Subdural Abscess in a Patient with Epidural Abscess Combined with Dural Tear

Ye-Soo Park; Seung-Wook Baek; Jeong-Han Oh; Hong-Sik Kim

doi:10.4055/jkoa.2011.46.6.518

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Park, Baek, Oh, and Kim: Subdural Abscess in a Patient with Epidural Abscess Combined with Dural Tear

Case Report

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2011; 46(6): 518-522.

Published online: 29 December 2011

DOI: https://doi.org/10.4055/jkoa.2011.46.6.518

Subdural Abscess in a Patient with Epidural Abscess Combined with Dural Tear

Ye-Soo Park, M.D., Seung-Wook Baek, M.D., Jeong-Han Oh, M.D., Hong-Sik Kim, M.D.

Department of Orthopedic Surgery, Guri Hospital, Hanyang University College of Medicine, Guri, Korea.

Correspondence to: Ye-Soo Park, M.D. Department of Orthopaedic Surgery, Guri Hospital, Hanyang University College of Medicine, 249-1, Gyomun-dong, Guri 471-701, Korea. TEL: +82-31-560-2317, FAX: +82-31-557-8781, hyparkys@hanyang.ac.kr

Received 3 July 2011 Accepted 16 September 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Abscesses of the epidural and subdural spine are relatively rare, but can rapidly progress and cause paraplegia; the mortality rate is high despite improvements in treatment method. In particular, the reoccurrence of subdural abscesses after treatment of an epidural abscess is extremely rare. We experienced a case in which the subdural abscess reoccurred after spinal decompression and drainage of an epidural abscess combined with a dural tear. We report this rare case with a review of the relevant literatures.

Keywords: epidural abscess, subdural abscess

Figures and Tables

Figure 1

Preoperative lumbar AP and lateral radiographs showing degenerative changes.

Figure 2

5×3.5×3 cm sized fluid collection at posterior aspect of the L5 vertebra, back muscle and subcutaneous fat tissue and, enhanced fluid collection were seen in the lumbar epidural space on T1, T2 weighted images (A, B) and on the gadolinium-enhanced images (C, D).

Figure 3

Laminectomy was performed and an epidural abscess was drained. Dural tear was seen at the L5 vertebrae level.

Figure 4

Postoperative follow up lumbar magnetic resonance imaging was cheked. In the gadolinium enhanced image, an enhanced signal subdural abscess was seen at the L2-S1 level.

Figure 5

(A) After the dura mater was incised, an abscess was seen in the subdural space. (B) The dura mater was repaired after the abscess was drained.

Figure 6

Epidural and subdural abscesses were no longer apparent on follow up (postoperative 7 months) lumbar MR images.

References

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