[Syrinx formation secondary to cervical epidural abscess].
We report a patient with syrinx formation secondary to cervical epidural abscess, cervical spondylitis, cervical discitis and meningitis. A 53-year-old woman developed sudden fever, headache and neck pain. On admission, neurological evaluation showed limitation of cervical motion, meningeal irritation, and exaggerated muscle stretch reflexes in all four extremities. Cerebrospinal fluid cell count was 832/mm3 and protein was 771 mg/dl. Bacterial culture of the cerebrospinal fluid showed Staphylococcus aureus. A cervical MRI scan with Gd-enhancement revealed focal high intensity signal in the T2-weighted and FLAIR images, at the anterior meninges of the C3-8 segments, the vertebral bodies of C5-6 and the intervertebral disks of C5-6 segment. Her diagnosis was cervical epidural abscess, cervical spondylitis, cervical discitis and meningitis. Antibiotics and steroids improved her symptoms. Six weeks after the onset of symptoms, a cervical MRI scan showed narrowing and synarthrosis in the intervertebral space between C5 and C6. MRI and myelo CT scans demonstrated a newly-formed syrinx from C3-C 7. This was an interesting case of syrinx formation secondary to cervical epidural abscess.
Tanaka
Yuji
Y
Department of Neurology and Geriatrics, Division of Neuroscience, Graduate School of Medicine, Gifu University.
Nishida
Hiroshi
H
Inuzuka
Takashi
T
D002574:Cervical Vertebrae / Q000473:pathology; D015299:Discitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D020802:Epidural Abscess / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D016920:Meningitis, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D008875:Middle Aged; D009187:Myelitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D009192:Myelography; D013166:Spondylitis / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D013203:Staphylococcal Infections; D014057:Tomography, X-Ray Computed