Ligamentum flavum hematoma due to stretching exercise: a case report and review of literature

Hui-Pu Liu; Chun-Lin Chen; Nan-Fu Chen; Chen-Yi Liao; Chien-Yu Ou

doi:10.1016/j.ajem.2016.03.042

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Ligamentum flavum hematoma due to stretching exercise: a case report and review of literature

Hui-Pu Liu, MD

Chun-Lin Chen, MD

Nan-Fu Chen, MD

Chen-Yi Liao, MD

Chien-Yu Ou, MD

Department of Neurosurgery, Kaohsiung Armed Forces General Hospital Kaohsiung, Taiwan

DOI: http://dx.doi.org/10.1016/j.ajem.2016.03.042

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Fig. 1

Sagittal and axial T₁-weighted (A and B), T₂-weighted (C and D) and gadolinium-enhanced T₂-weighted (E) magnetic resonance images showing an intrathecal cyst-like lesion with adjacent retrospinal soft tissue enhancement at L4-L5 level with severe thecal sac compression and severe encroachment of the bilateral neural foramina.

Fig. 2

Intraoperative findings showed ligamentum flavum (A, arrow). After dissecting ligamentum flavum, dark liquefied material (B, arrow) was found, and a capsule lesion was identified (C, arrow). Decompression and exposure of dura (D, arrow) was performed.

Fig. 3

Sagittal (A) and axial (B) T₂-weighted images of the same area 5 months later showing complete resolution after the patient underwent L4 through L5 laminectomies and removal of intraspinal lesion, which was proven to be a old hemorrhage in fibrous tissue.

Ligamentum flavum hematoma is a rare cause of spinal cord or root compression and usually occurs in the lower thoracic and lumbar spine. The differential diagnosis includes lumbar disk herniation and lumbar spinal canal stenosis caused by neoplasm, infection, epidural hematoma, and facet cyst.

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Ligamentum flavum hematoma due to stretching exercise: a case report and review of literature

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