[Acute epidural hematoma clearly demonstrated by fat suppression MR image]

We report a case of acute cervical epidural hematoma clearly demonstrated by fat suppression MR image. A 64-year-old woman was admitted because of quadriparesis with neck pain, both occurred suddenly. She had been healthy except for mild hypertension. No drug was administrated previously. Neurological examination suggested cervical myelopathy. MRI of the cervical spine was performed fifteen hours after the onset. Although no significant intensity change was observed on T1 or T2 image, fat suppression image clearly demonstrated epidural hematoma at the level of C4 to C5 cervical spine. Her symptoms were disappeared spontaneously within seven days. No vascular abnormality was observed by MR angiography. Although MRI is useful to detect epidural hematoma, signal intensity of the hematoma on T1 and T2 image may be unclear within 24 hours, which was shown in our case. We recommend that fat suppression image is helpful to detect epidural hematoma clearly, especially in acute phase.