We present a case of a 16-year-old boy with an atypical form of spinal tuberculosis, which circumferentially involved two noncontiguous vertebral levels without destruction of the adjacent vertebral bodies and intervertebral discs. The lesions caused paraplegia and loss of sphincter control, and they were confined to a single vertebra at each site; the findings more closely mimicked spinal malignancies. There was no evidence of pulmonary or other extrapulmonary tuberculous disease. The patient was successfully treated both surgically and medically using posterior decompression and a stabilizing procedure in combination with postoperative antituberculous therapy. Magnetic resonance imaging played a major role in determining the extent of the disease and the type of surgical procedure and in monitoring adequate medical treatment.
The commonest cause of the intracranial abscesses collected prospectively during the last two years was chronic middle ear infection (73%). The diagnosis was based on the clinical history, otological investigations, contrast enhanced computerized tomography and surgical findings. The clinical presentation was characterized by chronic otitis with an exacerbation of otorrhea, otalgia or pain in the temporal region or headache with high fever, vomiting and nausea. A review of our 14 patients with otogenic intracranial abscesses is reported to highlight that prompt diagnosis, appropriate therapy and careful monitoring can provide vastly improved results.
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