Spinal epidural fluid collection on MRI after a lumbar puncture mimicking a hematoma on ultrasonography

Abstract

Differentiating a spinal epidural fluid collection from a spinal epidural hematoma following a lumbar puncture is difficult due to the similarity of their physical findings. However, the respective neurological prognosis and therapeutic strategy differ. Herein we presented the case of a 2-year-old male patient with a spinal epidural fluid collection following a lumbar puncture. Ultrasonography showed a highly echoic area in his spinal canal suggesting a spinal hematoma. Magnetic resonance imaging revealed areas of iso-signal intensity surrounding the thecal sac, abnormal narrowing of the subarachnoid space in the cauda equina, and a heterogeneous signal in the epidural fat. Based on these findings, spinal epidural fluid collection was diagnosed. Appropriate use of ultrasonography and MR imaging can facilitate the diagnosis of spinal epidural fluid collection.