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A 47 year-old man underwent routine lumbar laminectomy for a herniated disk. Following the surgery, he developed progressive weakness and then frank paraplegia and urinary incontinence. On examination, he had a sensory level at L1 and no reflexes in the legs.
Sagittal MRI of the Thoracic Spine (Left - T1 weighted, Right - T2 weighted). Note the large lesion extradural lesion which is compressing the thecal sac from L2 through S1. It is iso-intense on T1 and slightly bright on T2. This is an acute epidural hematoma. Subsequently, the patient underwent emergency decompressive surgery
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