Acute spinal subdural hematoma: MR and CT findings with pathologic correlates

M. J.D. Post, J. L. Becerra, P. W. Madsen, W. Puckett, R. M. Quencer, R. P. Bunge, E. M.L. Sklar

Research output: Contribution to journalArticlepeer-review

90 Scopus citations


PURPOSE: To determine the MR and CT findings that characterize acute spinal subdural hematoma (ASSH). METHODS: The MR, CT, and clinical findings in three patients with surgically proved ASSH were reviewed and also correlated with the postmortem MR, CT, and cryomicrotome findings in three other patients, two with ASSH and one with an acute spinal epidural hematoma. RESULTS: Imaging findings in ASSH included: (a) hyperdense lesions on plain CT within the dural sac, distinct from the adjacent low-density epidural fat and silhouetted against the lower-density spinal cord and cauda equina, which it compressed; (b) lack of direct continuity with the adjacent osseous structures; (c) clumping, loculation, and streaking of blood within the dural sac on both MR and CT; and (d) on inhomogeneous and variable signal intensity to the ASSH on all MR pulse sequences, but, nevertheless, a striking low signal intensity on T2-weighted spin-echo or T2-weighted gradient-echo to a major part of the ASSH because of deoxyhemoglobin. Plain CT was most helpful in compartmentalizing the hematoma. CONCLUSION: When MR and plain CT are obtained as complementary studies, they provide characteristic findings that allow the prompt diagnosis of ASSH.

Original languageEnglish (US)
Pages (from-to)1895-1905
Number of pages11
JournalAmerican Journal of Neuroradiology
Issue number10
StatePublished - 1994

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology


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