Subdural abscess

Introduction to subdural abscess Subdural abscess is an infectious disease that occurs in the subdural space. Common manifestations were: fever (>50%), low back pain or radiculopathy (85%), dyskinesia (82%), loss of sensation (58%), bladder and rectal dysfunction (53%). basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: Somatosensory Disorder Pure Autonomic Failure

Cause of subdural abscess

Bacterial infection (65%):

The most common pathogen of subdural abscess is Staphylococcus aureus.

Disease factors (20%):

Most of the subdural abscesses are spread from the distant infections (such as rickets) through the bloodstream to the subdural space.

Secondary infection (15%):

A small number of congenital skin sinus (or sinus sinus) infections secondary to the midline of the lower back and infections after spinal surgery or anesthesia, lumbar puncture, etc., diabetes and intravenous drug abuse are risk factors.

Subdural abscess prevention

Attention to the treatment of infected lesions in various parts of the body can help prevent subdural abscess.

Subdural abscess complications Complications somatosensory disorder pure autonomic failure

Compression of the spinal cord after local abscess formation can cause secondary spinal edema and severe, irreversible neurological deficits.

Subdural abscess symptoms Common symptoms Migratory abscess Low back pain Abscess Dorsal sphincter dysfunction

Common manifestations were: fever (>50%), low back pain or radiculopathy (85%), dyskinesia (82%), loss of sensation (58%), bladder and rectal dysfunction (53%).

Similar to epidural abscess, the development of subdural abscess can be divided into three stages: the first stage: fever with or without low back pain or radiculopathy; the second stage: exercise, feeling and Sphincter dysfunction; Stage 3: including limb paralysis and complete sensation disappeared below the injured segment, duration of symptoms from 1 day to 1 year, but most cases develop between 2 and 8 weeks, dura The lower abscess is most common in the lumbar segment, followed by the thoracic segment, followed by the neck segment.

Examination of subdural abscess

Blood examination showed an increase in white blood cell count with left nucleus shift, erythrocyte sedimentation rate usually accelerated, lumbar puncture cerebrospinal fluid examination showed lymphocytosis, increased protein, decreased sugar, but often found no bacteria in cerebrospinal fluid.

Intra-arterial angiography with iodo-glucamide combined with CT scans can show the size and extent of the lesion. MRI can show the location and extent of the lesion by seeing an equal or enhanced signal between the vertebral body and the spinal cord on a T1-weighted image.

Diagnosis and diagnosis of subdural abscess

The accuracy of myelography in the diagnosis of subdural abscess is quite high, but it is difficult to locate without obstruction. However, even with MRI, it is very difficult to clearly distinguish between epidural and subdural abscesses, if accompanied by vertebral bodies. Infection with osteomyelitis or intervertebral disc space suggests an epidural abscess.

Differential diagnosis includes epidural abscess, acute transverse myelitis, vertebral osteomyelitis, epidural hematoma, and intraspinal tumor. Clinically, it is almost impossible to distinguish between epidural and subdural abscesses. .

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