Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report
Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabe...
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Yeungnam University College of Medicine, Yeungnam University Institute Medical Science
2025-01-01
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| Series: | Journal of Yeungnam Medical Science |
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| Online Access: | http://www.e-jyms.org/upload/pdf/jyms-2024-00948.pdf |
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| author | Da Woon Kim You Hyun Jeon Miju Bae Sang Heon Song |
| author_facet | Da Woon Kim You Hyun Jeon Miju Bae Sang Heon Song |
| author_sort | Da Woon Kim |
| collection | DOAJ |
| description | Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery. |
| format | Article |
| id | doaj-art-9c7865934cfc4278ae4a3a08e59b1692 |
| institution | Kabale University |
| issn | 2799-8010 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Yeungnam University College of Medicine, Yeungnam University Institute Medical Science |
| record_format | Article |
| series | Journal of Yeungnam Medical Science |
| spelling | doaj-art-9c7865934cfc4278ae4a3a08e59b16922025-02-11T06:26:37ZengYeungnam University College of Medicine, Yeungnam University Institute Medical ScienceJournal of Yeungnam Medical Science2799-80102025-01-014210.12701/jyms.2024.009482868Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case reportDa Woon Kim0You Hyun Jeon1Miju Bae2Sang Heon Song3 Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Busan, Korea Department of Internal Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, KoreaIschemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.http://www.e-jyms.org/upload/pdf/jyms-2024-00948.pdfarteriovenous fistulaischemic monomelic neuropathysteal phenomenonvascular access |
| spellingShingle | Da Woon Kim You Hyun Jeon Miju Bae Sang Heon Song Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report Journal of Yeungnam Medical Science arteriovenous fistula ischemic monomelic neuropathy steal phenomenon vascular access |
| title | Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report |
| title_full | Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report |
| title_fullStr | Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report |
| title_full_unstemmed | Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report |
| title_short | Ischemic monomelic neuropathy following arteriovenous fistula surgery: a case report |
| title_sort | ischemic monomelic neuropathy following arteriovenous fistula surgery a case report |
| topic | arteriovenous fistula ischemic monomelic neuropathy steal phenomenon vascular access |
| url | http://www.e-jyms.org/upload/pdf/jyms-2024-00948.pdf |
| work_keys_str_mv | AT dawoonkim ischemicmonomelicneuropathyfollowingarteriovenousfistulasurgeryacasereport AT youhyunjeon ischemicmonomelicneuropathyfollowingarteriovenousfistulasurgeryacasereport AT mijubae ischemicmonomelicneuropathyfollowingarteriovenousfistulasurgeryacasereport AT sangheonsong ischemicmonomelicneuropathyfollowingarteriovenousfistulasurgeryacasereport |