Las J Hwaizi
Aims: To report of a case with non-traumatic distal ulnar artery aneurism leading to ulnar nerve neuropathy at level of wrist in the ulnar tunnel. Ulnar nerve impingement has been mostly reported to be a result of posttraumatic false aneurysms, thrombosis, or anomalies distal ulnar artery in ulnar tunnel (Guyon’s canal). Methods: A 33 year-old woman with sever continuous pain which was gradual in onset over the last 9 months associated with intermittent burning sensation and continuous numbness on the ulnar side of her left hand was presented to causality unit. EMG examination showed an ulnar neuropathy in the ulnar tunnel and an ipsilateral carpal tunnel syndrome. Results: An operation was performed and exploration of the right ulnar nerve in the ulnar tunnel at the wrist showed that an ulnar artery aneurysm had pulsatile pressure like effect on the ulnar nerve. Ulnar nerve decompression by ulnar artery ligation was performed after ensuring of distal circulation, the carpal ligament was excised at the same session. After the operation, pain was improved completely in the first day postoperatively but numbness lasted for about 6 months post operatively. Conclusion: Peripheral nerve neuropathies are results of a variety of causes most of which are post traumatic, non-traumatic peripheral artery aneurism are very unlikely seen to be a leading cause to the neuropathy. Although the exact etiology is unknown but mostly it might be the pulsatile pressure like affect that predispose to the upcoming neuropathy which explains the disappearance of the pain first day postoperatively after the ligation of the aneurysm was performed.
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