Monday, May 9, 2011

Spinal Epidural Fluid Collection

Differential considerations for an epidural fluid collection in the spine:
  • Arachnoid cyst (shown above): Nonenhancing loculated collection that follows cerebrospinal fluid signal. Can be intradural or extradural.
  • Facet synovial cyst: Associated with facet arthropathy and located along the posterolateral aspect of spinal canal adjacent to the facet joint.
  • Pseudomeningocele: Look for evidence of prior trauma (e.g., surgery).
  • Abscess:
  • Epidural hematoma: Look for blooming on T2* images.
  • Idiopathic spinal cord herniation: Herniation of the cord through a ventral dural defect. Ventral deviation of the cord can mimic a posterior epidural collection. May be associated with an arachnoid cyst due to adhesions.

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