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Acute spinal subdural hematoma: MR and CT findings with pathologic correlates
M J Post1, J L Becerra, P W Madsen
1Department of Radiology (Neuroradiology Section), University of Miami School of Medicine/Jackson Memorial Medical Center, Fla.
AJNR. American Journal of Neuroradiology
|November 1, 1994
Summary
Magnetic resonance (MR) and computed tomography (CT) imaging reveal characteristic findings for acute spinal subdural hematoma (ASSH). These complementary studies aid in the prompt diagnosis of ASSH.
Area of Science:
- Radiology
- Neurology
- Neurosurgery
Background:
- Acute spinal subdural hematoma (ASSH) is a rare condition.
- Accurate and timely diagnosis is crucial for effective management.
Purpose of the Study:
- To identify and characterize the specific MR and CT imaging findings of ASSH.
- To differentiate ASSH from other spinal pathologies.
Main Methods:
- Review of MR, CT, and clinical findings in three surgically confirmed ASSH patients.
- Correlation with postmortem MR, CT, and cryomicrotome findings in three additional cases (two ASSH, one epidural hematoma).
Main Results:
- ASSH appears as hyperdense lesions within the dural sac on CT, distinct from epidural fat and compressing neural structures.
- CT demonstrates a lack of continuity with adjacent bone.
- MR and CT show clumping and streaking of blood within the dural sac.
- ASSH exhibits inhomogeneous signal intensity on MR, with a striking low signal on T2-weighted images due to deoxyhemoglobin.
- Plain CT is effective for hematoma compartmentalization.
Conclusions:
- Complementary use of MR and plain CT provides characteristic findings for ASSH diagnosis.
- These imaging modalities enable prompt and accurate identification of acute spinal subdural hematoma.