High Median Nerve Palsy Caused by Pseudoaneurysm After Brach
According to the aging of our population, incidence of ischemic heart disease is increasing these days. Brachial catheterization is one of the most common treatments for ischemic heart disease, and although very few, median nerve palsy caused by hematoma following brachial catheterization is a well-known complication after this treatment [1-4]. However, there are few cases of high median nerve palsy caused by pseudoaneurysm after brachial catheterization in English literature to the best of our knowledge [5, 6]. The purpose of this report was to present two cases of high median nerve palsy caused by pseudoaneurysm after brachial catheterization, and also to propose how to prevent and treat it.

Case 1
A 71-year-old woman visited our clinic with a chief complaint of difficulty in flexing her thumb and index finger. She first recognized difficulty in flexing her fingers 2 weeks after brachial catheterization for treating myocardial infarction. She had a pulsative, palpable soft tissue mass (about 3 cm in its diameter) on the flexor side of her elbow about 2 cm proximal to her medial epicondyle line (Fig. 1a), and had tender and a Tinel-like sign on the mass. Angiography confirmed that her mass was pseudoaneurysm at brachial artery (Fig. 1b). Ultrasonography and magnetic resonance angiography were not performed since these could not be done at the time of her treatment (in the year of 2001)....