PATHOLOGY OF ULNAR NERVE COMPRESSION IN MAN
PATHOLOGY OF ULNAR NERVE COMPRESSION IN MAN
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DOI：
10.1111/j.1365-2990.1975.tb00379.x
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发表时间：
1975-01-01
影响因子：
5
通讯作者：
EAMES, RA
中科院分区：
文献类型：
--
作者：
NEARY, D;EAMES, RA
手肘的三个尺神经在尸检时获得的两名患者无关的绝症，并进行了检查，通过光学和电子显微镜。在1例病例中，存在尺骨神经病变的临床证据。在尺侧腕屈肌腱弓近端的一条神经上发现神经瘤样肿胀。在这一水平上，在所有三个神经中发现了单个梳理纤维的异常，包括节段性脱髓鞘和髓鞘再生，以及结旁球状髓鞘和脱髓鞘的存在。横切面显示近端和远端的变化分级，最大的异常出现在腱弓水平。神经束膜增厚和神经内水肿，后者导致纤维密度降低，病变两侧恢复正常。百分比频率直方图显示，在病变水平的大直径纤维的比例显着减少。许多集群的再生和髓鞘再生纤维（再生集群）的存在，这些显着增加的数量在这些地区，其中异常存在于单一的梳理纤维。对这些变化的意义进行了讨论。有人建议，在其他明显正常的横切面的神经可能会发生卡压部位的存在下，许多再生集群表明，潜在的异常将被视为在单一戏弄的神经纤维和早期压迫性神经病变。
Three ulnar nerves at the elbow were obtained at necropsy on two patients with unrelated terminal illnesses and were examined by light and electron microscopy. In one case clinical evidence of ulnar neuropathy had been present. A neuromatous swelling was found on one nerve immediately proximal to the tendinous arch of the flexor carpi ulnaris muscle. At this level abnormalities in single teased fibres were found in all three nerves, including segmental demyelination and remyelination, and the presence of paranodal bulbous swellings and demyelination. Transverse sections showed a gradation of changes proximally and distally, the greatest abnormalities being present at the level of the tendinous arch. Perineurial thickening and endo‐neurial oedema were seen, the latter producing a reduction in fibre density which returned to normal on either side of the lesion. Percentage frequency histograms showed a marked reduction in the proportion of large diameter fibres at the level of the lesion. Numerous clusters of regenerated and remyelinated fibres (regeneration clusters) were present; these were significantly increased in number in those areas in which abnormalities were present in single teased fibres. The significance of the changes has been discussed. It is suggested that the presence of many regeneration clusters in otherwise apparently normal transverse sections of nerves taken from sites where entrapment may occur indicates that underlying abnormalities will be seen in single teased nerve fibres and early compression neuropathy is present.