Persistent Median Artery in the Carpal Tunnel: Anatomy, Embryology and Clinical Significance

The median artery is the main source of blood for the forearm in intrauterine life. During the process of development the median artery gets obliterated and supplies the median nerve. Variation of persistent median artery and its accompanying with the median nerve in the carpal tunnel is one of the important anatomic variations of the upper limb. Thrombosis of the artery inside the carpal tunnel may cause carpal tunnel syndrome. The present variation of persistent median artery inside the carpal tunnel was observed in a 28 year old female during magnetic resonance imaging of the wrist. The artery is originated from the ulnar artery and passes through the forearm accompanying the median nerve and then enters the carpal tunnel. The diameter of artery inside the carpal tunnel was 2 mm. Median artery thrombosis in this kind of variation can cause compression on the median nerve and symptoms of carpal tunnel syndrome. Doppler ultrasound is recommended to be used to diagnose vascular thrombosis in the carpal tunnel.