Definition An epidural abscess is a walled off area of infection that occurs in the space between the outermost membrane of the brain or spinal cord, and the overlying bone and ligaments.
What is going on in the body? In the head, the epidural space is the area between the outer layer of tissue covering the brain and the skull. In the spine, it is the space between the vertebra and the membrane covering the spinal cord. Whether in the head or spine, these types of abscesses usually result from the spread of infection either directly or through the bloodstream.
What are the signs and symptoms of the infection? The symptoms depend on the location of the infection. If the abscess is in the head, symptoms may include:
sudden weakness and loss of sensation below the level of the abscess
What are the causes and risks of the infection? An epidural abscess usually results from the spread of infection either directly or through the bloodstream. For example, an infection of the nasal sinuses or an open skull fracture can cause an abscess to develop. The risk for epidural abscess increases in a person with:
If untreated, epidural abscesses may continue to grow. This can put pressure on the surrounding nerves, causing them to lose function. It may also cause the abscess to rupture, spilling its contents into the bloodstream. In any case, the result of an untreated abscess is often death.
What can be done to prevent the infection? The only method of preventing an abscess is prompt, proper treatment of infections wherever they occur.
How is the infection diagnosed? Diagnosis is confirmed after a cranial CT scan or cranial MRI reveals the abscess.
What are the long-term effects of the infection? If the abscess is small and promptly treated, the person may have no long-term effects. If there is extensive damage to the brain, the person may have cognitive impairments, loss of motor function, or other problems.
What are the risks to others? There are no risks to others, as the abscess is not contagious.
What are the treatments for the infection? Treatment involves antibiotic therapy and a craniotomy for surgical drainage and/or removal of the abscess.
What are the side effects of the treatments? Infection at the site of surgery may occur. Also, there may be side effects specific to the antibiotic given. When a craniotomy is done to treat the abscess, it may actually spread the infection if all of the infectious organisms are not removed or destroyed. Recurrent infections may occur if the original source of infection is not completely eliminated.
What happens after treatment for the infection? The person should be watched for any signs of infection. If any infection is noted, it should be identified and treated appropriately. If the person has any impairments from brain damage, he or she may need speech therapy, physiotherapy, and/or occupational therapy.
How is the infection monitored? If there has been sigificant brain damage, the person may need regular visits from doctors. Any new or worsening symptoms should be reported to the doctor.
Author: James Warson, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
