Bilateral Compartment Syndrome Research Articles

Bilateral forearm compartment syndromes resulting from neuroleptic malignant syndrome

Neuroleptic malignant syndrome (NMS) is an idiosyncratic reaction to the administration of neuroleptic drugs. The primary manifestations of this syndrome are hyperthermia, rhabdomyolysis, muscle rigidity, autonomic dysfunction, and altered level of consciousness. Because rhabdomyolysis and muscle rigidity can lead to swelling within a closed compartment, an unusual complication of NMS is compartment syndrome. 1 We report a case of a patient with neuromuscular malignant syndrome who developed bilateral forearm compartment syndromes.

Bilateral forearm and hand compartment syndrome following thrombolysis for acute myocardial infarction: A case report

A patient suffering from a cocaine-induced myocardial infarction was treated with thrombolytic therapy and developed acute bilateral compartment syndromes of the upper extremities and hands from bleeding due to attempted bilateral radial artery cannulation. He was treated with emergent decompression of the forearm compartments and intrinsic muscles of the hands and recovered excellent hand function without significant neurologic or muscular damage. The problems encountered in the management of this case are detailed, and recommendations for prevention and therapy are discussed.

Bilateral spontaneous lateral compartment syndrome in the legs of a patient who received a kidney and heart transplant. A case report.

Bilateral spontaneous lateral compartment syndrome in the legs of a patient who received a kidney and heart transplant. A case report.

Bilateral chronic exertional compartment syndromes of forearm in an adolescent athlete

Bilateral chronic exertional compartment syndromes of forearm in an adolescent athlete

Bilateral Lower Extremity Compartment Syndromes Secondary to Intraosseous Fluid Resuscitation

Intraosseous infusions are reserved for use in life-threatening hypovolemic or cardiogenic shock when intravenous (i.v.) access cannot be readily established. Although minor fluid extravasation is a common problem with this technique, a fully established compartment syndrome has never been reported. We describe a child with severe compartment syndromes of both lower extremities complicating the use of intraosseous fluid resuscitation.

Streptococcal Toxic Shocklike Syndrome Leading to Bilateral Lower Extremity Compartment Syndrome and Renal Failure

Compartment syndrome is considered a true emergency in orthopedic practice. To reduce morbidity and mortality from this condition, prompt diagnosis and appropriate treatment are absolutely essential. An unusual bilateral lower extremity compartment syndrome leading to renal failure and crush syndrome occurred in a 13-year-old girl with Streptococcal toxic shocklike syndrome. This situation seems not to have been previously reported. Early diagnosis and expeditious treatment produced minimal sequelae of the condition.

Bilateral compartment syndrome after a long gynecologicoperation in the lithotomy position

Compartment syndrome occurred after a tubal anastomosis in a prolonged lithotomy position. This syndrome carries the risk of permanent neuromuscular and kidney damage. The pathophysiologic features of the syndrome are reviewed. Specific guidelines for the prevention and management of this syndrome in patients undergoing gynecologic procedures are presented.

Weight Lifting as a Cause of Bilateral Upper Extremity Compartment Syndrome.

In brief: Compartment syndrome caused by weight lifting occurs only rarely. In the case presented here, bilateral upper extremity compartment syndrome with rhabdomyolysis developed in a 30-year-old man who was an experienced weight lifter. Compartment pressure of 31 mm Hg in his right and left biceps, combined with other clinical findings, indicated that fasciotomy was necessary. Bilateral fasciotomies were performed from the mid-deltoid muscle to the distal forearm. Six weeks later the patient had good muscle strength and full range of motion in both arms. In addition to the case report, the authors discuss the clinical findings that suggest the presence of compartment syndrome.

Bilateral Anterior and Lateral Compartment Syndromes in a Patient with Sickle Cell Trait

Bilateral, exercise-induced compartment syndrome occurred in the legs of a 19-year-old black man with sickle trait. Necrosis in the anterior and lateral compartments was so severe that subtotal debridement was ultimately required. Bilateral tibial compartment syndrome is a rare condition. Its occurrence is usually associated with underlying systemic disorders. The authors suggest that sickle cell trait played a role in this patient's dramatic course.

Neuroleptic Malignant Syndrome and Dopaminergic Blockade

After receiving 90 mg of haloperidol and 100 mg of chlorpromazine hydrochloride within 25 hours, a 29-year-old man was found to have neuroleptic malignant syndrome (NMS), characterized by the acute onset of hyperpyrexia, extreme muscular rigidity, autonomic instability, and coma. Subsequently, rhabdomyolysis developed, with myoglobinuric renal failure and bilateral anterior tibial compartment syndromes. The patient's initial neuroleptic levels were in the therapeutic and nontoxic ranges. He was treated with supportive measures and his clinical improvement was paralleled by decreased neuroleptic levels, a return toward normal of an elevated prolactin level, and an increased responsiveness to a dopamine hydrochloride infusion. This supports an association between NMS and dopamine receptor blockade.

