SERIAL MAGNETIC-RESONANCE-IMAGING FINDINGS FOR A SPONTANEOUSLY RESOLVING SPINAL SUBDURAL-HEMATOMA - CASE-REPORT

OBJECTIVE AND IMPORTANCE: Spinal subdural hematoma (SSDH) is a rare en tity, and cases are usually managed as surgical emergencies. We descri be a patient with a SSDH who demonstrated incomplete clinical resoluti on with nonsurgical management, despite continued anticoagulation trea tment. We provide the most complete demonstration of the magnetic reso nance imaging (MRI) characteristics of a large SSDH from its initiatio n to its radiological resolution. CLINICAL PRESENTATION: A 61-year-old woman developed a large SSDH as a complication of a lumbar puncture. Her only neurological deficit was urinary retention, INTERVENTION: Bec ause of the extensiveness of the hematoma and the relative neurologica l preservation of the patient, she was treated conservatively. Serial MRI scans were obtained at 4, 7, 13, and 25 days. The evolution of deo xyhemoglobin in the hematoma to methemoglobin was observed. By 25 days , MRI scans showed virtual resolution, CONCLUSION: SSDHs undergo MRI s ignal changes that are similar to those of brain hematomas. In certain cases, even large SSDHs demonstrate swift and dramatic spontaneous re solution, despite continued anticoagulation treatment. This report sug gests that there is a role for conservative management for selected ca ses of SSDHs.