Abstract
Intraneural hematoma is a rare disease that results in an impaired nerve function
because of bleeding around the peripheral nerve, with only 20 cases reported. Trauma,
neoplasm, and bleeding disorders are known factors for intraneural hematoma. However,
here we report atypical features of asymptomatic and spontaneous intraneural hematoma
which are difficult to diagnose.
A 60-year-old woman visited our clinic with the complaint of a palpable mass on the
right calf. She reported no medical history or trauma to the right calf and laboratory
findings showed normal coagulopathy. Ultrasonography was performed, which indicated
hematoma near saphenous vein and sural nerve or neurogenic tumor. We performed surgical
exploration and intraneural hematoma was confirmed on sural nerve. Meticulous paraneuriotomy
and evacuation was performed without nerve injury. Histological examination revealed
intraneural hematoma with a vascular wall. No neurologic symptoms were observed.
In literature review, we acknowledge that understanding anatomy of nerve, using ultrasonography
as a diagnostic tool and surgical decompression is key for intraneural hematoma. Our
case report may help establish the implications of diagnosis and treatment. Also,
we suggested surgical treatment is necessary even in cases that do not present symptoms
because neurological symptoms and associated symptoms may occur later.
Keywords
hematoma - intraneural - subparaneurial - sural nerve - case report
