To review the CT and MRI findings of acquired epidural spinal lesions with illustrative cases. To give some clues to aim the correct diagnosis and diagnostic pitfalls . To perform a differential diagnosis combining imaging as well as the patients’ medical history and clinical evaluation.
The spinal dural sleeve is a thick,
vascularized connective tissue layer that extends from the foramen magnum,
to the filum terminale and continues along the filum to the coccyx. The rostrally fusion of spinal and periosteal layers of dura mater at foramen magnum prevents its’ intracranial extension . Laterally the dura continues outward around the nerve roots as the dural root sleeves . The epidural or extradural spinal space ,
which is space between the dura mater and the bony...
Findings and procedure details
INTRINSIC GROUP Traumatic: Hemorrhage Spinal epidural hematoma is an infrequent but very serious cause of acute neurologic deficit due to spinal cord compression that needs an early diagnosis and rapid surgical treatment .
Most cases are “spontaneous.” .
Traumatic situations occurs between 0.5% to 1.7% of all spinal injuries .
Besides trauma other non-spontaneous causes include coagulopathy,
and arteriovenous fistula or malformation .
Many of these lesions present with insidious neurological deterioration suggesting spinal cord compression. Patients often go to the emergency room where Spinal CT – in most cases being the first imaging method – may show intra spinal canal lesions or bone remodeling/destruction. MRI imaging is the gold standard method to correctly evaluate the lesions true extension,
as well as its signal intensity features and mass effect over the spinal canal. A systematic approach combined with relevant...
et al. Imaging the Spine - 1 st Edition .
ISBN: 978-1-4377-1551-4. Bromage PR.
In: Bromage PR,
editor. Epidural Analgesia .
Philadelphia: WB Saunders; 1978.
8–20. Gala FB,
Aswani Y. Imaging in spinal posterior epidural space lesions: A pictorial essay .
Indian J Radiol Imaging.
2016;26(3):299-315 . Chhabra A,et al. Spinal epidural space: Anatomy,
normal variations and pathological lesions on MR Imaging .
Volume 2005 (Issue 1:26):1–13....