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Hematoma in the cervical ligamentum flavum. Report of a case and review of the literature

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Abstract

Hematoma of the cervical ligamentum flavum is very rare, and its pathogenesis is unknown. We describe a case of ligamentum flavum hematoma in the cervical spine causing severe myelopathy. Postoperative histological examination suggested it was the result of the rupture of a hemangioma or of an arteriovenous malformation in the ligamentum flavum. After removal of the lesion, the patient’s condition immediately improved. Review of all three reported cases, including this one, showed that complete resection of the mass resulted in immediate relief of symptoms of incomplete paraplegia. The findings of magnetic resonance imaging (MRI) of the hematoma may vary with time, and they may show no characteristic intensity. However, MRI of this case revealed that the tissues surrounding the mass were enhanced with gadolinium diethylene triamine penta-acetic acid, and an area of homogeneous iso-intensity was clearly surrounded by a low-intensity area (flavum) on T2-weighed short-tau inversion recovery images. These findings could be characteristic of the ligamentum flavum hematoma and might help in the differentiation from a cervical epidural hematoma.

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References

  1. Maezawa Y, Baba H, Uchida K, Kokubo Y, Kubota C, Noriki S. Ligamentum flavum hematoma in the thoracic spine. Clin Imaging. 2001;25:265–7.

    Article  CAS  PubMed  Google Scholar 

  2. Minamide A, Yoshida M, Tamaki T, Natsumi K. Ligamentum flavum hematoma in the lumbar spine. J Orthop Sci. 1999;4:376–9.

    Article  CAS  PubMed  Google Scholar 

  3. Cruz-Conde R, Berjano P, Buitron Z. Ligamentum flavum hematoma presenting as progressive root compression in the lumbar spine. Spine. 1995;20:1506–9.

    Article  CAS  PubMed  Google Scholar 

  4. Hirakawa K, Hanakita J, Suwa H, Matsuoka N, Oda M, Muro H, et al. A post-traumatic ligamentum flavum progressive hematoma: a case report. Spine. 2000;25:1182–4.

    Article  CAS  PubMed  Google Scholar 

  5. Sweasey TA, Coester HC, Rawal H, Blaivas M, McGillicuddy JE. Ligamentum flavum hematoma. Report of two cases. J Neurosurg. 1992;76:534–7.

    CAS  Google Scholar 

  6. Yüceer N, Baskaya MK, Smith P, Willis BK. Hematoma of the ligamentum flavum in the lumbar spine: case report. Surg Neurol. 2000;53:598–600.

    Article  PubMed  Google Scholar 

  7. Chen HC, Hsu PW, Lin CY, Tzaan WC. Symptomatic hematoma of cervical ligamentum flavum: case report. Spine. 2005;30:E489–91.

    Article  PubMed  Google Scholar 

  8. Miyakoshi N, Shimada Y, Kasukawa Y, Ando S. Ligamentum flavum hematoma in the cervical spine—case report. Neurol Med Chir (Tokyo). 2006;46:556–8.

    Article  Google Scholar 

  9. Nishida K, Iguchi T, Kurihara A, Doita M, Kasahara K, Yoshiya S. Symptomatic hematoma of lumbar facet joint: joint apoplexy of the spine? Spine. 2003;28:E206–8.

    Article  PubMed  Google Scholar 

  10. Yayama T, Kobayashi S, Sato R, Uchida K, Kokubo Y, Nakajima H, et al. Calcium pyrophosphate crystal deposition in the ligamentum flavum of degenerated lumbar spine: histopathological and immunohistological findings. Clin Rheumatol. 2008;27:597–604.

    Article  PubMed  Google Scholar 

  11. Pizzutillo PD, Woods M, Nicholson L, MacEwen GD. Risk factors in Klippel-Feil syndrome. Spine. 1994;19:2110–6.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan

    Tatsuya Tamura, Toshinori Sakai, Koichi Sairyo, Shinsuke Katoh & Natsuo Yasui

  2. Department of Radiology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan

    Shoichiro Takao

  3. Department of Human Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan

    Seiko Kagawa

Authors
  1. Tatsuya Tamura
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  2. Toshinori Sakai
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  3. Koichi Sairyo
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  4. Shoichiro Takao
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  5. Seiko Kagawa
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  6. Shinsuke Katoh
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  7. Natsuo Yasui
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Correspondence to Toshinori Sakai.

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Tamura, T., Sakai, T., Sairyo, K. et al. Hematoma in the cervical ligamentum flavum. Report of a case and review of the literature. Skeletal Radiol 39, 289–293 (2010). https://doi.org/10.1007/s00256-009-0805-8

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  • DOI: https://doi.org/10.1007/s00256-009-0805-8

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