MRI Findings of Traumatic Spinal Subdural Hematoma

ABSTRACT

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.