University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Health System, Singapore.
Department of Neurosurgery, National University Hospital, Singapore.
Global Spine J. 2013 Dec;3(4):249-52. doi: 10.1055/s-0033-1337123. Epub 2013 Mar 5.
Intradural spinal cord abscesses especially in the cervical spine are a rare occurrence. We report a rare presentation of an intradural extramedullary abscess at the atlantoaxial level, initially misdiagnosed as an epidural collection. The patient presented with worsening quadriparesis preceded by a 2-week history of upper respiratory tract infection and neck pain. Magnetic resonance imaging showed evidence of an epidural abscess on the left side abutting the cervicomedullary junction. We performed occipitocervical fixation and surgical decompression. Absence of a suspected epidural abscess led us to consider a durotomy, and an intradural abscess was recognized and drained. Presence of an intradural abscess, though extremely rare, must always be considered in suspected spinal epidural collections as radiological and clinical findings are indistinguishable between the two conditions.
硬脊膜脊髓脓肿，尤其是颈椎部位的脓肿，较为罕见。我们报告了一例罕见的寰枢椎水平硬脊膜外脓肿，最初误诊为硬膜外脓肿。患者表现为四肢瘫痪进行性加重，此前有 2 周的上呼吸道感染和颈部疼痛病史。磁共振成像显示左侧硬膜外脓肿紧贴颈髓交界处。我们进行了枕颈固定和手术减压。由于没有发现疑似硬膜外脓肿，我们考虑进行硬脊膜切开术，发现并引流了硬脊膜内脓肿。虽然硬脊膜内脓肿极为罕见，但在疑似脊髓硬膜外脓肿时，始终应考虑到这种可能，因为两种情况下的影像学和临床发现无法区分。
