Posttraumatic hematoma beneath the epineurium of a branch of the median nerve. Case report

Sciatic Nerve Hematoma - Case Report

Hemorrhagic neuropathy is an extremely rare condition. This condition refers to bleed into or around a peripheral nerve, causing either an extra neural or an intraneural hematoma. When they do occur, it is usually due to iatrogenic/inherited coagulopathies or as a consequence of injections targeting nerves. We present a case of sciatic nerve palsy developed secondary to anticoagulant therapy (Warfarin). MRI imaging showed features of sciatic nerve hematoma following which warfarin was withdrawn. The patient showed symptomatic improvement and a follow up ultrasound of left thigh showed resolution of hematoma with normal sciatic nerve diameter. To the best of our knowledge there is limited available literature regarding nerve hematomas secondary to anticoagulation therapy. This complication should be promptly recognized and immediate steps should take place because of the favorable results of the early treatment.

Intraneural Hematoma: A Proposed Anatomic Classification with Potential Treatment Implications

Intraneural hematoma is a rare entity with fewer than 20 cases reported in the literature. There is no consensus on surgical treatment due to its rarity. We present a novel classification for intraneural hematomas based on a review of the literature and illustrated by 4 cases that were treated in our 3 centers. This classification system localizes the hematoma to the different connective tissue layers that compose the nerve: the paraneurium, epineurium, and perineurium. We believe that this classification has consequences for surgical treatment and can form the foundation for future research into the natural history of these types of lesions.

Chronic encapsulated intracerebral haematoma

We report a rare chronic encapsulated intracerebral haematoma (CEICH). A 52-year-old man had two seizures. Unenhanced computed tomography scanning of the head revealed a hypodense tumour with clusters of calcification in the left temporal lobe. Magnetic resonance imaging of the brain showed a left temporal tumour with a hypointense centre and hyperintense periphery on T(1)-weighted imaging and heterogeneous hypointensity on T(2)-weighted imaging. The tumour was heterogeneously enhanced after gadolinium injection. Craniotomy was carried out and a CEICH in the left temporal lobe was completely excised. No vascular anomaly was found. The tumour was histologically confirmed to be a CEICH. The patient recovered well after the operation. In this report, we describe this rare case and discuss the characteristics of CEICH.

Chronic encapsulated intracerebral hematoma--a well-defined disease. Report on two cases and review of the literature

Chronic encapsulated intracerebral hematoma (CEIH) is a rare disease which is believed to be caused by angiographically negative vascular malformations. CEIH has the following characteristic findings: 1. It affects all age groups 2. Clinical symptoms progress slowly after sudden onset. Often there is a latency of months or years 3. There is no correlation with arterial hypertension 4. Imaging reveals a typical fibrous capsule with enclosed blood contents and signs of recurrent bleedings 5. Cavernoma was identified histologically as the cause of bleeding in 30% of cases. 6. All patients had a primary diagnosis of intracerebral tumor. To the best of our knowledge, 27 cases have been reported in the literature. We now add two cases, one of which is the first in the available literature which was not operated and could be followed by imaging.

Intraneural hematoma of the sciatic nerve. Case report

A case of an encapsulated organizing hematoma of the sciatic nerve is reported. Hemorrhage-induced neuropathy as a complication of anticoagulant therapy, leukemia, hemophilia, and other bleeding diatheses has been frequently reported. While trauma is the most common etiology of a hemorrhagic neuropathy, actual hematoma formation beneath the epineurium is very rare.