Spinal subdural hematoma

Case contributed by Abenezer Zinaye
Diagnosis almost certain

Presentation

Known hemophilic patient, back pain and difficulty walking.

Patient Data

Age: 8 years
Gender: Male
ct

Axial, non-contrast thoracolumbar CT demonstrates a high density circumferential collection within the dural sac spanning the entire visualized thoracolumbar segments. The collection doesn't displace the epidural fat or abut the bone. It is bounded by three septa-like structures (lateral denticulate ligaments and the dorsal septum) giving the characteristic inverted Mercedes-Benz sign, more apparent in the lumbar region.

Case Discussion

The mentioned findings in a hemophilic patient are consistent with a spinal subdural hematoma.

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