Hematomyelia is hemorrhage within the gray matter of the spinal cord. An MRI scan should be ordered if hematomyelia is suspected.


Potential causes of hematomyelia:

(1) intraspinal arteriovenous malformation (AVM)

(2) anticoagulation or other coagulopathy

(3) trauma to the spinal cord, including traumatic delivery in a neonate

(4) surgery on the spinal cord

(5) inflammatory myelitis

(6) abscess

(7) spinal cord tumor

(8) syringomyelia


Nontraumatic hematomyelia is more common in the thoracic cord.


Traumatic hematomyelia is more common in the cervical cord.


Clinical and radiological findings may include:

(1) sudden onset of flaccid paralysis

(2) sensory loss consistent with spinal cord injury


Radiological findings:

(1) Routine spinal X-rays and a CT scan may be unremarkable.

(2) T1 and T2 weighted MRI with or without gadolinium scans will show the blood within the cord.


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