Department of Neurological Surgery, University of Southern California, Keck School of Medicine, Los Angeles, California, USA.
World Neurosurg. 2011 Sep-Oct;76(3-4):361.e11-4. doi: 10.1016/j.wneu.2010.01.008.
Intramedullary abscess of the spinal cord is a rare entity, especially in the setting of an intracardiac shunt, which, to our knowledge, has not been described in the literature. Here we present a case of an intramedullary spinal cord abscess in a patient with a patent foramen ovale.
The article includes a chart review and description of a clinical case presentation.
A 59-year-old man was admitted with rapidly progressive quadriparesis. Magnetic resonance imaging of the cervical spine demonstrated a large intramedullary mass extending from the level of C3 to C7. The patient was taken to the operating room for biopsy and surgical evacuation of the mass. Intraoperative pathology was consistent with abscess, and subsequent cultures grew Streptococcus viridans. On further workup, the patient was found to have a patent foramen ovale with right-to-left flow. Postoperatively, the strength improved significantly in all extremities with residual weakness.
This is the first published case of an intramedullary spinal cord abscess in the setting of an intracardiac right-to-left shunt. Although intramedullary spinal cord abscess is rare, there are certain predisposing conditions that increase the risk of its occurrence.
脊髓髓内脓肿是一种罕见的疾病，尤其是在心内分流的情况下，文献中尚未有报道。在此，我们报告一例卵圆孔未闭患者的脊髓髓内脓肿。
文章包括病例回顾和临床病例介绍。
一名 59 岁男性因进行性四肢瘫痪入院。颈椎磁共振成像显示从 C3 到 C7 水平有一个大的髓内肿块。患者被送往手术室进行活检和肿块切除术。术中病理与脓肿一致，随后的培养物培养出草绿色链球菌。进一步检查发现患者存在卵圆孔未闭伴右向左分流。术后四肢肌力显著改善，仍有残留无力。
这是首例报道的心内右向左分流的脊髓髓内脓肿病例。尽管脊髓髓内脓肿较为罕见，但某些特定的诱发因素会增加其发生的风险。
