Contrast enhancement of acute spinal epidural hematoma and its potential of mimicking a tumor: Case report and review of literature

Spinal epidural hematoma is a lesion capable of producing sudden spinal cord and/or cauda equina compression. Magnetic resonance imaging provides characteristic findings that allow a prompt diagnosis of acute epidural hematomas. Contrast enhancement of hematoma on MRI and CT indicates active hematoma. We report a 24-year-old man with traumatic fractures of the L2 and L3 vertebrae with an epidural lesion that showed homogenous enhancement at the L2 level. The spinal epidural hematoma can show various enhancement patterns in the acute stage and may be confused with neoplastic processes. Our case was the first one that shows homogenous type of enhancement. Although our patient had no progressive neurological deficit, rapid increase of contrast enhancement of lesion in follow up CT examination should alert us the possibility of active hematoma to prevent delay in diagnosis and operation.