J Korean Orthop Assoc.  2011 Dec;46(6):518-522.

Subdural Abscess in a Patient with Epidural Abscess Combined with Dural Tear

• Park YS
• Baek SW
• Oh JH
• Kim HS

Abstract

Abscesses of the epidural and subdural spine are relatively rare, but can rapidly progress and cause paraplegia; the mortality rate is high despite improvements in treatment method. In particular, the reoccurrence of subdural abscesses after treatment of an epidural abscess is extremely rare. We experienced a case in which the subdural abscess reoccurred after spinal decompression and drainage of an epidural abscess combined with a dural tear. We report this rare case with a review of the relevant literatures.

Keyword

epidural abscess; subdural abscess

MeSH Terms

Abscess
Decompression
Drainage
Epidural Abscess
Humans
Spine

Figure

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  Figure 1 Preoperative lumbar AP and lateral radiographs showing degenerative changes.

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  Figure 2 5×3.5×3 cm sized fluid collection at posterior aspect of the L5 vertebra, back muscle and subcutaneous fat tissue and, enhanced fluid collection were seen in the lumbar epidural space on T1, T2 weighted images (A, B) and on the gadolinium-enhanced images (C, D).

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  Figure 3 Laminectomy was performed and an epidural abscess was drained. Dural tear was seen at the L5 vertebrae level.

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  Figure 4 Postoperative follow up lumbar magnetic resonance imaging was cheked. In the gadolinium enhanced image, an enhanced signal subdural abscess was seen at the L2-S1 level.

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  Figure 5 (A) After the dura mater was incised, an abscess was seen in the subdural space. (B) The dura mater was repaired after the abscess was drained.

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  Figure 6 Epidural and subdural abscesses were no longer apparent on follow up (postoperative 7 months) lumbar MR images.

Reference

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