Superficial brachial artery traversing a median nerve loop in the arm associated with other vascular and muscular anomalies: case report and clinical implications

Knowledge of the various morphological patterns of the brachial artery and median nerve in the upper limb area is of considerable clinical and surgical importance to physicians intervening with these areas. In the current study, in the right upper limb of a male cadaver a rare variation of a superficial brachial artery associated with a median nerve loop in the upper arm is presented. The artery gave off a deep brachial artery in the arm and normally bifurcated in the cubital fossa. Additionally, a muscular bundle from the brachialis muscle was also present, overlapping the median nerve along with the deep brachial artery above the elbow. To the best of our knowledge such a combination of arterial, neural and muscular anatomical variations is extremely rare. Since brachial plexus and brachial artery variations are more prone to injury, their surgical, diagnostic and interventional importance are valuable to radiologists in interpreting images and to vascular surgeons, neurosurgeons and orthopedic surgeons involved in compressive peripheral neuropathy treatment. The relevant clinical and surgical implications are discussed as well