P.156 Spinal subdural hematoma from a type I spinal arteriovenous malformation: case report and literature review
Bibliographic record
Abstract
Background: Type 1 spinal arteriovenous malformations (AVM) are dural fistulas which classically present due to progressive congestive myelopathy. Acute hemorrhage resulting in a spinal subdural hematoma is exceedingly rare with only three reported cases. Methods: This 46-year-old female experienced rapidly progressive paraplegia over several hours. There was no history of anti-coagulant use, trauma, fever, or infection. On examination, she had 0/5 in the lower extremities bilaterally and decreased sensation to pinprick below the T6 level on both sides. She also had loss of bowel and bladder control. MRI demonstrated evidence of an intra-dural extramedullary lesion located anteriorly causing significant compression on the spinal cord from T4 down to T7 level. Results: She underwent thoracic laminectomy from T4 – T7. After dural opening, a well organized sub-dural hematoma with significant mass effect on a distorted spinal cord was evacuated. Subsequently, a large abnormal artery leading into a dilated serpiginous vein on the dorsal aspect of spinal cord at the T7 level was visualized. Indocyanine green angiography confirmed our suspicion of a dural arteriovenous fistula which was disconnected. Conclusions: Type I spinal AVM in rare cases can present acutely as subdural hematoma and should be kept in the differential diagnosis for acute paraplegia.
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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 | 0.001 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".