scholarly journals Holospinal epidural abscess in elderly patient: A case presentation and review

2019 ◽  
Vol 10 ◽  
pp. 204
Author(s):  
Ioannis D. Siasios ◽  
Aggeliki Fotiadou ◽  
Kostas Fountas ◽  
Vassilios Dimopoulos
Keyword(s):  
Epidural Abscess ◽  
Mortality Rates ◽  
Blood Cultures ◽  
Surgical Approaches ◽  
Spinal Instability ◽  
Laboratory Studies ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Magnetic Resonance Imaging Mri ◽  
Catheter Irrigation

Background: Holospinal epidural abscess (HEA) is a rare pathological entity with significant morbidity and mortality rates. Here, we present a 74-year-old male with HEA treated with focal skip laminectomies and catheter irrigation. Case Description: A 74-year-old male presented with fever, neck/back pain, and slight weakness in his legs bilaterally (4/5). The patient underwent a magnetic resonance imaging (MRI) of the entire spine showing an epidural collection extending from C5-C6 to the L4-L5 levels. Laboratory studies revealed a leukocytosis and an elevated C-reaction protein level. Blood cultures were positive for methicillin-sensitive Staphylococcus aureus. The patient underwent skip laminectomies at C6 and C7; T2, T3, T5, T6, T8, T9, T10, and T12; and L3, L4, and L5 with catheter irrigation between these levels; this minimized the risk of postoperative kyphosis and instability. His postoperative course was uneventful. Other surgical approaches to HEA described in literature include laminectomy, focal laminectomies, and skip laminectomies. Conclusion: In this case of a holospinal HEA, skip laminectomies and catheter irrigation avoided neurological deterioration and delayed spinal instability in a 74-year-old male.

scholarly journals Spinal epidural abscess: appearance on magnetic resonance imaging as a guide to surgical management

2004 ◽  
Vol 17 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Jonathon F. Parkinson ◽  
Lali H. S. Sekhon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Epidural Abscess ◽  
Surgical Approaches ◽  
Spinal Instability ◽  
Spinal Epidural Abscess ◽  
Resonance Imaging ◽  
Decompressive Laminectomy ◽  
Spinal Epidural ◽  
Invasive Techniques

Spinal epidural abscess is associated with considerable rates of morbidity and mortality despite its infrequent occurrence. Advances in magnetic resonance (MR) imaging technology have allowed easier diagnosis of this potentially devastating condition. It is also possible to predict the intraoperative appearance of each case of spinal epidural abscess prior to the procedure, based on the MR findings. Surgical treatment of this condition usually involves extensive decompressive laminectomy, which predisposes patients to spinal instability and deformity. Recent advances in surgical approaches to spinal epidural abscess have included the institution of less invasive techniques to manage this condition, including saline washes of the epidural space through catheters introduced via limited laminotomy. The cases reported here illustrate the ability to predict the intraoperative findings in patients with spinal epidural abscess, and to adjust the surgical approach accordingly to minimize the extent of potentially destabilizing procedures without impinging on the effectiveness of treatment.

scholarly journals Laparoscopic surgical management of a mature presacral teratoma: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Liming Wang ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Hiroka Kondo ◽  
Kiyoka Hara ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Mature Teratoma ◽  
Skin Incision ◽  
Histopathological Diagnosis ◽  
Tailgut Cyst ◽  
Resonance Imaging ◽  
Presumptive Diagnosis ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Abstract Background Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery. Case presentation A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas. Conclusions Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

Atlantoaxial epidural abscess secondary to grass awn migration in a dog

2014 ◽  
Vol 27 (02) ◽  
pp. 155-158 ◽  
Author(s):  
U. Geissbühler ◽  
P. Karli ◽  
F. Forterre ◽  
E. Linon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Epidural Abscess ◽  
Cervical Vertebrae ◽  
Clinical Signs ◽  
Resonance Imaging ◽  
Mri Findings ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Grass Awn

SummaryA two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.

scholarly journals A Rare Case of Thoracic Pyogenic Facet Joint Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tomoyuki Setoue ◽  
Jun-ichiro Nakamura
Keyword(s):  
Epidural Abscess ◽  
Facet Joint ◽  
Joint Infection ◽  
Severe Infection ◽  
Resonance Imaging ◽  
Decompressive Laminectomy ◽  
Common Complaint ◽  
Neurologic Impairment ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess

Pyogenic facet joint infection is a rare but severe infection. The most common complaint on presentation is pain followed by fever, then neurologic impairment. While the lumbar spine is involved in the vast majority of cases presented in the literature, the case presented here occurred in the thoracic spine. The patient was a 48-year-old immune-competent female who presented with left back pain. Magnetic resonance imaging (MRI) indicated a facet effusion, paraspinal abscess, and epidural abscess in the level of 9th-11th thoracic vertebra. On the 6th day of treatment, she presented a neurological disorder and underwent decompressive laminectomy and surgical debridement. We observed immediate improvement as a result of the surgery.

scholarly journals Body lateropulsion as the primary manifestation of medulla oblongata infarction: a case report

