Intraneural hematoma after nerve stimulation-guided femoral block in a patient with factor XI deficiency: case report

Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy

“…236,237,303,304,310,[321][322][323][324][325] In all patients with neurodeficits, neurologic recovery was complete within 6 to 12 months. Thus, while bleeding into a neurovascular sheath may result in significant decreases in hematocrit, the expandable nature of peripheral site may decrease the chance of irreversible neural ischemia.…”

“…In addition, there continue to be case reports of significant morbidity related to hematomas following peripheral nerve blockade in coagulopathic patients. 236,237,303,304 Idestrup et al 305 performed a prospective, observational study investigating the incidence of hematoma formation and subsequent neurovascular compromise in patients with femoral catheters who were started on rivaroxaban postoperatively. Rivaroxaban was administered daily, and the femoral catheter was removed 20 hours after the first dose.…”

Pathophysiology and Etiology of Nerve Injury Following Peripheral Nerve Blockade

“…Inadvertent vessel puncture, resulting in the formation of an internal or external hematoma that can mechanically compress the fascicles from within or outside the nerve sheath, has been implicated in cases of neurologic injury. 27,28 Chemical injury Chemical nerve injury results from tissue toxicity of injected solutions (eg, local anesthetics, alcohol, or phenol) or its additives. The toxic solution may be injected directly into the nerve or into adjacent tissues, causing an acute inflammatory reaction or chronic fibrosis involving the nerve.…”

One case of rare gastric cancer combined with lack of factor XI

“…Patients with the lack of factor XI show almost no obvious blood coagulation disorders, such as hematostaxis [2], and the difference of bleeding tendency is also very large [3]. After injury or operation, however, hematoma and coagulation delay may occur [4,5]. This increases the operative and postoperative risk, although an operation may be very necessary for such patients.…”