Ligamentum flavum hematoma in the lumbar spine mimicking epidural tumor: A case report

Nerve root compression due to ligamentum flavum hematoma is extremely rare, with less than 70 cases reported in the literature. The clinical presentation and images were similar to those of spinal epidural tumors. Herein, we reported a previously healthy 64-year-old female who presented with right radicular leg pain. Neurological examination was consistent with right L5 root compression. The magnetic resonance imaging revealed a mass posterior to the L5 thecal sac, appearing as high intensity on T1-weighted and T2-weighted images. During operation, the dark hematoma within the ligamentum flavum was found. The pathological examination confirmed the diagnosis of hemorrhage. Her prognosis following surgery was excellent. Neurology Asia 2015; 20(3) : 309 – 311 Address correspondence to: Dr. Cheng-Ta Hsieh, MD, Division of Neurosurgery, Department of Surgery, Cathay General Hospital, 280, Section 4, Jen-Ai Road, Taipei 106, Taiwan. Tel: +886-2-27082121 ext 3331, Fax: +886-2-27082121, Email: [email protected] INTRODUCTION Sciatica due to nerve root compression is frequently caused by a herniated disc, hypertrophic ligamentum flavum, degenerative spinal stenosis, infection, or tumor.1 However, ligamentum flavum hematoma has been rarely reported as a cause of nerve root compression, and may mimic epidural tumor.2 Herein, we report a case of ligamentum flavum hematoma in the lumbar spine mimicking epidural hematoma and review the relevant literature.