Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery
Summary:. In this article, we report a case of severe median nerve compression in the forearm caused by a large hematoma resulting from an iatrogenic pseudoaneurysm of the radial artery. Two weeks before presenting to our emergency room with neuropathic pain and persistent numbness of the palm, thum...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2025-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007049 |
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| author | Johannes C. Heinzel, MD Henrik Lauer, MD Jonas Kolbenschlag, MD, MHBA Adrien Daigeler, MD, MHBA Michael R. Bauer, MD |
| author_facet | Johannes C. Heinzel, MD Henrik Lauer, MD Jonas Kolbenschlag, MD, MHBA Adrien Daigeler, MD, MHBA Michael R. Bauer, MD |
| author_sort | Johannes C. Heinzel, MD |
| collection | DOAJ |
| description | Summary:. In this article, we report a case of severe median nerve compression in the forearm caused by a large hematoma resulting from an iatrogenic pseudoaneurysm of the radial artery. Two weeks before presenting to our emergency room with neuropathic pain and persistent numbness of the palm, thumb, index, and middle fingers, as well as thumb motor deficits, the patient had undergone wrist denervation at an external outpatient clinic. Duplex ultrasound indicated a large pseudoaneurysm of the radial artery, which was confirmed by computed tomography angiography. The patient underwent emergency surgery, including evacuation of the hematoma compressing the median nerve beneath the forearm fascia, repair of the injured radial artery, and decompression of the median nerve. The procedure also included a carpal tunnel release. The patient experienced symptom improvement immediately after surgery. By the third postoperative day, when discharged, sensation in the median nerve distribution was equal bilaterally as assessed by the TEN-test, and he was able to abduct his thumb using the abductor pollicis brevis muscle. This article highlighted a relatively rare complication following wrist denervation surgery. Because this procedure involves exposure of the radial artery, there is an increased risk for iatrogenic pseudoaneurysm. This case also illustrated the diagnostic steps and microsurgical expertise required to manage such complications and to prevent severe damage to the median nerve through early decompression. |
| format | Article |
| id | doaj-art-c63344dc6cdc40498cb0127b0ed8a6d1 |
| institution | Kabale University |
| issn | 2169-7574 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-c63344dc6cdc40498cb0127b0ed8a6d12025-08-26T03:24:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742025-08-01138e704910.1097/GOX.0000000000007049202508000-00047Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial ArteryJohannes C. Heinzel, MD0Henrik Lauer, MD1Jonas Kolbenschlag, MD, MHBA2Adrien Daigeler, MD, MHBA3Michael R. Bauer, MD4From the Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany.From the Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany.From the Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany.From the Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany.From the Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, Tuebingen, Germany.Summary:. In this article, we report a case of severe median nerve compression in the forearm caused by a large hematoma resulting from an iatrogenic pseudoaneurysm of the radial artery. Two weeks before presenting to our emergency room with neuropathic pain and persistent numbness of the palm, thumb, index, and middle fingers, as well as thumb motor deficits, the patient had undergone wrist denervation at an external outpatient clinic. Duplex ultrasound indicated a large pseudoaneurysm of the radial artery, which was confirmed by computed tomography angiography. The patient underwent emergency surgery, including evacuation of the hematoma compressing the median nerve beneath the forearm fascia, repair of the injured radial artery, and decompression of the median nerve. The procedure also included a carpal tunnel release. The patient experienced symptom improvement immediately after surgery. By the third postoperative day, when discharged, sensation in the median nerve distribution was equal bilaterally as assessed by the TEN-test, and he was able to abduct his thumb using the abductor pollicis brevis muscle. This article highlighted a relatively rare complication following wrist denervation surgery. Because this procedure involves exposure of the radial artery, there is an increased risk for iatrogenic pseudoaneurysm. This case also illustrated the diagnostic steps and microsurgical expertise required to manage such complications and to prevent severe damage to the median nerve through early decompression.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007049 |
| spellingShingle | Johannes C. Heinzel, MD Henrik Lauer, MD Jonas Kolbenschlag, MD, MHBA Adrien Daigeler, MD, MHBA Michael R. Bauer, MD Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery Plastic and Reconstructive Surgery, Global Open |
| title | Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery |
| title_full | Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery |
| title_fullStr | Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery |
| title_full_unstemmed | Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery |
| title_short | Median Nerve Compression by Hematoma Due to an Iatrogenic Pseudoaneurysm of the Radial Artery |
| title_sort | median nerve compression by hematoma due to an iatrogenic pseudoaneurysm of the radial artery |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000007049 |
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