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DOI:10.2214/AJR.07.2557
AJR 2007; 189:W118
© American Roentgen Ray Society

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Lisa H. Lowe1, Andrew J. Johanek2 and Charlotte W. Moore3

1 Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City, Kansas City, MO
2 St. Luke's Hospital, University of Missouri-Kansas City, Kansas City, MO
3 Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City, Kansas City, MO



 
WEB—This is a Web exclusive article.

We appreciate the opportunity to respond to the letter to the editor, "Spinal Subdural Hematoma Does Not Displace Dura from Bone" [1] regarding our pictorial essay recently published in the AJR [2]. The author of the letter explains that although he agrees that Figure 7 does show a subdural hematoma (uniform, hyperechoic, and circumferential blood in the potential space between the arachnoid and dura), the description in the text describing "displacement of dura from bone" is inaccurate. The author of the letter suggests that the echogenic line labeled dura is likely thickened arachnoid rather than dura.

We appreciate the comments made in the letter and concur with the author's statements and definitions. Specifically, we agree that the epidural space is located between the bone and the dura, compared with the subdural space, which is a potential space between the dura and arachnoid. We also agree that both epidural and subdural hematomas may occur as a result of spinal lumbar puncture. In conclusion, we agree that the legend to Figure 7 would have been more accurate if we had stated that there was separation of the arachnoid from the dura rather than dura from bone. Also, the echogenic line would have been better labeled as thickened arachnoid than as dura.


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  1. Berkowitz F. Spinal subdural hematoma does not displace dura from bone (letter). AJR 2007;189 : W117[Free Full Text]
  2. Lowe LH, Johanek AJ, Moore CW. Sonography of the neonatal spine: part 2, spinal disorders. AJR 2007;188 : 739-744[Abstract/Free Full Text]

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