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Spinal Epidural Hematoma

A 47 year-old man underwent routine lumbar laminectomy for a herniated disk. Following the surgery, he developed progressive leg weakness and then paraplegia and urinary incontinence. On examination, he had a sensory level at L1, paraplegia, and no reflexes in the legs.

Outline the Hematoma                                                  Show the Compressed Cauda Equina

Spinal Epidural Hematoma: MRI of the Thoracic Spine; (Left) T1-weighted; (Right) T2-weighted. Note the large extradural lesion which compresses the thecal sac from L2 through S1. It is isointense on the T1-weighted scan and slightly bright on the T2-weighted scan. This is a an acute epidural hematoma. The patient subsequently underwent emergency decompressive surgery.

Revised 11/22/06
Copyrighted 2006. David C Preston