A superficial brachioradial artery coexisting with an atypically formed median nerve and a distal anastomosis between musculocutaneous and median nerve

ABSTRACT

A radial artery (RA) of axillary or brachial origin is the most commonly reported variation of the upper limb arterial pattern. A variant RA with a high origin from the proximal segment of the axillary artery (AA) coursing anterior to the median nerve (MN), the so-called superficial brachioradial artery (SBRA), is a rare case. The current report describes an unusual high origin of the right RA from the 2nd part of the AA, 2.9cm proximal to the subscapular artery emersion. The RA advanced anterior to the MN and becomes a SBRA. The AA advanced as brachial artery (BA) with the typical branching pattern giving off the radial recurrent artery. The SBRA had no anastomosis with the BA in the cubital fossa. The latter, under bicipital aponeurosis, was divided into the ulnar and the common interosseous arteries. Besides the SBRA, a MN with three (two lateral and one medial) roots and three anastomoses coexisted; one between the lateral cord (LC) of the brachial plexus and the medial root (MR) of the MN, the other between the LC and the ulnar nerve (UN) and the last one between musculocutaneous (MCN) and MN, found at the lower third of the arm. A connection of the left-sided LC with the MR was also observed. The present paper focuses on an aberration of the typical arterial pattern at the right axilla and arm highlighting the concomitant neural aberrations and their embryological background. This could be valuable to any physician involved in the treatment of vascular emergencies, requiring prompt diagnosis and surgical repair

RESUMEN

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