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A post-traumatic ligamentum flavum progressive hematoma: a case report
K Hirakawa1, J Hanakita, H Suwa
1Department of Neurosurgery and Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan.
Spine
|May 2, 2000
Summary
Surgical intervention effectively resolved progressive symptoms in a rare case of ligamentum flavum hematoma. Histologic examination confirmed the diagnosis after initial imaging challenges.
Area of Science:
- Neurosurgery
- Spinal Pathology
- Radiology
Background:
- Ligamentum flavum hematoma is an exceptionally rare spinal condition, with only two prior case reports documented.
- Understanding the clinical and radiological characteristics of this pathology is crucial due to its rarity.
Observation:
- A patient presented with progressive L5 radiculopathy attributed to a ligamentum flavum hematoma.
- Despite conservative management for seven months, symptoms persisted and worsened.
- Magnetic resonance imaging revealed an epidural mass at L4-L5, contiguous with the ligamentum flavum, with characteristic signal intensities and enhancement patterns.
Findings:
- Surgical excision of the epidural mass resulted in complete symptom resolution.
- Preoperative diagnosis was challenging, even with advanced imaging, with definitive diagnosis achieved through histologic analysis.
- The etiology remained unclear, with only a history of minor back injury noted.
Implications:
- Surgical treatment is a viable option for managing ligamentum flavum hematoma and alleviating associated radiculopathy.
- This case underscores the importance of considering rare pathologies in the differential diagnosis of spinal epidural masses.
- Further research and case reporting are needed to better understand the etiology and optimal management of ligamentum flavum hematoma.