Patent median artery as a cause of carpal tunnel syndrome.

Persistent median artery should be considered in the evaluation of patients with carpal tunnel syndrome. We present 5 instances of carpal tunnel syndrome caused by pressure from patent median arteries. The arteries caused bilateral carpal tunnel syndrome in 1 patient. Neuropraxia can be so severe that thenar muscle atrophy and complete loss of sensation occur. We review the embryonic development of the median nerve vascular supply and the reported incidence of persistent median artery. The use of Doppler examination is stressed in evaluating whether a median artery is present, and if it is essential to digital blood supply. In each instance, the neuropraxia resolved after the patent median artery was resected.