Title : Acute nerve compression syndromes
Abstract:
Acute & subacute nerve compression syndromes are encountered frequently as isolated entities or as a component or complication of other clinical conditions. Typical examples include compartment syndrome, tourniquet palsy and nerve compression in relation to injuries like acute dislocation of lunate.
While traumatic injuries to nerves are well classified and studied, the same is not true of acute compression neuropathies. There are no classification systems or good guidelines for investigation & management of these conditions. The existing literature is very limited and consists of case reports, series and reviews of such heterogenic reports.
Based on his literature study & own experience, the author is making a case for using classification systems like Seddon’s & Sunderland’s and make management decisions based on such a classification with serial neurological examination and appropriate & timely use of neurophysiological studies (electromyography & nerve conduction studies) to guide timely decisions about nerve exploration, reconstruction and salvage surgery.
After discussing these general principles, further attention will be paid to two major individual classes of acute nerve compression syndromes - Tourniquet palsies and compartment syndrome related nerve compression syndromes, with a particular attention to the retroperitoneal haematomas (Iliacus &/or psoas major) compressing lower limb nerves / plexus (femoral nerve &/or lumbar plexus).
