Perineurial hemorrhage in ischemic nerve after anticoagulation

We report a 29-year-old woman who developed severe left leg ischemia after aortic dissection and left common iliac artery occlusion. Light microscopic studies revealed severe nerve and muscle ischemic changes at the calf level. Nerves also showed extensive perineurial hemorrhage, most likely secondary to heparin administration. Perineurial hemorrhage should be considered as one of the possible complications of anticoagulant therapy.