Fact-sheet: Epidural hematoma of spine
Updated on 09/30/2019 at 6:19 PM
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Definition
Intraspinal hematoma developing within the epidural space
Rare condition
May be spontaneous or traumatic
Clinical features
Asymptomatic
Rapidly progressive neurological deficit
CT
Spontaneously hyperdense epidural collection displacing the dural sac
Effacement of the epidural fat
MRI will better visualize it and better assess the spinal cord impact
MRI
Collection in
- Isointense (acute) or T1 hyperintense (subacute) in the epidural space (between the bony walls and the dura mater)
- Heterogeneous T2 hyperintensity
- T2 gradient echo hypointensity
- No enhancement after injection
Displacement of the perimedullary fluid spaces
Adjacent spinal cord T2 hyperintensity if associated cord injury
Management
Emergency decompressive surgery if neurological deficit (laminectomy and evacuation of the hematoma)