Large intramedullary abscess of the spinal cord associated with an epidermoid cyst without dermal sinus. Case report

An intramedullary abscess of the spinal cord (IASC) represents a rare disease associated with a potentially devastating outcome. Few cases involving children suffering from an IASC have been reported in the neurosurgical literature. In the majority of the reported pediatric cases there were either congenital abnormalities, such as a dermal sinus, or signs of local infections leading to a secondary hemopoietic spread. The authors report the case of an 18-month-old girl with an extensive IASC associated with an epidermoid cyst extending from T-11 to S-2 without evidence of a dermal sinus or history of clinically apparent systemic infection. To their knowledge, this is the first case report of an IASC without a condition facilitating either direct contamination via a dermal sinus or hemopoietic spread from an infectious focus outside the central nervous system. Signs and symptoms, the clinical course, and imaging features are discussed and the relevant literature is reviewed.     

Intramedullary abscess associated with a spinal cord ependymoma: case report.

Intramedullary spinal cord abscesses are relatively uncommon. We report the first case of an intramedullary spinal cord abscess in a preexisting spinal cord ependymoma. The clinical features and pathogenesis are discussed. Salient features of the management of intramedullary spinal cord abscesses are outlined.     

Intramedullary epidermoid cyst of the cervical spinal cord associated with an extraspinal neuroenteric cyst: case report.

A 4-year-old girl presented with an intramedullary epidermoid cyst of the cervical spinal cord. The clinical, radiological, and surgical features and a brief critical review of the literature are included in this report. The cyst contents were removed totally in two operations. The child had a coexisting neuroenteric cyst in the posterior mediastinum. To our knowledge, this coexistence has not been previously reported. Contemporary imaging modes and prospects of the surgical treatment are discussed.     

Brain abscess secondary to intracranial extradural epidermoid cyst

A case of brain abscess in the right temporal lobe secondary to an intracranial extradural epidermoid cyst in the right parasellar region is reported. The etiology of the brain abscess in this particular case was deduced using the findings of computed tomography, carried out several times over a 3-year period, after an initial operation to remove the epidermoid cyst. One of the scans showed a very-low-density spot in the right parasellar region compatible with air, suggesting a communication between the intracranial space and the paranasal sinuses.     

Intramedullary epidermoid cysts of the spinal cord. Case report.

Epidermoid cysts are tumors familiar to neurosurgeons, but intramedullary epidermoid cysts are rare. The authors report the case of a 6-year-old girl presenting with progressive paraparesis. A midthoracic intramedullary mass was revealed on myelography and magnetic resonance (MR) imaging and confirmed as an intramedullary epidermoid cyst at surgery, at which time the cyst was removed. This is the fourth report documenting a purely intramedullary epidermoid cyst occurring in a child. The pathology and etiology, epidemiology, clinical features, radiology (including MR image characteristics), and surgical treatment of such rare intramedullary benign tumors are discussed. Magnetic resonance imaging reduces the delay in diagnosis of spinal cord tumors but should be guided by clinical judgment.     

Cervical spinal cord intramedullary abscess. Case report

A case of progressive symptoms and signs of cervical spinal cord damage due to intramedullary abscess is reported. The literature is reviewed and the radiological features, particularly magnetic resonance image, are analyzed.     

Diastematomyelia and intramedullary epidermoid spinal cord tumor combined with extradural teratoma in an adult. Case report

Diastematomyelia is rarely diagnosed in the adult. Only a few such cases have been reported in the literature. A 26-year-old Mexican man with lumbar diastematomyelia is reported who also harbored a T-12 intramedullary epidermoid tumor and an extradural teratoma located in the dorsal aspect of the dural sac opposite L-4. These three rare coincidental lesions were removed at surgery. The patient's condition improved.     

Acute intramedullary spinal cord abscess: case report.

We report the first case of an acute pyogenic intramedullary cervical spinal cord abscess, brain abscesses and meningitis due to an unusual anerobe, Bacteroides disiens. The importance of spinal magnetic resonance imaging for establishing the diagnosis is emphasized.     

Intramedullary spinal abscess: a case report with a review of 53 previously described cases.

A patient suffering from intramedullary spinal cord abscess associated with an infected dermal sinus, meningitis, and low-lying spinal cord, underwent laminectomy and drainage, after which there was marked improvement. Review of previously reported cases provides a better understanding of this process. The embryology and anatomy of cutaneous lumbrosacral defects are discussed with reference to their potential for subsequent infection and possible association with severe neurological dysfunction. Prophylactic intervention is recommended.     

Extensive spinal epidural abscess associated with an unremarkable recovery

Spinal epidural abscess is a rare complication of epidural catheter insertion, with an incidence reported to be as low as 0.02%, but with a high morbidity and mortality. This reflects the difficulty in diagnosis of the condition, as early symptoms and signs are usually non-specific with late neurological manifestations. We report a case of spinal epidural abscess in a diabetic patient who underwent splenectomy and distal pancreatectomy. Early investigation with magnetic resonance imaging was effective in demonstrating an extensive epidural abscess involving the thoracic spine, with extension to the base of the skull and associated cord compression. Extensive multilevel laminectomies with thorough irrigation and washout of the epidural space were successful in treating this patient and preventing the development of permanent neurological sequelae.