Cause:

1. Trauma (71%)
   1. vertebral fracture / dislocation
   2. traumatic lumbar puncture
   3. spine surgery (0.1–3%)
2. Hypertension
3. Pregnancy
4. AVM
5. Vertebral hemangioma
6. Bleeding diathesis / anticoagulation / hemophilia
7. Idiopathic (45%)

Pathophysiology: tearing of epidural veins

Mean age: 41–52 years

• acute radicular pain; rapid onset of paraplegia

Location: cervical >thoracic >lumbar spine

Site: anterior / posterior to cord

• spinal cord compression
• high attenuation lesion on CT

MR:

• iso- / hyperintense on T1WI + hyperintense on T2WI compared to spinal cord (intensities quite variable)
• strikingly low SI on gradient-echo sequences ← deoxyhemoglobin

Rx: conservative management