Spontaneous lumbar intraspinal hematoma

Case contributed by Dr Andrew Dixon

Presentation

Acute back pain and cauda equina syndrome. No history of trauma.

Patient Data

Age: 70
Gender: Female

Large lentiform shaped posterior intraspinal density extending from T12 to S1. 

Large lentiform shaped posterior intraspinal collection extending from T12 to S1 with intermediate T1 signal, heterogenous high T2 signal with susceptibility artifact on gradient echo sequences consitent with hematoma.  The hematoma is mainly extradual, with some areas of intradural hemorrhage.  At L3 and L4 the hematoma occupies almost the entire spinal canal. 

Case Discussion

CT and MRI reveal a large spontaneous lumbar intraspinal hematoma in patient taking anti-platelet therapy. 

CT shows a large lentiform shaped posterior intraspinal density extending from T12 to S1. This is seen on MRI to be of intermediate T1 signal, heterogenous high T2 signal with susceptibility artifact on gradient echo sequences consitent with hematoma.  The hematoma is mainly extradual, with some areas of intradural hemorrhage.  At L3 and L4 the hematoma occupies almost the entire spinal canal. 

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Case information

rID: 9485
Published: 23rd Apr 2010
Last edited: 7th Nov 2018
Tag: spine
Inclusion in quiz mode: Included

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