[Neuropathy of the median nerve caused by intraneural haematoma after carpal tunnel release in an anticoagulated patient].
We report about the sudden onset of a median nerve neuropathy in an anticoagulated patient eight weeks after uneventful carpal tunnel release. Several differential diagnosis have to be considered: compression syndrome as well as iatrogenic damage of the median nerve due to the preliminary procedure or even concomitant disease can generate symptoms of peripheral neuropathy. We diagnosed an intraneural haematoma through surgical exploration. This rare complication of oral anticoagulation therapy occurred spontaneously and was treated successfully by interfascicular neurolysis.
Abteilung für Hand-, Plastische und Mikrochirurgie, Zentrum für Schwerbrandverletzte, Berufsgenossenschaftliches Unfallkrankenhaus Hamburg, Germany. f.wolfrum@buk-hamburg.de
F
F
Wolfrum
M
M
Völlinger
K-D
KD
Rudolf
B-D
BD
Partecke
D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001282:Atrial Flutter / Q000188:drug therapy; D002349:Carpal Tunnel Syndrome / Q000601:surgery*; D003937:Diagnosis, Differential; D006406:Hematoma / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D020423:Median Neuropathy / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D009460:Neurologic Examination; D010138:Pacemaker, Artificial; D010644:Phenprocoumon / Q000009:adverse effects* / Q000627:therapeutic use; D011183:Postoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010644:Phenprocoumon