{"id":1689,"date":"2016-04-02T21:03:11","date_gmt":"2016-04-03T03:03:11","guid":{"rendered":"https:\/\/learningneurology.com\/?page_id=1689"},"modified":"2018-10-14T18:08:07","modified_gmt":"2018-10-14T18:08:07","slug":"epidural-abscess-intracranial-or-spinal","status":"publish","type":"post","link":"https:\/\/learningneurology.com\/epidural-abscess-intracranial-or-spinal\/","title":{"rendered":"Epidural Abscess (intracranial or spinal)"},"content":{"rendered":"<h4>Diagnosis:<\/h4>\n<p>Imaging (MRI with and without contrast) plus biopsy for confirmation<\/p>\n<h4>Pathology:<\/h4>\n<p>Biopsy:<\/p>\n<ul>\n<li>Necrosis with inflammation (neutrophils &amp; later macrophages &amp; lymphocytes), rim of fibrosis (if absent this is cerebritis)<\/li>\n<li>Surrounding gliosis<\/li>\n<\/ul>\n<h4>Clinical features:<\/h4>\n<ul>\n<li>Intracranial: focal neurological deficit<\/li>\n<li>Spinal: transverse myelopathy and a flexed posture resisting extension, back pain with fever.<\/li>\n<\/ul>\n<h4>Investigations to consider:<\/h4>\n<p>FBC, ESR, CRP<br \/>\nBlood cultures<br \/>\nLP for CSF:<\/p>\n<ul>\n<li>Pleocytosis &amp; increased protein<\/li>\n<li>NB. Not at the site of abscess<\/li>\n<li>Gram stain &amp; culture of excised material<\/li>\n<\/ul>\n<p>MRI, gadolinium enhanced<br \/>\nConsider myelography<\/p>\n<h4>Treatment:<\/h4>\n<p>Neurological emergency<br \/>\nSurgery, not done in some cases in absence of compression<br \/>\nAntibiotics:<\/p>\n<ul>\n<li>Naficillin or vancomycin intravenous empirically<\/li>\n<li>Same doses as meningitis<\/li>\n<\/ul>\n<h4>Related articles:<\/h4>\n<ul>\n<li><a href=\"https:\/\/learningneurology.com\/approach-to-weakness\/\">Approach to weakness<\/a>,<\/li>\n<li><a href=\"https:\/\/learningneurology.com\/diseases\/bacterial-meningitis\/\">Bacterial Meningitis<\/a>, <a href=\"https:\/\/learningneurology.com\/diseases\/intracranial-empyema\/\">intracranial empyema<\/a>, <a href=\"https:\/\/learningneurology.com\/diseases\/brain-abscess\/\">brain abscess<\/a>,<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Diagnosis: Imaging (MRI with and without contrast) plus biopsy for confirmation Pathology: Biopsy: Necrosis with inflammation (neutrophils &amp; later macrophages &amp; lymphocytes), rim of fibrosis (if absent this is cerebritis) Surrounding gliosis Clinical features: Intracranial: focal neurological deficit Spinal: transverse myelopathy and a flexed posture resisting extension, back pain with fever. Investigations to consider: FBC, &hellip; <a href=\"https:\/\/learningneurology.com\/epidural-abscess-intracranial-or-spinal\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Epidural Abscess (intracranial or spinal)<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[32],"tags":[4,5,10,14,29],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p71rnx-rf","jetpack-related-posts":[],"_links":{"self":[{"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/posts\/1689"}],"collection":[{"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/comments?post=1689"}],"version-history":[{"count":0,"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/posts\/1689\/revisions"}],"wp:attachment":[{"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/media?parent=1689"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/categories?post=1689"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/learningneurology.com\/wp-json\/wp\/v2\/tags?post=1689"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}