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01-07-2011 | Case Report

Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review

Authors: Motoyuki Iwasaki, Shunsuke Yano, Takeshi Aoyama, Kazutoshi Hida, Yoshinobu Iwasaki

Published in: European Spine Journal | Special Issue 2/2011

Abstract

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.

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Title: Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review
Authors: Motoyuki Iwasaki
Shunsuke Yano
Takeshi Aoyama
Kazutoshi Hida
Yoshinobu Iwasaki
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue Special Issue 2/2011
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-011-1703-z

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Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review

Abstract

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