Answer:
Spontaneous Spinal Epidural Haematoma
Findings
MRI Well defined, biconvex, longitudinally oriented lesion in the epidural space D4 to D7 level with Cord edema Located posteriorly on right pushing the spinal cord anteriorly and to left, compressing it. Tapering uperior & inferior borders T1 hyperintense, T2 hypointense, STIR hypointense Blooming on Gradient Contrast study not performed due to pregnancy
MANAGEMENT Patient was managed LSCS and delivery, Laminectomy and decompression Per op –Evacuation of blood clot about 10g HPE: Chronic non specific inflammation
Discussion
Spinal epidural hematoma rare cause of spinal cord compression Rare spinal emergency Less than 1% of spinal space-occupying lesions Diagnosis to be made early to enable full recovery MRI important diagnostic role Surgery to be performed as rapidly as possible Interval between onset of symptoms and surgery & pre-operative clinical status determine the clinical outcome.
Contributed By: Dr. Shankaranandh PG-Y3, Barnard Institute of Radiology
Spontaneous Spinal Epidural Haematoma
Findings
MRI Well defined, biconvex, longitudinally oriented lesion in the epidural space D4 to D7 level with Cord edema Located posteriorly on right pushing the spinal cord anteriorly and to left, compressing it. Tapering uperior & inferior borders T1 hyperintense, T2 hypointense, STIR hypointense Blooming on Gradient Contrast study not performed due to pregnancy
MANAGEMENT Patient was managed LSCS and delivery, Laminectomy and decompression Per op –Evacuation of blood clot about 10g HPE: Chronic non specific inflammation
Discussion
Spinal epidural hematoma rare cause of spinal cord compression Rare spinal emergency Less than 1% of spinal space-occupying lesions Diagnosis to be made early to enable full recovery MRI important diagnostic role Surgery to be performed as rapidly as possible Interval between onset of symptoms and surgery & pre-operative clinical status determine the clinical outcome.
Contributed By: Dr. Shankaranandh PG-Y3, Barnard Institute of Radiology