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Case #23

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Demographics: 57 years old, Male
Indication: Trauma, no fracture on CT

Findings

  • T2/STIR signal hyperintensity in the interspinous interval at C1-C2 extending into the supraspinous ligament
  • T2/STIR signal hyperintensity in the facet joints on the right from C2-C3 through C6-C7
  • T1 isointense, T2/STIR hyperintense ventral epidural collection spanning C1-T1, measuring up to 5 mm in thickness, which effaces the ventral CSF and contributes to multilevel spinal canal stenosis, moderate in severity at C3-C4
  • Associated uplifting of the dura
  • No definite discontinuity of the posterior longitudinal ligament
  • Normal marrow signal and vertebral body alignment
  • Normal cord signal
  • Multilevel facet hypertrophy and uncovertebral spurring contribute to moderate neural foraminal stenosis on the left at C3-C4 and mild neural foraminal stenosis on the right at C3-C4 and on the left at C4-C5

Diagnosis

Epidural hematoma, ligamentous injury

Sample Report

Ventral epidural hematoma spanning C1-T1 measuring up to 5 mm in thickness, which effaces the ventral CSF and contributes to multilevel spinal canal stenosis, moderate in severity at C3-C4.

Findings concerning for ligamentous injury involving the interspinous and supraspinous ligaments at C1-C2 and C2-C3. No marrow edema to suggest an acute fracture that was occult on the preceding CT.

Normal cord signal.

Discussion

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