NONTRAUMATIC SPINAL EPIDURAL HEMATOMAS - MR FEATURES

Purpose: Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak out come. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH. Material and Methods : Seven patients with nontraumatic SEH were examined by MR at 1.5 T. T wo patients were under anticoagulation therapy with heparin, and 2 oth ers were taking salicylic acid. One patient had lupus erythematodes wi th a marked thrombocytopenia. One patient had a spinal arteriovenous m alformation.Results: MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characte ristic signal intensities of blood. Five patients underwent laminectom y and evacuation of the hematoma. In the acute phase. the hematomas ap peared isointense when compared with the spinal cord on T1-weighted im ages and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to tho se of cerebrospinal fluid (CSF) on T2-weighted images. Confusion: MR i maging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hem atomas.