ABSCESS EPIDURAL

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	ABSCESS EPIDURAL
	*ABSCESS EPIDURAL*

ABSCESS EPIDURAL

Epidural abscess

Accumulation of pus caused by a bacterial infection of the most external covers of the brain and the spinal marrow.

Age

It affects all the ages.

Causes

Frequently one is not able to find out the primary cause of the bacterial infection that causes the epidural abscess. Usually the pathogens arrive at the brain by one from these three routes:

By contiguidad; infection that extends from the neighboring structures, like paravertebrales osteomielitis or abcesos.

By direct inoculation; infection caused by a wound in the head or the spine.

By hemática route; infection that extends through the sanguineous irrigation from other infected organs, like lungs, skin or cardiac valves.

Signs and symptoms

The following symptoms throughout several hours usually appear. A cerebral tumor or an accident is resembled those of to cerebrovascular:

Headache.

Nauseas and vomits.

Weakness, entumecimiento or paralysis of a side of the body.

Backache and radicular (sciatic type) when the infection is located in the spinal marrow.

Irregular step.

Convulsions.

Fever.

Confusion or delirium.

Difficulty to speak.

Factors of risk

Hurt in the head.

Diseases that diminish the resistance, like the diabetes mellitus.

Recent infection, specially around the nose, the eyes and the face.

Diseases of the valves cardiac, or prótesis in the same ones.

Prevention

See its doctor if it has some infection - mainly around the nose or in the face to avoid that one extends.

If he is carrying of artificial valves cardiac, or it has them damaged, it will have to follow a protocol of antibiotic protection before banal problems, like the dental manipulations.

Consult with its doctor.

Diagnosis and treatment

DIAGNOSIS:

File and physical examination by a doctor.

Analysis of blood and the spinal liquid.

Electroencefalografía.

Cerebral Imaginería, by means of x-rays of the head, T.A.C. or R.M.N.

TREATMENT:

The treatment is centered in the antibiotic administration, that is made initially by parenteral route (in serum) in the hospital.

Sometimes it is necessary to extract the pus by means of an operation.

General measures

There is no in special.

Medication

The doctor can prescribe to him:

4 to 6 weeks of antibiotics to fight the infection (in VERY IMPORTANT to make all the treatment).

Anticonvulsivos, if it is necessary.

Analgesicos for the pain, if it is necessary.

Activity

While it is entered, it will have to remain in bed.

After a convalecencia of 2 to 3 weeks it could be as active as they allow its forces it.

Diet

Normal, balanced.

The mineral vitamins and supplements will not be necessary unless they appear symptoms of deficiency or cannot eat with normality.

Warn its medico if the fever more of 38º Raises.

They appear inexplicable new symptoms. The drugs used in the treatment can produce indirect effect.

Complications

Without treatment, convulsions, comma and death.

They can be left sequels definitive if the treatment is delayed, or existed an underlying serious disease.

Prognosis

The combination of antibiotics and surgery to drain the pus is very effective, curing itself most of the cases.

In inmunosuprimidos patients it can be more serious and the most frequent sequels.

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