Four roots of median nerve and its surgical and clinical significance

Variations in the formation of brachial plexus have been reported by many authors since decade. In this case study, it was found that in the right axilla median nerve along with its normal medial root and lateral root had two additional roots from lateral cord of brachial plexus. These two variant roots crossed the axillary artery from lateral to medial side and joined the main trunk of median nerve. In the left arm the formation of median nerve was as usual .The distribution of the variant median nerve was normal in arm, forearm and palm. The arterial pattern in the arm (axillary and brachial arteries) was also normal. Variations in median nerve has been reported by many investigators but such type of variation in which four roots of median nerve compressing the axillary artery is very rare. Knowledge of such type of variations is essential for surgeons dealing with surgery in axilla and upper arm.