Intraneural microcirculation.

Peripheral nerve trunks are well-vascularized structures where a well-developed collateral system may compensate for local vascular damage. Interference with intraneural blood flow is reflected rapidly in disturbances in nerve function. In compression lesions and nerve entrapments, the microvascular factor plays an important pathophysiologic role for development of symptoms. Although endoneurial capillaries normally constitute a BNB helping to optimize endoneurial environment, damage to the vessels may induce a miniature closed compartment syndrome by increasing the permeability, thereby contributing to increased endoneurial fluid pressure and development of an intrafascicular edema. Surgeons, performing intraneural dissections, should be aware of the potential risks associated with intraneural bleedings, edema, and intraneural fibrosis.