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Suggest Treatment To Regenerate The Femoral Nerve Damaged By A Haemorrage

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Posted on Fri, 9 Jan 2015
Question: What can be done to regenerate the femoral nerve damaged by a haemorrage 3 months ago.?
How long may this take to heal?
At present there is no feeling in and no use of his R leg
The haemorrage was at the base of the spine
doctor
Answered by Dr. Ajay Panwar (54 minutes later)
Brief Answer:
Please upload MRI image/Detailed medication history.

Detailed Answer:
Hi XXXX,
I am Dr.Ajay Panwar,a neurologist.I really feel concerned about your husband and I'd surely help you with your query.Please provide the following additional details:

1)Upload either the magnetic resonance imaging(MRI) image(or atleast a copy of report) or any other imaging study,with which I can get that where was the hemorrhage(Just telling the base of spine does not give a fair idea).
2)Since what time he is on the medications you have mentioned about,particularly prednisolone?
3)What did the treating doctors tell about that why he had this hemorrhage?
4)Is he still continuing with warfarin(as it increases the tendency to bleed)?

Please revert back with details and I shall be glad to help you.

Dr.Ajay Panwar
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ajay Panwar (1 hour later)
I cannot access the report on the MRI scan till Monday at the earliest as I shall have to get it from the hospital. How do I make sure that it goes to you?
He has been on prednisolone for about 8 years as he has polymyalgia rheumatica
The doctor in the orthopaedic ward to which he was admitted from A&E attributed the haemorrage to his INR level which was 4.6 It is normally kept at between 2 and 3. Yes he is still on warfarin because of the factor V leiden and the tendency to DVTs
We have been told that nerves regenerate at 1cm a day (his thigh is 460cm so we are looking at trying to speed up this process.
doctor
Answered by Dr. Ajay Panwar (47 minutes later)
Brief Answer:
Neuroregeneration and neurorehabilitation therapy may help.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.

Maintaining INR in the target range of 2-3 is an extremely important step to prevent adverse consequences,when patient is on warfarin. Please monitor INR at least once fortnightly,henceforth so as to prevent the recurrence of similar complication again.

Yes,you rightly said that nerves have tendency to regenerate even after severe injuries but the rate you mentioned is slightly on a higher side.Various studies have documented the rate of neuroregeneration to be 5 mm/day on an average and the range varying from 1 mm/day to 0.9 mm/day.However,this is just an experimental observation of structural recovery and does not necessarily correlate with functional recovery.

Thanks to the advancements in medical sciences nowadays,that we have seen well emerging neuroregeneration and neurorehabilitation therapies which can help a lot in damaged nerves as a result of spinal cord injuries.The concept is to inject autologous stem cells taken from the hip bone of the patient and inject it around the spinal cord,where the nerve emerges.This process is followed by dedicated physiotherapy and other neurorehabilitation measures and shows promising clinical improvement.We have dedicated centres doing this.

In cases of peripheral nerve injuries, peripheral nerve surgeons can do nerve reconstruction which also shows good clinical results.Also,there are dedicated medical centres where nerve growth factors can be injected around injuired peripheral nerves,which can help them regenerate.
One thing very crucial regarding regeneration is regular,physiotherapy.

You can ask me a direct query at my link-

http://doctor.healthcaremagic.com/doctors/dr-ajay-panwar/69273

and upload the MRI image and report to me so that I can see,what part of the roots or the nerves are exactly impaired by the hemorrhage and guide you further.

Hope I cleared your queries to some extent.If you have still some follow up questions for now,I shall be glad to help you,else you can close the thread and rate it.
I pray to God for your husband's good health.Please write a review if you liked the advice.

Dr.Ajay Panwar
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ajay Panwar

Neurologist

Practicing since :2007

Answered : 1827 Questions

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Suggest Treatment To Regenerate The Femoral Nerve Damaged By A Haemorrage

Brief Answer: Please upload MRI image/Detailed medication history. Detailed Answer: Hi XXXX, I am Dr.Ajay Panwar,a neurologist.I really feel concerned about your husband and I'd surely help you with your query.Please provide the following additional details: 1)Upload either the magnetic resonance imaging(MRI) image(or atleast a copy of report) or any other imaging study,with which I can get that where was the hemorrhage(Just telling the base of spine does not give a fair idea). 2)Since what time he is on the medications you have mentioned about,particularly prednisolone? 3)What did the treating doctors tell about that why he had this hemorrhage? 4)Is he still continuing with warfarin(as it increases the tendency to bleed)? Please revert back with details and I shall be glad to help you. Dr.Ajay Panwar MD,DM(Neurology)