41. Radiology, University Of Rochester Medical Center 4). Figure 1, Figure 2. Figure 3, Figure 4. Diagnosis epidural abscess.Discussion epidural abscess typically results from direct hematogeneous http://www.urmc.rochester.edu/smd/Rad/neurocases/Neurocase03.htm

Radiology Home Department Overview Faculty Residency ... Next Case Neuroradiology Case of the Week Case 3 Matthew Cham, MD and and P-L Westesson, MD, PhD, DDS Clinical Presentation A 62-year-old man presented with acute onset quadriplegia and fever. Radiological Findings: Sagittal T2-weighted MR images show an epidural fluid collection centered around the C4/5 disk space ( Fig.1 ). Anterior to the vertebral column there is also slightly increased T2 signal indicating a phlegmon and less likely a fluid collection. These each measure approximately 4 mm in AP dimension. The cervical cord is displaced posteriorly and there is compression of the cord but there is no appreciable signal alterations. The fluid collection is in a left paracentral region ( Fig. 2 The sagittal T1 post-contrast enhanced image ( Fig. 3

42. Spinal Epidural Abscess Professionals only. Spinal epidural abscess,, Print this article, (alsocalled spinal dural empyema). The Spinal epidural abscess, Fig. 1 a, b http://www.amershamhealth.com/medcyclopaedia/Volume VI 1/SPINAL EPIDURAL ABSCESS

Medcyclopaedia About Medcyclopaedia Amersham Health Search for: Type a word or a phrase. All forms of the word are searchable. Advanced search Browse entry words starting with: A B C D ... Other characters Try our Medcyclopaedia Premium Edition with added tools and functionality tailored to make your working day easier. The following tools are presently available: Expanded search *For Medical Professionals only, registration required Spinal epidural abscess, (also called spinal dural empyema). The spinal epidural space, being a true space which is filled with fat and vessels, is much more susceptible to infection than the intracranial epidural space, where the dura mater is tightly laminated to the inner layer of the skull and infection is more likely to occur in the subdural space. The estimated incidence of spinal epidural abscess is approximately 2.8 cases per 10,000 admissions to large tertiary-care centres, the range of age being very broad from 3 months to 81 years without gender prevalence. Infection in the spinal epidural space may occur by haemotogenous or local spread.

43. Cervical Epidural Abscess Cervical epidural abscess,, Print this article, see spinal epidural abscessor empyema GS The Encyclopaedia of Medical Imaging Volume VI1, http://www.amershamhealth.com/medcyclopaedia/Volume VI 1/CERVICAL EPIDURAL ABSCE

Medcyclopaedia About Medcyclopaedia Amersham Health Search for: Type a word or a phrase. All forms of the word are searchable. Advanced search Browse entry words starting with: A B C D ... Other characters Try our Medcyclopaedia Premium Edition with added tools and functionality tailored to make your working day easier. The following tools are presently available: Expanded search *For Medical Professionals only, registration required Cervical epidural abscess, see spinal epidural abscess or empyema GS The Encyclopaedia of Medical Imaging Volume VI:1 Welcome to Medcyclopaedia. This site is open to a public audience, still we want to know a little more about our visitors. Please tick off the boxes that match your profile. Do you live in Europe? Yes No Are you a medical professional? Yes No This frame will disappear when submitted Legal Contact us Making Waves

44. Kussman Whithill He had an infection surrounding his spinal cord ( epidural abscess ), butthe doctors failed to do appropriate tests or make proper diagnosis. http://www.lawinfo.com/forum/kussman/sterkin-.html

Settlement Report Form Case Name: UNDISCLOSED Case #: (PASADENA) Type of Case: Medical Malpractice Date Settled: Department: A Settlement: $1,900,000.00 Cash TOTAL Disbursements: Payment: Pltf.Atty.: RUSSELL S. KUSSMAN Firm: Deft.Atty.: DO NO HAVE AUTHORITY Firm Yes/No Deft.Atty.: TO DISCLOSE DEFENSE COUNSEL Firm Yes/No Deft.Atty.: NAMES Firm Yes/No Pltf(s). Age: Pltf(s). Occupation: Owner of Trucking Company Date of incident: Facts of the case: 62 year old diabetic man entered hospital with foot ulcer, back pain and fever. He came under the care of multiple pysicians. He had an infection surrounding his spinal cord ("epidural abscess"), but the doctors failed to do appropriate tests or make proper diagnosis. The infection worsened, causing pressure on the spinal cord and, ultimately, permanent damage and quadriplegia. Finally, surgery was done to drain the abscess, but it was too late. Pltf(s). Contentions: Defendants failed to consider epidural abscess, and therefore failed to make a proper and timely diagnosis. This was below thestandard of care and resulted in permanent spinal cord injury. They failed to do a lumbar puncture until it was too late. They failed to properly perform and interpret a CT scan of the cervical spine. Injuries: Incomplete quadriplegia, loss of bowel and bladder control, recurrent decubitus ulcers, permanent colostomy. Past Meds: Approx. $700,000 TOTAL = $

