MRI findings in spinal subdural and epidural hematomas.
BACKGROUND
Spinal hematomas are rare entities that can be the cause of an acute spinal cord compression syndrome. Therefore, an early diagnosis is of great importance.


METHODS
From 2001 to 2005 seven patients with intense back pain and/or acute progressive neurological deficit were studied via 1.5 T MRI (in axial and sagittal T1- and T2-weighted sequences). Follow-up MRI was obtained in six patients.


RESULTS
Four patients showed the MRI features of a hyperacute spinal hematoma (two spinal subdural hematoma [SSH] and two spinal epidural hematoma [SEH]), isointense to the spinal cord on T1- and hyperintense on T2-weighted sequences. One patient had an early subacute SEH manifest as heterogeneous signal intensity with areas of high signal intensity on T1- and T2-weighted images. Another patient had a late subacute SSH with high signal intensity on T1- and T2-weighted sequences. The final patient had a SEH in the late chronic phase being hypointense on T1- and T2-weighted sequences.


CONCLUSIONS
MRI is valuable in diagnosing the presence, location and extent of spinal hematomas. Hyperacute spinal hematoma and the differentiation between SSH and SEH are particular diagnostic challenges. In addition, MRI is an important tool in the follow-up in patients with conservative treatment.
Braun
Petra
P
Department of Radiology, Hospital La Plana, Ctra. De Vila-real a Borriana km. 0,5, 12540 Vila-real, Castelló, Spain. PetraBraun@gmx.de
Kazmi
Khuram
K
Nogués-Meléndez
Pablo
P
Mas-Estellés
Fernando
F
Aparici-Robles
Fernando
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis*; D046649:Hematoma, Subdural, Spinal / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011859:Radiography; D013116:Spinal Cord / Q000473:pathology*