Lumbosacral plexopathy due to pelvic hematoma after extracorporeal membrane oxygenation Article Swipe
Anson W. Wilks
,
Muhammad Al‐Lozi
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/md.0000000000025698
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/md.0000000000025698
Rationale: Peripheral nerve injury related to vascular complications associated with extracorporeal membrane oxygenation (ECMO) is perhaps underappreciated. Compared to the well-described central nervous system complications of ECMO, brachial plexopathy and lumbosacral plexopathy have rarely been reported. We report this case to heighten awareness of lumbosacral plexus injury due to pelvic hematoma formation after ECMO. Patient concerns: A 53-year-old woman developed a large pelvic hematoma with significant mass effect on intrapelvic structures after receiving lifesaving venoarterial ECMO for cardiogenic shock following a cardiac arrest. During her hospital course, she developed bilateral foot drop that was attributed to critical illness. Her lack of neurological recovery after 6 months prompted referral to neuromuscular medicine for consultation. Diagnosis: The patient was retrospectively diagnosed with bilateral lumbosacral plexopathy due to the large pelvic hematoma. Intervention: Electromyography/nerve conduction study (EMG/NCS) obtained at the time of referral to neuromuscular medicine localized her neurological deficits to the bilateral lumbosacral plexus and demonstrated no volitional motor unit action potentials in her lower leg muscles. Outcomes: The patient had minimal recovery of strength at the level of the ankles but was ambulatory with solid ankle–foot orthoses due to spared proximal lower extremity strength. Unfortunately, the absence of any volitionally activated motor unit action potentials in her lower leg muscles on EMG performed 6 months after the initial injury was a poor prognostic indicator for successful reinnervation and future neurological recovery. Lessons: Neurological deficits occurring during the course of administration of ECMO require accurate localization. Neurology consultation and/or EMG/NCS may be useful if localization is not clear. Lesions localizing to the lumbosacral plexus should prompt radiographic evaluation with computed tomography of the abdomen and pelvis. Hemostasis of a retroperitoneal hematoma may be achieved with embolization. However, if neurological deficits do not improve, surgical consultation for hematoma evacuation may be warranted.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1097/md.0000000000025698
- OA Status
- gold
- Cited By
- 4
- References
- 20
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3158663204
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W3158663204Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1097/md.0000000000025698Digital Object Identifier
- Title
-
Lumbosacral plexopathy due to pelvic hematoma after extracorporeal membrane oxygenationWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-04-28Full publication date if available
- Authors
-
Anson W. Wilks, Muhammad Al‐LoziList of authors in order
- Landing page
-
https://doi.org/10.1097/md.0000000000025698Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1097/md.0000000000025698Direct OA link when available
- Concepts
-
Medicine, Brachial Plexopathy, Lumbosacral plexus, Electromyography, Surgery, Extracorporeal membrane oxygenation, Hematoma, Brachial plexus, Anesthesia, Physical medicine and rehabilitationTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
4Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 1, 2024: 1, 2023: 1, 2021: 1Per-year citation counts (last 5 years)
- References (count)
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20Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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