45. Nature Publishing Group Original Article. Reversal of tetraplegia in patients with cervical osteomyelitis epidural abscess using anterior debridement and fusion†. http://www.nature.com/cgi-taf/DynaPage.taf?file=/sc/journal/v39/n10/abs/3101207a

46. Iliopsoas Strain Spinal Osteomyelitis. epidural abscess. Spinal epidural abscess. Sites of Spinal InfectionMost cases involve thoracolumbar spine; Anterior epidural abscess (20%) http://www.fpnotebook.com/ORT201.htm

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47. 1989 Scientific Program - Nongranulomatous Spinal Epidural Abscess American Academy of Orthopaedic Surgeons 1989 Annual Meeting ScientificProgram. Nongranulomatous Spinal epidural abscess. Paper No. 369. http://www.aaos.org/wordhtml/anmeet89/scipro/ppr369.htm

American Academy of Orthopaedic Surgeons 1989 Annual Meeting - Scientific Program Nongranulomatous Spinal Epidural Abscess Paper No. 369 TUESDAY, FEBRUARY 14, 1989 11:30 AM Las Vegas Convention Center Rooms E1-E3 *Ronald D. Gardner, MD, Miami, FL *Frank P. Cammisa, Jr., MD, Miami, Fl Frank J. Eismont, MD, Miami, FL *Barth Green, MD, Miami, FL Fourteen patients with spinal epidural abscesses were reviewed. All presented with pain, fever and elevated white blood cell count. Thirteen had preoperative paralysis including 1 with Frankel A and 5 with Frankel B paralysis. Nine patients had associated vertebral osteomyelitis. Myelogram accurately demonstrated the abscesses. Magnetic resonance imaging was falsely negative in one patient, but allowed early detection of vertebral osteomyelitis in others. All patients were treated with surgical decompression (average 8 levels) with 9 laminectomies, 3 anterior decompressions and 2 having both procedures. Seven patients died. Mortality correlated with increasing age, presence of diabetes, and severe paralysis. All surviving patients with paralysis improved at least one Frankel grade. *By Invitation Moderator: John W. Frymoyer, MD, Burlington, VT

48. RAAHEC - West Blockton Family Practice Digital Library epidural abscess Patient/Family Resources. Miscellaneous epidural abscessPatient Family Resources Healthfinder (US DHHS) Homepage http://westblocktonfp-dl.slis.ua.edu/patientinfo/infectious/bybodysystem/cns/epi

Patient/Family Resources by Topic: Infectious Diseases Epidural Abscess Patient/Family Resources Spanish Miscellaneous See also: General Neurology Patient/Family Resources Epidural Abscess Clinical Resources MEDLINE plus Medical Encyclopedia: Table of contents Epidural Abscess: English Spanish Spanish MEDLINE plus Medical Encyclopedia: Table of contents Epidural Abscess: English Spanish Miscellaneous Epidural Abscess Patient Family Resources Healthfinder (US DHHS): Homepage Brain Diseases: List of documents National Library of Medicine Medline plus Health Topics: List of topics Brain Diseases List of documents YAHOO - Health:Diseases and Conditions:Infectious Diseases Additional Infectious Diseases resources ( These sites have not been reviewed. YAHOO - Health:Medicine:Infectious Diseases Additional Infectious Diseases resources ( These sites have not been reviewed. YAHOO - Health:Diseases and Conditions:Neurological Disorders Additional Neurological Disorders resources ( These sites have not been reviewed. YAHOO - Health:Medicine:Neurology Additional Neurology resources ( These sites have not been reviewed.

