Postoperative Acute Lumbar Epidural Hematoma With White Clot Formation Causing Cauda Equina Syndrome: A Case Report and Review of the Literature
Bibliographic record
Abstract
While the majority of spinal epidural hematomas after a spinal operation are clinically asymptomatic, the reported percentage of hematomas needing surgical evacuation is only 0.1%. A 69-year-old woman presented after a rapidly progressive worsening of her neurologic status at both legs. The patient was under anticoagulant medication with acenocoumarol due to atrial fibrillation and underwent a decompression laminectomy and L5, S1 left nerve root decompression. Eleven hours after the operation she presented with acute progressive cauda equina syndrome due to an epidural hematoma and was immediately transferred to the operating theater. A membrane of white clot was found and the presence of epidural clotted blood beneath the membrane was verified. The surgeon must be aware of this catastrophic complication that requires a high level of suspicion and prompt intervention. Large, multicentre prospective, randomized studies are needed to fully investigate the risks of anticoagulation therapy after spinal surgery. J Med Cases. 2012;3(1):76-80 doi: https://doi.org/10.4021/jmc462w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".