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Epidural Abscess

Alain Cunqueiro, Meir H Scheinfeld
Intracranial gas is commonly detected on neuroimaging. The recognition of this finding can at first blush be unsettling. Being able to localize this gas to a specific compartment: intraarterial, intravenous, intraparenchymal, subdural, epidural, subarachnoid and intraventricular, is the first step in determining the importance of the gas. Determination of the route of entry: through the skull, extension from a paranasal sinus or the mastoid air cells, via the spine, or trans-vascular, is the other important factor in determining potential consequences...
March 15, 2018: Emergency Radiology
Witold Szyfter, Anna Bartochowska, Łukasz Borucki, Adrian Maciejewski, Aleksandra Kruk-Zagajewska
PURPOSE: The objective of this study was to analyse 51 patients with intracranial complications of sinusitis treated in the Department of Otolaryngology and Laryngeal Oncology at Poznań University of Medical Sciences from 1964 to 2016. MATERIALS AND METHODS: Males made up a significant portion of study participants at 70.5%. Treatment included simultaneous removal of inflammatory focal points in the paranasal sinuses and drainage of cerebral and epidural abscesses and subdural empyemas under the control of neuronavigation preceded by the implementation of broad-spectrum antibiotics continuously for 4 weeks...
March 13, 2018: European Archives of Oto-rhino-laryngology
Costansia Bureta, Hiroyuki Tominaga, Takuya Yamamoto, Takao Setoguchi, Hideki Kawamura, Satoshi Nagano, Ichiro Kawamura, Masahiko Abematsu, Hironori Kakoi, Yasuhiro Ishidou, Setsuro Komiya
BACKGROUND: Here we report a rare case of lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae, which had spread to the iliopsoas muscles, leading to urine retention. CASE PRESENTATION: A 68-year-old woman with low back pain experienced a sudden onset of bilateral lower limb weakness, it was followed 14 days later by urine retention. At consultation, magnetic resonance imaging and identification of serum β-hemolytic streptococci provided a diagnosis of Streptococcus agalactiae infection...
March 13, 2018: BMC Surgery
Faris Shweikeh, Stephanie Zyck, Fadi Sweiss, Ajleeta Sangtani, Mohammed Shweikeh, Husam Issa, Michael P Steinmetz, Georges Z Markarian
Study design: In this review, we present a case of Aspergillus spinal epidural abscess (ASEA) and review the literature. Objectives: To provide further insight on a rare condition. Setting: A description of a patient with ASEA in a 58-year-old woman that was successfully treated with conservative management is presented. Methods: Following case presentation, a literature search (MedLine and PubMed) and assessment of epidemiology, presentation, diagnosis, treatments, and outcomes is performed...
2018: Spinal Cord Series and Cases
Ghazwan Abdulla Hasan, Saif Mohammed Kani, Ahmed Alqatub
INTRODUCTION: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2-L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence...
2018: SICOT-J
Brian Wetherington, Talal W Khan
BACKGROUND: Spinal cord stimulation (SCS) can be beneficial for low back and radicular pain. A short trial of SCS evaluates the potential effectiveness of this therapy for a specific patient, while also decreasing the likelihood of a failed permanent implant. While rare, an epidural abscess is difficult to diagnose based on its nonspecific and unreliable clinical presentation. CASE: We present a case of an acute onset methicillin-sensitive Staphylococcus aureus epidural abscess 72-96 hours into a trial of a percutaneous spinal cord stimulator...
March 8, 2018: Pain Practice: the Official Journal of World Institute of Pain
Y Sasabuchi, H Yasunaga, H Matsui, A K Lefor, K Fushimi, M Sanui
BACKGROUNDS AND AIMS: Epidural analgesia is an option for pain control in patients with acute pancreatitis. The aim of this study is to describe characteristics, morbidity and mortality of patients with acute pancreatitis treated with epidural analgesia. PATIENTS AND METHODS: n on patients hospitalized with acute pancreatitis between July 2010 and March 2013. A total of 44,146 patients discharged from acute care hospitals were included in this retrospective cohort study...
July 2017: Acta Gastro-enterologica Belgica
Tsunemasa Matsubara, Kei Yamada, Kimiaki Sato, Masafumi Gotoh, Kensei Nagata, Naoto Shiba
BACKGROUND CONTEXT: Patients with infective spondylodiscitis who failed conservative treatment are generally indicated for open surgery. However, some patients are poor candidates for standard surgery, hence the need to evaluate less invasive approaches. Good outcomes were previously reported for percutaneous suction aspiration and drainage (PSAD) in the treatment of infective spondylodiscitis resistant to conservative therapy. We recently extended the surgical approach of PSAD to allow drainage of paravertebral or epidural abscesses in patients with progressive infective spondylodiscitis...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
Sjaak Pouwels, Darryl M Coll, Alexander G J van Marle
A 70-year-old man was admitted to our hospital for a penile circumcision due to phimosis using continuous dose spinal anaesthesia. On postoperative day 10 he came to the emergency department with a superficial abscess localised at the injection site of the spinal catheter. He was treated with intravenous antibiotics for 10 days, and the superficial abscess was incised and drained. Ten days later, the patient was readmitted to the emergency department with complaints of back pain and fever. A repeat MRI scan of his lumbar sacral area was done and showed epidural abscesses without any compression of the medulla or the myelum...
