Persistent median artery of the forearm with bifid median nerve - bilateral
Presentation
Asymptomatic. Incidental finding during ultrasound tutorial.
Patient Data
Right anterior wrist
In the right forearm, there is a bifid median nerve, with a pulsatile persistent median artery interposed between the two nerve bundles.
Left anterior wrist
Findings in the left forearm are the same as the right. The persistent median artery is patent with pulsatile flow on color Doppler.
Bilaterally, the median nerve bundle on the radial side of the artery is larger than the bundle on the ulnar side.
Case Discussion
The patient was asymptomatic. He was advised that his bilateral anatomic variants can be associated with an increased risk of developing carpal tunnel syndrome in future.
If it is not preoperatively identified, a persistent median artery is at risk of damage during surgical release of the flexor retinaculum.
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