Central gadolinium enhancement of an acute spontaneous spinal epidural haematoma

Chen, C. J.; Ro, Long‐Sun

doi:10.1007/bf02278136

Cited by 17 publications

(11 citation statements)

References 24 publications

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“…These show mainly peripheral enhancement, however, mixed central and peripheral enhancement and internal septations may be seen. Central enhancement is rare though reported in few cases of spontaneous spinal epidural hematoma,[ 56 ] other differentials of tumor, aneurysm, and vascular malformations should be considered. Variable degrees of cord compression may be observed which dictates further management of these patients—urgent decompressive surgery or conservation and observation.…”

Section: Pathologies Affecting Posterior Spinal Epidural Spacementioning

confidence: 99%

Imaging in spinal posterior epidural space lesions: A pictorial essay

Gala

Aswani

2016

Indian Journal of Radiology and Imaging

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Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed. Various pathologies affecting the posterior epidural space either arising from the space itself or occurring secondary to vertebral/intervertebral disc pathologies. Primary spinal bone tumors affecting the posterior epidural space have been excluded. The etiological spectrum affecting the posterior epidural space ranges from degenerative, infective, neoplastic - benign or malignant to miscellaneous pathologies. MRI is the modality of choice in evaluation of these lesions with CT scan mainly helpful in detecting calcification. Due to its excellent soft tissue contrast, Magnetic Resonance Imaging is extremely useful in assessing the pathologies of posterior epidural space, to know their entire extent, characterize them and along with clinical history and laboratory data, arrive at a specific diagnosis and guide the referring clinician. It is important to diagnose these lesions early so as to prevent permanent neurological complication.

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Section: Pathologies Affecting Posterior Spinal Epidural Spacementioning

confidence: 99%

Imaging in spinal posterior epidural space lesions: A pictorial essay

Gala

Aswani

2016

Indian Journal of Radiology and Imaging

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“…(4,5) Reported predisposing factors include coagulopathy, anticoagulation, vascular anomaly, disc herniation, Paget's disease, Valsalva manoeuvre, hypertension and neoplasms. (1,5) While SSEH is regarded as a rare entity, its diagnosis is now more frequent than before, owing to the increased availability and use of MR imaging. MR imaging is now the investigation of choice for the detection and diagnosis of SSEH.…”

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (150)

Mahmud

Singh

Wong

et al. 2013

smedj

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A 19-year-old Chinese man presented to the emergency department with pain in the lower back, which started soon after he had carried some heavy boxes. He denied any fall or trauma preceding the pain. There was no sciatica or neurological deficit on examination. He maintained a normal gait and anal tone. The lumbar spine radiographs were normal. Magnetic resonance (MR) imaging was requested in order to evaluate his persistent back pain. What do the MR images show? What is the diagnosis? Clinics in diagnostic imaging (150)Nor DIAGNOSISAcute spontaneous spinal epidural haematoma. CLIN ICA L COU RS EThe patient was admitted under the care of a spinal surgeon. Those older than 40 years of age show two peak locations, namely the cervicothoracic and thoracolumbar junctions. M e d ic a l E d u c atio n 668 668The presence of the posterior epidural venous plexus supports the commonly accepted theory of a venous cause to the haematoma, where the valveless venous plexus permits a reversal in blood flow when pressure is increased during injury or activity. On sagittal MR images, SSEH is seen as a biconvex-shaped mass separated from the underlying neural structures by a curvilinear low-signal-intensity structure -the dura mater

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“…Contrast enhancement of chronic spinal epidural hematomas has been described in the literature as either being peripheral [6,7] or central [8,9]. While contrast enhancement in the acute setting is often focal and only rarely homogeneous (most likely representing active extrav- asation), homogeneous contrast enhancement of a chronic spinal epidural hematoma has not been described in the literature before.…”

Section: Discussionmentioning

confidence: 99%