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Epidural Abscess

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https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#1
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29765819/complications-in-salvage-surgery-for-nasal-and-paranasal-malignant-tumors-involving-the-skull-base
#2
Masanori Teshima, Hirotaka Shinomiya, Naoki Otsuki, Hidehito Kimura, Masaaki Taniguchi, Kazunobu Hashikawa, Eiji Kohmura, Ken-Ichi Nibu
Objective  Nasal and paranasal malignant tumors invading the skull base are rare and poorly studied. We evaluated postoperative complications in patients undergoing salvage surgery for such tumors. Design  Retrospective study. Setting  Kobe University Hospital. Participants  Among 48 patients who underwent surgery for tumors involving the skull base between 1993 and 2015, 21 patients had squamous cell carcinoma, 13 had olfactory neuroblastoma, 5 had adenocarcinoma, 2 had sarcoma, 2 had adenoid cystic carcinoma, and 1 each had malignant melanoma, poorly differentiated carcinoma, undifferentiated carcinoma, myoepithelial carcinoma, and malignant peripheral nerve sheath tumor...
June 2018: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/29757891/spinal-epidural-abscess-in-an-infant-presenting-as-fever-and-respiratory-distress
#3
Katherine M Gupta, Khoon-Yen Tay
A 9-month-old healthy female presented during winter to the emergency department with a chief complaint of fever and prominent respiratory symptoms. She was discharged on oseltamivir with a presumptive diagnosis of influenza. She returned to the emergency department 2 days later with continued fever and more upper respiratory symptoms. She was admitted for intravenous hydration to the observation unit with a diagnosis of viral illness (with viral testing that returned positive for adenovirus) and dehydration...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29745733/anterior-cervical-approach-for-the-treatment-of-axial-or-high-thoracic-levels
#4
Ran Harel, Maya Nulman, Zvi R Cohen, Nachshon Knoller
PURPOSE: Application of the anterior sub-axial cervical approach to the axial spine or the high thoracic spine has been previously described. Evaluation methods to determine the feasibility of these approaches were also described but alternative method was utilized in the current study. We describe our experience expanding the boundaries of anterior cervical approach utilizing a novel algorithm for approach selection. MATERIALS AND METHODS: A retrospective analysis of patients' files and imaging data of all anterior cervical approach to treat pathologies above C2-3 disc space or below C7-D1 disc space...
May 10, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29742784/-contra-is-postoperative-epidural-analgesia-the-gold-standard
#5
Hans Jürgen Gerbershagen
As strategy for postoperative pain therapy, epidural analgesia (EDA) is superior to systemic opiate analgesia after abdominal and thoracic surgery. In addition, EDA may significantly reduce the incidence of complications in some large operations, such as, e.g. cardiac (myocardial infarction, atrial fibrillation) and pulmonary complications (pneumonia, atelectasis), and even reduce mortality. Intestinal motility can also be improved. However, these positive effects do not appear in all interventions and not to the same degree...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29740507/major-risks-and-complications-of-cervical-epidural-steroid-injections-an-updated-review
#6
REVIEW
Nancy E Epstein
Background: Too many patients, with or without significant cervical disease, unnecessarily undergo cervical epidural steroid injections (CESIs). These include interlaminar (ICESI) and transforaminal ESI (TF-CESI) injections that are not Food and Drug Administration (FDA) approved, have no documented long-term efficacy, and carry severe risks and complications. Methods: Here we reviewed recent reports of morbidity and mortality attributed to the various types of CESIS...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29740504/epidural-abscess-presenting-as-severe-depression-with-suicidal-ideations-case-report
#7
Erin D'Agostino, Vyacheslav Makler, David F Bauer
Background: Epidural abscess (EDA) is an uncommon form of intracranial infection that generally presents with fever, headache, and focal neurologic deficit. Imaging generally reveals a lentiform collection with diffusion restriction on diffusion weighted image. We present an interesting case in which a patient with EDA presented with three weeks of depression with suicidal ideations. The patient displayed no notable infectious signs and the imaging was suggestive of chronic subdural hematoma (SDH) rather than EDA...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29721349/abscess-due-to-textiloma-gossypiboma-retained-surgical-cottonoid
#8
Ali Akhaddar, Hassan Baallal, Abderrahim Elktaibi
Background: Surgical site infections following spinal surgery, including spinal abscesses, are rare but serious as they are major causes of morbidity, and even mortality. They are, however, rarely attributed to infected, retained surgical cottonoids or sponges (textiloma or gossypiboma) inadvertently left in an operative field. Case Description: A 53-year-old female with a history of two prior spinal operations at the L4-S1 levels (11 and 2 years previously) presented over a few weeks with the acute onset of a cauda equina syndrome (e...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29721126/simultaneous-occurrence-of-spinal-epidural-abscess-and-disk-herniation-causing-irreversible-neurologic-deficits-a-case-report-and-review-of-the-literature
#9
Abdullah Cetinkaya, Claude Pierre-Jerome
No abstract text is available yet for this article.
