Spinal Subdural Empyema

Abstract

The present case report plus the literature provide ten examples of this disorder. Common to the majority are (1) a history of preceding or concurrent bacterial infection, (2) the absence of vertebral percussion tenderness, (3) varying degrees of slowly evolving neurological deficit, and (4) cerebrospinal fluid and myelographic abnormalities compatible with parameningeal inflammation but not diagnostic of the latter's location. Acute transverse myelopathy and acute epidural spinal abscess are disorders to be considered in the differential diagnosis. Diagnostic studies should include myelography via a lateral cervical route. Devastating morbidity and mortality can be avoided by early recognition and appropriate therapy.