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052097077
Author(s):  
Hui Li ◽  
Na Wei ◽  
Lu Zhang ◽  
Xiuli Liu ◽  
Jingzhe Han
Keyword(s):  
Medulla Oblongata ◽  
Brain Function ◽  
Plasma Lipids ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
International Peace ◽  
Case Presentation ◽  
Vertebrobasilar System ◽  
Magnetic Resonance Imaging Mri ◽  
Cerebellar Symptoms

Background Isolated body lateropulsion is a possible predominant manifestation of medulla oblongata infarction, and can occur without vestibular and cerebellar symptoms. However, it is relatively rare and challenging to diagnose. Case presentation A 67-year-old woman was admitted to the Harris International Peace Hospital complaining mainly of instability when standing and walking for the previous 8 hours. Based on the neural localization and multiple head magnetic resonance imaging (MRI) examinations, a diagnosis of cerebral infarction (vertebrobasilar system) was made. Consequently, the patient was managed using therapy aimed at preventing platelet aggregation, lowering plasma lipids, stabilizing plaques, protecting mitochondria, and improving circulation and brain function. The patient’s gait improved and she was discharged after 14 days because she was able to walk unaided. The patient was followed up for 6 months and had no noticeable undesirable side effects or signs of neurological deficits. Conclusion The possibility of lateral medulla oblongata infarction should be considered when patients present with isolated body lateropulsion, without other signs or symptoms of brainstem damage.

scholarly journals Cervical Intramedullary Cavernoma in Children: Case report and literature review

2019 ◽  
Vol 29 (4) ◽  
pp. 690-696
Author(s):  
Catarine Cavalcante Ary ◽  
Sebastião Carlos de Sousa Oliveira ◽  
Joaquim Francisco Cavalcante Neto ◽  
Mateus Aragão Esmeraldo ◽  
Francisco Abdoral Brito Júnior ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Vascular Malformations ◽  
Pediatric Population ◽  
Single Layer ◽  
Complete Regression ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Vascular Channels ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Cavernomas

Case presentation: A 10-year-old male patient was admitted due to posterior cervicalgia, vomiting and progressive generalized weakness. Physical examination showed difficulty in ambulation and tetraparesis. Magnetic resonance imaging (MRI) of the cervical medulla enhanced by the contrast agent, gadolinium, showed a poorly contrasted mass with a hemorrhagic center. We undertook a posterior cervicotomy (C1-C3). Post-operative evolution was satisfactory with complete regression of the deficits 90 days after surgery. Control MRI at intervals of 1 and 4 years confirmed absence of the tumor. Discussion: Cavernomas are vascular malformations, consisting of coarsely dilated vascular channels and coated by a single layer of endothelial cells, devoid of endothelium and myothelium. They represent only 5-12% of all vascular pathologies of the medulla, with only 10% affecting the pediatric population. There are only thirty cases of pediatric intramedullary spinal cavernomas in the literature, with predominance among males (2.1:1). Thoracic and cervical spinal cavernomas consist in 55% and 45% of the cases, respectively. In six cases (20%) cavernomatous lesions were associated with synchronic intracranial cavernoma. Among the reported cases, only one had poor evolution after surgery, whereas six patients persisted with prior symptoms. Conclusion: Spinal intramedullary cavernomas are rare entities, especially in the pediatric population, and are treated with surgery which improves prior neurologic deficits, besides preventing rebleeding

scholarly journals Ocular Infection Preceding Major Epidural Abscess

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Liam Dunbar ◽  
Ryan Johnstone
Keyword(s):  
Epidural Abscess ◽  
Primary Source ◽  
Ocular Infection ◽  
Resonance Imaging ◽  
Radiological Features ◽  
Short Course ◽  
Intravenous Antibiotics ◽  
Magnetic Resonance Imaging Mri ◽  
Discharge From Hospital ◽  
High Index Of Suspicion

Staphylococcal bacteremia is an important clinical entity. A 74-year-old lady presented with an isolated staphylococcal ocular infection; this was treated with a short course of antibiotics, a prolonged course of steroids, and discharge from hospital with outpatient clinic followup. She represented three weeks later to the emergency department with back pain, raised inflammatory markers, and positive blood cultures. On magnetic resonance imaging (MRI), an extensive epidural collection was seen. This was surgically decompressed, and she was treated with appropriate intravenous antibiotics. Despite a complicated postoperative course, she made an excellent recovery. This case reviews the important clinical and radiological features of the presentation of a major epidural abscess and it also suggests a potentially unusual primary source. The clinician is reminded to always have a high index of suspicion regarding staphylococcal bacteremia and the potential for seeding to the epidural space.

scholarly journals Vulvar lipoma: So giant and rare?

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ayşegül Karadayı Büyüközsoy ◽  
Ömer Aydıner
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Tumor Localization ◽  
Rare Tumor ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Inguinal Hernias ◽  
Magnetic Resonance Imaging Mri ◽  
Vulvar Mass

Abstract Background Lipomas are often small tumors and rarely reach a size larger than 2 cm. Vulvar lipoma is a rare tumor localization, and only a few cases have been reported. It is important to distinguish lipomas from other vulvar masses like liposarcomas, Nuck canal cyst, Bartholin’s cyst, and inguinal hernias. Case presentation We report on a case of a 43-year-old woman who presented with a giant left vulvar mass and discuss the magnetic resonance imaging (MRI) results. Conclusions MRI is useful in evaluating vulvar lipomas and differentiating them from other vulvar pathologies.

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