Nixon Alena, Ajayi Adeola, Lee Steve K, Nwawka Ogonna K
Radiology, Staten Island University Hospital, Staten Island, USA.
Radiology, Drexel University College of Medicine, Philadelphia, USA.
Cureus. 2025 Apr 30;17(4):e83270. doi: 10.7759/cureus.83270. eCollection 2025 Apr.
This case report demonstrates the utility of ultrasound (US) in the diagnosis, characterization, and follow-up of an intraneural median nerve hematoma following peripherally inserted central catheter (PICC) placement. A patient presenting with neuropathy in the median nerve distribution was evaluated in the US clinic. US successfully identified an intraneural hematoma of the median nerve, characterized it as subepineural, and detected its incomplete resolution during follow-up imaging. This case highlights the value of the US as a first-line modality for the evaluation of median nerve hematoma in patients exhibiting neuropathy following PICC placement. On US, a subepineural intraneural hematoma will cause eccentric displacement of and mass effect on nerve fascicles, with both the hematoma and fascicles encased within the epineurium.
本病例报告展示了超声（US）在外周静脉置入中心静脉导管（PICC）后正中神经内血肿的诊断、特征描述及随访中的应用价值。一名表现为正中神经分布区神经病变的患者在超声诊所接受了评估。超声成功识别出正中神经内血肿，将其特征描述为神经束膜下血肿，并在随访成像中检测到其未完全消退。本病例突出了超声作为评估PICC置管后出现神经病变患者正中神经血肿的一线检查方法的价值。在超声检查中，神经束膜下正中神经内血肿会导致神经束偏心移位及占位效应，血肿和神经束均被包裹在神经外膜内。
