Bifid median nerve
Updates to Article Attributes
A bifid median nerve is an uncommon anatomical variation in the forearm, it can be accompanied by and has an increased association with a persistent median artery4.
Epidemiology
It has an incidence of ~39-19%4. A persistent median artery is present in approximately half of those with a bifid median nerve 4.
Gross anatomy
The median nerve usually divides into two or three branches after exiting the distal edge of the transverse carpal ligament that covers the carpal tunnel. These subdivide into digital nerves that supply opposing sides of the digits. The median nerve may divide into two nerve bundles in the distal forearm and appear as a bifid median nerve in the carpal tunnel.
A bifid median nerve may be accompanied by an accessory artery, the persistent median artery of the forearm, which lies in between the two nerve bundles. The artery and bifid nerve can be enclosed by a common epineurium.
Practical points
As the median artery can be easily detected on ultrasound, it is essential that this be mentioned in the radiologist's report to avoid inadvertent injury to the nerve and artery during surgical release of the transverse carpal ligament.
-<p>A <strong>bifid median nerve</strong> is an uncommon anatomical variation in the forearm, it can be accompanied by a <a title="Persistent median artery of the forearm" href="/articles/persistent-median-artery-of-the-forearm">persistent median artery</a>. </p><h4>Epidemiology</h4><p>It has an incidence of ~3%. </p><h4>Gross anatomy</h4><p>The median nerve usually divides into two or three branches after exiting the distal edge of the <a href="/articles/transverse-carpal-ligament">transverse carpal ligament</a> that covers the carpal tunnel. These subdivide into digital nerves that supply opposing sides of the digits. The <a href="/articles/median-nerve-2">median nerve</a> may divide into two nerve bundles in the distal forearm and appear as a bifid median nerve in the <a href="/articles/carpal-tunnel">carpal tunnel</a>.</p><p>A bifid median nerve may be accompanied by an accessory artery, the <a href="/articles/persistent-median-artery-of-the-forearm">persistent median artery of the forearm</a>, which lies in between the two nerve bundles. The artery and bifid nerve can be enclosed by a common epineurium. </p><h4>Practical points</h4><p>As the median artery can be easily detected on ultrasound, it is essential that this be mentioned in the radiologist's report to avoid inadvertent injury to the nerve and artery during surgical release of the transverse carpal ligament.</p>- +<p>A <strong>bifid median nerve</strong> is an uncommon anatomical variation in the forearm and has an increased association with a <a href="/articles/persistent-median-artery-of-the-forearm" title="Persistent median artery of the forearm">persistent median artery</a> <sup>4</sup>.</p><h4>Epidemiology</h4><p>It has an incidence of 9-19% <sup>4</sup>. A persistent median artery is present in approximately half of those with a bifid median nerve <sup>4</sup>.</p><h4>Gross anatomy</h4><p>The median nerve usually divides into two or three branches after exiting the distal edge of the <a href="/articles/transverse-carpal-ligament">transverse carpal ligament</a> that covers the carpal tunnel. These subdivide into digital nerves that supply opposing sides of the digits. The <a href="/articles/median-nerve-2">median nerve</a> may divide into two nerve bundles in the distal forearm and appear as a bifid median nerve in the <a href="/articles/carpal-tunnel">carpal tunnel</a>.</p><p>A bifid median nerve may be accompanied by an accessory artery, the <a href="/articles/persistent-median-artery-of-the-forearm">persistent median artery of the forearm</a>, which lies in between the two nerve bundles. The artery and bifid nerve can be enclosed by a common epineurium. </p><h4>Practical points</h4><p>As the median artery can be easily detected on ultrasound, it is essential that this be mentioned in the radiologist's report to avoid inadvertent injury to the nerve and artery during surgical release of the transverse carpal ligament.</p>
References changed:
- 4. Eyer B. Persistent Median Artery - Radsource. Radsource. <a href="https://radsource.us/persistent-median-artery">Radsource</a>
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