Case 98 Lumbar Epidural Hematoma

Fig. 98.1 (A) Magnetic resonance imaging of lumbar spine with sagittal T2-weighted image, (B) axial T2-weighted image through the L2 vertebral body and (C) axial T2-weighted image through L3 vertebral body.
Clinical Presentation
- An 86-year-old woman presents with a longstanding history of lower back pain, exacerbated over the past 12 days.
- This is associated with a 12-day history of left leg pain in a radicular pattern, mainly affecting the left thigh area and radiating down to the foot.
- On examination, she has diffuse weakness in the left leg (about 4/5 motor strength throughout all muscle groups as determined by the Medical Research Council scoring system) and some sensory loss in the L2–L3 distribution. She is unable to ambulate because of the pain.
- She does have a medical history of hypertension, diabetes, and stroke. She is currently medicated with aspirin, oral hypoglycemics, and antihypertensives.
Questions

Fig. 98.2 (A) Magnetic resonance imaging of lumbar spine with sagittal T2-weighted image, (B) sagittal T1-weighted image with gadolinium contrast infusion (T1W+C), (C) axial T2-weighted image through lower L3 vertebral body, and (D) axial T1W+C image through lower L3 vertebral body.
Answers
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