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Chronic Lumbar Epidural Hematoma in a Patient Who Had Spondylolysis at the Third Lumbar Vertebra. Report of a Rare Case Involving a Seventeen-Year-Old Adolescent*
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Investigation performed at Kurume University, Kurume
J Bone Joint Surg Am, 1998 Oct 01;80(10):1515-20
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A spinal epidural hematoma may result from one of many causes, including coagulopathy, trauma, a vascular lesion, iatrogenesis, and spontaneous occurrence2,4,6,7,11,12. Groen and van Alphen7 reviewed the cases of 333 patients who had a spontaneous spinal epidural hematoma; they had excluded patients in whom the hematoma had occurred after a traumatic episode involving spinal dislocation or fracture, after epidural anethesia, after diagnostic lumbar puncture, after an operation, or in association with a tumor in the spinal canal. Of the 333 patients, forty (12 per cent) had a lumbar epidural hematoma. Overall, fifty-five (17 per cent) of the patients were younger than twenty years old, and only four (7 per cent) of these young patients had a spontaneous lumbar epidural hematoma. Boyd and Pear reported that a hematoma caudad to the level of the conus medullaris was more likely to be chronic because the spinal roots appear to tolerate pressure better than the spinal cord does.
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