Epidural abscess CT: Difference between revisions
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In this location of the abscess the [[CT scan]] may be used, in case an [[MRI]] isn't available or to image [[skull|bone]]. | In this location of the abscess the [[CT scan]] may be used, in case an [[MRI]] isn't available or to image [[skull|bone]]. | ||
===Spinal Epidural Abscess=== | ===Spinal Epidural Abscess=== | ||
Due to its insufficient capacity to differentiate densities of soft tissues, particularly in the cervical region, it isn't always reliable to delineate the spinal cord, contained lesions or the epidural space. <ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref> | Due to its insufficient capacity to differentiate densities of soft tissues, particularly in the [[cervical vertebrae|cervical region]], it isn't always reliable to delineate the [[spinal cord]], contained lesions or the [[epidural space]], however the use of [[contrast]] may help in the identification of soft tissues. <ref name="Grewal2006">{{cite journal|last1=Grewal|first1=S.|title=Epidural abscesses|journal=British Journal of Anaesthesia|volume=96|issue=3|year=2006|pages=292–302|issn=0007-0912|doi=10.1093/bja/ael006}}</ref> It may be used to guide [[percutaneous drainage]], alternatively to surgical drainage. | ||
==References== | ==References== | ||
Revision as of 03:31, 26 March 2014
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Epidural abscess Microchapters |
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Case Studies |
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Epidural abscess CT On the Web |
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American Roentgen Ray Society Images of Epidural abscess CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
An epidural abscess is a rare suppurative infection of the central nervous system, a collection of pus localised in the epidural space lying outside the dura mater, which accounts for less than 2% of focal CNS infections. [1] It may occur in two different places: intracranially or in the spinal canal. Because the initial symptoms and clinical characteristics are not always identical, and are similar to the ones in other diseases, along with the fact that they are both rare conditions, the final diagnosis might be delayed in time. This late diagnosis comes at great cost to the patient, since it is usually accompanied by a bad prognosis and severe complications with a potential fatal outcome. The diagnosis of epidural abscess should be first suspected from the clinical findings and posteriorly supported by laboratory tests and imaging studies, however it can only be confirmed after surgical drainage and proper study of the collected material. According to the location of the collection, the abscess may have different origins, different organisms involved, symptoms, evolutions, complications and therapeutical techniques. [2][3]
CT Scan
Despite being an important and valuable imaging study and considered the imaging study of choice until very recently, the CT scan is considered secondary, compared to the MRI. It's a non-invasive procedure, which allows for study of intracranial and spinal abscesses. [4]
Intracranial Epidural Abscess
In this location of the abscess the CT scan may be used, in case an MRI isn't available or to image bone.
Spinal Epidural Abscess
Due to its insufficient capacity to differentiate densities of soft tissues, particularly in the cervical region, it isn't always reliable to delineate the spinal cord, contained lesions or the epidural space, however the use of contrast may help in the identification of soft tissues. [5] It may be used to guide percutaneous drainage, alternatively to surgical drainage.
References
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
- ↑ Danner, R. L.; Hartman, B. J. (1987). "Update of Spinal Epidural Abscess: 35 Cases and Review of the Literature". Clinical Infectious Diseases. 9 (2): 265–274. doi:10.1093/clinids/9.2.265. ISSN 1058-4838.
- ↑ Darouiche, Rabih O. (2006). "Spinal Epidural Abscess". New England Journal of Medicine. 355 (19): 2012–2020. doi:10.1056/NEJMra055111. ISSN 0028-4793.
- ↑ Longo, Dan L. (Dan Louis) (2012). Harrison's principles of internal medici. New York: McGraw-Hill. ISBN 978-0-07-174889-6.
- ↑ Grewal, S. (2006). "Epidural abscesses". British Journal of Anaesthesia. 96 (3): 292–302. doi:10.1093/bja/ael006. ISSN 0007-0912.