Myelopathy due to spinal epidural abscess without cord compression: a diagnostic pitfall.
Spinal epidural abscess (SEA) is a neurological emergency that requires urgent diagnosis and treatment. We report 2 patients with SEA, in whom, on neuropathological examination, the neurological signs were found to be caused by spinal cord ischemia due to thrombosis of leptomeningeal vessels and compression of spinal arteries, respectively, while evidence of spinal cord compression was absent. Clinicians and neuropathologists should be aware of the variable mechanisms underlying the neurological involvement in SEA. Absence of spinal cord compression by the abscess may hamper early diagnosis and treatment.
van de Warrenburg
B P C
BP
Department of Neurology, University Medical Center Nijmegen, The Netherlands. b.vandewarrenburg@neuro.umcn.nl
Wesseling
P
P
Leyten
Q H
QH
Boerman
R H
RH
D000368:Aged; D001157:Arterial Occlusive Diseases / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D001416:Back Pain / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000382:microbiology / Q000473:pathology; D003951:Diagnostic Errors; D020802:Epidural Abscess / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D004824:Epidural Space / Q000382:microbiology / Q000473:pathology; D017809:Fatal Outcome; D005334:Fever / Q000382:microbiology; D006801:Humans; D007238:Infarction / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D012131:Respiratory Insufficiency / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D013116:Spinal Cord / Q000098:blood supply* / Q000473:pathology* / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000175:diagnosis*; D013118:Spinal Cord Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D013203:Staphylococcal Infections / Q000150:complications; D013904:Thoracic Vertebrae / Q000382:microbiology / Q000473:pathology