{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:43:48Z","timestamp":1783626228918,"version":"3.55.0"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3171\/2014.7.spine14117","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T14:01:08Z","timestamp":1409925668000},"page":"799-804","source":"Crossref","is-referenced-by-count":15,"title":["Endometriosis of the conus medullaris causing cyclic radiculopathy"],"prefix":"10.3171","volume":"21","author":[{"given":"Jeffrey A.","family":"Steinberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Gonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karra","family":"Muller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Ciacci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14117","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ejogrb.2010.10.026","article-title":"Attachment to extracellular matrices is enhanced in human endometriotic stromal cells: a possible mechanism underlying the pathogenesis of endometriosis","volume":"155","author":"Adachi","year":"2011"},{"key":"b2-spine14117","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"E428","DOI":"10.1227\/01.NEU.0000223375.23617.DC","article-title":"Intramedullary endometriosis of the conus medullaris: case report","volume":"59","author":"Agrawal","year":"2006"},{"key":"b3-spine14117","series-title":"Hum Reprod","doi-asserted-by":"publisher","first-page":"1744","DOI":"10.1093\/humrep\/15.8.1744","article-title":"Relationship between endometriotic foci and nerves in rectovaginal endometriotic nodules","volume":"15","author":"Anaf","year":"2000"},{"key":"b4-spine14117","series-title":"Hum Reprod","doi-asserted-by":"publisher","first-page":"1895","DOI":"10.1093\/humrep\/17.7.1895","article-title":"Hyperalgesia, nerve infiltration and nerve growth factor expression in deep adenomyotic nodules, peritoneal and ovarian endometriosis","volume":"17","author":"Anaf","year":"2002"},{"key":"b5-spine14117","series-title":"Annu Rev Physiol","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1146\/annurev-physiol-012110-142158","article-title":"Endometriosis: the role of neuroangiogenesis","volume":"73","author":"Asante","year":"2011"},{"key":"b6-spine14117","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"652","DOI":"10.3171\/jns.1966.25.6.0652","article-title":"Endometriosis within the sheath of the sciatic nerve. Report of two patients with progressive paralysis","volume":"25","author":"Baker","year":"1966"},{"key":"b7-spine14117","series-title":"Histol Histopathol","first-page":"1111","article-title":"Spinal intradural m\u00fcllerianosis: a case report","volume":"21","author":"Barresi","year":"2006"},{"key":"b8-spine14117","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1016\/j.ejogrb.2013.03.029","article-title":"Spread of endometriosis to pelvic sentinel lymph nodes: gene expression analysis","volume":"169","author":"B\u00fcrkle","year":"2013"},{"key":"b9-spine14117","series-title":"Fertil Steril","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.fertnstert.2012.06.029","article-title":"Pathogenesis and pathophysiology of endometriosis","volume":"98","author":"Burney","year":"2012"},{"key":"b10-spine14117","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1007\/BF01401117","article-title":"Radicular compression by extradural spinal endometriosis. Case report","volume":"114","author":"Carta","year":"1992"},{"key":"b11-spine14117","series-title":"Surg Radiol Anat","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s00276-010-0624-6","article-title":"Laparoscopic nerve-sparing transperitoneal approach for endometriosis infiltrating the pelvic wall and somatic nerves: anatomical considerations and surgical technique","volume":"32","author":"Ceccaroni","year":"2010"},{"key":"b12-spine14117","series-title":"Medicine (Baltimore)","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1097\/MD.0b013e3181df67d5","article-title":"Thoracic endometriosis: revisiting the association between clinical presentation and thoracic pathology based on thoracoscopic findings in 110 patients","volume":"89","author":"Channabasavaiah","year":"2010"},{"key":"b13-spine14117","series-title":"J Obstet Gynaecol India","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1016\/j.fertnstert.2006.05.084","article-title":"John A. Sampson and the origins of endometriosis","volume":"60","author":"Dastur","year":"2011"},{"key":"b14-spine14117","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/0028-2243(95)80023-L","article-title":"Endometriosis of the sciatic nerve: case report demonstrating the value of MR imaging","volume":"58","author":"Descamps","year":"1995"},{"key":"b15-spine14117","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s10143-008-0173-1","article-title":"Intramedullary lesions of the conus medullaris: differential diagnosis and surgical management","volume":"32","author":"Ebner","year":"2009"},{"key":"b16-spine14117","series-title":"J Minim Invasive Gynecol","doi-asserted-by":"publisher","first-page":"764","DOI":"10.1016\/j.jmig.2007.06.005","article-title":"Laparoscopic excision of endometriosis of the obturator nerve: a case report","volume":"14","author":"Ekpo","year":"2007"},{"key":"b17-spine14117","series-title":"J Reprod Med","first-page":"955","article-title":"Management of intramedullary endometriosis of the conus medullaris. A case report","volume":"47","author":"Erbayraktar","year":"2002"},{"key":"b18-spine14117","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"281","DOI":"10.3171\/2010.10.SPINE09162","article-title":"Cyclic sciatica from extrapelvic endometriosis affecting the sciatic nerve. Case report","volume":"14","author":"Floyd","year":"2011"},{"key":"b19-spine14117","series-title":"Clin Obstet Gynecol","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1097\/00003081-199909000-00021","article-title":"Extrapelvic endometriosis","volume":"42","author":"Honor\u00e9","year":"1999"},{"key":"b20-spine14117","series-title":"Eur J Med Res","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/2047-783X-18-13","article-title":"Endometriosis of the lung: