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Case Reports
. 2016 May 23;8(5):e621.
doi: 10.7759/cureus.621.

Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient

Alexa Bodman  1 , Margaret Riordan  1 , Lawrence S Chin  1
Affiliations
Case Reports

Delayed Presentation of a Cervical Spinal Epidural Abscess of Dental Origin after a Fall in an Elderly Patient

Alexa Bodman et al. Cureus. .

Abstract

Spinal epidural abscesses are an uncommon cause of spinal cord injury but, depending on the size and presence of neurological deficits, urgent neurosurgical intervention may be required. We present a unique case of a patient presenting with a spinal epidural collection several days after a fall. While a spinal epidural hematoma was suspected based on the patient's history and MRI findings, a spinal epidural abscess was found during surgery. The patient underwent laminectomy and instrumented fusion with successful treatment of her infection.

Keywords: delayed epidural hematoma; mid-cervical spinal cord injury; spinal epidural abscess.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Sagittal CT of the Cervical Spine
Sagittal CT image of the cervical spine showing no obvious fracture or dislocation at the time of the initial fall and evaluation by Emergency Department.
Figure 2
Figure 2. Sagittal MRI of Cervical Spine at Presentation
A) T1-weighted images showing isointense epidural collection at the level of C6/7 and hypointense vertebral bodies of C6 and C7. B) T2-weighted images showing a hypointense epidural collection at the level of C6/7 concerning for hematoma with a slight hyperintensity of C6 and the C6 vertebral bodies. C) Short T1 inversion recovery (STIR) sequences images showing prevertebral edema and disruption of the anterior longitudinal ligament at C6/7 and slight hyperintensity of C6/7 disc space and C6 and C7 vertebral bodies likely representing bone marrow edema concerning for underlying injury though no discrete fracture line is noted. D) T1-weighted image with contrast; no significant ring enhancement of the collection is noted.
Figure 3
Figure 3. X-rays of Cervical Spine
A) Lateral X-ray; B) AP X-ray showing postoperative images of instrumentation.
See this image and copyright information in PMC

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