# Brachial Plexus Injury Secondary to Spontaneous Upper Limb Haematoma

## TL;DR

A rare case of a spontaneous muscle haematoma leading to brachial plexus injury is presented, emphasizing the need for timely diagnosis and surgical intervention.

## Contribution

Highlights a rare clinical scenario where spontaneous haematoma leads to brachial plexus injury and advocates for surgical intervention.

## Key findings

- A 52-year-old male presented with a spontaneous muscle haematoma that was initially missed.
- The haematoma led to mixed upper limb neuropathy requiring surgical evacuation and fasciotomy.
- The case underscores the importance of prompt diagnosis to prevent complications like compartment syndrome.

## Abstract

Spontaneous upper limb muscle haematomas are rare clinical phenomenons, which often go under- or misdiagnosed. They can present management challenges in the context of anticoagulant therapy, especially in the presence of other medical conditions. We present the case of a 52-year-old male with an initially missed presentation of a spontaneous muscle haematoma that progressed and re-presented to the emergency department (ED) with signs of mixed upper limb neuropathy requiring surgical evacuation and an emergency fasciotomy. This case highlights the importance of prompt diagnosis and intervention. While brachial plexus injuries from haematoma compression are uncommon, in our case, we discuss the need for surgical intervention to relieve pressure and optimise patient outcomes when clinically concerned about compartment syndrome or progressive neuropathy.