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Subacute Femoral Compressive Neuropathy from Iliacus Compartment Hematoma

Published online by Cambridge University Press:  24 February 2017

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
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Abstract:

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
Copyright
Copyright © The Canadian Journal of Neurological 2001

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