February 23, 2018: BMJ Case Reports
Guang-Lin Chen, Ting-Ting Feng, Shi-Tao Xu, Jin-Qiang Wang, Lei Tan, Jing-Yan Wang, Yong Ma, Gui-Cheng Huang
No abstract text is available yet for this article.
December 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Meera Raghavan, Elena Lazzeri, Christopher J Palestro
Spondylodiscitis is an infection of the vertebral body or disc and may also involve the epidural space, posterior elements, and paraspinal soft tissues. It is a cause of morbidity and mortality, and warrants early diagnosis and prompt treatment. Diagnosis can be difficult because of nonspecific signs and symptoms. Magnetic resonance imaging is sensitive and specific and is the imaging modality of choice for spondylodiscitis. Gadolinium contrast can show the extent of soft tissue and bone phlegmon and abscess...
March 2018: Seminars in Nuclear Medicine
Nilesh H Pawar, Ealing Loke, Derrick C Aw
Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness...
December 6, 2017: Curēus
Chloe Thomson
A 66-year-old woman presented with a 4-day history of fever, lethargy, neck and lower back pain. Neurological examination revealed mild quadraparesis. In view of this, MRI whole spine with contrast was performed and showed extensive spinal epidural abscess extending from the cervical to lumbar region causing compression of the thecal sac, spinal cord and nerves. The patient received multiple laminectomies to decompress the spinal cord and required a prolonged course of intravenous flucloxacillin as Staphylococcus aureus was cultured from three sets of blood cultures...
February 7, 2018: BMJ Case Reports
Karam Asmaro, Aqueel H Pabaney, Richard Rammo, Rizwan Tahir, Max K Kole
Background: Man-in-the-barrel syndrome (MBS) is an uncommon clinical condition for which patients present with bilateral brachial diplegia but intact lower extremity strength. This syndrome is typically attributed to a cranial/cortical injury rather than a spinal pathology. Case Description: A 62-year-old diabetic male presented with bilateral upper extremity paresis attributed to a ventral cervical epidural abscess diagnosed on magnetic resonance imaging. Emergent cervical decompression resulted in slight improvement of upper extremity strength...
2018: Surgical Neurology International
Andrea Ziegler, Monica Patadia, James Stankiewicz
PURPOSE OF REVIEW: Acute and chronic sinusitis can give rise to a wide array of intracranial and orbital complications. These complications include brain abscess, subdural empyema, epidural abscess, meningitis, venous sinus thrombosis, frontal bone osteomyelitis, and orbital cellulitis and abscess. Despite numerous medical advances, these complications carry a risk of mortality and significant morbidity. RECENT FINDINGS: Recent studies have shown improvement in both the mortality and the morbidity associated with the neurologic complications of acute and chronic sinusitis...
February 5, 2018: Current Neurology and Neuroscience Reports
Vinay K Maurya, Pankaj Sharma, R Ravikumar, J Debnath, Vivek Sharma, Satyabrat Srikumar, Mukul Bhatia
Background: Tuberculosis of spine is known as tubercular spondylitis or Pott's spine. The vertebral involvement leads to various pathological processes such as abscess formation, cord compression, and gibbus deformity. Magnetic Resonance Imaging (MRI) is the imaging modality of choice which not only helps in diagnosing a case of Pott's spine but also gives valuable information about its impending complications, thereby, aiding in management of these cases. Methods: In this study, MRI scans of 80 proven cases of tubercular spondylitis were studied retrospectively for the various pathological processes affecting the spine...
January 2018: Medical Journal, Armed Forces India
Suzaan Marais, Izanne Roos, Ayesha Mitha, Sepelong J Mabusha, Vinod Patel, Ahmed I Bhigjee
Background: Mycobacterium tuberculosis is a major cause of myelopathy and radiculopathy in high TB/HIV prevalent settings. However, a paucity of publications exists on the spectrum of neurological and magnetic resonance imaging (MRI) findings of spinal tuberculosis in these populations. Methods: A retrospective study of adults with spinal tuberculosis conducted at a referral center for patients with spinal disease without bony involvement on plain film radiography in South Africa...
January 11, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sudhir Dubey, Amit Agrawal
Cervicothoracic junction can be approached anteriorly, anterolaterally, posterolaterally, and posteriorly. The anterior approaches in this region best address the ventral vertebral body disease but may cause significant morbidity. Twelve patients with their disease process located ventral to the spinal cord in the cervicothoracic junction underwent expansile manubriotomy and corpectomy. Eleven patients underwent fusion. One patient underwent an oblique corpectomy. All patients had their disease process from T1 to T3 vertebral levels...
January 2018: Neurology India
Christian Herren, Norma Jung, Miguel Pishnamaz, Marianne Breuninger, Jan Siewe, Rolf Sobottke
BACKGROUND: A recent population-based study from Denmark showed that the incidence of spondylodiscitis rose from 2.2 to 5.8 per 100 000 persons per year over the period 1995-2008; the age-standardized incidence in Germany has been estimated at 30 per 250 000 per year on the basis of data from the Federal Statistical Office (2015). The early diagnosis and treatment of this condition are essential to give the patient the best chance of a good outcome, but these are often delayed because it tends to present with nonspecific manifestations, and fever is often absent...
December 25, 2017: Deutsches Ärzteblatt International
D W Hewson, N M Bedforth, J G Hardman
Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity...
January 2018: Anaesthesia
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