Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report

Roh, Jae Eun; Lee, Seung Young; Cha, Sang-Hoon; Cho, Bum Sang; Jeon, Min Hee; Kang, Min Ho

doi:10.3348/kjr.2011.12.2.241

Cited by 16 publications

(12 citation statements)

References 8 publications

(24 reference statements)

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“…7,[9][10][11] In the current case, the patient had granuloma formation after the initial surgical and antibiotic treatments. An accurate recurrence rate for spinal infection cannot be determined, and treatment failure is often reported in cases of spondylodiscitis.…”

Section: Discussionmentioning

confidence: 66%

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Intramedullary spinal cord abscess and subsequent granuloma formation: a rare complication of vertebral osteomyelitis detected by diffusion-weighted magnetic resonance imaging

Takebe¹,

Iwasaki²,

Hashikata³

et al. 2014

FOC

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An intramedullary spinal cord abscess, which is usually associated with discitis, is an uncommon but potentially important complication of vertebral osteomyelitis. The authors describe a rare case of an intramedullary conus medullaris abscess and lumbar osteomyelitis sparing the intervertebral discs and without discitis. The patient also developed a granuloma in the cauda equina during treatment. Diffusion-weighted MRI was useful for differentiating the granulomatous lesion from the relapse of infection. A 65-year-old immunocompetent man with moderately controlled diabetes presented with progressive lowerextremity numbness and weakness with urinary dysfunction. He had progressive paraparesis, bilateral leg paresthesia, and sphincter compromise. Magnetic resonance imaging revealed an intramedullary ring-enhanced lesion, which was hyperintense on diffusion-weighted images. The lesion, an intramedullary spinal cord abscess, was surgically drained. During antibiotic treatment, serial MRI showed an enlarging enhanced lesion in the cauda equina, and a recurrent infection was suspected. A second-look surgery confirmed the formation of a granuloma and the absence of a relapse of the abscess. Although the enhanced lesion increased in size, its intensity on diffusion-weighted images remained unchanged. After 3 months of antibiotic treatment, all enhanced lesions were diminished. An intramedullary spinal cord abscess is a rare but important complication of vertebral osteomyelitis, and it requires immediate treatment. Diffusion-weighted MRI was useful for the initial diagnosis as well as for monitoring treatment efficacy.

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Section: Discussionmentioning

confidence: 66%

“…7,[9][10][11] Early diagnosis is essential to minimize the neurological deficits, and immediate treatment enhances the chance of recovery. 1 In the current case, a granuloma formed after abscess drainage and during antibiotic treatment.…”

Section: ©Aans 2014mentioning

confidence: 99%

Intramedullary spinal cord abscess and subsequent granuloma formation: a rare complication of vertebral osteomyelitis detected by diffusion-weighted magnetic resonance imaging

Takebe¹,

Iwasaki²,

Hashikata³

et al. 2014

FOC

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“…In most reported cases, patients underwent surgical abscess drainage together with antibiotic treatment. 2,7,11,13,14 In HIV patients the biopsy must be necessary 15 and in cases ISCA resolve with antibiotic treatment alone. 3 We chose medical treatment as single approach because of the fast and satisfactory initial response of both the clinical and the imaging findings.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary abscess of the cervical spinal cord in an HIV-1 infected patient

Boukobza¹,

Laissy²

2019

JNSK

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Intramedullary spinal cord abscess (ISCA) is a rare condition. Wedescribe the magneticresonance imaging (MRI) findings, including the diffusion-weighted imaging (DWI) findings, of a cervical ISCA in a HIV-infected 43-year-old male with breakdown of antiretroviral treatment. The patient presented with 1-month history ofneck and dorsal pain and left upper extremitynumbness and weakness. Although the etiology of the cervical spinal cord abscess could not be detected (cryptogenetic ISCA), the patient was successfully managedwith antitoxoplasmosis and antituberculosis treatment. Our findings indicate that an ISCA should be considered in HIV-infected patients with central nervous system signs or symptoms, regardless of CD4 T-cell counts.

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“…The radiological technique of choice is an MRI with intravenous gadolinium to accurately determine the location and size of ISCA and to identify any predisposing structural abnormalities of the spinal cord or vertebral body. 8,9 MRI features include increased signal intensity on the T2W image and marginal enhancement with central low-signal intensity on the T1W image with gadolinium. 7 A ring-enhancing mass is a nonspecific finding and a variety of noninflammatory benign and the neoplastic process can have a similar appearance.…”

Section: Cases and Reviewmentioning

confidence: 99%

Intramedullary Spinal Cord Abscess: Illustration of Two Cases and Review of Literature

Chandran

Bhanuprabhakar

Sumukhan

2017

IJNS

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Intramedullary spinal cord abscess is a rare infection of the spinal cord with less than 120 cases reported since its first description by Hart in 1830. It is usually associated with abnormalities of the spinal cord or documented source of infection or immunodeficiency, requiring clinical radiological suspicion for accurate diagnosis. The first case is a middle-aged healthy woman without any underlying risk factors, presented with progressive paraparesis, in whom prompt, accurate diagnosis with contrast magnetic resonance imaging, diffusion-weighted imaging, and apparent diffusion coefficient mapping followed by early surgery was possible, which resulted in the favorable neurological outcome. The second case is a 10-year-old boy with paraparesis whose definite treatment and surgery was delayed due to a delay in accurate clinical and radiological diagnosis which resulted in poor outcomes. Hence, we try to establish that prompt diagnosis and surgical treatment can result in a favorable neurological outcome, though the prognosis, in general, is poor in this clinical condition. A review of literature in support of our cases is given.

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Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report

Cited by 16 publications

References 8 publications

Intramedullary spinal cord abscess and subsequent granuloma formation: a rare complication of vertebral osteomyelitis detected by diffusion-weighted magnetic resonance imaging

Intramedullary spinal cord abscess and subsequent granuloma formation: a rare complication of vertebral osteomyelitis detected by diffusion-weighted magnetic resonance imaging

Intramedullary abscess of the cervical spinal cord in an HIV-1 infected patient

Intramedullary Spinal Cord Abscess: Illustration of Two Cases and Review of Literature

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