Intramedullary Spinal Abscess: Case Report.

Shin, Kyu Man; Choi, Ho Ick; Kye, Chong Soo; Lee, Ki Chan; Chu, Jeong Wha

Original Article

Journal of Korean Neurosurgical Society 1975;4(1): 155-158.

Kyu Man Shin, Ho Ick Choi, Chong Soo Kye, Ki Chan Lee, Jeong Wha Chu

Department of Neurosurgery, College of Medicine, Korea University, Seoul, Korea.

ABSTRACT

Intramedullary spinal cord abscess is rare condition, and that, the diagnosis of an abscess is rarely established before operative interference is indicated. A case of spinal cord abscess is reported upon 42 year-old male who was admitted to this hospital because of severe pain in the posterior lower neck and weakness in all 4 extremities. The patient have no history of infection or operation in recent past. On admission the subject was in state of quadriparesis, and the superficial sensory impairement was up to the level of T1 3 spinal dermatome. In an early course of the illness the motor weakness had started to appear in the left arm and the impairement of pain and temperature sensations in the right leg, indicating a picture of Brown-Sequard's syndrome. Radiographic examinations disclosed a localized enlargement of lower cervical canal with a widening of interpedicular distance and showed a defect and obstruction of dye column at C6 spinal level, which were suggestive of picture of intramedullary tumor. Operation the exposed spinal laminae and dura showed nothing abnormal, but the dura mater was under the grerat pressure. Opening the dura the spinal cord was swollen, tense and nonpulsatile with dusky red discoloration on a surface of the cord. Pus contents were obtained by needle aspiration and through a myelotomy opening the contents were evacuated completely. Culture of the pus contents produced no organisms. Pathology reported a nonspecific suppurative inflammation on the biopsy. The surgical treatment was combined with the administration of antibiotics, in full theapeutic doses and steroid postoperatively. Two weeks after the surgery he showed significant recovery from the neurological dysfunctions in his legs.