The carpal tunnel syndrome. The role of a persistent median artery.

After the first description by Paget (1854) and later on by Mohr (1890) and Schultze (1892), more than 100 years have passed by before it was generally recognized that compression of the median nerve in the carpal tunnel could be related to the majority of cases with nocturnal acroparaesthesiae in the hand and fingers. A short survey is given on 914 surgically treated patients (1117 operations). In one of them a bilateral carpal tunnel syndrome is related to a large persistent median artery. Although persistent median arteries have a low incidence (2.2-4.4%), this anomaly is rarely the cause of a carpal tunnel syndrome. In our case material this amounts to 1.1% of our patients and to 1.8% of all operations. In order to avert unexpected findings at surgery, it is suggested that patients should be asked whether their complaints have a pulsating character.