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Updated: Aug 14, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
MRI of acute spinal epidural hematomas
E M Sklar1, J M Post, S Falcone
1Department of Radiology, University of Miami School of Medicine, FL 33136, USA.
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.
Insights
Magnetic resonance (MR) imaging reveals characteristic findings for acute spinal epidural hematomas (ASEHs). These findings aid in the prompt diagnosis of ASEHs, which can cause sudden spinal cord compression.
Area of Science:
- Radiology
- Neurology
- Medical Imaging
Background:
- Acute spinal epidural hematomas (ASEHs) are collections of blood in the epidural space of the spinal canal.
- These hematomas can lead to rapid and severe neurological deficits due to spinal cord or cauda equina compression.
Purpose of the Study:
- To identify and characterize the specific magnetic resonance (MR) imaging findings associated with acute spinal epidural hematomas (ASEHs).
Main Methods:
- Retrospective review of MR imaging findings in 17 patients diagnosed with ASEH.
- Analysis included hematoma location (cervical, thoracic, lumbar) and etiology (traumatic vs. spontaneous).
- Correlation with computed tomography (CT) and surgical findings was performed in a subset of cases.
Main Results:
- Characteristic MR findings included variable signal intensity on T1 and T2-weighted images, capping of epidural fat, and direct continuity with adjacent bone.
- Hematomas typically caused compression of epidural fat, the subarachnoid sac, and the spinal cord.
- A posterolateral location within the spinal canal was common.
Conclusions:
- MR imaging demonstrates distinct features that enable the accurate and timely diagnosis of acute spinal epidural hematomas.
- Prompt diagnosis is crucial as ASEHs can cause sudden and potentially irreversible spinal cord or cauda equina compression.
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