PMC9371806_01
MRI T2-weighted sagittal planes (a, b) of the cervical, thoracic, and lumbar vertebral column showing an extensive heterogeneous intramedullary lesion (arrows) and the presence of a hypointense dorsal rim suggesting subdural haematoma (small arrows on (b)). On the transverse planes at the level of C2 (c) and L5 (d), there are similar isointense lesions surrounded by a hyperintense rim (arrows). These signal patterns are consistent with a haematomyelia changing from early subacute to late subacute with intra- and extracellular methemoglobin.
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fig1
Intraparenchymal heterogeneous spinal cord lesions were found along the entire spinal cord from first cervical segments to the conus medullaris (Figures 1(a)-1(d)).
MRI transverse planes at T8 level (a, b). The images show an intramedullary lesion which is hyper- to isointense with and hypointense rim on T1-weighted images (a) and hypointense with a hyperintense rim on T2-weighted images (b). This pattern is suggestive of early subacute haematoma surrounded by fluid. At T12 level (c, d), the images show an intramedullary lesion which is mildly hyperintense on T1-weighted images (c) and hyperintense on T2 (d). These findings are suggestive of late subacute haematoma.
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fig2
The lesions were mainly isointense or slightly hyperintense compared to normal gray matter in T1-weighted images (Figures 2(a)-2(c)), hyperintense in T2-weighted images (Figures 2(b) and 2(d)), and hypointense (signal void) in T2*-weighted images (Figure 3(a)) consistent with early to late subacute haemorrhages.
MRI gradient eco transverse planes at T9 level show an intramedullary round focal signal void in the dorsal funiculus (arrow in (a)) characteristic of haemorrhage and a dorsolateral hypointense rim at T12 level (arrows in (b)) compatible with subdural haematoma, with hemosiderin creating the magnetic susceptibility variation depicted on this sequence.
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fig3
The lesions were mainly isointense or slightly hyperintense compared to normal gray matter in T1-weighted images (Figures 2(a)-2(c)), hyperintense in T2-weighted images (Figures 2(b) and 2(d)), and hypointense (signal void) in T2*-weighted images (Figure 3(a)) consistent with early to late subacute haemorrhages.