title: Conservative management of a cervical ligamentum flavum hematoma: Case report.
abstract: BACKGROUND
  Spontaneous epidural hematoma arising from the ligamentum flavum is a rare cause of acute spinal cord compression. There are only four reports in the cervical spine literature, and all were managed with surgery. Here, we describe an acute case of a spontaneous epidural hematoma arising from the ligamentum flavum in the cervical spine successfully managed without surgery.
  
  
  METHODS
  A 69-year-old woman with a cervical spine epidural hematoma contained within the ligamentum flavum presented with paroxysmal neck pain and stiffness without a history of trauma. The magnetic resonance imaging (MRI) revealed a posterolateral epidural hematoma contained within the ligamentum flavum. As the patient was intact, she was managed conservatively with cervical orthosis. Three months later, she was symptom-free, and the hematoma resolved on the follow-up MRI study.
  
  
  CONCLUSIONS
  Spontaneous epidural hematoma arising from ligamentum flavum is a rare cause of spinal cord compression. Previous reports have described success with surgical decompression. However, initial observation and conservative management may be successful as illustrated in this case.
authors.affiliation: Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Hanna
authors.initials: H
authors.lastname: Algattas
authors.affiliation: Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York, USA.
authors.forename: Kristopher T
authors.initials: KT
authors.lastname: Kimmell
authors.affiliation: Department of Neurosurgery, Rochester Regional Health System, Rochester, New York, USA.
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Petraglia
authors.affiliation: Department of Neurosurgery, Rochester Regional Health System, Rochester, New York, USA.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Maurer
keywords: Cervical spine; epidural hematoma; ligamentum flavum