Renflement fusiforme d'origine mécanique d'un nerf périphérique. Étude anatomique

Summary

This paper reports on the study of a symptomless fusiform enlargement of the superficial peroneal nerve. The swelling was located in the part of the nerve passing through the aponevrosis. On incision of the epineurium small swellings were seen in the nerve fascicles. A fascicular biopsy was done and the fascicles studied by teasing and by optic and electron microscopy. Isolated nerve fiber study gave evidence of segmental demyelinisation with subsequent remyelinisation in almost all the myelinated fibers. These abnormalities were only encountered in the swollen part of the fascicle. A striking proliferation of cells was demonstrated in isolated fibers by counter-staining with hematoxylin. Electron microscopy showed primary demyelinsation and cellular proliferation affecting Schwann-cells (without onion bulb formations), fibroblasts and giant-vacuolated histiocytes. There was also a massive increase of endoneurial fluid. A few Büngner bands were seen. These rare abnormalities appear to be caused by chronic irritation of the nerve in its passage through the aponebrosis.