Hyperacute spinal subdural haematoma: MRI features in two cases

Spinal subdural haematoma is a rare condition seldom diagnosed in the hyperacute phase. We describe the MRI features of two patients with a hyperacute spinal subdural haematoma and their clinical evolution. On MRI hyperacute spinal subdural haematomas were isointense on T1-weighted sequences and showed high signal intensity on T2-weighted sequences. One patient underwent emergency surgery due to severe symptoms; the other patient had a favourable evolution so conservative treatment was chosen. MRI was used to monitor the evolution of the spinal subdural haematoma. In conclusion, MRI is the best imaging modality to evaluate a spinal subdural haematoma, however, diagnosis in the hyperacute phase is difficult due to the lesion's imaging characteristics.