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THE PATHOLOGY OF ULNAR NERVE COMPRESSION IN MAN
Author(s) -
NEARY D.,
EAMES ROSEMARY A.
Publication year - 1975
Publication title -
neuropathology and applied neurobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.538
H-Index - 95
eISSN - 1365-2990
pISSN - 0305-1846
DOI - 10.1111/j.1365-2990.1975.tb00379.x
Subject(s) - anatomy , medicine , lesion , ulnar nerve , remyelination , elbow , pathology , myelin , central nervous system , endocrinology
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.