The surgical treatment of exertional compartment syndrome in athletes.

We studied the cases of twelve patients who had bilateral exertional compartment syndrome involving one or all of the compartments of the lower extremities. The patients were divided into three groups based on the clinical findings. Group I consisted of seven patients with symptoms involving the anterior or lateral compartments only; Group II, of three patients with involvement of the deep posterior compartments alone; and Group III, of two patients with involvement of both the anterior and deep posterior compartments. On the basis of their clinical signs and symptoms each patient underwent dynamic tissue-pressure measurements using a slit catheter before, during, and for as long as thirty minutes after exercise. All patients had elevated resting and peak-to-peak dynamic pressure measurements. Treatment consisted of bilateral compartmental fasciotomy, as indicated. All of the patients in Group I had complete relief of symptoms; however, one patient in Group II and one in Group III had a recurrence of symptoms in the deep posterior compartment.

Gas-Producing Escherichia coli Fasciitis in a Patient With the Neuroleptic Malignant Syndrome

To the Editor.— The neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal reaction to major tranquilizers. It is characterized by hyperpyrexia, muscle rigidity, altered consciousness, and autonomicdysfunction. 1,2 We report a dramatic case of the NMS complicated by bilateral anterior tibial compartment syndromes that were infected by gasproducing Escherichia coli . Report of a Case.— A 29-year-old man was admitted to the Bernalillo County Mental Health Center, Albuquerque, with the diagnosis of acute paranoid schizophrenia. During a 12-hour period, he received 90 mg of haloperidol and 100 mg of chlorpromazine orally. Two hours later, he was comatose, hypotensive, hyperpyrexic (rectal temperature, 41.3 °C), and rigid, with clonic jerking movements, and was transferred to the University of New Mexico Hospital, Albuquerque. His creatine kinase level was 220,000 IU/L, his uric acid level was 25.2 mg/mL, and the scanty urine specimens were positive for myoglobin and initially yellow and then burgundy-colored

Bilateral Compartment Syndrome Associated with Androgen Therapy

A patient being treated with androgens developed an acute bilateral compartment syndrome. Androgens are known to cause hypertrophy of muscle, which in a closed fascial compartment may predispose to a compartment syndrome. While an acute syndrome has not been reported previously, patients on androgen therapy frequently complain of cramps and leg pain, which may be manifestations of chronic compartment syndrome. The above case report does not establish a positive cause and effect relationship, but because this occurrence has not been documented before we believe the relationship should be considered. Patients on androgens should be examined for the possibility of compartment syndromes, either acute or chronic. The actual compartment pressures can be measured in suspected cases.

Anterior Tibial Compartment Syndrome Associated with Ergotamine Ingestion

This is the first reported case of acute anterior tibial compartment syndrome following ergotamine tartrate overdosage. A 25-year-old man developed signs and symptoms of ergotism after ingestion of 72 mg of ergotamine tartrate over the 12 days prior to his hospital admission. On the fourth hospital day, the patient developed bilateral anterior tibial compartment syndrome. The development of this syndrome is postulated to have been due to the progressive edema and tissue pressure in the anterior tibial compartments, worsened by the gradual improvement of the peripheral circulation which followed the diminished vasopastic effect of the ergotamine.

Anterior tibial compartment syndrome following prolonged tetany

A patient developed a persistent, disabling, bilateral anterior tibial compartment syndrome after salicylate self-poisoning. Prolonged tetany is postulated as the probable mechanism.

Popliteal artery entrapment syndrome misdiagnosed as chronic exertional compartment syndrome in a young male athlete: Role of dynamic ultrasound

Popliteal artery entrapment syndrome (PAES) is an uncommon cause of exercise-induced pain in the lower extremity of young athletes. However, it might explain the symptoms of those athletes who do not respond to treatment for the more common overuse syndromes. We present a case of a young professional male athlete who was diagnosed with bilateral chronic exertional compartment syndrome (CECS), for which he was operated on twice. His symptoms persisted for 5 years before PAES was diagnosed withdynamic ultrasound, and after bilateral surgical release a few months apart, he was completely symptom-free except for some discomfort in the fasciotomy scars.

The occurrence of heart-block in coronary artery thrombosis

In recent years, synthetic cathinones, often labeled as “bath salts” in an attempt to evade drug laws, have emerged as substances of abuse. Sympathomimetic drugs are well known to cause rhabdomyolysis but are rarely associated with acute compartment syndrome. In this case series, we describe 3 patients who presented with sympathomimetic signs or symptoms including hyperthermia and agitation and had confirmed synthetic cathinone use. All 3 patients had severe rhabdomyolysis with delayed development of an acute compartment syndrome. Two patients developed paraspinal compartment syndromes, whereas 1 developed bilateral forearm compartment syndromes. Management included fasciotomy in 2 patients and medical management in the third. Two of the 3 patients made a complete recovery before hospital discharge; the third patient was hemodialysis dependent at 5-month follow-up.