Median nerve bisection: a morbid complication of a peripherally inserted central catheter.
Considering the reported safety, efficiency, and low cost of peripherally inserted central catheters (PICCs), they are increasingly preferred to central venous catheters for short-term delivery of medical therapies. Here, we report a case of severe median nerve bisection during PICC placement via a brachial vein. While such nerve damage is uncommon, the case indicates that when the brachial vein is selected as an access site over the basilic and cephalic veins, caution should be exercised during PICC placement since the brachial vein traverses in close proximity to the median nerve.
Alomari
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Department of Radiology, Mount Sinai Medical Center, New York, NY, USA. ahmad.alomari@childrens.harvard.edu
Falk
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D001132:Arm / Q000098:blood supply / Q000294:innervation; D016121:Brachiocephalic Veins / Q000294:innervation; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D006406:Hematoma / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000293:injuries*; D020423:Median Neuropathy / Q000209:etiology / Q000601:surgery; D008875:Middle Aged