Intramedullary Abscess of the Spinal Cord

Chidambaram, B.; Balasubramaniam, V.

doi:10.1159/000055991

Cited by 16 publications

(11 citation statements)

References 3 publications

(5 reference statements)

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“…Clinical suspicion and radiological findings are essential for early diagnosis and treatment; consequently, irreversible spinal cord damage can be avoidable. In children, limited laminectomy with myelotomy focused above the most bulbous segment of the spinal cord for drainage of the abscess and adequate antibiotics is the treatment of choice [1][2][3][4][5]7].…”

Section: Introductionmentioning

confidence: 99%

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

et al. 2009

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Intramedullary spinal cord abscess (ISCA) in children is extremely a rare infection of the central nervous system (CNS); and probably a devastating neurological condition. Clinical awareness of patients at risk is crucial for early diagnosis and intervention; as this entity is one of the treatable conditions of paraparesis. Association with congenital neuro-ectodermal abnormality in children is frequent. This pathology highlights the importance of complete neurological checks of infants as a part of their routine physical examination and early management of patients with congenital dermal sinus, prophylactic surgical resection of such a congenital anomaly is recommended by most authors to prevent serious infections of the CNS. However, once the abscess is established; immediate surgical drainage along side adequate antibiotics should be instituted. This may guarantee improving neurological outcome. In this communication, the authors present their experience with four cases of ISCA in children treated successfully with surgical drainage, intravenous antibiotics and neuro rehabilitation between 2001 and 2006 and discuss their results. We concluded that early diagnosis and treatment is essential; before a devastating mechanico-vascular insult of the spinal cord is established from rapid formation of the abscess and a swift expansion of the spinal cord within the limited intraspinal space.

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Section: Introductionmentioning

confidence: 99%

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

et al. 2009

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“…Abscesses of spinal cord which can be extradural, subdural or intramedullary are rare [2]. Intramedullary spinal cord abscess (ISCA) is rare in children [3,4].…”

Section: Discussionmentioning

confidence: 99%

“…If the clinical picture is suggestive of cord compression then MRI spine is the diagnostic modality that can indicate the extent, the damage and the volume of abscess [3,5,6]. Antibiotics and surgical removal of pus after laminectomy has been the mode of treatment used in all past reports [2][3][4][5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Intramedullary spinal cord abscess – an unusual presentation

Choudhary

Yadav

Dewan

et al. 2015

J Pediatr Infect Dis

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“…Die häufigste Lokalisation stellt der posteriore Anteil des thorakalen Rückenmarks dar [19]. Der häufigste Erkrankungsbeginn lag in den ersten drei Lebensdekaden bei einer Spannbreite von 8 Tagen bis 75 Jahren [10,21,24,26]. Der häufigste Erkrankungsbeginn lag in den ersten drei Lebensdekaden bei einer Spannbreite von 8 Tagen bis 75 Jahren [10,21,24,26].…”

Section: Diskussionunclassified

“…Intramedulläre Abszesse des Rückenmarks stellen ein sehr seltenes Krankheitsbild dar [5,10]. Obwohl die Erstbeschreibung bereits im Jahre 1830 durch Hart [14] erfolgte, finden sich nach unserer Kenntnis in der wissenschaftlichen Literatur bis heute weniger als 100 dokumentierte Fälle [1,3,6,10,12,21,22,24,26].…”

Section: Introductionunclassified

Der intramedulläre Abszess des Rückenmarks - ein seltenes Krankheitsbild

Esenwein

Horch²,

Meindl³

et al. 2003

Zentralbl Neurochir

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Although the presence of an intramedullary abscess of the spinal cord is extremely rare, it is most important to be aware of its existence in the differential diagnosis of neurological diseases. Existing neurological deficits with progressive symptoms of paraplegia should always be regarded as suspect and a differential diagnosis of an intramedullary abscess of the spinal cord should then be included in the therapeutical regimen. A correct diagnosis using MR-tomography followed by an early surgical treatment strategy are essential for the affected patients, simply because an early diagnosis and an immediate operative intervention represent decisive prognostic factors independent from the cause of infection. Surgical intervention must include a decompressive laminectomy, a myelotomy, and also a secure intraoperative abscess drainage. In this analysis two patients will be reported on, both of whom were already showing symptoms of paraplegia at the time they were admitted to hospital. In both cases MR-tomographically an intramedullary nodulary lesion of the spinal cord could be detected. However, due to a complete lack of any acute symptoms of inflammatory reaction in one patient, an intramedullary abscess was not actually diagnosed before surgical treatment was performed. These two cases, together with existing scientific literature, aim to present an overview of the pathogenesis, the clinical symptomatology, the treatment strategy, and the expected therapeutical outcome of an intramedullary abscess formation. It will be shown that by treating this disease as early as possible using adequate therapeutic interventions a functional improvement of the resulting neurological symptoms can be expected.

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Intramedullary Abscess of the Spinal Cord

Abstract: A case of intramedullary abscess of the spinal cord in a child aged 3 years is reported. Successful outcome depends on early diagnosis and aggressive management.

Cited by 16 publications

References 3 publications

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes

Intramedullary spinal cord abscess – an unusual presentation

Der intramedulläre Abszess des Rückenmarks - ein seltenes Krankheitsbild

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