Sonographic diagnosis and treatment of a median nerve epineural hematoma caused by brachial artery catheterization.

ercutaneous brachial catheterization has become an alternative method for carotid and vertebral angiography.1 Brachial artery catheterization carries risk of injury to the adjacent median nerve with secondary epineural hemorrhage, especially in patients receiving anticoagulants.2 In the case of a mobile cubital brachial artery, it would lead to several attempts of misleading puncture injuries to the adjacent median nerve. Needle injury may result in epineural hemorrhage and then compressed bundles of nerve fibers and may impair their function. Epineural hemorrhage could even occur as a subacute crescendo pattern.3 Here we report such a rare case. High-resolution sonography was used to diagnose the epineural hemorrhage. Furthermore, sonographically guided percutaneous fineneedle aspiration (FNA) was promptly performed to achieve dramatic symptom relief.