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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".