Intraneural hematoma after nerve stimulation-guided femoral block in a patient with factor XI deficiency: case report

Intraneural hematoma after a peripheral nerve block is a theoretical cause of postoperative nerve injury that has not been previously documented in humans. We report an intraneural hematoma after nerve stimulation-guided femoral block, which occurred in a patient with undiagnosed factor XI deficiency and a slightly prolonged activated partial thromboplastin time. Onset of paralysis several days after surgery prompted early surgical exploration and removal of an intraneural hematoma at the femoral nerve. Improvement in motor function was noted after epineurolysis of the femoral nerve. Early nerve decompression contributed to a satisfactory outcome.