglion originating from the pisotriquetral joint is the most common cause of distal ulnar nerve compression. Midpalmar ganglions causing ulnar nerve compression are rare. This case describes a ganglion arising from the third carpometacarpal joint causing compression of the deep motor branch of the ulnar nerve.Investigation performed at the Toronto Western Hospital, University Health Network Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada     

Irritative neuritis of the dorsal sensory branch of the ulnar nerve from underlying ganglion

Although sites of ulnar nerve compression or disruption are generally apparent in a detailed physical examination, ulnar nerve involvement that is confined to the dorsal sensory branch of the ulnar nerve is unusual. Three patients presented with pain over the dorsal ulnar aspect of the hand associated with a cystic mass on the ulnar border of the wrist and hand. Stretching of the dorsal cutaneous branch from an underlying ganglion or proliferative synovium was present in all three of the patients.     

Intraneural ganglion cyst of the ulnar nerve in an unusual location: A case report

IntroductionIntraneural ganglion cysts are benign, mucinous, non-neoplastic lesions of the peripheral nerves. While the most common location of intraneural ganglion cysts is the ulnar nerve and its branches, intraneural ganglion cyst involving the superficial branch of the ulnar nerve has not yet been reported.Presentation of caseA-25-year-old woman presented with pain and a palpable mass in the hypothenar region of the volar side of her right hand. Her neuromuscular examination was normal. The pain was unresponsive to nonsurgical treatments. After confirming with imaging modalities, the initial diagnosis was considered as an intraneural ganglion cyst arising from superficial ulnar nerve. Excision of the ganglion and exploration of the articular branch (if seen in operation) decision was undertaken by the senior author. Whether MRI or intraoperative exploration, not identified an articular branch.DiscussionIntraneural ganglion cysts of peripheral nerves may be seen in miscellaneous locations in the body. However, to our knowledge, an intraneural ganglion cyst involving the superficial branch of the ulnar nerve is unique. While a variety of theories have been proposed to enlighten the etiopathogenesis of intraneural ganglia, the latest and most affirmed is the unifying articular (synovial) theory.ConclusionIntraneural ganglion cysts may be seen on the hypothenar side of the palm. The etiology and treatment of choice are closely associated with each other in this rare disorder. It is important to realize a related articular branch, otherwise the origin of cyst formation remains, and this may cause other para-articular cysts.     

Microsurgical principles related to excision of intraneural ganglion at the elbow

We describe the treatment of a ganglion within the ulnar nerve at the elbow and apply the concept that an intraneural ganglion arises from the joint adjacent to the nerve in which the ganglion is located. Successful treatment of nerve compression and prevention of recurrence of the ganglion require disconnection of the nerve from the joint and deflation, not excision, of the ganglion.     

Diagnosis of ganglion in Guyon's canal by magnetic resonance imaging

Compression of the ulnar nerve at the wrist can be caused by a multitude of intrinsic and extrinsic factors. The exact diagnosis and location of compression can frequently be difficult to determine. Magnetic resonance imaging can be a useful method in diagnosing the cause and location of ulnar nerve compression. A case is presented of ulnar nerve compression caused by a ganglion in Guyon's and diagnosed preoperatively by magnetic resonance imaging.     

Compression of the deep branch of the ulnar nerve in Guyon’s canal by a ganglion: two cases

INTRODUCTION: Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion compressing the nerves. MATERIALS AND METHODS: We present two cases of compression of deep branch of ulnar nerve by a ganglion in the Guyon's canal. Two male patients presented with history of progressive weakness and paraesthesia in the medial 1(1/2) digits of the non-dominant hand. Interestingly, both the patients noticed sudden onset and rapid progress of the symptoms and signs. Clinical examination revealed typical symptoms of ulnar nerve (deep branch) palsy. Nerve conduction studies showed severe denervation of the deep branch of the ulnar nerves in both the patients and ultrasound confirmed the diagnosis. Surgical decompression led to complete recovery. RESULTS AND DISCUSSION: Whilst compression by a ganglion in the Guyon's canal is rare but well recognized, a feature of both of our cases was the rapid progression and severe nature of the compressive symptoms and signs. This is in contrast to the more typical features of compressive neuropathy and should alert the clinician to the possible underlying cause of compression. Early decompression has the potential to promote a complete recovery.     

A ganglion within the ulnar nerve and communication with the distal radioulnar joint via an articular branch: case report

An intraneural ganglion is rare, and involvement of an articular nerve may suggest a possible pathogenesis. We report an intraneural ganglion of the ulnar nerve with a connection to the distal radioulnar joint via the articular branch. We excised the ganglion, the stalk, and the articular branch. To date, there has been no recurrence.     

Pisiform-hamate synostosis with ulnar neuropathy. Case report

Entrapment of the ulnar nerve at the wrist is rare compared with the more commun site at the elbow. This condition was secondary to reccurent blunt trauma, ganglion cyst, vasculitic disorders, and fibrous bands. Compression of the ulnar nerve caused by pisiform-hamate coalition is rare entity. One case of this condition is reported.     

