Nontraumatic spinal epidural hematomas. MR features.
OBJECTIVE
Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak outcome. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH.


METHODS
Seven patients with nontraumatic SEH were examined by MR at 1.5 T. Two patients were under anticoagulation therapy with heparin, and 2 others were taking salicylic acid. One patient had lupus erythematodes with a marked thrombocytopenia. One patient had a spinal arteriovenous malformation.


RESULTS
MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characteristic signal intensities of blood. Five patients underwent laminectomy and evacuation of the hematoma. In the acute phase, the hematomas appeared isointense when compared with the spinal cord on T1-weighted images and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to those of cerebrospinal fluid (CSF) on T2-weighted images.


CONCLUSIONS
MR imaging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hematomas.
Lövblad
K O
KO
Department of Neuroradiology, Inselspital, University of Berne, Switzerland.
Baumgartner
R W
RW
Zambaz
B D
BD
Remonda
L
L
Ozdoba
C
C
Schroth
G
G
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006407:Hematoma, Epidural, Cranial / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives; D013116:Spinal Cord / Q000473:pathology*
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA