Hydromyelia secondary to spinal epidural abscess. A case report
R Saponiero1, A Toriello, G Locatelli
1Neuroradiological Unit, S. Giovanni di Dio e Ruggi d'Aragona Specialist Universitary Hospital; Salerno, Italy - renato-saponiero@sangiovannieruggi.it.
The Neuroradiology Journal
|October 24, 2013
Summary
Spinal epidural abscess (SEA) is a rare, potentially fatal condition. Early diagnosis and prompt treatment are crucial to prevent severe neurological deficits, as symptoms can be vague.
Area of Science:
- Neurology
- Neurosurgery
- Infectious Diseases
Background:
- Spinal epidural abscess (SEA) is a rare but serious condition with potentially fatal outcomes if untreated.
- Risk factors include immunocompromised states and spinal procedures.
- SEA presents with nonspecific signs and symptoms, often leading to delayed diagnosis.
Purpose of the Study:
- To highlight the importance of early diagnosis and prompt treatment in managing spinal epidural abscess.
- To report a rare case of hydromyelia formation secondary to SEA.
- To emphasize the need for a high index of suspicion and advanced imaging in SEA diagnosis.
Main Methods:
- Case report of a 48-year-old woman with thoracic back pain and neurological deficits.
- Diagnosis confirmed via spinal MRI with Gd-enhancement.
- Treatment involved posterior decompression and drainage of the SEA.
Main Results:
- The patient developed flaccid paraplegia and sphincter loss.
- Post-treatment MRI revealed newly-formed hydromyelia.
- The patient experienced poor outcomes with only partial neurological improvement.
Conclusions:
- SEA requires early diagnosis due to vague initial symptoms; the classic triad is infrequent at presentation.
- Timely intervention is essential to mitigate permanent neurological deficits.
- A high index of suspicion and modern imaging are critical for effective SEA management.
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