ABSTRACT
To emphasize the importance of timely diagnosis of spinal epidural abscess, thirteen patients admitted to a single general hospital are presented. In 10 patients, diagnosis was not appreciated at the time of presentation. After treatment, four remained paraparetic and three died. Nine patients had predisposing factors, including seven with infections at sites other than the spinal canal. Staphylococcus aureus was the predominant organism. Outcome was equally devastating for the seven patients with acute and the six patients with chronic infections. Gadolinium-enhanced magnetic resonance imaging was the most useful diagnostic test, and we recommend that it be performed promptly in any patient with clinical features suggesting spinal epidural abscess since early surgical drainage and appropriate antibiotics may yield a favorable outcome.
Subject(s)
Abscess/diagnostic imaging , Spinal Diseases/diagnostic imaging , Staphylococcal Infections/diagnostic imaging , Abscess/complications , Adult , Aged , Female , Gadolinium , Humans , Magnetic Resonance Imaging , Middle Aged , Radionuclide Imaging , Spinal Cord Compression/diagnostic imaging , Spinal Cord Compression/etiology , Spinal Diseases/complications , Staphylococcal Infections/complicationsABSTRACT
Vasospasm may be one of the causes of amaurosis fugax. A patient is reported who daily experienced multiple brief episodes of amaurosis fugax. The absence of physical, laboratory, or radiographic evidence for thromboembolism, hemodynamic compromise, or vasculitis, suggested that the amaurosis might be caused by vasospasm. This hypothesis was supported by cessation of the attacks of amaurosis when the patient was treated with a calcium channel blocker.
