Posterior interosseous nerve palsy after brachiocephalic arteriovenous fistula construction: report of two cases.
Two cases of delayed posterior interosseous nerve palsy after brachiocephalic arteriovenous fistula creation are presented. Both patients suffered from end-stage renal disease, necessitating chronic hemodialysis. After fistula construction, both developed progressive weakness of the muscles innervated by the posterior interosseous nerve. One patient also demonstrated sensory loss in the distribution of the superficial radial nerve. Electrophysiological studies confirmed posterior interosseous mononeuropathies in both cases. Surgical exploration demonstrated posterior interosseous nerve continuity, with severe compression from the hypertrophied venous limb of the arteriovenous fistula. The superficial radial nerve was also compressed in one patient. After neurolysis and fistula revision, both patients recovered neurological function.
Sawin
P D
PD
Division of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA.
Loftus
C M
CM
D000368:Aged; D001166:Arteriovenous Shunt, Surgical; D016122:Brachiocephalic Trunk / Q000601:surgery; D016121:Brachiocephalic Veins / Q000601:surgery; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D011826:Radial Nerve / Q000601:surgery*; D012086:Reoperation