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Subacute Femoral Compressive Neuropathy from Iliacus Compartment Hematoma

Published online by Cambridge University Press:  24 February 2017

Farhad Pirouzmand  and
Rajiv Midha
Farhad Pirouzmand
Affiliation:
Division of Neurosurgery, University of Toronto, Toronto, ON, Canada
Rajiv Midha*
Affiliation:
Division of Neurosurgery, Department of Surgery, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, Toronto, ON, Canada
*
A-131, Division of Neurosurgery, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, M4N 3M5 Canada
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Abstract:

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Background:

Traumatic retroperitoneal hematoma in the iliacus muscle is an unusual but potentially serious cause of femoral compression neuropathy.

Case report:

We describe the clinical, imaging, and management features of a case of traumatic iliacus retroperitoneal hematoma with delayed manifestation of femoral neuropathy.

Discussion:

The anatomical substrate for hematoma formation with subacute compression of the femoral nerve is emphasized. A subacute compartment syndrome with progressive edema, swelling and ischemia of iliacus compartment is suggested as the underlying cause. Early fasciotomy with or without hematoma evacuation should be considered in order to provide rapid decompression and to minimize the chance of permanent nerve injury.

Résumé:

RÉSUMÉ:Introduction:

L'hématome rétropéritonéal traumatique du muscle iliaque est une cause rare mais potentiellement sérieuse de neuropathie fémorale compressive.

Cas clinique:

Nous décrivons les aspects cliniques, radiologiques et thérapeutiques d'un cas d'hématome rétropéritonéal traumatique de la loge iliaque ayant entraîné subséquemment des manifestations de neuropathie fémorale.

Discussion:

Nous insistons sur le substrat anatomique sous-jacent à la formation d'un hématome avec compression subaiguë du nerf fémoral. Un syndrome compartimental subaigu avec oedème progressif, gonflement et ischémie de la loge iliaque est suggéré comme cause sous-jacente. Une fasciotomie précoce avec ou sans évacuation de l'hématome devrait être considérée dans le but d'obtenir une décompression rapide et ainsi minimiser le risque de lésion nerveuse permanente.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 28 , Issue 2 , May 2001 , pp. 155 - 158
Copyright
Copyright © The Canadian Journal of Neurological 2001

References

REFERENCES

1. Stewart, JD. Compression and entrapment neuropathies. In: Dyck, PJ, Thomas, PK, eds. Peripheral Neuropathy. Vol. 2, 3rd Ed. Philadelphia: W.B. Saunders Company, 1993; 961–979.Google Scholar
2. Calverley, JR, Mulder, DW. Femoral neuropathy. Neurology 1960;10: 963–976.CrossRefGoogle ScholarPubMed
3. Goodfellow, J. Iliacus haematoma. A common complication of haemophilia. J Bone Joint Surg Br 1967; 49: 748–756.Google Scholar
4. Sasson, Z. Spontaneous iliopsoas hematoma in patients with unstable coronary syndromes receiving intravenous heparin in therapeutic doses. Can J Cardiol 1996; 12: 490–494.Google ScholarPubMed
5. Guivarc’h, M. Hematomas of the iliac psoas: 29 cases. J Chir-Paris 1997; 134: 382–389.Google Scholar
6. Young, MR, Norris, JW. Femoral neuropathy during anticoagulant therapy. Neurology 1976; 26: 1173–1175.CrossRefGoogle ScholarPubMed
7. Kent, KC, Moscucci, M. Retroperitoneal hematoma after cardiac catheterization: prevalence, risk factors, and optimal management. J Vasc Surg 1994; 20: 905–910.Google Scholar
8. Kent, KC, Moscucci, M. Neuropathy after cardiac catheterization: incidence, clinical patterns, and long-term outcome. J Vasc Surg 1994; 19: 1008–1013.Google Scholar
9. Chen, SS, Lin, ATL, Chen, KK, Chang, LS. Femoral neuropathy after pelvic surgery. Urology 1995; 46: 575–576.Google Scholar
10. Kim, DH, Kline, DG. Surgical outcome for intra- and extrapelvic femoral nerve lesions. J Neurosurg 1995; 83: 783–790.Google Scholar
11. Rakolta, GG, Omer, GE. Combat-sustained femoral nerve injuries. Surg Gynecol Obstet 1969; 128: 813–817.Google Scholar
12. Kumar, S. Posttraumatic hematoma of iliacus muscle with paralysis of the femoral nerve. J Orthop Trauma 1992; 6: 110–112.Google Scholar
13. Giuliani, G, Poppi, M, Acciarri, N, Forti, A. CT scan and surgical treatment of traumatic iliacus hematoma with femoral neuropathy: case report. J Trauma 1990; 30: 229–231.Google Scholar
14. Warfel, BS, Marini, SG, Lachmann, EA, Nagler, W. Delayed femoral nerve palsy following femoral vessel catheterization. Arch Phys Med Rehabil 1993; 74: 1211–1215.Google Scholar
15. Papastefanou, SL, Stevens, K, Mulholland, RC. Femoral nerve palsy: an unusual complication of anterior lumbar interbody fusion. Spine 1994; 19: 2842–2844.Google Scholar
16. Hudson, AR, Hunter, GA, Waddell, JP. Iatrogenic femoral nerve injuries. Can J Surg 1979; 22: 62–66.Google Scholar
17. Nobel, W, Marks, SC, Kubik, S. The anatomical basis for femoral nerve palsy following iliacus hematoma. J Neurosurg 1990; 52: 533–540.Google Scholar
18. Lenchik, L. CT of the iliopsoas compartment: value in differentiating tumor, abscess, and hematoma. AJR Am J Roentgenol 1994; 162: 83–86.Google Scholar
19. Salmon, M. Arteries of the muscles of the extremities and the trunk, 1st ed. St. Louis, Mo.: Quality Medical Publishing Inc, 1994:138–142.Google Scholar
20. Holscher, RS, Leyten, FSS, Oudenhoven, LFIJ, Puylaert, JBCM. Percutaneous decompression of an iliopsoas hematoma. Abdom Imaging 1997; 22: 114–116.Google Scholar
21. Kuntzer, T, Van Melle, G, Regli, F. Clinical and prognostic features in unilateral femoral neuropathies. Muscle Nerve 1997; 20: 205–211.Google Scholar
22. Osgaard, O, Husby, J. Femoral nerve repair with nerve autografts. J Neurosurg 1977; 47: 751–754.Google Scholar