report of a case and literature review","volume":"18","author":"Huang","year":"2013"},{"key":"b21-spine14117","series-title":"Obstet Gynecol Clin North Am","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/S0889-8545(05)70311-9","article-title":"Extrapelvic endometriosis","volume":"24","author":"Jubanyik","year":"1997"},{"key":"b22-spine14117","series-title":"Clin Radiol","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.crad.2013.07.017","article-title":"Differentiation between intramedullary spinal ependymoma and astrocytoma: comparative MRI analysis","volume":"69","author":"Kim","year":"2014"},{"key":"b23-spine14117","series-title":"J Clin Endocrinol Metab","first-page":"643","article-title":"Aberrant integrin expression in the endometrium of women with endometriosis","volume":"79","author":"Lessey","year":"1994"},{"key":"b24-spine14117","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1212\/WNL.18.5.423","article-title":"Subarachnoid hemorrhage due to endometriosis of the spinal canal","volume":"18","author":"Lombardo","year":"1968"},{"key":"b25-spine14117","series-title":"J Bone Joint Surg Br","first-page":"98","article-title":"Cyclical sciatica: endometriosis of the sciatic nerve","volume":"90","author":"Mannan","year":"2008"},{"key":"b26-spine14117","series-title":"Fertil Steril","doi-asserted-by":"publisher","first-page":"1856","DOI":"10.1016\/j.fertnstert.2008.09.006","article-title":"A pilot study to evaluate the clinical relevance of endometriosis-associated nerve fibers in peritoneal endometriotic lesions","volume":"92","author":"Mechsner","year":"2009"},{"key":"b27-spine14117","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1056\/NEJM199306173282407","article-title":"Endometriosis","volume":"328","author":"Olive","year":"1993"},{"key":"b28-spine14117","series-title":"Fertil Steril","first-page":"417.e17","article-title":"Isolated infiltrative endometriosis of the sciatic nerve: a report of three patients","volume":"87","author":"Possover","year":"2007"},{"key":"b29-spine14117","series-title":"Fertil Steril","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1016\/j.fertnstert.2010.08.048","article-title":"Laparoscopic therapy for endometriosis and vascular entrapment of sacral plexus","volume":"95","author":"Possover","year":"2011"},{"key":"b30-spine14117","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"842","DOI":"10.3109\/02688697.2013.795519","article-title":"Endometriosis of conus medullaris: a case report","volume":"27","author":"Sahu","year":"2013"},{"key":"b31-spine14117","series-title":"Ann N Y Acad Sci","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1196\/annals.1434.014","article-title":"Stem cells and the pathogenesis of endometriosis","volume":"1127","author":"Sasson","year":"2008"},{"key":"b32-spine14117","series-title":"Ann N Y Acad Sci","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1111\/j.1749-6632.2002.tb02775.x","article-title":"Paracrine regulation of matrix metalloproteinase expression in endometriosis","volume":"955","author":"Sharpe-Timms","year":"2002"},{"key":"b33-spine14117","series-title":"Hum Reprod Update","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1093\/humupd\/4.5.730","article-title":"Extracellular matrix remodelling in the endometrium and its possible rel evance to the pathogenesis of endometriosis","volume":"4","author":"Sillem","year":"1998"},{"key":"b34-spine14117","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"975","DOI":"10.3171\/jns.1984.61.5.0975","article-title":"Spontaneous spinal subarachnoid hemorrhage and subdural hematoma. Report of two cases","volume":"61","author":"Swann","year":"1984"},{"key":"b35-spine14117","series-title":"Obstet Gynecol","first-page":"383","article-title":"Evidence for asymmetric distribution of sciatic nerve endometriosis","volume":"102","author":"Vercellini","year":"2003"},{"key":"b36-spine14117","series-title":"Best Pract Res Clin Obstet Gynaecol","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.bpobgyn.2004.01.007","article-title":"Endometriosis: epidemiology and aetiological factors","volume":"18","author":"Vigan\u00f2","year":"2004"},{"key":"b37-spine14117","series-title":"Eur J Obstet Gynecol Reprod Biol","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/S0301-2115(00)00405-X","article-title":"Theories of endometriosis","volume":"96","author":"Vinatier","year":"2001"},{"key":"b38-spine14117","series-title":"Jpn J Radiol","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1007\/s11604-012-0060-0","article-title":"Perineural spread of endometriosis along the obturator nerve into the adductor thigh compartment","volume":"30","author":"Waer","year":"2012"},{"key":"b39-spine14117","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2705","DOI":"10.1097\/BRS.0b013e3181b43484","article-title":"Surgical treatment of one hundred seventy-four intramedullary spinal cord tumors","volume":"34","author":"Yang","year":"2009"},{"key":"b40-spine14117","series-title":"Skeletal Radiol","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00256-003-0663-8","article-title":"Cyclic sciatica caused by infiltrative endometriosis: MRI findings","volume":"33","author":"Yekeler","year":"2004"},{"key":"b41-spine14117","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"937","DOI":"10.3171\/jns.1994.81.6.0937","article-title":"Intramedullary hemorrhage in spinal cord hemangioblastoma. Report of two cases","volume":"81","author":"Yu","year":"1994"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/21\/5\/article-p799.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/21\/5\/article-p799.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/21\/5\/article-p799.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T22:57:35Z","timestamp":1681599455000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/21\/5\/article-p799.xml"}},"subtitle":["Case report"],"short-title":[],"issued":{"date-parts":[[2014,11]]},"references-count":41,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2014.7.spine14117","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2014,11]]}}}