慢性胸腰段硬脑膜下积脓：病例报告及手术治疗
Chronic thoracolumbar subdural empyema: Case report and surgical management.
作者信息
Basheer Azam, Macki Mohamed, Buraimoh Morenikeji, Mahmood Asim
机构信息
Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
Department of Orthopedic Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
出版信息
Surg Neurol Int. 2017 Aug 1;8:167. doi: 10.4103/sni.sni_171_17. eCollection 2017.
BACKGROUND
Spinal cord abscesses and spinal subdural empyemas are rare and difficult to treat.
CASE DESCRIPTION
A 35-year-old male presented to an outside institution with 2 months of progressive low back pain, weakness, and bowel incontinence; he was diagnosed with an L4 epidural abscess that was poorly managed. When the patient presented to our institution, magnetic resonance imaging (MRI) revealed a well-organized chronic subdural abscess at the thoracolumbar junction. Following resection, his back pain resolved but he was left with a residual paraparesis.
CONCLUSION
Subdural abscesses are rare and should be considered among the differential diagnoses for intraspinal mass lesions. Treatment should include prompt surgical exploration and decompression combined with appropriate prolonged antibiotic treatment.
背景
脊髓脓肿和硬脊膜下脓肿较为罕见且治疗困难。
病例描述
一名35岁男性因持续2个月的进行性下背痛、无力和大便失禁就诊于外院；他被诊断为L4硬膜外脓肿，但治疗效果不佳。当该患者就诊于我院时，磁共振成像（MRI）显示胸腰段交界处有一个组织良好的慢性硬脊膜下脓肿。切除术后，他的背痛缓解，但仍遗留残余轻瘫。
结论
硬脊膜下脓肿罕见，在脊髓内占位性病变的鉴别诊断中应予以考虑。治疗应包括及时的手术探查和减压，并结合适当的长期抗生素治疗。
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