Composed sagittal T2-weighted, T1-weighted, and post-contrast T1-weighted images are presented. Each image is an automatically generated composition of two high-resolution independent cervicothoracic and thoracolumbar image acquisitions. The patient was on aspirin and Plavix, and presented with urinary retention and poor anal sphincter tone, consistent with a lesion compressing the conus medullaris. A predominantly deoxyhemoglobin epidural hemorrhage is noted posteriorly, with low signal intensity on the T2-weighted image, compressing the conus at the T12 level.

Part of the on-line supplement to Neuroradiology – The Essentials with MR and CT (© 2015)