Intramedullary spinal cord abscess (ISCA): management

Evidence-based neurology checklist on intramedullary spinal cord abscess (isca): management: Magnetic resonance imaging (MRI) features Intramedullary lesion with restricted diffusion Low ADC on DWI: this distinguishes abscesses from necrotic tumours Contrast enhancement: ring or spotty Areas of…

Magnetic resonance imaging (MRI) features

  • Intramedullary lesion with restricted diffusion
  • Low ADC on DWI: this distinguishes abscesses from necrotic tumours
  • Contrast enhancement: ring or spotty
  • Areas of intramedullary T2 high signal
  • MR angiography: this may show spinal artery occlusion

Other investigations

Treatment

Synonym

References

  1. Iwasaki M, Yano S, Aoyama T, Hida K, Iwasaki Y. Acute onset intramedullary spinal cord abscess with spinal artery occlusion: a case report and review. Eur Spine J 2011; 20 Suppl 2(Suppl 2):S294-S301. 
  2. Verdier EP, Konsol O, Portillo S. Intramedullary cervical abscess mimicking a spinal cord tumor in a 10-year-old girl: a case-based review. Childs Nerv Syst 2018; 34:2143-2147.
  3. Harrold GK, Ali AS, Berkowitz AL, Bhattacharyya S. Clinical features and diagnosis of intramedullary spinal cord abscess in adults: a systematic review. Neurology 2023; 101:e836-e844.
  4. Al Barbarawi M, Khriesat W, Qudsieh S, Qudsieh H, Loai AA. Management of intramedullary spinal cord abscess: experience with four cases, pathophysiology and outcomes. Eur Spine J 2009; 18:710-717.
  5. Hardwidge C, Palsingh J, Williams B. Pyomyelia: an intramedullary spinal abscess complicating lumbar lipoma with spina bifida. Br J Neurosurg 1993; 7:419-422.

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