Intramedullary spinal cord abscess (ISCA): management
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Intramedullary spinal cord abscess (ISCA): management. Intramedullary lesion with restricted diffusion. Fully referenced neurology checklist.
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
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Treatment
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Synonym
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References
- 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.
- 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.
- 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.
- 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.
- Hardwidge C, Palsingh J, Williams B. Pyomyelia: an intramedullary spinal abscess complicating lumbar lipoma with spina bifida. Br J Neurosurg 1993; 7:419-422.
