• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of pnasPNASInfo for AuthorsSubscriptionsAboutThis Article
Proc Natl Acad Sci U S A. Dec 1990; 87(24): 9828–9832.
PMCID: PMC55267

Structural alterations of nerve during cuff compression.

Abstract

Whether compression nerve injury is due to ischemia, direct mechanical injury, or both remains unsettled. To assess structural changes of nerve during compression, peroneal nerves of rats were compressed at various pressures for different times, and the structural alterations were stopped by simultaneous in situ and perfusion fixation. The structural changes observed during a few minutes of compression cannot be explained by ischemic injury because the pathologic alterations characteristic of ischemia take many hours to develop and in any case are different from the ones found here. The pressure- and time-related structural changes observed in the present study under the cuff were (i) decrease in fascicular area and increase in fiber density due to expression of endoneurial fluid; (ii) compression and expression of axoplasm, sometimes to the point of fiber transection; (iii) lengthening of internodes; and (iv) obscuration of nodes of Ranvier due to cleavage and displacement of myelin and overlapping of nodes by displaced loops of myelin. At the edges of the cuff the changes were (i) increase of fascicular area probably from expressed endoneurial fluid; (ii) widening of nodal gaps, perhaps mainly from translocated axonal fluid; and (iii) disordered structure of axoplasm. We suggest that the process of paranodal demyelination and axonal transection are linked, occur during the act of compression, and are due to shear forces. The initial event is expression of endoneurial fluid, followed by compression and expression of axoplasm and cleavage and displacement of layers of myelin. Conceivably, with prolonged cuff compression ischemic injury might be found to be superimposed on mechanical injury.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Dyck PJ, Lambert EH, Wood MB, Linscheid RL. Assessment of nerve regeneration and adaptation after median nerve reconnection and digital neurovascular flap transfer. Neurology. 1988 Oct;38(10):1586–1591. [PubMed]
  • Ochoa J, Danta G, Fowler TJ, Gilliatt RW. Nature of the nerve lesion caused by a pneumatic tourniquet. Nature. 1971 Sep 24;233(5317):265–266. [PubMed]
  • Powell HC, Myers RR. Pathology of experimental nerve compression. Lab Invest. 1986 Jul;55(1):91–100. [PubMed]
  • Ochoa J, Fowler TJ, Gilliatt RW. Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J Anat. 1972 Dec;113(Pt 3):433–455. [PMC free article] [PubMed]
  • Dyck PJ, Conn DL, Okazaki H. Necrotizing angiopathic neuropathy. Three-dimensional morphology of fiber degeneration related to sites of occluded vessels. Mayo Clin Proc. 1972 Jul;47(7):461–475. [PubMed]
  • Korthals JK, Wiśniewski HM. Peripheral nerve ischemia. Part 1. Experimental model. J Neurol Sci. 1975 Jan;24(1):65–76. [PubMed]
  • Korthals JK, Korthals MA, Wisniewski HM. Peripheral nerve ischemia: Part 2. Accumulation of organelles. Ann Neurol. 1978 Dec;4(6):487–498. [PubMed]
  • Nukada H, Dyck PJ. Microsphere embolization of nerve capillaries and fiber degeneration. Am J Pathol. 1984 May;115(2):275–287. [PMC free article] [PubMed]
  • Nukada H, Dyck PJ. Acute ischemia causes axonal stasis, swelling, attenuation, and secondary demyelination. Ann Neurol. 1987 Sep;22(3):311–318. [PubMed]
  • Dyck PJ, Engelstad JK, Giannini C, Lais AC, Minnerath SR, Karnes JL. Resistance to axonal degeneration after nerve compression in experimental diabetes. Proc Natl Acad Sci U S A. 1989 Mar;86(6):2103–2106. [PMC free article] [PubMed]
  • Zimmerman IR, Karnes JL, O'Brien PC, Dyck PJ. Imaging system for nerve and fiber tract morphometry: components, approaches, performance, and results. J Neuropathol Exp Neurol. 1980 Jul;39(4):409–419. [PubMed]
  • Parry GJ, Brown MJ. Selective fiber vulnerability in acute ischemic neuropathy. Ann Neurol. 1982 Feb;11(2):147–154. [PubMed]
  • Strain RE, Olson WH. Selective damage of large diameter peripheral nerve fibers by compression: an application of Laplace's law. Exp Neurol. 1975 Apr;47(1):68–80. [PubMed]
  • Williams IR, Jefferson D, Gilliatt RW. Acute nerve compression during limb ischaemia--an experimental study. J Neurol Sci. 1980 May;46(2):199–207. [PubMed]
  • Haak RA, Kleinhans FW, Ochs S. The viscosity of mammalian nerve axoplasm measured by electron spin resonance. J Physiol. 1976 Dec;263(2):115–137. [PMC free article] [PubMed]
  • Hong CZ, Yu J. Electrophysiologic recovery of acute conduction block of rat tail nerve. Arch Phys Med Rehabil. 1989 Mar;70(3):205–209. [PubMed]

Articles from Proceedings of the National Academy of Sciences of the United States of America are provided here courtesy of National Academy of Sciences

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...