Von Willebrand’s Disease presenting as Acute Carpal Tunnel Syndrome

Parthenis, Dimitrios G.; Karagkevrekis, Charalampos; Waldram, M. A.

doi:10.1016/s0266-7681(98)80239-8

Cited by 14 publications

(9 citation statements)

References 3 publications

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“…In the reported case, the diagnosis was purely based on clinical findings, similar to other reported cases [8,22,26]. A forearm fasciotomy was performed simultaneously due to the combined clinical diagnosis of volar forearm compartment syndrome.…”

Section: Discussionsupporting

confidence: 61%

Acute Carpal Tunnel Syndrome Secondary to Iatrogenic Hemorrhage. A Case Report

Kokosis

Blueschke

Blanton

et al. 2010

Hand (New York, N,Y.)

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Carpal tunnel syndrome is a common compression neuropathy of the median nerve. Acute carpal tunnel syndrome (aCTS) is rare, associated with a variety of conditions. In this case report we present a patient who developed aCTS and volar forearm compartment syndrome after a radial artery line placement, while receiving intravenous heparin. The patient underwent immediate forearm fasciotomy and surgical release for restoration of nerve function, which resulted in improved hand function and mild residual median nerve neuropathy. There is controversy whether to discontinue or not anticoagulation in a patient with aCTS. In our patient, heparin therapy was restarted on the second postoperative day.

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Section: Discussionsupporting

confidence: 61%

Acute Carpal Tunnel Syndrome Secondary to Iatrogenic Hemorrhage. A Case Report

Kokosis

Blueschke

Blanton

et al. 2010

Hand (New York, N,Y.)

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“…Etiologies include bleeding secondary to chronic lymphatic leukemia, hemophilia, Colles' fracture of the wrist, epiphyseal fracture (Salter II) of the distal radius, bleeding secondary to giant cell tumour of the tendon sheath, unstable distal radioulnar joint, displaced intra-articular fracture of the distal radius, rheumatoid synovitis and vasculitis, Hansen's disease and trans-scaphoid perilunar fracture dislocation of the wrist. Other causes include gout, pseudogout, foreign body within the carpal tunnel and acute thrombosis of persistent median artery (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18).…”

Section: Discussionmentioning

confidence: 99%

“…ACTS due to spontaneous bleeding without a history of injury is rare. In these patients, hematological investigations are required to rule out von Willebrand's disease (10).…”

Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Balakrishnan¹,

Jarrahnejad²,

Balakrishnan³

2008

J Plastic Surgery

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Acute carpal tunnel syndrome is the most common compression neuropathy of the upper extremity following trauma. A rare occurence of spontaneous bleeding into the carpal tunnel, presenting as acute carpal tunnel syndrome, is presented.Key Words: Carpal tunnel syndrome; Spontaneous bleeding Syndrome du tunnel carpien aigu consécutif à une hémorragie spontanée Le syndrome du tunnel carpien est la neuropathie par compression la plus fréquente à survenir au niveau des membres supérieurs par suite de traumatismes. On présente ici un cas rare d'hémorragie spontanée au niveau du tunnel carpien ayant donné lieu à un syndrome aigu du tunnel carpien. C lassic carpal tunnel syndrome (CTS) occurs most often in women, and manifests as hypoesthesia and tingling in the median nerve distribution distal to the wrist joint. In acute CTS (ACTS), the intracarpal interstitial pressure rises above the threshold, and capillary blood flow is reduced below the level of median nerve viability. This leads to ischemia of the muscles and nerves, resulting in the clinical signs and symptoms. ACTS due to spontaneous bleeding into the carpal tunnel is rare. We report a patient who developed ACTS from spontaneous bleeding into the carpal tunnel following strenuous exercise. CASE PRESENTATIONA 51-year-old man presented to the emergency department with acute pain and swelling of the right hand following a workout at a gym. He had no history of serious illness in the past. Medications included acetylsalicylic acid (81 mg/day) and vitamin E once per day. His pain started after his workout and increased over a 2 h period. There was no history of trauma. His hematological work-up was negative. He complained of tingling and paresthesia of the median nerve distribution.On examination, there was swelling of the hand with slight bluish discolouration (Figure 1). The wrist was maintained in a flexed position. The signs and symptoms were those of acute tenosynovitis originating in the common flexor synovial sheath at the wrist with associated paresthesia in the distribution area of the median nerve in the hand.X-rays of the wrist and hand were negative. A clinical diagnosis of ACTS was made. He underwent decompression of the carpal tunnel under general anesthesia. At exploration, blood was seen inside the carpal tunnel (Figure 2). The carpal tunnel was decompressed. His symptoms improved following decompression and at six weeks he had full function of the hand.

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“…Hamartomas involving the peripheral nerves were first described in 1953 by Mason,1 mostly involving the median nerve in the forearm and wrist and usually presenting as chronic CTS. Acute CTS may occur consecutive to hamate and triquetral fractures,2 acute metacarpal osteomyelitis3 compression by anomalous flexor digitorum superficialis,4 after internal fixation of scaphoid,4 secondary to pyogenic infections,5 classical hemophilia,6 von Willebrand's disease7 oral anticoagulant therapy,8 distal radial fractures,9 filarial infections,10 thrombosed persistent median artery,11 idiopathic tumoral calcinosis,12 decompression sickness,13 Hansen's disease,14 peritendinitis calcarea,15 pseudogout,16 scaphoid pseudoarthroses 17. Bilateral cases may occur due to human parvovirus B19 infection 18…”

Section: Discussionmentioning

confidence: 99%

Acute carpal tunnel syndrome due to a hemangioma of the median nerve

Meena¹,

Sharma²,

Sharma³

et al. 2007

Indian J Orthop

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Hemangioma of the median nerve presenting as acute carpal tunnel syndrome is unusual A-18- year old male presented with severe incapacitating pain of sudden onset of left forearm and hand after manual field work. There was swelling on volar aspect of forearm, with hyperalgesia in the median nerve distribution. The fingers and wrist were inmarked flexion and the patient did not allow wrist and finger extension. X-rays were within normal limits. An emergency volar carpal ligament release revealed, haematoma about 100 ml with numerous vessels encircling the median nerve. Histopathology of lesion turned out to be a cavernous hemangioma. Post operatively patient had full recovery.

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Von Willebrand’s Disease presenting as Acute Carpal Tunnel Syndrome

Abstract: We describe a patient who developed acute carpal tunnel syndrome due to spontaneous bleeding without a history of injury. Immediate decompression relieved the symptoms. Further haematological investigations revealed that the patient was suffering from von Willebrand’s disease.

Cited by 14 publications

References 3 publications

Acute Carpal Tunnel Syndrome Secondary to Iatrogenic Hemorrhage. A Case Report

Acute Carpal Tunnel Syndrome Secondary to Iatrogenic Hemorrhage. A Case Report

Acute carpal tunnel syndrome as a result of spontaneous bleeding

Acute carpal tunnel syndrome due to a hemangioma of the median nerve

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