Case report: intraneural ganglion cyst of the ulnar nerve at the wrist

We report a case of a 69-year-old male who presented with pain, weakness, and clumsiness of his right hand. Initial evaluation suggested possible neoplastic process affecting his cervical spine, which was fortunately ruled out by bone biopsy. Subsequent electrodiagnostic studies and magnetic resonance imaging confirmed a lesion of the deep ulnar motor branch. Exploration of Guyon’s canal was performed, and an intraneural ganglion involving the deep motor branch of the ulnar nerve was found and excised. Despite more than 14 months of symptomatic duration, the patient made a near-complete recovery with virtually no functional limitations. This provides supporting evidence for a functional benefit of intraneural ganglion excision and nerve decompression even in cases of chronic muscle atrophy.     

Neuropathy of motor branch of median or ulnar nerve induced by midpalm ganglion.

Two cases of neuropathy of a motor branch caused by a midpalmal ganglion are presented. In the first case the ganglion originated from the midcarpal joint, protruded into the thenar muscle, and compressed the motor branch of the median nerve. In the second case the ganglion, distal to the fibrous arch of the hypothenar muscles, originated from the third carpometacarpal joint and compressed the motor branch of the ulnar nerve. In both cases muscle weakness and finger deformity recovered well after resection of the ganglion. This clinical condition is rare compared with carpal tunnel syndrome and Guyon's tunnel syndrome, which are caused by a ganglion in the wrist.     

Epineural ganglion of the ulnar nerve at the elbow

Ganglion cysts of peripheral nerves in the upper extremity are rare. Cysts located in the substance of the nerve and extraneural ganglia that cause symptomatic nerve compression have been reported. Intraneural ganglia may be difficult to separate from the neural elements without resultant nerve injury. This case involved a ganglion cyst confined to the epineurium of the ulnar nerve at the elbow. Because of the peripheral location, it was removed without damage to the underlying nerve.     

Intraneural ganglion of the ulnar nerve

We report the case of a 76-year-old right-hand dominant man with hypertension and type 2 diabetes mellitus who presented with numbness of the right ring and little fingers for 8 months and a palpable mass lesion in the right forearm for 3 months before his hospital visit. The patient exhibited grip power weakness and atrophy of intrinsic muscles. Magnetic resonance imaging confirmed a well-defined oval mass of 1.5 × 0.6 × 0.6 cm³ between the ulnar bone and nerve. This lesion was hyperintense on T2-weighted images and isointense on T1-weighted images. A zigzag incision was made for ulnar nerve exposure, and the tumor lesion was identified and carefully excised with minimal damage of ulnar nerve. A cystic mass invaded ulnar nerve extending approximately 1.5 cm was resected and reconstructed by sural nerve grafting. The patient was examined 6 months after surgery. His grip power and muscle strength increased, and no numbness or pain was detected. The outcome of this case suggests a potential surgical benefit exists even in cases of apparent chronic or severe denervation atrophy and that ganglion excision and nerve grafting should be considered.     

Compression of the deep motor branch of the ulnar nerve by a synovial cyst. A case report

The authors report a case of compression of the deep palmar branch of the ulnar nerve beyond the piso-uniform arch by a ganglion cyst. A review of the literature finds this pattern as uncommon.     

Ulnar nerve entrapment in Guyon’s canal caused by a ganglion cyst: two case reports and review of the literature

European Journal of Orthopaedic Surgery & Traumatology - In this article, two cases of ulnar nerve neuropathy in Guyon’s canal caused by a ganglion cyst are reported. A review of the...     

Cubital tunnel syndrome associated with medial elbow Ganglia and osteoarthritis of the elbow

BACKGROUND: Medial elbow ganglia have been reported in association with cubital tunnel syndrome. This lesion is thought to occur rarely and has not been emphasized in the literature. The purposes of the present study are to report our experience with this lesion in order to elucidate its prevalence as well as its clinical and radiographic features, to describe our operative findings, and to present the results of surgical treatment. METHODS: Four hundred and eighty-seven elbows in 472 patients were treated for cubital tunnel syndrome between 1980 and 1999. We performed a retrospective study of the thirty-eight patients who had a medial ganglion. All of the ganglia were excised, and the ulnar nerve was translocated subcutaneously. Thirty-two patients were followed for a mean of thirty-seven months. RESULTS: Medial elbow ganglion was the third most common causative factor associated with cubital tunnel syndrome, with an overall prevalence of 8%. Resting pain in the medial aspect of the elbow was reported by twenty-five of the thirty-eight patients, and a sudden onset of numbness in the ring and little fingers or of medial elbow pain without prior symptoms was reported by twenty-nine patients. The symptoms lasted two months or less in thirty-one patients. All ganglia originated from the medial aspect of the ulnohumeral joint, and radiographs of that joint showed degenerative changes in thirty-seven patients. At the time of follow-up, all measurements of sensory and motor function of the ulnar nerve had improved and no recurrence of nerve palsy was found. CONCLUSIONS: Although uncommon, medial elbow ganglia have a strong association with osteoarthritis of the elbow and can cause a relatively acute onset of cubital tunnel syndrome. A patient with cubital tunnel syndrome associated with elbow osteoarthritis who complains of medial elbow pain or severe numbness within two months after the onset of the syndrome should be strongly suspected of having a ganglion. Most ganglia are occult, and ultrasonography and magnetic resonance imaging can assist in the preoperative diagnosis. Careful excision of the ganglion performed concurrently with subcutaneous anterior transposition of the ulnar nerve can produce satisfactory results.