49. Epidural Abscess epidural abscess. Spinal epidural abscess Fever and back pain (the back pain maybe confined to the spine or may radiate to the extremities, the arms or legs); http://www.pennhealth.com/ency/article/001416sym.htm

Disease Injury Nutrition Poison ... Prevention Epidural abscess Alternative Names: Abscess - epidural Symptoms: Spinal epidural abscess: Fever and back pain (the back pain may be confined to the spine or may radiate to the extremities, the arms or legs) Bowel or bladder incontinence Difficulty urinating (urinary retention) Intracranial epidural abscess: Headache , fever, lethargy, (if associated with sinusitis or chronic ear infections, there may be localized pain in those areas) Progressive pain at the site of recent surgery (neurosurgery) especially if accompanied by fever Neurological symptoms depending on the location of the abscess which can be varied and include: Weakness or decreased movement of any area of the body A decrease in sensation of any area of the body Signs and tests: Persistent back pain with fever or headache with fever should lead to medical evaluation including a neurological exam to look for focal neurological deficits (loss of neurologic functions such as movement or sensation). Tests such as CT (cat scan) or MRI are frequently needed to confirm the presence of epidural abscess.

50. Epidural Abscess epidural abscess. Alternative Names An epidural abscess is a medical emergency.Early diagnosis and treatment greatly improve the chance of a good outcome. http://www.pennhealth.com/ency/article/001416trt.htm

Disease Injury Nutrition Poison ... Prevention Epidural abscess Alternative Names: Abscess - epidural Treatment: The goal of treatment is to cure the infection and reduce the risk of permanent neurologic damage. This is usually accomplished by a combination of antibiotics and surgery. In rare cases, antibiotics alone are used. Antibiotics are usually given intravenously for at least 4-6 weeks, yet may be given longer depending on the type of bacteria and the extent of the disease. Surgery is usually necessary to achieve drainage or removal of the abscess (as antibiotics alone have poor penetration into abscesses). In addition, surgery is often needed to reduce pressure on the spinal cord or brain in order to prevent further loss of neurological function. Expectations (prognosis): Untreated, the prognosis includes severe, permanent neurologic damage and death. If diagnosed and treated early, the chances of recovery are better. Unfortunately, if treatment is delayed, there may be irreversible loss of neurological function. Complications: Recurrence of infection (common even if the disorder is treated) Spread of infection Brain abscess Spinal cord abscess Meningitis Permanent neurological damage if diagnosis and treatment are delayed Calling your health care provider: Call your health care provider if fever , persistent headache back pain , or other symptoms of epidural abscess develop, particularly if there is a known risk for the disorder.

51. Health Library Find Information On Epidural Abscess At Find information on epidural abscess at MerckSource. Learn more aboutEpidural epidural abscess. Definition An inflammation including a http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcns

52. CUMC Courseware At surgery, a large epidural abscess was evacuated. An epidural abscesswas found most likely from direct extension from her frontal sinus. http://edcenter.med.cornell.edu/Pathophysiology_Cases/CNS/CNS_10.html

Advanced Search CNS Case 10 by Dr. Richard B. Roberts CAT scan (red arrows on sinuses) - opacification of both frontal and left maxillary, sphenoid sinuses and a possible large non-enhanced lesion in the brain (yellow arrow). What is the most likely diagnosis? Parasagittal MRI and axial MRI show a large (7 cm) well-circumscribed epidural collection compressing the left frontal lobe. At surgery, a large epidural abscess was evacuated. Pathology showed acute and chronic inflammatory cells and a dense fibrous capsule. Post-operatively, the patient had no neurologic sequalae. Cultures from the abscess were negative. Summary In this patient, the only complaint other than chronic sinus infections that suggested a neurologic problem was having been a straight A student, she began failing tests. An epidural abscess was found most likely from direct extension from her frontal sinus. The abscess, because it was epidural, did not invade the meninges or brain but caused significant compression on her frontal lobe. Lesions localized to the frontal lobe may remain clinically silent for prolonged time periods. Cultures from the surgical specimen were negative probably because of the recent antibiotics she had received.