June 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29695393/not-quite-pott-s-puffy-tumour
#10
Rasads Misirovs, Rohit Gohil, Peter Ross, Jaiganesh Manickavasagam
Pott's puffy tumour (PPT) is characterised by a subperiosteal abscess associated with osteomyelitis of the frontal bone-a rare complication of frontal sinusitis, more common in the paediatric population. We describe a case mimicking PPT, where abscess extension was facilitated by previous surgery. Usually patients with PPT would be systemically unwell, but our patient, a 63-year-old Caucasian man, was systemically well with a large swelling of his forehead. A CT was performed to evaluate possible intracranial and intracerebral complications such as epidural, subdural and brain abscesses...
April 25, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29682450/first-case-of-cervical-epidural-abscess-caused-by-brucellosis-in-saudi-arabia-a-case-report-and-literature-review
#11
Meshal Alyousef, Rabia Aldoghaither
Spinal epidural abscess (SEA) is an extremely rare and disastrous musculoskeletal complication of spondylodiscitis and sacroilitis secondary to brucellosis infection. Few case reports and retrospective studies have been published reporting patients with epidural abscesses mainly lumbar, and thoracic while cervical abscess are rare. Management of spinal epidural abscess due to Brucella species is not standard and remains controversial. To the best of our knowledge this is the first case of brucellar cervical epidural abscess reported in Saudi Arabia...
2018: IDCases
https://www.readbyqxmd.com/read/29682055/pneumorrhachis-following-chest-injury-a-rare-entity
#12
Shivender Sobti, S Bhaskar, Rajesh K Sharma, Ajay Choudhary
Pneumorrhachis (PR) - the phenomenon of intraspinal air - is a rare radiological finding. The presence of intraspinal air is usually after epidural injections, spinal manipulations, synovial cysts, degenerative disc disease, and epidural abscess. PR is mostly asymptomatic but can also be symptomatic. We report a case with PR after chest trauma and attempt to explain its development.
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29670792/pyogenic-spondylitis-caused-by-methicillin-resistant-staphylococcus-aureus-associated-with-tracheostomy-followed-by-resection-of-ossification-of-the-anterior-longitudinal-ligament
#13
Michio Hongo, Naohisa Miyakoshi, Masashi Fujii, Yuji Kasukawa, Yoshinori Ishikawa, Daisuke Kudo, Yoichi Shimada
Symptomatic ossification of the anterior longitudinal ligament (OALL) is rare. However, when the osteophyte enlarges and obstructive symptoms occur, the patient may require surgery. We present a case of pyogenic spondylitis caused by methicillin-resistant Staphylococcus aureus associated with tracheostomy followed by resection of OALL. A 69-year-old woman with OALL complained of dysphagia and suffocation, which was caused by prominent OALL at C4-5. Tracheostomy was performed, followed by osteophytectomy 6 weeks later...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29666075/rogue-one-a-story-of-tophaceous-gout-in-the-spine
#14
Karthik Dwarki, Andy Dothard, Bryan Abadie, Matthew C Miles
A 26-year-old man with history of extensive tophaceous gout presented to the referring facility with decreased bilateral lower extremity sensation and motor function that began acutely 1 week prior to admission and had progressed to urinary incontinence. The patient was admitted to the intensive care unit due to concern for sepsis secondary to epidural abscess. The patient was started on empiric vancomycin and cefepime. Neurosurgery did not recommend acute neurosurgical intervention given the lack of a compressive lesion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29661109/prevalence-and-risk-factors-for-methicillin-resistant-staphylococcus-aureus-mrsa-infections-in-custodial-populations-a-systematic-review
#15
Leigh Haysom, Melanie Cross, Rebecca Anastasas, Elizabeth Moore, Stephen Hampton
Methicillin-resistant Staphylococcus aureus (MRSA) in prisons can result in serious morbidity and death. We reviewed rates and risk factors for MRSA infection in custody, searching Medline, EMBASE, and CINAHL databases. Between 1997 and 2015, 17 studies reported MRSA skin and soft tissue infections (SSTIs), with four case reports of MRSA non-SSTI (necrotizing pneumonias, brain abscess, and epiduritis). Significant associations with MRSA SSTI were found: MRSA colonization, previous skin infection, sharing soap or personal items, SSTI presenting as an abscess or furuncle, younger age, non-Caucasian, overweight, communal laundering, infrequent handwashing, lower hygiene score...
