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Abstract
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Background and Aims The brachial plexus (BP) branching pattern is highly variable. Due to their clinical implications, the study determines the BP variants and interconnections (ICs) between its trunks, lateral and medial cords (LC and MC), and peripheral nerves. Coexisted arterial variants are also described.
Methods Twelve (7 male and 5 female) formalin-embalmed donated Greek cadavers (72-91 years of age) were dissected. After written informed consent, the donated cadavers were bilaterally dissected at the neck, axilla, and arm by following a well-established dissection protocol.
Results Various ICs were identified in 70% of the cases. Special findings were: 1. The musculocutaneous nerve (MCN) and the lateral root (LR) of the median nerve (MN) were found to have atypical right-side formations and course. 2. On the right side, the MCN was absent, the anterior arm muscles were supplied by the MN, and contralaterally, the MCN-MN IC existed. 3. a right-sided MN bifurcation after its formation 4. a right-side LR duplication, along with an MCN duplication and an IC between LC and MC 5. a right-side IC of the MCN-MN 6. a right-side IC of the LR with the MR and the BP medial cord (MC) 7. 3 cases of IC between median and ulnar nerve (MN-UN) 8. 1 case of IC between intercostobrachial nerve (ICBN) and RN
A right-sided (R) interconnections between median and ulnar nerve (MN-UN) in the forearm
A right-sided (R) interconnection between the middle trunk (MT) and the median root (MR) of median nerve(MN) and the ulnar nerve (UN)
A left-sided (L) double interconnection between the lateral cord (LC), the medial cord (MC) and the median root (MR) of median nerve (MN)
Conclusions Most of the findings were consistent with the literature. Knowledge of these variants is important during surgical, therapeutic, and diagnostic upper limb procedures, especially for anesthesiologists who perform peripheral nerve blocks.