53. ENLmedical.com: Conditions And Concerns: Medical Encyclopedia: Epidural Abscess Table of content. epidural abscess. An epidural abscess of the spine maycause sudden severe neurologic losses and may be life threatening. http://www.enlmedical.com/article/001416.htm

Medical Dictionary Naturapathic Glossary Aphrodisiacs Immune System ... Table of content Epidural abscess Causes and Risks: An epidural abscess is caused by infection in the skull or spine, located in the area between the bones of the skull and/or spine and the meninges (the membranes covering the brain and spinal cord). The infection is usually bacterial (staphylococcus is common) but may be fungal or viral. Pus is formed by a collection of fluid, destroyed tissue cells, white blood cells, and live and dead microorganisms. The pus becomes enclosed(encapsulated) by a lining or membrane that forms at the edges of the fluid collection. There is inflammation of the tissues around the abscess in response to the infection. General symptoms such as fever are usually present as a result of the infection. Enlargement of the abscess and swelling in conjunction with inflammation cause symptoms because of compressed tissues in the brain and spinal cord. An epidural abscess of the head usually enlarges slowly and causes gradual, progressive loss of neurologic functions (such as movement and sensation). An epidural abscess of the spine may cause sudden severe neurologic losses and may be life threatening. The infection is commonly the result of direct extension of nearby infections or may result from microorganisms that spread from infection in distant locations. An epidural abscess of the head commonly results from disorders such as

54. BRAIN ABCESS 1. epidural abscess where the infection is between the dura and the skull bone.This is usually a complication of sinus infection and trauma. epidural abscess. http://www.health.adelaide.edu.au/paed-neuro/abscess.html

INTRACRANIAL INFECTION This is classified into the following : Epidural abscess : where the infection is between the dura and the skull bone. This is usually a complication of sinus infection and trauma. EPIDURAL ABSCESS Subdural empyema or abscess This is infection in the subdural space. This is usually secondary to frontal or ethmoidal sinus infection. Brain abscess This is infection of the brain parenchyma as a result of direct infection spread from infected sinuses or implantation through an open wound as in a penetrating injury. It can also be the result of haematogenous infection as a result of bacteremia and is commonly seen in congenital heart disease. post abscess excision The organism responsible for intracranial infection varies according to the source of infection. From the sinuses the most common organism is Streptococcus, Staph aureus and also anaerobic streptococcus. Pseudomonas aeruginosa is also a common bacterial infection. Bacteroides and haemophilus are common organisms seen from ear infections. The location of the abscess depends on the source of the infection; they usually are located next to the infected sinus.

55. EMedicine Answer Spinal epidural abscess An area of fluid of approximately 6.5 X 1cm hascollected in the posterior epidural space extending from thoracic vertebrae T4 http://knowledge.emedicine.com/splash/shared/pub/xrotw/0034answer.html

eMedicine Image Case Update My Profile Feedback Weakness: Delay in Diagnosis Can Be Disastrous Search eMedicine Search Problems ? Click Here Alcoholic Hepatitis Esophagitis Hemorrhoids ... View all free courses Answer BACKGROUND A 34-year-old African American woman presents to the emergency department with a 1-day history of lower-back pain, bilateral lower-extremity weakness, and an inability to walk. Her symptoms began with numbness and weakness in her right leg; however, the symptoms progressed quickly to the left leg. The woman has a history of hepatitis C. She has no history of back trauma. Hint Physical examination reveals bilateral positive Babinski signs. Author: N. Shaikh, MD, and S. Singh, MD Mercy Catholic Medical Center- Mercy Fitzgerald Hospital Associate Editor: Joanne Connaughton, MD

56. SRS-X, The SRS Educational Resource For Radiology, Staphylococcal Osteomyelitis Case 24. Staphylococcal osteomyelitis with epidural abscess. A 56 year old man withfalls. Diagnosis. Staphylococcal osteomyelitis with epidural abscess. Discussion. http://www.radiology.co.uk/srs-x/cases/024/d.htm

Home Cases Main Index Spine Index SRS-X The SRS Educational Resource Case 24 Staphylococcal osteomyelitis with epidural abscess A 56 year old man with falls This 56 year old man had a five year history of Parkinson's disease. Six months earlier he had been treated for septicaemia, and had made a full recovery. Over recent weeks he had suffered an increasing number of falls. He was admitted and again found to be septicaemic, for which he was treated. However he also complained of pain in the groin, and was noted to have bilateral weakness and spasticity of the legs. Investigations revealed a lytic bone lesion in the right superior pubic ramus. However X-rays of the spine were reported to show only some degenerative change in the cervical region. An MRI of the spine was obtained to investigate his leg weakness. Further images were obtained following contrast. Findings The T1 weighted image shows reduced signal from the marrow of the C6 and C7 vertebral bodies, with narrowing of the C6/7 intervertebral disc. There is additional soft tissue posteriorly which impinges on the cord. The post contrast images demonstrate marked enhancement of the marrow of the affected vertebral bodies, and also of the posterior extension.

