Chronic Lumbar Epidural Hematoma in a Patient Who Had Spondylolysis at the Third Lumbar Vertebra

A spinal epidural hematoma may result from one of many causes, including coagulopathy, trauma, a vascular lesion, iatrogenesis, and spontaneous occurrence2-4-6-71U2. Groen and van Alphen7 reviewed the cases of 333 patients who had a spontaneous spinal epidural hema-toma; they had excluded patients in whom the hema-toma had occurred after a traumatic episode involving neous lumbar epidural hematoma. Boyd and Pear re-ported 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. In a review of the literature, we found four cases of lumbar epidural hematoma in patients who were youn-FlG. 1 Lateral and bilateral oblique radiographs made on admission showed spondylolysis (arrows) at the third lumbar vertebra with normal spinal alignment. spinal dislocation or fracture, after epidural anesthesia, 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 pa-tients were younger than twenty years old, and only four (7 per cent) of these young patients had a sponta-*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study