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Chronic human nerve compression--a histological assessment.

S E Mackinnon, A L Dellon, A R Hudson

    Neuropathology and Applied Neurobiology
    |November 1, 1986
    PubMed
    Summary
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    Histological analysis of human superficial radial nerves revealed early changes in compression neuropathy, including perineurial alterations and fibrosis. Both myelinated and unmyelinated nerve fibers showed distinct pathological responses to compression.

    Area of Science:

    • Neurology
    • Histopathology
    • Nerve Biology

    Background:

    • Compression neuropathy is a prevalent clinical issue.
    • Studying human nerve tissue affected by compression is challenging due to limited availability.
    • Entrapment syndromes represent a significant cause of peripheral nerve damage.

    Purpose of the Study:

    • To histologically examine human superficial radial nerve tissue from patients with entrapment syndrome.
    • To identify early pathological changes associated with nerve compression.
    • To understand the differential response of myelinated and unmyelinated nerve fibers to compression.

    Main Methods:

    • Histological assessment of superficial radial nerve biopsies from four human cases.
    • Microscopic examination focusing on perineurium, endoneurial microvessels, and nerve fibers.

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  • Analysis of connective tissue changes, including fibrosis.
  • Evaluation of myelinated and unmyelinated fiber populations.

    • Main Results:

    • Earliest histological abnormalities included changes in the perineurium, endoneurial microvessels, and the presence of Renaut bodies.
    • Significant epineurial and perineurial fibrosis was observed.
    • Nerve fiber pathology varied between fascicles.
    • Myelinated fibers exhibited marked myelin thinning.
    • Unmyelinated fibers showed a shift towards smaller diameters, indicating degeneration and regeneration.

    Conclusions:

    • Histopathology provides crucial insights into human compression neuropathy.
    • Early signs of nerve compression involve perineurial and microvascular changes, alongside fibrosis.
    • Myelinated and unmyelinated nerve fibers demonstrate distinct adaptive and degenerative responses to sustained compression.