Cluster-like headache as an opening symptom of cervical spinal epidural abscess
Department of Neurology, Chang Gung Memorial Hospital- Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan, Republic of China
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Fig. 1
Magnetic resonance imaging of cervical spine revealed fusiform low T1W, high T2W with enhanced lesion in posterior spinal canal at the C2-6 level and heterogenous signal intensity in left paraspinal soft tissue C2-6 with heterogenous enhancement consistent with posterior epidural abscess at C2-6.
Many patients with spinal epidural abscess did not have classic symptoms, and delayed diagnosis may occur. We present a patient who visited the emergency department for a headache. The pain was twitching and over the left fronto-pariero-occipital area. Left eye lacrimation was found. Erythematous change of the skin over left parietooccipital area was also noted. The patient was hospitalized for further evaluation. Cervical epidural abscess was diagnosed when upper limb weakness developed during hospitalization.
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© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
