Early Diagnosis of Spontaneous Spinal Epidural Hematoma with Echo-Planar Gradient-Echo T2*-Weighted MR Imaging

Koichi Iwatsuki; Toshiki Yoshimine; Yu-Ichiro Ohnishi; Koshi Ninomiya; Toshika Ohkawa; Kousuke Iwaisako

doi:10.4236/nm.2015.61004

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Neuroscience and Medicine > Vol.6 No.1, March 2015

Early Diagnosis of Spontaneous Spinal Epidural Hematoma with Echo-Planar Gradient-Echo T2*-Weighted MR Imaging ()

Koichi Iwatsuki^1*, Toshiki Yoshimine¹, Yu-Ichiro Ohnishi¹, Koshi Ninomiya¹, Toshika Ohkawa¹, Kousuke Iwaisako²

¹Department of Neurosurgery, Osaka University Medical School, Osaka, Japan.
²Department of Neurosurgery, Kyoritu Hospital, Hyogo, Japan.

DOI: 10.4236/nm.2015.61004 PDF HTML XML 2,512 Downloads 2,916 Views

Abstract

Spontaneous spinal epidural hematoma (SSEH) is a rare idiopathic condition that leads to the acute onset of neurological deficits, which can have catastrophic consequences if not recognized early. It is important to make an early precise diagnosis. Spinal epidural hematoma has been increasingly recognized since the advent of magnetic resonance imaging (MRI). However, T1- and T2-weighted gradient-echo sequences are relatively less sensitive to the magnetic susceptibility effects of hemorrhage. Echo-planar gradient-echo T2*-weighted MR imaging (T2* MRI) is sensitive to these magnetic susceptibility effects and is commonly used for the detection of hemorrhage. We reported that the case of a 76-year-old man who presented with tetra paresis had an early diagnosis of spontaneous spinal epidural hematoma early diagnosed by T2* MRI.

Keywords

Spinal Epidural Hematoma, T2* MRI, Diagnosis, Hemorrhage

Share and Cite:

Iwatsuki, K. , Yoshimine, T. , Ohnishi, Y. , Ninomiya, K. , Ohkawa, T. and Iwaisako, K. (2015) Early Diagnosis of Spontaneous Spinal Epidural Hematoma with Echo-Planar Gradient-Echo T2*-Weighted MR Imaging. Neuroscience and Medicine, 6, 20-23. doi: 10.4236/nm.2015.61004.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Jackson, R. (1869) Case of Spinal Apoplexy. The Lancet, 94, 5-6. http://dx.doi.org/10.1016/S0140-6736(02)67624-X
[2]	Bain, W.A. (1897) A Case of Haematorrachis. BMJ, 2, 455. http://dx.doi.org/10.1136/bmj.2.1912.455
[3]	Holtas, S., Heiling, M. and Lonntoft, M. (1996) Spontaneous Spinal Epidural Hematoma: Findings at MR Imaging and Clinical Correlation. Radiology, 199, 409-413. http://dx.doi.org/10.1148/radiology.199.2.8668786
[4]	Foo, D. and Roissier, A.B. (1981) Preoperative Neurological Status in Predicting Surgical Outcome of Spinal Epidural Hematomas. Surgical Neurology, 15, 389-401. http://dx.doi.org/10.1016/0090-3019(81)90178-6
[5]	Awada, A., Russell, N., al Fayez, N., Naufal, R. and al Kohlani, H. (1998) Spontaneous Cervical Epidural Hematoma: Case Report. Spinal Cord, 36, 71-72. http://dx.doi.org/10.1038/sj.sc.3100521
[6]	Liao, C.C., Hsieh, P.C., Lin, T.K., Lin, C.L., Lo, Y.L. and Lee, S.C. (2009) Surgical Treatment of Spontaneous Spinal Epidural Hematoma: A 5-Year Experience. Journal of Neurosurgery: Spine, 11, 480-486. http://dx.doi.org/10.3171/2009.4.SPINE08904
[7]	Jamjoom, Z.A. (1996) Acute Spontaneous Spinal Epidural Hematoma: The Influence of Magnetic Resonance Imaging on Diagnosis and Treatment. Surgical Neurology, 46, 345-349. http://dx.doi.org/10.1016/S0090-3019(96)00149-8
[8]	Avrahami, E., Tadmor, R., Ram, Z., Feibel, M. and Itzhak, Y. (1989) MR Demonstration of Spontaneous Acute Epidural Hematoma of the Thoracic Spine. Neuroradiology, 31, 89-92.
[9]	Offenbacher, H., Fazekas, F., Schmidt, R., Koch, M., Fazekas, G. and Kapeller, P. (1996) MR of Cerebral Abnormalities Concomitant with Primary Intracerebral Hematomas. AJNR—American Journal of Neuroradiology, 17, 573-578.
[10]	Greenberg, S.M., Finklestein, S.P. and Schaefer, P.W. (1996) Petechial Hemorrhages Accompanying Lobar Hemorrhage: Detection by Gradient-Echo MRI. Neurology, 46, 51-54. http://dx.doi.org/10.1212/WNL.46.6.1751
[11]	Fazekas, F., Kleinert, R., Roob, G., Kleinert, G., Kapeller, P., Schmidt, R., et al. (1999) Histopathologic Analysis of Foci of Signal Loss on Gradient-Echo T2*-Weighted MR Images in Patients with Spontaneous Intracerebral Hemorrhage: Evidence of Microangiopathy-Related Microbleeds. AJNR—American Journal of Neuroradiology, 20, 637-642.
[12]	Liang, L., Korogi, Y., Sugahara, T., Shigematsu, Y., Okuda, T., Ikushima, I., et al. (1999) Detection of Intracranial Hemorrhage with Susceptibility-Weighted MR Sequences. AJNR—American Journal of Neuroradiology, 20, 1527-1534.
[13]	Patel, M.R., Edelman, R.R. and Warach, S. (1996) Detection of Hyperacute Primary Intraparenchymal Hemorrhage by Magnetic Resonance Imaging. Stroke, 27, 2321-2324. http://dx.doi.org/10.1161/01.STR.27.12.2321