Femoral Neuropathy and Meralgia Paresthetica Secondary to an Iliacus Hematoma

Abstract

Compressive femoral and lateral femoral cutaneous neuropathies from an iliacus hematoma are unusual presentation. We report a case of a 16-year-old boy who developed right femoral and lateral femoral cutaneous neuropathies as a complication of traumatic ipsilateral iliacus hematoma formation. The patient complained of numbness in the right thigh and calf as well as right leg weakness, and pain in the right inguinal area. Nerve conduction study and needle electromyography identified the neuropathies. After the electrodiagnostic studies, the pelvic bone MRI revealed a large, 9×5×4.5 cm right iliacus hematoma. As a result, diagnosis of a right iliacus hematoma compressing the femoral and lateral femoral cutaneous nerves was made, and the patient underwent an operation to remove the hematoma. Symptoms and neurological signs showed notable improvement after surgical decompression. Subsequent follow-up electrodiagnostic studies after 11 weeks demonstrated regeneration evidence.

Meralgia Paresthetica as a Presentation of Acute Appendicitis in a Girl With Acute Lymphoblastic Leukemia

“…8 MP occurs when the lateral femoral cutaneous nerve is compressed by mechanical causes such as tight clothes, obesity, pregnancy, or an abdominal mass. 8 In the previously reported patient described above, MP may have been caused by inflammation of the appendix, because no adhesions were detected between the appendix and adjacent structures. 10 In our patient, MP resolved with antibiotic therapy, suggesting that the symptoms were caused by acute inflammation rather than the periappendiceal abscess.…”

“…7 MP is usually caused by mechanical compression such as tight clothing, obesity, pregnancy, or an abdominal mass. 8 Here we report an unusual case of MP caused by appendicitis in a girl with acute lymphoblastic leukemia (ALL).…”

Meralgia paresthetica caused by inguinal lymphadenopathy related to tinea pedis infection: A case report

“…After successful therapy of the fungal infection, swollen lymph nodes were regressed, while the patient’s need for pain therapy disappeared. Although rare causes such as mass, hematoma, and urinary stones were shown to result in MP by mechanical compression of LFCN,[ 4 - 7 ] it was noteworthy to find out a distant pathology such as tinea pedis infection as the initiative factor for MP. To the best of our knowledge, this is the first report showing the relevance between inguinal lymphadenopathy and MP in the literature.…”

“…[ 1 - 3 ] There are rare causes as compressive factors like mass, hematoma, and urinary stone. [ 4 - 7 ] Although a detailed medical history and physical examination are usually enough for the diagnosis, ultrasonography (US) and nerve conduction studies are also useful to identify the etiological factor and differential diagnosis. [ 8 ]…”

Hématome post traumatique du muscle iléopsoas avec paralysie du nerf fémoral: à propos d’un cas et revue de la littérature

“…On peut citer notamment les abcès, les hématomes compliquant un traitement anticoagulant [ 2 , 3 ] ainsi que les ostéochondroses du petit trochanter [ 4 ]. L'originalité de ce cas clinique résidait dans l’étiologie post-traumatique de l'hématome du muscle iliopsoas responsable de la compression du nerf, qui reste rare et peu décrite dans la littérature (16 cas en 40 ans) [ 5 , 6 ].…”