Traumatic lumbar disc extrusion mimicking spinal epidural hematoma: Case report and literature review

Background: Because the neurological presentation of spinal epidural hematomas (SEH) is often not specific, they may be misdiagnosed as acute lumbar disk herniations. Here, we present a case in which a traumatic disc extrusion mimicked an epidural hematoma and reviewed the appropriate literature. Case Description: A 27-year-old male sustained a high-energy fall. The lumbar MRI scan showed a L4-S1 ventral medium/high signal intensity mass on the T1- and high signal intensity lesion on T2-weighted images; the original diagnosis was spinal epidural hematoma. However, at surgery, consisting of a left L4 and L5 hemilaminectomy with L4-L5 and L5-S1 laminotomy, an extruded lumbar disc was encountered at the L4-L5 level and removed; no additional pathology or SEH was found at either level. Conclusion: On MR, SEH may mimic acute lumbar disk herniations. Depending on the clinical symptoms/signs, surgical intervention will both correctly confirm the diagnosis and relieve neural compression.

Download Full-text

The Significance of High Signal Intensity on MRI of Lumbar Disc Herniation.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.40.1459 ◽

1992 ◽

Vol 40 (4) ◽

pp. 1459-1462

Author(s):

Hiroshi Maeda ◽

Hideaki Kira ◽

Hiroshi Fujiki ◽

Katsuya Fujimoto ◽

Isao Shimokawa ◽

...

Keyword(s):

Lumbar Disc Herniation ◽

Disc Herniation ◽

Signal Intensity ◽

Lumbar Disc ◽

High Signal Intensity ◽

High Signal

Download Full-text

Recovery of increased signal intensity of the cervical cord on magnetic resonance imaging after surgery for spontaneous spinal epidural hematoma causing hemiparesis

Neurology India ◽

10.4103/0028-3886.39332 ◽

2008 ◽

Vol 56 (1) ◽

pp. 98 ◽

Cited By ~ 4

Author(s):

Eiichi Ishikawa ◽

Atsushi Saito ◽

Yuji Kujiraoka ◽

Akira Matsumura

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Signal Intensity ◽

Epidural Hematoma ◽

Spinal Epidural Hematoma ◽

Cervical Cord ◽

Resonance Imaging ◽

Spontaneous Spinal Epidural Hematoma ◽

Spinal Epidural

Download Full-text

Unique case of successful surgical treatment of recurrent spinal epidural hematoma after lumbar disc surgery in a Glanzmann thrombasthenia patient

British Journal of Neurosurgery ◽

10.1080/02688697.2019.1678736 ◽

2019 ◽

pp. 1-3

Author(s):

Mohammed M. Al Barbarawi ◽

Mohammed Z. Allouh ◽

Ziad A. Audat ◽

Abdelwahab J. Aleshawi ◽

Osama M. Al-Shari

Keyword(s):

Surgical Treatment ◽

Epidural Hematoma ◽

Lumbar Disc ◽

Lumbar Disc Surgery ◽

Spinal Epidural Hematoma ◽

Unique Case ◽

Glanzmann Thrombasthenia ◽

Disc Surgery ◽

Spinal Epidural

Download Full-text

Nightmare after iliac vein stenting: Spinal epidural hematoma

Clinical Case Reports ◽

10.1002/ccr3.4522 ◽

2021 ◽

Vol 9 (7) ◽

Author(s):

Yaser Jenab ◽

Mohammad E. Barbati ◽

Ali Ajam ◽

Saeed Tofighi ◽

Kaveh Hosseini ◽

...

Keyword(s):

Epidural Hematoma ◽

Iliac Vein ◽

Spinal Epidural Hematoma ◽

Spinal Epidural

Download Full-text

The joint involvement in adult onset Still's disease is characterised by a peculiar magnetic resonance imaging and a specific transcriptomic profile

Scientific Reports ◽

10.1038/s41598-021-91613-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Piero Ruscitti ◽

Antonio Barile ◽

Onorina Berardicurti ◽

Sonia Iafrate ◽

Paola Di Benedetto ◽

...

Keyword(s):

Signal Intensity ◽

Clinical Characteristics ◽

High Signal Intensity ◽

Adult Onset Still’S Disease ◽

Joint Involvement ◽

High Signal ◽

Bone Erosions ◽

Transcriptomic Profile ◽

Synovial Tissues ◽

Bone Oedema

AbstractAdult onset Still's disease (AOSD) is a rare systemic autoinflammatory disease, characterised by fever, arthritis, and skin rash, and joint involvement is one of its clinical manifestations. The aims of this work were to assess joint involvement, to describe main patterns of involvement, and associated clinical characteristics. In this work, we aimed at assessing the joint involvement in AOSD by using MRI, to describe main patterns and associated clinical characteristics. In addition, we aimed at assessing the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved. We also evaluated the global transcriptomic profile of synovial tissues to elucidate possible pathogenic pathways involved in the disease. Thus, AOSD patients, who underwent to MRI exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone oedema and MRI-bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. Patients with MRI-bone erosions showed a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate, and ferritin. In AOSD synovial tissues, a hyper-expression of interleukin (IL)-1, IL-6, and TNF pathways was shown together with ferritin genes. In conclusion, in AOSD patients, the most common MRI-finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. MRI-bone erosions and bone oedema were also observed. In AOSD synovial tissues, IL-1, IL-6, and TNF pathways together with ferritin genes resulted to be hyper-expressed.

Download Full-text