PMC6499461_01
Preoperative noncontrast spine CT (a and b) scan showing nonhomogenous hyperdense lesion extending from T2 to T6 levels (a; solid arrows) on the left side of the spinal canal (b; asterix), and MRI (c-e) showing hyperintense lesion (solid arrow) on T2-weighted sagittal (a) and axial (b) images and hypointense lesion on T1-weighted (c) images from extending T3 to T6 levels
SNI-10-28-g001.jpg
PMC6499461_01_SNI-10-28-g001.jpg
F1
T2 to T6 levels [Figure 1a and b]. The patient was transferred to the neurosurgery department for further management. T6 levels on the left side of the spinal canal. The lesion was hyperintense on T2-weighted sequences and heterogeneous intensity on T1-weighted sequences, which was suggestive of acute-to-subacute subdural blood clot, with dislocation of the spinal cord by the hematoma and signs of myelopathy [Figure 1c-e]. The patient was administered 2000 International Units of human prothrombin complex concentrate (PCC) for coagulopathy and underwent emergent surgery that was performed 3 days after his initial symptoms and within 24 hours of neurological deterioration.
MRI the next days after the surgery (a-c) showing completely removed hematoma with hyperintense signal (a and b; solid arrow) and nonhomogenous hypointense (a; dashed arrows) suggestive of myelopathy. T2-weighted MRI at 3 months after the surgery (d-f) showing myelopathy extending from T3 to T6 levels (d) on the left side (e) of the spinal cord (solid arrow) with CSF collection on the right side of the dural sac causing medullary dislocation to the left (f)
SNI-10-28-g002.jpg
PMC6499461_01_SNI-10-28-g002.jpg
F2
There was T2-weighted hyperintense signal in the central portion of the spinal cord suggestive of myelopathy and edema extending from T1 to T8 levels, as well as nonhomogenous hypointense areas on T2-weighted sequences extending from T1 to T6 levels [Figure 2a-c]. MRI was suggestive of myelopathy extending from T3 to T6 levels with deviation of the spinal cord to the left [Figure 2d-f].