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Spontaneous intraneural hematoma of the sural nerve

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Abstract

Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient’s history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery.

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Acknowledgments

The authors would like to acknowledge the contributions of Eugene T.H. Ek, MBBS, PhD, for his efforts and contributions to the manuscript.

Conflict of interest

Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

This report has received approval from the Institutional Review Board at the Hospital for Special Surgery. Work was performed at the Hospital for Special Surgery.

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Authors and Affiliations

  1. Orthopaedic Surgery Resident, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Shawn S. Richardson & Alexander S. McLawhorn

  2. Associate Attending Radiologist, Hospital for Special Surgery, New York, NY, USA

    Douglas N. Mintz

  3. Associate Attending Pathologist, Hospital for Special Surgery, New York, NY, USA

    Edward F. DiCarlo

  4. Attending Orthopaedic Surgeon, Hospital for Special Surgery, New York, NY, USA

    Andrew J. Weiland

Authors
  1. Shawn S. Richardson
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  2. Alexander S. McLawhorn
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  3. Douglas N. Mintz
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  4. Edward F. DiCarlo
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  5. Andrew J. Weiland
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Corresponding author

Correspondence to Shawn S. Richardson.

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Richardson, S.S., McLawhorn, A.S., Mintz, D.N. et al. Spontaneous intraneural hematoma of the sural nerve. Skeletal Radiol 44, 605–608 (2015). https://doi.org/10.1007/s00256-014-2030-3

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  • DOI: https://doi.org/10.1007/s00256-014-2030-3

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