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J Neurosurg Spine. 2014 Nov;21(5):799-804. doi: 10.3171/2014.7.SPINE14117. Epub 2014 Sep 5.

Endometriosis of the conus medullaris causing cyclic radiculopathy.

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Division of Neurosurgery, University of California, San Diego, California.


Intramedullary spinal cord hematomas are a rare neurosurgical pathological entity typically arising from vascular and neoplastic lesions. Endometriosis is an extremely rare cause of intramedullary spinal cord hematoma, with only 5 previously reported cases in the literature. Endometriosis is characterized by ectopic endometrial tissue, typically located in the female pelvic cavity, that causes a cyclical pain syndrome, bleeding, and infertility. In the rare case of intramedullary endometriosis of the spinal cord, symptoms include cyclical lower-extremity radiculopathies and voiding difficulties, and can acutely cause cauda equina syndrome. The authors report a case of endometriosis of the conus medullaris, the first to include radiological, intraoperative, and histopathological imaging. A brief review of the literature is also presented, with discussion including etiological theories surrounding intramedullary endometriosis.


ER = estrogen receptor; LE = lower extremity; conus medullaris; endometriosis; hematoma; hemorrhage; lumbar spine; radiculopathy; spinal cord

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