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Epidural hematoma - thoracic spine

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

This elderly patient woke from a laparotomy (for resection of a colonic malignancy) paraplegic.

Patient Data

Age: 70 years
Gender: Female

Chest

ct

CT chest demonstrates a hyperdense extradural collection within the spinal canal. Left sided pleural catheter and bilateral pleural collections are present. 

Thoracic spine

mri

MRI demonstrates a large extradural collection which has intermediate signal on T1 weighted images, with some regions of intrinsic higher signal, heterogeneous T2 signal with fluid-fluid levels and peripheral signal drop out, best seen on STIR. Features are consistent with a spinal epidural hematoma.  

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