Spinal epidural hematoma: Relationship between imaging findings and neurological outcomes

Purpose: The purpose of this study was to evaluate the usefulness of CT or MR imaging findings in patients with spinal epidural hematoma (SEH) for predicting neurological outcome. Materials and Methods: MR images of our six patients with SEH were evaluated retrospectively : complete recovery was achieved in two patients; paresis remained in two patients; and paraplegia remained in two patients. The ratio of the maximum anteroposterior diameter of the SEH to that of the spinal canal was calculated in each patient on midline on axial images in our six patients and 23 previously reported patients. Results: Among our six patients, the ratio was less than 60 % in two patients with total recovery, whereas all four patients with remaining motor impairment had ratios of 60% or more. Of 29 cases, 18 of 22 patients without residual motor impairment had ratios of less than 60%, but five of seven patients with residual motor deficits had ratios of 60% or more (p = 0.023). Conclusion: The degree of spinal cord compression by hematoma may be a prognostic factor in SEH.