Teaching NeuroImages: Posttraumatic lumbar epidural hematoma.

Teaching NeuroImages: Spontaneous spinal epidural hematoma with spot sign positivity.

Teaching NeuroImages: multiple epidural abscesses after acupuncture.

An 80-year-old woman presented with 2 days of progressive quadriparesis, difficulty voiding, and fever. She had received acupuncture in the cervical and lumbar regions for 5 days beginning a week before. Whole-spine MRI showedmultiple epidural abscesses at levels C3-C7, L3-L5, and L5-S1 (figure). Broad-spectrum antibiotics were administered, and the abscesses were surgically drained. Strains of...

Teaching NeuroImages: Idiopathic hypertrophic spinal pachymeningitis mimicking epidural lymphoma.

A 41-year-old man presented with bilateral leg numbness and paraparesis for 3 months. MRI showed a circumferential long epidural mass extending from T2 to T4 level (figure 1). Histologic examination demonstrated dense fibrous tissue with inflammatory infiltrate (figure 2). By exclusion of trauma, infectious diseases, and autoimmune diseases, idiopathic hypertrophic spinal pachymeningitis (IHSP)...

Teaching neuroimages: a dangerous complication of spontaneous intracranial hypotension.

A 43-year-old man presented with a nontraumatic orthostatic headache, spatial disorientation, and visual hallucinations ("colored flames"). General and neurologic examination were normal. Turbo spin echo T2-weighted MRI showed bilateral subdural fluid collection and venous sinus engorgement (figure, A), suggesting spontaneous intracranial hypotension (SIH). Two subdural hematomas were also foun...

Acute posttraumatic paraplegia caused by epidural hematoma at the vertex.

Vertex epidural hematomas (VEDHs) are well known but uncommon. Their clinical presentation may be misleading and missed by routine CT axial scanning; thus, diagnosis may be delayed, with possibly fatal consequences. We report a case of acute posttraumatic paraplegia caused by a VEDH, which was evident at CT and for which the patient underwent successful surgery.