[Dysfunction of the femoral nerve caused by hemorrhage in anticoagulant use]

Femoral neuropathy resulting from iliopsoas muscle haematoma during anticoagulant therapy is described with reference to five patients. The clinical picture is stereotypic. The patient experiences sudden, excruciating pain in the inguinal area and flank radiating to the anterior section of the thigh. This is followed by weakness of the quadriceps muscle. Computed tomography is the method of choice to show the presence of an iliopsoas haematoma. To prevent serious and sometimes irreversible nerve damage the anticoagulant therapy should be stopped and antagonists should be given. Surgical decompression of the haematoma has been advocated, but this intervention has been done only in a few patients.