case_images: PMC11812072_01
case_images: The nerve conduction study shows reduced compound muscle action potential (CMAP) of the left ulnar nerve above the wrist and no CMAP of the left median nerve above the wrist. The patient's left hand exhibits weakness in multiple intrinsic hand muscles innervated by the median and ulnar nerves. (A) Initial complaint of transient left wrist drop, which spontaneously recovered the next day. (B) Decreased grip strength due to ischemic monomelic neuropathy.
case_images: jyms-2024-00948f1.jpg
case_images: PMC11812072_01_jyms-2024-00948f1.jpg
case_images: f1-jyms-2024-00948
case_images: He could not raise his hand, which became pale and numb, and his handgrip became progressively impaired (Fig. 1).
case_images: Ligation of the fistula and anastomosis between the axillary artery and forearm of the cephalic vein using a polytetrafluoroethylene (PTFE) graft is performed to improve blood flow into the distal artery. (A) The left brachiocephalic fistula operation is initially conducted. Square box indicates anastomosis site of fistula connecting brachial artery and cephalic vein. Arrows indicate the direction of blood flow. (B) Proximalization of the arterial inflow using a PTFE graft. Square boxes indicate anastomosis sites of graft. (1) Anastomosis of cephalic vein and graft; (2) anastomosis of axillary artery and graft. Arrows indicate the direction of blood flow.
case_images: jyms-2024-00948f2.jpg
case_images: PMC11812072_01_jyms-2024-00948f2.jpg
case_images: f2-jyms-2024-00948
case_images: AVF (Fig. 2). After surgery, the patient's left hand warmed, and his neurological symptoms gradually improved with consistent rehabilitation therapy.