MR Imaging and Clinical Findings of Spontaneous Spinal Epidural Hematoma

PURPOSE: To describe the MR imaging and clinical findings of spontaneous spinal epidural hematoma. MATERIALS AND METHODS: The MR and clinical findings in six patients (M:F=4:2;adult:child=3:3) with spontaneous spinal epidural hematoma were reviewed. Five patients without any predisposing factor which might cause the condition and one with acute myelogeneous leukemia were included. Emergency surgery was performed in two patients, and the other four were managed conservatively. RESULTS: The epidural lesion involved between three and seven vertebrae (mean: 4.5), and relative to the spinal cord was located in the posterior-lateral (n=4), anterior (n=1), or right lateral (n=1) area. The hematoma was isointense (n=1) or hyperintense (n=5) with spinal cord on T1-weighted images, and hy-pointense (n=2) or hyperintense (n=4) on T2-weighted images. It was completely absorbed in four of five patients who underwent follow-up MR imaging, but not changed in one. The clinical outcome of these patients was complete recovery (n=4), spastic cerebral palsy (n=1), or unknown (n=1). CONCLUSION: Because of the lesion's characteristic signal intensity, MR imaging is very useful in the diagnosis and evaluation of spontaneous spinal epidural hematoma.

MR Imaging and Clinical Findings of Spontaneous Spinal Epidural Hematoma

PURPOSE: To describe the MR imaging and clinical findings of spontaneous spinal epidural hematoma. MATERIALS AND METHODS: The MR and clinical findings in six patients (M:F=4:2;adult:child=3:3) with spontaneous spinal epidural hematoma were reviewed. Five patients without any predisposing factor which might cause the condition and one with acute myelogeneous leukemia were included. Emergency surgery was performed in two patients, and the other four were managed conservatively. RESULTS: The epidural lesion involved between three and seven vertebrae (mean: 4.5), and relative to the spinal cord was located in the posterior-lateral (n=4), anterior (n=1), or right lateral (n=1) area. The hematoma was isointense (n=1) or hyperintense (n=5) with spinal cord on T1-weighted images, and hy-pointense (n=2) or hyperintense (n=4) on T2-weighted images. It was completely absorbed in four of five patients who underwent follow-up MR imaging, but not changed in one. The clinical outcome of these patients was complete recovery (n=4), spastic cerebral palsy (n=1), or unknown (n=1). CONCLUSION: Because of the lesion's characteristic signal intensity, MR imaging is very useful in the diagnosis and evaluation of spontaneous spinal epidural hematoma.

MRI Findings of Traumatic Spinal Subdural Hematoma

PURPOSE: To describe the MR imaging findings of traumatic spinal subdural hematoma. MATERIALS AND METHODS: We retrospectively reviewed the MR images of six patients, with symptoms of acute spinal cord or cauda equena compression after trauma, together with spinal subdural hematoma. We analysed the extent, location, configuration and signal intensity of the lesions. RESULTS: In five of six cases, hematomas were distributed extensively throughout the thoracolumbosacral or lumbosacral spinal levels. In five cases they were located in the dorsal portion of the thecal sac, and in one case, in the ventral portion. On axial images, hematomas showed a concave or convex contour, depending on the amount of loculated hematoma. A lobulated appearance was due to limitation of free extension of the hematoma within the subdural space at the lateral sites (nerve root exist zone) at whole spine levels, and at the posteromedian site under lumbar 4-5 levels. CONCLUSION: In cases of spinal subdural hematoma, the lobulated appearance of hematoma loculation in the subdural space that bounds the lateral sites at all spinal levels and at the posteromedian site under L4-5 levels is a characteristic finding.