Ischemic Monomelic Neuropathy after a Brachio-Cephalic AVF Creation: A Case Report and Review of Literature

Ischemic monomelic neuropathy (IMN) is an under-diagnosed and disabling complication of upper extremity hemodialysis access. The hemodynamic disturbance that occurs during the time of access creation can lead to both neurologic and ischemic complications. These complications are most commonly seen following proximal procedures involving the upper limbs. Diagnosis and treatment are often delayed, and even with early intervention, neurologic dysfunction may be irreversible. IMN can lead to significant long-term disability. Almost all cases of IMN occur with brachial artery-based access, procedures and the vast majority of patients are diabetic and females. I report a case of IMN after left BC AVF operation which was treated successfully by early access ligation, providing a review of the literature.