罕见的神经压迫综合征

IF 0.4 4区 医学 Q4 SURGERY Handchirurgie Mikrochirurgie Plastische Chirurgie Pub Date : 2024-02-01 Epub Date: 2024-03-20 DOI:10.1055/a-2250-8389
Anne Carolus, Anne-Kathrin Uerschels
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引用次数: 0

摘要

不常见的神经压迫综合征:由于外周神经与肌肉、肌腱、筋膜的解剖关系复杂,而且它们在这些解剖结构中的走向较长,与骨骼结构的接触也较密切,因此很容易出现局部压迫综合征。因此,绝大多数的卡压综合征--文献中对几乎每一条神经都有详细描述。本文旨在概述症状、体征、诊断研究和治疗方案,尤其是针对鲜为人知的综合征。上臂和肩部的压迫综合征包括肩胛上神经综合征、腋神经在四肢棘突内的压迫以及胸壁长胸椎神经的压迫。上肢有各种不常见的卡压综合征,如前臂正中神经受压导致的前臂综合征和前骨间神经综合征。上肢远端桡神经的压迫性神经病变也被称为上桡神经综合征。Guyon's管综合征相当于众所周知的腕管综合征的尺侧。在腕痛症的病例中,可以看到桡神经浅支的感觉分支受到压迫。在下肢,特别是腹股沟和大腿部位的各种神经会受到压迫,因为它们会穿过腹部肌肉之间或腹股沟韧带下方的狭窄空间。股外侧皮神经受压是最常见的综合征。股神经和闭孔神经的压迫综合征多为先天性。膝关节周围的疼痛,尤其是外侧和膝关节矫形手术后的疼痛,可能是由于隐神经髌下小分支受压或发生病变所致。另一种可能诊断不足的综合征是坐骨神经综合征,它是坐骨神经穿过某些肌肉结构时被卡住所致。在下肢远端,腓肠神经和胫神经可能在多个部位受到压迫,临床上称为腓肠神经麻痹,这是由于腓骨头周围的神经受到压迫、跗骨隧道前后综合征和莫顿跖痛造成的。
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[Rare nerve compression neuropathies]

Uncommon nerve compression syndromes: In regard to the complex anatomical relationship of peripheral nerves and muscles, tendons, fasciae as well as their long course within those anatomical structures and additional close contact to bony structures, they are prone to suffer from local compression syndromes. Hence creating a vast majority of entrapment syndromes - well described in literature for almost every single nerve. The purpose of this article is to give an overview of symptoms, signs, diagnostic studies and treatment options, addressing especially the less known syndromes. Compression syndromes of the upper arm and shoulder region include the suprascapular nerve syndrome the compression of the axillary nerve within the spatium quadrilaterale and the compression of the long thoracic nerve at the chest wall. The upper extremity offers a variety of infrequent entrapment syndromes, as the pronator teres syndrome and anterior interosseus syndrome, both resulting from pressure to the median nerve in the forearm. Compression neuropathy in the course of the radial nerve in the distal upper extremity is also known as supinator syndrome. Guyon's canal syndrome is the ulnar side equivalent to the well-known carpal tunnel syndrome. In the case of a Cheiralgia paresthetica, a compression of a sensory branch of the superficial radial nerve can be seen. In the lower extremities, a variety of nerves especially in the groin and thigh area can be compressed as they pass through the narrow spaces between the abdominal muscles or underneath the inguinal ligament. Compression of the lateral femoral cutaneous nerve is the most common syndrome. Compression syndromes of the femoral and obturator nerves are most often iatrogenic. Pain around the knee, especially the lateral part and following orthopedic procedures of the knee, can arise from a compression or a lesion of a small infrapatellar branch of the saphenous nerve. Another probably underdiagnosed syndrome is piriformis syndrome, resulting from an entrapment of the sciatic nerve as it passes through certain muscular structures. In the distal lower extremity, the peroneal and tibial nerves can be compressed at multple sites, clinically known as peroneal nerve paralysis resulting from nerve compression around the fibular head, the anterior and posterior tarsal tunnel syndrome, and Morton's metatarsalgia.

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来源期刊
CiteScore
1.00
自引率
16.70%
发文量
85
审稿时长
6-12 weeks
期刊介绍: In Originalarbeiten und Fallberichten finden Sie die neuesten Informationen über: Diagnostik Verfahrenswahl state of the art / neueste Techniken rekonstruktive Verfahren Behandlung infolge von Traumata oder OP Bewertung der Ergebnisse Klinische Forschung Interessante Darstellung der neuesten Erkenntnisse in Originalarbeiten und Fallberichten. Exzellent veranschaulicht durch ein klares Layout und reiche Bebilderung. Überzeugen Sie sich selbst! Organschaften Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie, Deutschen Gesellschaft für Handchirurgie und Österreichischen Gesellschaft für Handchirurgie Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße Organ der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen
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