Bilateral variations in the formation of the median nerve associated with the absence of musculocutaneous nerve and radial nerve with two roots

We report a case of bilateral multiple variations of the brachial plexus in a 60-year old Caucasian female cadaver. In the right upper limb the musculocutaneous nerve was absent. The flexors of the arm and skin of the lateral aspect of forearm were supplied by branches from the medial cord of the brachial plexus and median nerve. In the left upper limb, the median nerve was formed by four roots; three from the lateral cord and one from the medial cord of the brachial plexus. The radial nerve also had two roots, one from the posterior cord and another from the medial cord, which formed a loop anterior to the subscapular artery. Such a combination of variations in a single cadaver is rare. The frequent anatomic variations of the brachial plexus should always be considered as an important risk factor while performing surgery of the axilla.