57. Health Content Encyclopedia Article Epidural Abscess epidural abscess. Alternate Names. Abscess epidural Definition. An inflammationincluding a collection of infected material (pus) between http://www.baptisteast.com/adamcontent/ency/article/001416.asp

58. Cranial Epidural Abscess Due To Mycobacterium Tuberculosis In A to return to AIDSLINE main menu Cranial epidural abscess due to Mycobacterium tuberculosisin a patient infected with the human immunodeficiency virus letter http://www.aegis.com/pubs/aidsline/1994/jan/M9410715.html

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date. Cranial epidural abscess due to Mycobacterium tuberculosis in a patient infected with the human immunodeficiency virus [letter] Clin Infect Dis. 1993 Aug;17(2):289-90. Unique Identifier : AIDSLINE MED/94002799 Gettler JF; el-Sadr W Keywords: Adult AIDS-Related Opportunistic Infections/*MICROBIOLOGY Brain Abscess/*MICROBIOLOGY Case Report Dura Mater Epidural Space Female Hematoma, Epidural/COMPLICATIONS Human Mycobacterium tuberculosis *Tuberculosis LETTER JOURNAL ARTICLE National Library of Medicine . Reproduced under license with the National Library of Medicine, Bethesda, MD. AEGiS is made possible through unrestricted grants from Boehringer Ingelheim iMetrikus, Inc. , the National Library of Medicine , and donations from users like you. Always watch for outdated information. This article first appeared in 1994. This material is designed to support, not replace, the relationship that exists between you and your doctor. AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

59. Acute Spinal Epidural Abscess. Acute spinal epidural abscess is an uncommon disease. Click here to returnto AIDSLINE main menu Acute spinal epidural abscess. J Natl Med Assoc. http://www.aegis.com/pubs/aidsline/1991/may/M9150777.html

Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date. Acute spinal epidural abscess. J Natl Med Assoc. 1990 Oct;82(10):713-6. Unique Identifier : AIDSLINE MED/91124482 Slade WR Jr; Lonano F; Neurology Service, VA Medical Center, Brooklyn, NY 11209. Abstract: Acute spinal epidural abscess is an uncommon disease. Recommended management has been mainly surgical. We recently treated three cases within 4 weeks. Lowered immune resistance played a role in two of the cases. We suggest that acquired immunodeficiency syndrome will increase the incidence of this uncommon entity and advise that acute spinal epidural abscess can be successfully treated by nonsurgical means in some cases. Keywords: Abscess/*DRUG THERAPY Acquired Immunodeficiency Syndrome/COMPLICATIONS Adult Aged Antibiotics/THERAPEUTIC USE Case Report Diagnosis, Differential Epidural Space Human Male Middle Age Spinal Diseases/*DRUG THERAPY Staphylococcal Infections/DRUG THERAPY JOURNAL ARTICLE National Library of Medicine . Reproduced under license with the National Library of Medicine, Bethesda, MD.

60. The Journal Of The Respiatory Society SELECT LANGUAGE. ArticleTitle, Spinal epidural abscess following EpiduralBlock in a Patient Who underwent Rectal Cancer Surgery A Case Report. http://www.jsgs.gr.jp/journal/2002/035050561e.html

SELECT LANGUAGE ArticleTitle Spinal Epidural Abscess following Epidural Block in a Patient Who underwent Rectal Cancer Surgery: A Case Report AuthorList Katsuki Danno, Masao Kameyama, Kohei Murata, Osamu Ishikawa, Yoshihiko Kishi and Shingi Imaoka Affiliation Department of Surgery and Anesthesiology , Osaka Medical Center for Cancer and Cardiovascular Diseases Journal,Vol,Page,Year Jpn J Gastroenterol Surg 35: 561-565, 2002 Keywords spinal epidural abscess, epidural catheter, rectal cancer Abstract Reprint requests Katsuki Danno Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular diseases 1-3-3 Nakamichi, Higasinari-ku, Osaka, 537-8511, JAPAN

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