J Korean Acad Rehabil Med.  2001 Feb;25(1):168-172.

Bilateral Femoral Neuropathy Secondary to Unilateral Retroperitoneal Hematoma

• Lee SH
• Kim KH
• Jo GY

Abstract

The location of pelvic portion of the femoral nerve between the iliacus and psoas muscles makes the nerve particularly vulnerable in hemorrhage within iliacus. We report a uncommon case of bilateral femoral neuropathy resulting from unilateral retroperitoneal hematoma. A 28-year-old man developed zero-trace grade of muscular weakness on both knee extensor muscles, numbness over bilateral anteromedial thighs and medial lower legs, tenderness of both hip adductor muscles after stab wound at left abdominal region. Abdominal computerized tomographic finding showed hematoma of left psoas muscles. Electromyographic examination revealed no motor unit action potentials in both iliopsoas, vastus medialis and adductor longus muscles. Nerve conduction study noted no compound motor action potentials of both femoral nerves. The fascial walls and laminae of the pouches in the lower abdominal wall tend to reinforce the rigidity of the fibrous arch over the femoral nerve in the intermuscular groove. This neuropathy is suggested, when the pouches are filled with blood, would further increase pressure on the subjacent nerves, especially bilateral femoral nerves.

Keyword

Bilateral femoral neuropathy; Unilateral retroperitoneal hematoma

MeSH Terms

Abdominal Wall
Action Potentials
Adult
Femoral Nerve
Femoral Neuropathy*
Hematoma*
Hemorrhage
Hip
Humans
Hypesthesia
Knee
Leg
Muscle Weakness
Muscles
Neural Conduction
Psoas Muscles
Quadriceps Muscle
Thigh
Wounds, Stab