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Journal of the Korean Geriatrics Society 2005;9(1):62-65.
Published online March 31, 2005.
A Case of Intramedullary Myelitis due to Bacterial Meningitis with Cervical Epidural Abscess
Go Un Yun, Jung Hwa Seo, Jong Kuk Kim, Kyung Won Park, Sang Ho Kim
경추부 경막외 농양을 동반한 세균성 뇌막염에 의한 연수내 척수염 1예
Intramedullary myelitis due to bacterial meningitis associated with cervical epidural abscess is very rare. Its cause and clinical features are non-specific, therefore exact diagnosis is often missed or mistaken for other disease and immediate treatment may be delayed. We report a case of intramedullary myelitis due to epidural abscess presented with prominent symptoms of meningitis and manifestations of acute cerebrovacular accident. A 69 -year-old man was admitted due to right hemicranial headache with pain on right posterior neck and febrile sensation. At first, the patient's headache was improved by conservative therapy. Three weeks later, the patient showed abrupt right hemiparesis (MRC grade 2/5) with drowsy mentality. The CSF findings of the patient were compatible with acute bacterial meningitis. Cervical spine MRI showed cervical epidural abscess and extensive intramedullary myelitis from cervical to lumbar spinal cord. After antibiotic therapy, mentality of the patient became to be alert and right hemiparesis was improved to MRC grade 4/5. Follow up cervical spine MRI after several weeks represented that the lesions of cervical epidural abscess and intramedullary myelitis were significantly diminished.
Key Words: Intramedullary myelitis, Bacterial meningitis, Cervical epidural abscess
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