Cervical intradural abscess masquerading as an epidural collection.
Muhammed Yaser Hasan1, K Karuppiah Kumar1, Sein Lwin2
1University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, Singapore.
Global Spine Journal
|January 18, 2014
Summary
Intradural spinal cord abscesses are rare, particularly in the cervical spine. This case highlights an intradural abscess misdiagnosed as an epidural collection, emphasizing the need for consideration in spinal infections.
Area of Science:
- Neurosurgery
- Infectious Diseases
- Spinal Cord Imaging
Background:
- Intradural spinal cord abscesses are exceptionally rare, especially within the cervical spine.
- Cervical spine infections pose diagnostic challenges due to their rarity and potential for severe neurological deficits.
Observation:
- A patient presented with progressive quadriparesis and neck pain following an upper respiratory infection.
- Initial magnetic resonance imaging suggested an epidural abscess at the atlantoaxial level, near the cervicomedullary junction.
Findings:
- Surgical exploration revealed an intradural abscess, not the suspected epidural collection, requiring durotomy for drainage.
- Radiological and clinical presentations of intradural and epidural spinal abscesses can be indistinguishable.
Implications:
- This case underscores the importance of considering intradural abscesses in the differential diagnosis of suspected spinal epidural collections.
- Accurate and timely diagnosis is crucial for effective management and preventing neurological damage from spinal cord compression.
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