RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.
Acute central cord syndrome arising from a cervical epidural abscess: case report.
Neurosurgery 2007 August
OBJECTIVE: Acute central cord syndrome (ACCS) is a well-known sequela to spinal trauma but has rarely been associated with nontraumatic etiologies. Spinal epidural abscess (SEA) and spinal osteomyelitis/discitis are also well characterized clinical entities. Neither SEA nor osteomyelitis leading to ACCS has been previously reported.
CLINICAL PRESENTATION: In this report, a patient presented with refractory neck pain after minor trauma followed by development of left hand weakness and paresthesia, which progressed to a classic central cord injury clinical pattern over a period of 4 weeks.
INTERVENTION: Imaging and laboratory studies were consistent with SEA and osteomyelitis. Motor evoked potentials obtained during surgery definitively corroborated the clinical diagnosis of ACCS and supported a long tract pathophysiology.
CONCLUSION: ACCS may be caused by SEA.
CLINICAL PRESENTATION: In this report, a patient presented with refractory neck pain after minor trauma followed by development of left hand weakness and paresthesia, which progressed to a classic central cord injury clinical pattern over a period of 4 weeks.
INTERVENTION: Imaging and laboratory studies were consistent with SEA and osteomyelitis. Motor evoked potentials obtained during surgery definitively corroborated the clinical diagnosis of ACCS and supported a long tract pathophysiology.
CONCLUSION: ACCS may be caused by SEA.
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