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Child's Nervous System
Published in: Child's Nervous System 1/2013

01-01-2013 | Original Paper

Infections of the Spinal Subdural Space in Children: A Series of 11 Contemporary Cases and Review of all Published Reports. A Multinational Collaborative Effort

Authors: Adam L. Sandler, Dominic Thompson, James T. Goodrich, Jasper van Aalst, Eliezer Kolatch, Mostafa El Khashab, Farideh Nejat, Erwin Cornips, Sandeep Mohindra, Rahul Gupta, Reza Yassari, Lawrence B. Daniels III, Arundhati Biswas, Rick Abbott

Published in: Child's Nervous System | Issue 1/2013

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Abstract

Introduction

Positioned anatomically between the spinal epidural space and the intramedullary compartment, the spinal subdural space remains the least common area of localized infection in the central nervous system. Infectious processes of the subdural spinal space include subdural spinal empyema, subdural spinal abscess, infected spinal subdural cyst, and infectious spinal subdural cyst. To date, there has been no systematic review of these entities in children, with the cumulative knowledge of the pathophysiologic, microbiologic, and demographic characteristics of these infections relegated solely to few small series and case reports.

Methods

A series of 11 recent cases culled from the collaboration of international authors are presented. In addition, an exhaustive MEDLINE search and manual review of the international literature was performed, identifying a total of 73 cases of spinal subdural infections in patients under the age of 21. Data of interest include the age, sex, signs, and symptoms at presentation, spinal location of infection, presence of spinal dysraphism, and other comorbidities, offending organism, treatment, outcome, and follow-up.

Results

Patients ages ranged from 4 weeks to 20 years (mean, 6.5 years). Males outnumbered females by a ratio of 2:1. Over half (53 %) of spinal subdural infections in children were associated with spinal dysraphism or other congenital abnormalities of the spine. The commonest organism to infect the spinal subdural space in children is mycobacterium tuberculosis and the thoracic spinal region was most commonly infected.

Conclusions

The disease is usually treated surgically, although a more expectant approach consisting of antibiotics and observation has also been proposed.
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Metadata
Title
Infections of the Spinal Subdural Space in Children: A Series of 11 Contemporary Cases and Review of all Published Reports. A Multinational Collaborative Effort
Authors
Adam L. Sandler
Dominic Thompson
James T. Goodrich
Jasper van Aalst
Eliezer Kolatch
Mostafa El Khashab
Farideh Nejat
Erwin Cornips
Sandeep Mohindra
Rahul Gupta
Reza Yassari
Lawrence B. Daniels III
Arundhati Biswas
Rick Abbott
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Child's Nervous System / Issue 1/2013
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-012-1916-4

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