A post-traumatic ligamentum flavum progressive hematoma - A case report

Study Design. A case report. Objectives. To understand a rare case of ligamentum flavum progressive hema toma. Summary of Background Data. Previously there were only two reports about li gamentum flavum hematoma. Methods. A patient was surgically treated for ligamentum flavum hematoma ca using progressive L5 radiculopathy. Clinical and neuroradiologic features w ere reported, and the literature was reviewed. Results. The etiology of this case could not be defined except by minor bac k injury. In spite of conservative therapy, the symptoms were progressive f or 7 months. Magnetic resonance imaging demonstrated the epidural mass lesi on at L4-L5 that was continuous with the ligamentum flavum. The mass was hy pointense in T1-weighted images and central hyperintense and marginal hypoi ntense in T2-weighted images. The margin was well enhanced by Gd-DTPA admin istration. After removal of the mass lesion, the patient's symptoms complet ely resolved. Before surgery, accurate diagnosis was difficult even based o n magnetic resonance imaging and was achieved after histologic examinations . Conclusions. Surgery could be a choice of the treatment modality to resolve symptoms in ligamentum flavum hematoma.