1/39. Postoperative lateral femoral cutaneous neuropathy. Lateral femoral cutaneous (LFC) neuropathy was diagnosed in a woman who developed pain and paresthesias in the right thigh 6 days after abdominal hysterectomy by a suprapubic approach. After surgery, the patient slept in the fetal position to control the postoperative suprapubic pain. The LFC neuropathy improved with therapy including avoidance of hip flexion during sleep. Prolonged postoperative hip flexion to relieve the abdominal incisional pain provides an explanation for LFC neuropathy after abdominal surgery when the onset of symptoms is delayed. ( info) |
2/39. Malignant peripheral nerve sheath tumors in the setting of segmental neurofibromatosis. Case report. Approximately 100 cases of segmental neurofibromatosis (NF5) have been reported in the recent literature. patients with NF5 present with cafe-au-lait macules, freckles, and/or neurofibromas limited to one or adjacent dermatomes. Neurofibromas arising in NF5 have been uniformly considered to be benign; patients were thought to have an excellent prognosis without the risk of developing malignant peripheral nerve sheath tumors (PNSTs), which are characteristic in patients with the generalized form of this disease, von Recklinghausen's NF. In this report the authors detail the first observations of malignant PNSTs in two patients with NF5. Indications for surgical removal of a neurofibroma in a patient with NF include pain. neurological impairment, compression of adjacent structures, cosmetic disfigurement, and rapid tumor growth suggestive of malignant degeneration. Surgical indications are similar for patients with NF5. All patients with neurofibromas should be considered at risk for malignant degeneration. ( info) |
3/39. femoral neuropathy: an infrequently reported postoperative complication. Report of four cases. Postoperative femoral neuropathy is an uncommon complication of abdominal surgery. We present four cases occurring after colectomy at our institution and discuss the diagnosis and treatment. ( info) |
| radiculopathy resulting from ossification of the ligamentum flavum (OLF) is extremely rare and concerns only intercostal neuralgias. We describe a 37-year-old Caucasian woman with a lumbar radiculopathy revealing an OLF. Her symptoms were completely and definitively relieved by surgery. ( info) |
5/39. Posterior femoral cutaneous nerve mononeuropathy: a case report. Isolated posterior femoral cutaneous nerve (PFCN) lesions are rare, with only six cases reported in the modern literature and one case documented with a nerve conduction study. A 25-year-old woman had sensory loss in the posterolateral thigh after two right gluteal intramuscular injections. Nerve conduction studies using Dumitru's technique showed a 9microV response on the asymptomatic side, but no response on the symptomatic side, and no abnormalities on needle examination of the back and lower extremities. Although a single case does not prove the validity of a technique, this case provides the rare opportunity to demonstrate the utility of Dumitru's technique. ( info) |
6/39. femoral nerve palsy in hip replacement due to pelvic cement extrusion. We report a case in which cement protrusion into the pelvis led to a major complication. During reaming and preparation of the anterosuperior acetabulum, a bony defect resulted which made fixation of an uncemented cup impossible, and a cemented polyethylene cup was used instead. After surgery the patient suffered a complete loss of femoral nerve function. Postoperative x-rays and CTs showed that a huge mass of bone cement protruded into the pelvis in close proximity to the iliac vessels and the femoral nerve. This probably led to nerve damage during the cement's polymerisation process due to the heat. ( info) |
7/39. Lumbar disc herniation mimicking meralgia paresthetica: case report. BACKGROUND: Meralgia paresthetica, a syndrome of pain and/or dysesthesia in the anterolateral thigh, is normally caused by an entrapment of the lateral femoral cutaneous nerve (LFCN) at the anterior superior iliac spine. In a few cases compression of the nerve in the retroperitoneum has been reported to mimic meralgia paresthetica. CASE DESCRIPTION: A 67-year-old woman presented with a 5-year history of permanent paresthesia in the anterolateral thigh. Motor weakness was not detected. electromyography showed a neurogenic lesion at the level of L3. Lumbar spine MRI detected a foraminal-extraforaminal disc herniation at L2/L3, which was extirpated via a lateral transmuscular approach. The patient was free of symptoms on the first postoperative day. CONCLUSION: In patients with meralgia paresthetica we emphasize a complete radiological investigation of the lumbar spine, including MRI, to exclude radicular compression by a disc herniation or a tumour at the level of L2 or L3. ( info) |
8/39. Hemangiomatosis presenting as meralgia paresthetica. The authors present a 15-year-boy with meralgia paresthetica caused by the recurrence of a diffuse congenital hemangiomatosis in the pelvic region. Relief of the patient's symptoms was achieved by neurolysis of the lateral femoral cutaneous nerve in the thigh and partial excision of the tumor. To our knowledge, hemangiomatosis has never been suggested as a cause of meralgia paresthetica. ( info) |
| femoral nerve palsy occurred in a 65-year-old man after he had undergone a revision total hip arthroplasty using cementless components. The magnetic resonance imaging scan showed a mass in the iliacus muscle. The mass showed increased signal intensity on T1-weighted and T2-weighted spin-echo images and contained linear septa and a nodule. The gadolinium-enhanced T1-weighted image showed a rim of significant enhancement in the nodule. The findings of magnetic resonance images were suggestive of iliacus hematoma and of liposarcoma. The patient underwent surgery, and the mass was identified as an iliacus hematoma. The femoral nerve was stretched by the hematoma. After removal of the hematoma, the nerve palsy was improved completely. Iliacus hematoma may occur after total hip arthroplasty, even without anticoagulant therapy. The hematoma might appear to be a liposarcoma on magnetic resonance imaging scans. ( info) |
10/39. Metastatic cardiac myxoma. A 22-year-old woman who had a history of three cardiac operations and a bilateral femoral embolectomy for recurrent cardiac myxoma and myxoma embolism, respectively, was accepted to our clinic with multiple immobile peripheral masses. One of them was compressing the left common femoral artery. This mass was extirpated. pathology examination revealed myxoma. Chemotherapy was given to the patient and regression of the masses was observed. ( info) |