ABSTRACT
Objective To evaluate MR findings and clinical features in patients with spontaneous spinal epidural hematoma (SSEH). Methods Eight patients (5 men, 3 women; aged 16-50 years ) with SSEH underwent MR imaging during 1994-2001, including 7 cases without history of trauma or coagulation disorders and 1 case with history of hypertension. MR imaging was performed from 4 hours to 3 days after the onset of symptoms in all 8 patients with surgical and pathologic diagnosis. Results The hematomas were in lateral posterior or posterior epidural space, including 3 cases in cervical vertebra, 2 cases in thoracic vertebra, 2 cases in cervical and thoracic junction region, and 1 case in thoracic and lumbar part. The MRI confirmed an encapsulated hematoma caused by arteriovenous malformation in 1 case and two hematomas associated with disc herniation. The signal intensity of the hematoma varied with the hematoma age, but T 1-weighted images reflected its typical signal changes. Sagittal and coronal T 1- weighted images revealed isointense (7 cases) and slight high-intense (1 case) signal; Sagittal and axial T 2-weighted images revealed mixed-intensity (6 cases) and mixed high-intensity (2 cases). Conclusion MR imaging has an important value on localization, identification, and differential diagnosis of the lesion, therefore, it is the most helpful diagnostic tool for this condition.