In a series of 15 patients who underwent early and follow up magnetic resonance imaging following spinal cord injury, those with focal spinal cord abnormalities such as cord contusion or haematoma had worse neurological outcomes, and most developed spinal cord cysts, showing as well-defined areas of CSF intensity within the cord on T1 weighted images. Patients with cord oedema initially, had better outcomes, with the development of residual areas of myelomalacia. These observations suggest that patients with focal initial spinal cord abnormalities may have an increased risk of developing posttraumatic spinal cord cysts, which may be associated with the development of delayed neurological deterioration.