An epidural abscess is swelling between the spinal cord or skull and the nervous system. This usually is caused by an infection between the meninges, or the membranes covering the brain and spinal cord, and the bones of the spine or the skull. About 90 percent of the time, an epidural abscess is found bordering the spine. The most common causes of abscesses in the head and spine area are infections either in the site of the abscess or elsewhere in the body. These infections might be caused by bacteria or fungus, but occasionally, an epidural abscess will occur in someone with no visible infection.
If the abscess is between the skull and brain, it is called an intracranial epidural abscess. This type of abscess causes typical symptoms of infections such as fever, nausea and vomiting. It also causes headaches, lethargy and pain at the site of the swelling. An intracranial epidural abscess is more likely to happen in patients who have a history of ear infections or sinus infections, and it also can happen after head surgery or a head injury.
If the site of the swelling is somewhere along the spine, it is called a spinal epidural abscess. Spinal abscesses can cause bowel or bladder problems such as incontinence or difficulty urinating. Some patients will also feel back pain, paralysis or weakness. People who have had back surgery or recent bloodstream infections are at the highest risk for spinal epidural abscesses.
Anyone who has persistent back pain or headache with a fever, experiences vomiting and a fever or has weakness and difficulty moving should consult a medical professional. The earlier the epidural abscess is diagnosed and treated, the better the prognosis. If the symptoms persist to the point of causing paralysis or severe weakness, however, it might be an indication that significant nerve damage has occurred, and in some cases, the damage is permanent.
If a patient has symptoms of an epidural abscess, a physician typically will do scans of the head and back area using a computed tomography (CT) scan or magnetic resonance imaging (MRI). After an abscess is found, the doctor might take samples of it to determine the cause of the infection. Typically, a treatment for abscess has two components. Patients undergo surgery to drain the abscess and relieve the pressure on the brain or spinal cord and take strong antibiotics, usually through an intravenous (IV) line for four to six weeks.