Case: Spinal cord compression arising from a failure to diagnose and treat a spinal epidural abscess

✓ An experimental model of spinal epidural abscess was developed in rabbits by injecting Staphylococcus aureus into the posterior thoracolumbar epidural space. This model has been shown to reproduce the neurological, bacteriological, and radiological aspects of the human disease. In this study, the effect of the infectious epidural mass on the vasculature of the spinal cord in paraplegic rabbits was studied using microangiographic techniques. The normal vascular anatomy of the rabbit spinal cord was defined in control experiments. Vascular proliferation was demonstrated in the epidural space surrounding the abscesses. Anterior and paired posterior spinal arteries remained patent in paraplegic rabbits with mild or moderate spinal cord compression and in some cases of severe compression. In animals with severe compression, the anterior epidural venous plexus remained patent, but the dorsal spinal vein was occluded. Occlusion of perforating arteries occurred only with extreme spinal cord compression. These data indicate that the initial neurological deficit associated with experimental spinal epidural abscess is not due to vascular thrombosis.

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Pressure Ulcer Associated with Testicular Prosthesis as a Rare Cause of Spinal Epidural Abscess

Case Reports in Infectious Diseases ◽

10.1155/2019/9090462 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Amulya Prakash ◽

Rishi Raj ◽

Aasems Jacob ◽

Douglas Ross

Keyword(s):

Spinal Cord ◽

Pressure Ulcer ◽

Epidural Abscess ◽

Cord Compression ◽

Sensory Function ◽

Cervical Region ◽

Spinal Epidural Abscess ◽

Delay In Diagnosis ◽

Spinal Cord Decompression ◽

Spinal Epidural

Spinal epidural abscess is a neurologic emergency with a potential complication to the spinal cord such as paralysis. Frequently, it has a nonspecific initial presentation such as neck or back pain, and hence there is a delay in diagnosis. We present the case of a 60-year-old Caucasian male who presented to emergency room with one week of numbness and weakness of all four extremities. Neurological examination showed variable quadriparesis. Urgent MRI of spine with contrast revealed epidural abscess in the cervical region C4–C6 with resultant cord compression, the underlying etiology for hematogenous spread of infection being pressure ulcer associated with testicular prosthesis. Urgent neurosurgical intervention was done to achieve spinal cord decompression. Both blood and pus cultures were positive for Streptococcus intermedius, requiring prolonged administration of intravenous antibiotics. Clinical outcome was encouraging with progressive gain in motor and sensory function. Spinal epidural abscess is a rare diagnosis; hence, clinicians should have a high index of suspicion for timely diagnosis.

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Spontaneous Spinal Epidural Haematomas and the Prognostic Implications of Interval to Surgical Decompression: A Report of Two Cases

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700220 ◽

2009 ◽

Vol 17 (2) ◽

pp. 216-219 ◽

Cited By ~ 7

Author(s):

Colin Yi-Loong Woon ◽

Benedict Chan-Wearn Peng ◽

John Li-Tat Chen

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Lower Limb ◽

Cord Compression ◽

Surgical Decompression ◽

Neurological Recovery ◽

Uncontrolled Hypertension ◽

Motor Deficit ◽

Mri Features ◽

Spinal Epidural

Spontaneous spinal epidural haematomas (SSEHs) are rare causes of spinal cord compression. We present 2 cases of thoracic SSEHs with similar magnetic resonance imaging (MRI) features. Patient 1 was on long-term oral anticoagulants and patient 2 had uncontrolled hypertension. Patient 1 presented with a dense motor deficit, whereas patient 2 developed progressive lower limb weakness. Decompression laminectomy and haematoma evacuation was performed 51 hours later for patient 1 and 14 hours later for patient 2. Both had recovered their lower limb power, but neurological recovery was greater for patient 2. In patients with bleeding diatheses or uncontrolled hypertension, acute SSEHs must be suspected when they present with atraumatic back pain and signs of spinal cord compression. The interval to surgical decompression greatly influences the prognosis for neurological recovery.

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Primary vertebral and spinal epidural non-Hodgkin's lymphoma with spinal cord compression

Neuroradiology ◽

10.1007/s002340050256 ◽

1996 ◽

Vol 38 (4) ◽

pp. 333-337 ◽

Cited By ~ 1

Author(s):

M. Boukobza ◽

C. Mazel ◽

E. Touboul

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Hodgkin’S Lymphoma ◽

Cord Compression ◽

Hodgkin's Lymphoma ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Spinal Epidural

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Primary Spinal Epidural Non-Hodgkin's Lymphoma the Contribution of Nuclear Magnetic Resonance Imaging, Therapeutic Approach and Review of the Literature

Tumori Journal ◽

10.1177/030089169207800612 ◽

1992 ◽

Vol 78 (6) ◽

pp. 397-402 ◽

Cited By ~ 5

Author(s):

llan G. Ron ◽

Irith Reider ◽

Nelly Wigler ◽

Samario Chaitchik

Keyword(s):

Spinal Cord ◽

Back Pain ◽

Spinal Cord Compression ◽

Hodgkin’S Lymphoma ◽

Cord Compression ◽

Hodgkin's Lymphoma ◽

Characteristic Appearance ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Spinal Epidural

Primary spinal epidural lymphoma (Stage I) is diagnosed predominantly late after a long prodromal phase of local back pain resulting in spinal cord compression. The use of CT and NMR images in the early stage of investigation and their analysis may help to diagnose these cases prior to the appearance of neurologic deficit. We report on 2 patients who presented with prolonged localized back pain with sudden symptoms of spinal cord compression. CAT scan and NMR imaging demonstrated the characteristic appearance of lymphoma. Decompressive laminectomy supported the diagnosis. Radiotherapy treatment to the region of the non-Hodgkin's lymphoma resulted in complete resolution. Thereafter, systemic chemotherapy with CHOP achieved a good response.

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Spinal epidural angiolipoma: A rare cause of spinal cord compression

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.102617 ◽

2012 ◽

Vol 03 (03) ◽

pp. 341-343 ◽

Cited By ~ 11

Author(s):

Rajesh K Ghanta ◽

Kalyan Koti ◽

Srinivas Dandamudi

Keyword(s):

Spinal Cord ◽

Blood Vessels ◽

Spinal Cord Compression ◽

Surgical Excision ◽

Cord Compression ◽

Benign Tumors ◽

Thoracic Region ◽

Spinal Angiolipomas ◽

Spinal Epidural

ABSTRACTSpinal epidural angiolipomas are rare, benign tumors composed of mature lipocytes admixed with abnormal blood vessels. Only 128 cases of spinal epidural angiolipomas have been reported in literature till now. Spinal angiolipomas are predominantly located in the mid-thoracic region. We report a case of dorsal epidural angiolipoma in a 56-year-old male who presented with paraparesis and was diagnosed to have D4-5 epidural angiolipoma. Total surgical excision of the epidural angiolipoma was done and his paraparesis gradually improved.

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