MRI of acute spinal epidural hematomas

Purpose: The purpose of this work was to determine the MR findings that cha racterize acute spinal epidural hematomas (ASEHs). Method: The MR findings of 17 patients with ASEH (9 cervical, 7 thoracic, a nd 2 lumbar) were reviewed. Fifteen of the hematomas were secondary to trau ma and two were spontaneous. Correlation with CT (8 cases) and surgical fin dings (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 wer e slightly hyperintense; T2-weighted images showed hyperintensity with area s of hypointensity); (b) capping of epidural fat; (c) direct continuity wit h the adjacent osseous structures; (d) compression of epidural fat, subarac hnoid sac, and spinal cord; (e) usually posterolateral location in the spin al canal. Conclusion: Epidural hematomas in the spinal canal are lesions capable of p roducing sudden spinal cord and/or cauda equina compression. MR provides ch aracteristic findings that allow a prompt diagnosis of acute epidural hemat omas.