[Paraplegia associated with intramedullary spinal cord and epidural abcesses, meningitis and spondylodiscitis

J-P Ferroir1, F-X Lescure, C Giannesini

  • 1Service de neurologie, hôpital Tenon, 4 rue de la Chine, Paris cedex 20, France. jean-pierre.ferroir@tnn.aphp.fr

Revue Neurologique
|May 11, 2012
PubMed
Abstract

Insights

Spinal cord abscesses, often caused by Staphylococcus aureus, can lead to paraplegia. Early surgical drainage and antibiotics are crucial for better outcomes in these rare infections.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Radiology

Background:

  • Intramedullary spinal cord abscesses are rare neurological infections.
  • Often associated with meningitis and epidural abscesses, leading to paraplegia.
  • Staphylococcus aureus is the most common causative organism.

Observation:

  • A case of meningitis with coexisting intramedullary and epidural abscesses is presented.
  • Multiple lesions precluded surgical drainage.
  • Paraplegia persisted despite antibiotic treatment.

Findings:

  • MRI reveals intramedullary collections with characteristic signal intensities on T1 and T2-weighted images.
  • Abscesses show peripheral contrast enhancement on T1-weighted sequences.
  • Adjacent medullary edema is typically extensive.

Implications:

  • Early surgical intervention, when feasible, is critical for managing spinal cord abscesses.
  • Prompt and appropriate antibiotic therapy is essential for favorable prognosis.
  • Multifocal abscesses present significant management challenges.

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