[A case of acute cervical epidural abscess].
Epidural abscess is very uncommon in the cervical region, and it is difficult to diagnose because of the diversity of its clinical course. The resulting neurological deficits remain unacceptably severe because of delays in diagnosis and treatment. We present a rare case of acute cervical epidural abscess. A 57-year-old man was admitted to our hospital because of esophageal carcinoma. During an overnight stay outside the hospital, he experienced sudden lumbago while removing snow at his home. The next day he developed back pain and high fever. He was drowsy but complained of neck pain. Lumbar puncture was dry. Two hours after the procedure, he developed respiratory arrest and became comatose. Consciousness and motor function recovered in response to artificial ventilation, but tetraplegia developed three days later. Cervical enhanced-CT suggested an epidural abscess. Emergency decompression laminectomy and drainage of the abscess combined with systemic antibiotics was performed. Postoperatively, the patient was afebrile, and his respiration and motor function gradually recovered. The histopathological diagnosis was abscess, but its origin was undetermined.
Kimura
T
T
Department of Neurosurgery, Asahikawa Medical College, Japan.
Hashizume
K
K
Tanaka
T
T
Yonemasu
Y
Y
D000038:Abscess / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed