Bilateral Three-Rooted Median Nerve Formation With Musculocutaneous-Median Nerve Communications: A Cadaveric Case Report

The median nerve (MN) is typically formed by the union of lateral and medial roots arising from the corresponding cords of the brachial plexus.Variations in its formation and communications with the musculocutaneous nerve (MCN) are well documented, but their coexistence bilaterally remains anatomically noteworthy.During routine anatomical dissection of a 78-year-old male human cadaver, bilateral variations in MN formation and MCN-MN communications were identified.In both upper limbs, the MN was formed by two distinct lateral roots and one medial root.Additionally, a communicating branch between the MCN and MN was observed in each arm.The anatomical relationships of the roots and communicating branches to adjacent neural and vascular structures were documented photographically.Supernumerary roots and MCN-MN communications represent recognized variations of brachial plexus anatomy.Their bilateral coexistence in the present specimen highlights the complexity of peripheral nerve organization and the importance of distinguishing variations in nerve formation from interconnecting branches.Such configurations may complicate anatomical identification during surgical procedures, brachial plexus exploration, and regional anesthesia.This case report documents the bilateral coexistence of three-rooted MN formation and MCN-MN communications, adding to the anatomical literature on brachial plexus variations.Awareness of these configurations may enhance anatomical interpretation and help reduce the risk of inadvertent nerve injury during clinical interventions.