Median Nerve Compression at the Axilla by an Infiltrating Coracobrachialis Muscle: An Unusual Cause of Early CRPS - A Case Report
Abstract: Median nerve neuropathy is most frequently encountered at distal entrapment sites; proximal compression at the axillary level is uncommon and may present diagnostic challenges, particularly in patients with prior malignancy. We report a 66-year-old male with a history of completely treated non-Hodgkin lymphoma 5 years back, who presented with severe neuropathic pain initially started along the median nerve distribution and later spread to entire arm in glove & stocking pattern for four months, unresponsive to conservative pharmacotherapy. Clinical findings were consistent with early complex regional pain syndrome (CRPS) with vasomotor and trophic changes. Magnetic resonance imaging (MRI) of the brachial plexus demonstrated long-segment thickening of the median nerve with associated axillary lymphadenopathy, raising suspicion of infiltrative pathology. Surgical exploration revealed compression of the median nerve by an infiltrating coracobrachialis muscle, producing inflammatory nerve thickening. Surgical decompression was performed, followed by stellate ganglion block three weeks later for residual sympathetically maintained pain, resulting in complete symptom resolution. This case underscores the importance of comprehensive clinical and radiological evaluation before proceeding with interventional pain management and highlights the need to identify and correct structural pathology prior to sympathetic blockade.
Keywords: Median nerve neuropathy, Proximal nerve compression, Coracobrachialis muscle, Complex regional pain syndrome, Stellate ganglion block
How to Cite?: Dr. Srikanth Batchu, Dr. KVD Praveen, Dr Pennada Ragha Srujana, "Median Nerve Compression at the Axilla by an Infiltrating Coracobrachialis Muscle: An Unusual Cause of Early CRPS - A Case Report", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 920-922, https://www.ijsr.net/getabstract.php?paperid=SR26215145701, DOI: https://dx.doi.org/10.21275/SR26215145701