Document Detail

Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review.
MedLine Citation:
PMID:  21308472     Owner:  NLM     Status:  MEDLINE    
Intramedullary spinal cord abscess (ISCA) without meningitis is an extremely rare entity in the central nervous system, and it is often difficult to diagnose immediately, and no definitive imaging findings have been established. We experienced the case of a 61-year-old male who presented with a sudden onset back pain without fever following rapidly worsening paraparesis for 3 days, who subsequently become unable to walk. According to the initial MRI and 3D-CTA, the presumptive diagnosis was spinal infarction due to spinal artery embolism. However, his symptoms did not improve, despite the gradual changes in MRI following antiplatelet therapy. He underwent a biopsy in an attempt to prevent the lesion from progressing toward the upper spinal cord. The pathological examination revealed an intramedullary abscess, so we performed a midline myelotomy and drained the pus from the abscess. After surgery, MRI showed improvement, but the patient's paraplegia persisted. To the best of our knowledge, this is the first case report of spinal cord abscess with the confirmation of spinal artery occlusion on angiography, which could have been caused by a bacterial embolism. We herein discuss its possible etiology and also review recent reports on ISCA.
Motoyuki Iwasaki; Shunsuke Yano; Takeshi Aoyama; Kazutoshi Hida; Yoshinobu Iwasaki
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2011-02-10
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  20 Suppl 2     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-06-10     Completed Date:  2011-08-23     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  S294-301     Citation Subset:  IM    
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
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MeSH Terms
Abscess / complications*,  pathology,  surgery
Arterial Occlusive Diseases / etiology*,  pathology,  surgery
Lumbar Vertebrae / pathology,  surgery
Middle Aged
Spinal Cord / blood supply*
Spinal Cord Diseases / complications*,  pathology,  surgery
Thoracic Vertebrae / pathology,  surgery
Treatment Outcome

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