Epidural AbscessSymptoms, Doctors, Treatments, Advances & More
Learn About Epidural Abscess
An epidural abscess is a collection of pus (infected material) and germs between the outer covering of the brain and spinal cord and the bones of the skull or spine. The abscess causes swelling in the area.
Abscess - epidural; Spinal abscess
Epidural abscess is a rare disorder caused by an infection in the area between the bones of the skull, or spine, and the membranes covering the brain and spinal cord (meninges). This infection is called an intracranial epidural abscess if it is inside the skull area. It is called a spinal epidural abscess if it is found in the spine area. Most are located in the spine.
The spinal infection is usually caused by bacteria but may be caused by a fungus. It can be due to other infections in the body (especially a urinary tract infection), or germs that spread through the blood. In some people, though, no other source of infection is found.
An abscess inside the skull is called an intracranial epidural abscess. The cause may be any of the following:
- Chronic ear infections
- Chronic sinusitis
- Head injury
- Mastoiditis
- Recent neurosurgery
An abscess in the spine is called a spinal epidural abscess. It may be seen in people with any of the following:
- Prior back surgery or another invasive procedure involving the spine
- Bloodstream infections
- Boils, especially on the back or scalp
- Bone infections of the spine (vertebral osteomyelitis)
People who inject illicit drugs are also at increased risk.
Spinal epidural abscess may cause these symptoms:
- Bowel or bladder incontinence
- Difficulty urinating (urinary retention)
- Fever and back pain
Intracranial epidural abscess may cause these symptoms:
- Fever
- Headache
- Lethargy
- Nausea and vomiting
- Pain at the site of recent surgery that gets worse (especially if fever is present)
Nervous system symptoms depend on the location of the abscess and may include:
- Decreased ability to move any part of the body
- Loss of sensation in any area of the body, or abnormal changes in sensation
- Weakness
The goal of treatment is to cure the infection and reduce the risk for permanent damage. Treatment usually includes antibiotics and surgery. In some cases, antibiotics alone are used.
Antibiotics are usually given through a vein (IV) for at least 4 to 6 weeks. Some people need to take them for a longer time, depending on the type of bacteria and how severe the disease is.
Surgery may be needed to drain or remove the abscess. Surgery is also often needed to reduce pressure on the spinal cord or brain, if there is weakness or damage to the nerves.
Spine Specialists At SNI
Dr. Oskouian is a neurosurgeon who specializes in the diagnosis and treatment of complex spinal disorders. As the Chief of the Complex Spine Department, his clinical practice located on the Swedish/Cherry Hill campus in Seattle focuses on scoliosis, spinal deformities, spine trauma, spine fractures, spinal surgery revisions, osteoporosis, spinal cord injury, degenerative disc disease, spine tumors, stereotactic spinal radiosurgery, spine infections, and minimally invasive spinal surgery. Dr. Oskouian received his medical degree from the University of California, Los Angeles. He completed his residency in neurosurgery at the University of Virginia under the late Dr. John Jane, Sr. Dr. Oskouian completed his neurosurgery fellowship at the New Zealand National Hospital in Auckland. Dr. Oskouian has published in numerous medical journals and textbooks, including Neuroscience, Neurosurgery, Neurosurgical Clinics of North America, the Journal of Neurosurgery, Neurosurgical Focus and Spine. His philosophy of care is to provide comprehensive, individualized medical care for his patients based on the most recent scientific advances. Dr. Oskouian also believes prevention, communication and education are a vital component of a patient’s long-term health and well-being. Dr. Oskouian offers the Digital Surgical Experience to guide his practice and maintain consistent communication with his patients throughout their care. This includes offering virtual visits to patients, timely access to information, and interactive messages, check-ins, and reminders, allowing patients to become custodians of their own care. Dr. Oskouian was selected by Seattle Magazine and Seattle Met Magazine as a Top Doctor. Dr. Oskouian is rated as a Distinguished provider by MediFind in the treatment of Epidural Abscess. He is also highly rated in 25 other conditions, according to our data. His clinical expertise encompasses Spondylolisthesis, Epidural Hematoma, Scoliosis, Laminectomy, and Spinal Fusion. Dr. Oskouian is board certified in American Board Of Neurological Surgery. Dr. Oskouian is currently accepting new patients.
