MRI of acute spinal epidural hematomas

J Comput Assist Tomogr. Mar-Apr 1999;23(2):238-43. doi: 10.1097/00004728-199903000-00012.


Purpose: The purpose of this work was to determine the MR findings that characterize acute spinal epidural hematomas (ASEHs).

Method: The MR findings of 17 patients with ASEH (9 cervical, 7 thoracic, and 2 lumbar) were reviewed. Fifteen of the hematomas were secondary to trauma and two were spontaneous. Correlation with CT (8 cases) and surgical findings (11 cases) was also performed.

Results: Imaging findings in ASEH were the following: (a) a variable signal intensity (on T1-weighted images, 10 showed isointensity to cord and 7 were slightly hyperintense; T2-weighted images showed hyperintensity with areas of hypointensity); (b) capping of epidural fat; (c) direct continuity with the adjacent osseous structures; (d) compression of epidural fat, subarachnoid sac, and spinal cord; (e) usually posterolateral location in the spinal canal.

Conclusion: Epidural hematomas in the spinal canal are lesions capable of producing sudden spinal cord and/or cauda equina compression. MR provides characteristic findings that allow a prompt diagnosis of acute epidural hematomas.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Hematoma, Epidural, Cranial / diagnosis*
  • Hematoma, Epidural, Cranial / etiology
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Canal / pathology