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This may lead to subsequent physiological abnormalities including gut dysbiosis and systemic inflammation, eventually resulting in a pathological clotting system, chronic endothelialitis, vasoconstriction, and hypoxia, as found in similar conditions such as heat stroke (183)

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The following tests were performed: Phalens test: Positive Reverse Phalens test: Positive Tinels sign: Positive Durkans test: Positive Ultrasound findings Bifid median nerve Persistent medial artery Sonoanatomy in a patient with carpal tunnel syndrome with a bifid median nerve and persistent medial artery