Peripheral-Nerve Lesions in Hemorrhagic Diseases

Acute Anticoagulant-Induced Compressive Lumbar Plexus Neuropathy

“…Neuropathy occurring during the course of anticoagulant therapy or in patients with haemorrhagic diathesis may be due to haem orrhage within the nerve as documented in a detailed study of patient IV of Bigelow and Graves (1952). Debolt and Jordan [1966] re ported a moderately large hacmatoma in the right retroperitoneal area, right flank and right abdominal wall, resulting in femoral neuropathy and suggested that pressure was the cause of the neuropathy.…”

“…Our case shows that: (a) there was no bleeding within the perineurium and endoneurium, and (b) the retroperitoneal haemor rhage resulted in external pressure on the nerves. Therfore, there is evidence that pe ripheral neuropathies in the lower limbs asso ciated with coagulopathies may arise from pressure on the nerve due to external haem orrhage or from haemorrhage within the nerve itself [Bigelow and Graves, 1952], In this context it is interesting to consider that distortion of the surrounding tissues by the haemorrhage may result in stretching of the plexus and/or its branches and can further damage the nerve structures. It should be noted that in cases of Wernicke's encephalop athy, Victor el al.…”

An Acute Carpal Tunnel Syndrome in a Haemophiliac

“…The most common nerve affected is the femoral nerve, as it lies behind the iliacus fascia (Seddons 1930;Aggeler & Lucia, 1944;Richards 1951;Bigelow & Graves 1952;Goodfellow & Fern 1965;Brower & Wilde 1966). Parkes (1945) quotes two cases of Seddon's in which the median nerve function had been affected, together with that of the ulnar nerve by a haematoma in the forearm flexor muscle com-Partment, secondary to trauma, 1.…”

“…In haemophilia, interruption of peripheral nerve conduction could occur either as a result of intraneural haemorrhage or by pressure from an adjacent haematoma (Bigelow & Graves 1952). Formerly, however, because of the nature of the underlying pathology, the cause in most cases had not been determined although Aggeler and Lucia (1944) thought that most cases were probably due to haematoma.…”

Hemorrhagic polyneuropathy in idiopathic thrombocytopenic purpura

“…By contrast, bleeding adjacent to nerve in soft tissue is thought to cause gross nerve displacement without injurious compression. Microvessel bleeding from the perineurial blood supply was proposed as the mechanism of the intraneural hemorrhage in a patient with drug‐induced thrombocytopenia ( Bigelow and Graves, 1952 ) .…”