Advocate Medical Group Neurosurgery
Ryan Trombly is a Neurosurgery provider practicing medicine in Oak Lawn, Illinois. Dr. Trombly is rated as an Advanced provider by MediFind in the treatment of Epidural Abscess. He is also highly rated in 10 other conditions, according to our data. His clinical expertise encompasses Cervical Myelopathy, Cerebellum Agenesis Hydrocephaly, Spinal Cord Abscess, Microdiscectomy, and Herniated Disc Surgery. Dr. Trombly is board certified in American Board Of Neurological Surgery.
Texas Health Neurosurgery And Spine Specialists
Dr. Moneeb Ehtesham is a fellowship-trained neurosurgeon with specialized expertise in cerebrovascular/endovascular neurosurgery and complex spinal surgery. He has served in teaching and senior academic research and leadership capacities for over two decades. Dr. Ehtesham currently serves as an Associate Professor at the TCU Burnett School of Medicine. His areas of special focus include open and endovascular surgery for aneurysms and other cerebrovascular conditions as well as spinal surgery. Additionally, he has been recognized for his research in the areas of stem cell therapies and brain tumors. He was a recipient of the Young Investigator Award from the American Association of Neurological Surgeons and Congress of Neurological Surgeons.Dr. Ehtesham completed his neurological surgery residency at Vanderbilt University Medical Center in Nashville, where he served as chief resident in his final year. He also completed his neurointerventional/ endovascular neurosurgery fellowship at Vanderbilt. Dr. Ehtesham is a Diplomate of the American Board of Neurological Surgery and a Fellow of the American Association of Neurological Surgeons and the American College of Surgeons. Dr. Ehtesham is rated as an Advanced provider by MediFind in the treatment of Epidural Abscess. He is also highly rated in 26 other conditions, according to our data. His clinical expertise encompasses Subarachnoid Hemorrhage, Stroke, Subdural Hematoma, Laminectomy, and Stent Placement.
Early diagnosis and treatment greatly improve the chance of a good outcome. Once weakness, paralysis, or sensation changes occur, the chance of recovering lost function is greatly reduced. Permanent nervous system damage or death may occur.
Complications may include:
- Brain abscess
- Brain damage
- Bone infection (osteomyelitis)
- Chronic back pain
- Meningitis (infection of the membranes covering the brain and spinal cord)
- Nerve damage
- Return of infection
- Spinal cord abscess
An epidural abscess is a medical emergency. Go to the emergency room or call 911 or the local emergency number if you have symptoms of a spinal cord abscess.
Treatment of certain infections, such as ear infections, sinusitis, and bloodstream infections, may decrease the risk for an epidural abscess. Early diagnosis and treatment are important to prevent complications.
Summary: This is a prospective study involving all patients treated at the University of Kentucky for spinal epidural abscess over a 2-year period. Based on ongoing referrals of patients with SEA, we expect that 200 patients will be enrolled during this time window. We propose to study all available clinical, pathological, radiological, and socioeconomic data of patients diagnosed with a spinal infection w...
Published Date: November 10, 2024
Published By: Jatin M. Vyas, MD, PhD, Roy and Diana Vagelos Professor in Medicine, Columbia University Vagelos College of Physicians and Surgeons, Division of Infectious Diseases, Department of Medicine, New York, NY. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Rajasekaran S, Viswanathan VK, Shetty AP. Primary infections of the spine. In: Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 44.
Tunkel AR. Subdural empyema, epidural abscess, and suppurative intracranial thrombophlebitis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 91.