April 2018: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/29656303/spondylodiscitis-following-endovascular-abdominal-aortic-aneurysm-repair-imaging-perspectives-from-a-single-centre-s-experience
#16
Ramin Mandegaran, Christopher S W Tang, Erlick A C Pereira, Ali Zavareh
OBJECTIVE: Very few reports have previously described spondylodiscitis as a potential complication of endovascular aortic aneurysm repair (EVAR). We present to our knowledge the first case series of spondylodiscitis following EVAR based on our institution's experience over an 11-year period. Particular attention is paid to the key imaging features and challenges encountered when performing spinal imaging in this complex patient group. MATERIALS AND METHODS: Of 1,847 patients who underwent EVAR at our institution between January 2006 and January 2017, a total of 9 patients were identified with imaging features of spondylodiscitis (0...
April 14, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29649612/independent-predictors-of-spinal-epidural-abscess-recurrence
#17
Akash A Shah, Huiliang Yang, Paul T Ogink, Joseph H Schwab
BACKGROUND CONTEXT: Recurrence of spinal epidural abscess (SEA) after treatment is an important cause of continued morbidity for patients. PURPOSE: The purpose of this study is to identify independent predictors of recurrence of SEA. STUDY DESIGN/SETTING: This was a retrospective, case-control study. PATIENT SAMPLE: Patients 18 years or older with a diagnosis of SEA admitted to our hospital system during the study period were included in the study sample...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29643682/lumbar-gout-tophus-mimicking-epidural-abscess-with-magnetic-resonance-imaging-bone-and-gallium-scans
#18
Justo Serrano Vicente, Alejandro Lorente Gómez, Rafael Lorente Moreno, Jose Rafael Infante Torre, Lucía García Bernardo, Juan Ignacio Rayo Madrid
Gout is a common metabolic disorder, typically diagnosed in peripheral joints. Tophaceous deposits in lumbar spine are a very rare condition with very few cases reported in literature. The following is a case report of a 52-year-old patient with low back pain, left leg pain, and numbness. Serum uric acid level was in normal range. magnetic resonance imaging, bone scan, and gallium-67 images suggested an inflammatory-infectious process focus at L4. After a decompressive laminectomy at L4-L5 level, histological examination showed a chalky material with extensive deposition of amorphous gouty material surrounded by macrophages and foreign-body giant cells (tophaceous deposits)...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29626020/bone-and-joint-infection
#19
Julia Colston, Bridget Atkins
Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. It also emphasises the importance of early surgical intervention in many cases. Consideration of alternative diagnoses, appropriate imaging and high-quality microbiological sampling is important to allow appropriate and targeted antimicrobial therapy...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29613923/nonoperative-management-of-spinal-epidural-abscess-development-of-a-predictive-algorithm-for-failure
#20
Akash A Shah, Paul T Ogink, Sandra B Nelson, Mitchel B Harris, Joseph H Schwab
BACKGROUND: Prompt diagnosis and treatment are critical in spinal epidural abscess, as delay can lead to paralysis or death. The initial management decision for spinal epidural abscess is not always clear, with the literature showing conflicting results. When considering nonoperative management, it is crucial to avoid failure of treatment, given the neurologic compromise incurred through failure. Unfortunately, data regarding risk factors associated with failure are scarce. METHODS: All patients admitted to our hospital system with a diagnosis of spinal epidural abscess from 1993 to 2016 were identified...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
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