An epidural abscess is a collection of pus in the space between the skull or spinal bones and the dura mater, which is the outermost of the three meninges, or membranes that cover the brain and spinal cord. The pus is usually due to a bacterial infection. As the pus collects it exerts pressure on the nerve tissue. In rare cases, toxins, or harmful chemicals that are produced by bacteria, may cause damage to the dura mater.

What are The Symptoms?

An abscess on the spinal cord can cause loss of muscular power in the legs and numbness of the entire lower part of the body. An abscess in the brain may have the same symptoms as a stroke, causing weakness down one side of the body or difficulty with speech. The onset of stroke like symptoms is seldom rapid; they usually appear gradually over several hours. In addition, you will probably have general symptoms caused by the infection, such as fever, confusion, and perhaps delirium or convulsions.

What are The Risks?

Epidural abscesses are extremely rare, because the infections that used to cause them can now be treated with antibiotics. Such infections include acute infection of the middle ear and sinusitis.

What Should be Done?

If you suspect that you have an abscess, consult your physician, who will probably consider the history of previous infection, and may order diagnostic tests. Among them may be blood tests to identify the invading bacteria, a skull X-ray, and perhaps an electroencephalogram (EEG). Arteriography, a CAT scan of the brain, and an examination of the spinal cord (myelography) may also be required for a diagnosis.

What is The Treatment?

To combat infection, your physician will probably prescribe an antibiotic. In some cases, however, this will not solve the problem, and surgery will be necessary. The surgeon makes an opening in the skull or in the vertebral bone through which pus can be removed. After such an operation, antibiotic treatment is continued. If the original cause of infection is also dealt with, you have a good chance of full recovery.