PMC9282782_01
Pre-operative sagittal T2-weighted MRI of the spine. (a) Cervicothoracic image demonstrating SIEH at T1/2. (b) Enlarged field of view (as indicated by the white arrow) over the region of hemorrhage in (a) with dimensions, demonstrating displacement of the cord anteriorly. Note the areas of cord signal change superiorly and inferiorly, indicated by yellow arrows in both (a) and (b). (d) Thoracolumbar image demonstrating SIEH anteriorly at T9/10 and posteriorly at T10/11. (c) Enlarged field of view (as indicated by the white arrow) over the region of hemorrhage in (d) with dimensions. In all panels, the vertebral levels are labeled. Abbreviations: MRI, magnetic resonance imaging; SIEH, spontaneous intradural extramedullary hemorrhage.
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F1
Our patient's pre-operative radiology is depicted in Figure 1.
Axial MRI of the foramen magnum showing dependent blood products. (a) T1-weighted imaging. (b) T2-weighted imaging. (c) T2-FLAIR sequenced imaging. The yellow arrows indicate the blood products lying in the spinal canal. This was thought to have migrated from another site of bleeding, during our patient's period of recumbency. MRI: Magnetic resonance imaging, T2-FLAIR: T2-weighted fluid-attenuated inversion recovery.
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F2
This radiology is depicted in Figure 2.
Post-operative sagittal T2-weighted MRI of the spine. (a): Cervicothoracic image showing the decompressed spinal cord at T1/2. (b) Thoracolumbar image showing the decompressed spinal cord from T9-11. In both (a) and (b), note the areas of persistent cord signal change, indicated by the yellow arrows. In both panels, the vertebral levels are labeled. MRI: Magnetic resonance imaging.
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F3
His post-operative radiology is depicted in Figure 3.