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Case Report

Vol. 17 No. 1 (2019)

Carpal Tunnel Syndrome Secondary to Acute Thrombosis of Persistent Median Artery and Review of the Literature

July 15, 2018


Carpal tunnel syndrome (CTS) is the most common neuropathy of the upper extremity.1 We report a case in which a twenty-eight-year-old manual labourer presented with acute thrombosis in a persistent median artery which triggered acute carpal tunnel symptoms. A bifid median nerve was found upon carpal tunnel release. The knowledge of the existence of this anatomic variation is important in order to prevent inadvertent injury. We further discuss the possible aetiologies for CTS as well as neurovascular anomalies which may lead to median nerve compression at the wrist.


  2. Narayan S, Bifid median nerve in a patient with carpal tunnel syndrome: A case report and literature review. Australasian Society for Ultrasound in Medecine. 2016; 19 (4): 164-168.
  3. Bijannejad D, Azandeh S, Fatemeh J et al. Persistent median artery in the carpal tunnel and anastomosis with superficial palmar arch. Case reports in plastic surgery and hand surgery. 2016; 3 (1): 25-27.
  4. Salter M, Sinha N, Szmigielski W. Thrombosed persistent median artery causing carpal tunnel syndrome associated with bifurcated median nerve: A case report. Polish J Radiol. 2011; 76 (2): 46–48.
  5. Mitchell R, Chesney A, Seal S, McKnight L, Thoma A. Anatomical variations of the carpal tunnel structures. Can J Plast Surg. 2009 ; 17 (3) : e3–e7.
  6. Chen L, Chen J, Hu B, Jiang LX. 3. Sonographic Findings of the Bifid Median Nerve and Persistent Median Artery in Carpal Tunnel: A Preliminary Study in Chinese Individuals. Clinics Sao Paulo. 2017 ; 72 (6) : 358-362.
  7. Srivastava A, Sharma P, Pillay S. Persistent median artery thrombosis: A rare cause of carpal tunnel syndrome. Australas J Ultrasound Med. 2015; 18 (2): 82-85.
  8. Barfred T, Hojlund AP, Bertheussen K. Median artery in carpal tunnel syndrome. J Hand Surg. 1985; 10: 864-867.
  9. Singla RK, Kaur N, Dhiraj GS. Prevalence of the persistent median artery. J Clin Diagn Res. 2012; 6 (9): 1454-1457.
  10. Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surgery Gynaecology and Obstetrics. 1961;113:409–24.
  11. Lanz U. Anatomic variations of the median nerve in the carpal tunnel. Journal of Hand Surgery. 1997 ; 2 (1) : 44-53.


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