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Axillary sheath hematomas causing neurologic complications following arterial access
Daniel D Tran1, Charles A Andersen
1Department of Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA. daniel.tran@us.army.mil
Annals of Vascular Surgery
|April 26, 2011
Summary
Iatrogenic brachial plexus injuries from expanding hematomas after arteriography can cause neurologic deficits. Prompt surgical decompression and repair are crucial for full recovery and preventing permanent nerve damage.
Area of Science:
- Vascular Surgery
- Neurology
- Anatomy
Background:
- Iatrogenic injuries to the brachial plexus are uncommon complications.
- Expanding hematomas and pseudoaneurysms following vascular procedures can lead to nerve compression.
Observation:
- A 55-year-old woman experienced neurologic deficits due to a compressive hematoma after axillary arteriography.
- The hematoma exerted pressure on the brachial plexus, causing symptoms.
Findings:
- Emergent surgical exploration of the left arm was performed.
- Decompression of the axillary sheath and brachial artery repair resulted in complete recovery.
Implications:
- This case highlights the importance of recognizing iatrogenic brachial plexus injuries.
- Early surgical intervention is vital to prevent irreversible neurologic deficits.
- Understanding axillary anatomy is key for managing such complications.
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