Epiduralis abscessus a leggyakrabban otitis media, sinusitis és mastoiditis következtében alakul ki. Ezekben az esetekben a kórokozók a legtöbbször a vénás és artériás rendszeren keresztül jutnak az epiduralis térbe, míg nyílt törések vagy idegsebészeti műtétek során direkt módon is kerülhetnek baktériumok a koponyacsont és a dura közé. Esetismertetésünk irodalmi ritkaságnak tekinthető, mivel az enormis nagyságú epiduralis tályog kialakulásában szerepet játszott a tüdődaganat áttéte miatt kialakult craniumdestrukció, mely megnyitotta a nem steril sinusokat és a mastoid rendszert az epiduralis tér irányába. A gyors állapotromlásban szerepet játszott a beteg szegényes együttműködése és krónikus alkoholizálása. Orv Hetil. 2024; 165(2): 69–73.
Epidural abscess most often develops as a result of otitis media, sinusitis, and mastoiditis. In these cases, most of the time, pathogens enter the epidural space through the venous and arterial system, while during open fractures or neurosurgery, bacteria can also enter the skull bone and dura directly. Our case report can be considered a literary rarity, since the destruction of the cranium – caused by the metastasis of a lung tumor – played a role in the development of the enormous epidural abscess, which opened the non-sterile sinuses and mastoid system in the direction of the epidural space. The patient’s low compliance and chronic alcoholism played a role in the rapid deterioration. Orv Hetil. 2024; 165(2): 69–73.
Chow F. Brain and spinal epidural abscess. Neuroinfect Dis. 2018; 24: 1327–1348.
Kuwata T, Kamei I, Uematsu Y, et al. Intracranial epidural abscess: radiologic features and therapy. Report of two cases. Neurol Med Chir. 1988; 28: 1218–1222.
Castells L, Serra J, Planas M, et al. Absceso epidural intracraneal. An intracranial epidural abscess. Rev Clin Esp. 1992; 190: 435–436.
Schadel A, Böttcher HD, Haverkamp U, et al. Computed tomographic diagnosis of epidural abscess, subdural empyema, meningitis and brain abscess. [Computertomographische Diagnostik der epiduralen Abszesse, subduralen Empyeme, Meningitiden und Hirnabszesse.] Laryngol Rhinol Otol. 1983; 62: 164–167. [German]
Sharif HS, Ibrahim A. Intracranial epidural abscess. Br J Radiol. 1982; 55: 81–84.
Eggart MD, Greene C, Fannin ES, et al. A 14-year review of socioeconomics and sociodemographics relating to intracerebral abscess, subdural empyema, and epidural abscess in Southeastern Louisiana. Neurosurgery 2016; 79: 265–269.
Lefkowitz MA, Chin LS, Couldwell WT. Pediatric intracranial epidural abscess secondary to an infected scalp vein catheter. Pediatr Neurosurg. 1998; 29: 297–299.
Kanu OO, Ukponmwan E, Bankole O, et al. Intracranial epidural abscess of odontogenic origin. J Neurosurg Pediatr. 2011; 7: 311–315.
Clayman GL, Adams GL, Paugh DR, et al. Intracranial complications of paranasal sinusitis: a combined institutional review. Laryngoscope 1991; 101: 234–239.
Karatas A, Is M, Guclu E, et al. Intracranial epidural abscess secondary to isolated sphenoid sinusitis. Br J Neurosurg. 2007; 21: 616–618.
Pradilla G, Ardila GP, Hsu W, et al. Epidural abscess of the CNS. Lancet Neurol. 2009; 8: 292–300.
Chang WC, Tsou HK, Kao TH, et al. Successful treatment of extended epidural abscess and long segment osteomyelitis: a case report and review of the literature. Surg Neurol. 2008; 69: 117–120.
Perić A, Milojević M, Ivetić D. A Pott’s puffy tumor associated with epidural – cutaneous fistula and epidural abscess: case report. Balkan Med J. 2017; 34: 284–287.
Popper HH. Progression and metastasis of lung cancer. Cancer Metastasis Rev. 2016; 35: 75–91.
Tsuya A, Kurata T, Tamura K, et al. Skeletal metastases in non small cell lung cancer: a retrospective study. Lung Cancer 2007; 57: 229–232.
Pallis AG. A review of treatment in non-small-cell lung cancer. Eur Oncol Haematol. 2012; 8: 208–212.
Kumar PM, Manisha M. Epidural hematoma secondary to solitary skull metastasis from an ovarian carcinoma. Asian J Neurosurg. 2014; 9: 112–114.
Berenson JR, Rajdev L, Broder M. Managing bone complications of solid tumors. Cancer Biol Ther. 2006; 5: 1086–1089.
Botteman M, Foley I, Marfatia A, et al. Economic value of zoledronic acid versus placebo in the treatment of skeletal metastases in patients with lung cancer: the case of the United Kingdom. J Clin Oncol. 2007; 25(18 Suppl): 6617.
Mundy GR. Metastasis to bone: causes, consequences and therapeutic opportunities. Nat Rev Cancer 2002; 2: 584–593.
Sugiura H, Yamada K, Sugiura T, et al. Predictors of survival in patients with bone metastasis of lung cancer. Clin Orthop Relat Res. 2008; 466: 729–736.
D’Antonio C, Passaro A, Gori B, et al. Bone and brain metastasis in lung cancer: recent advances in therapeutic strategies. Ther Adv Med Oncol. 2014; 6: 101–114.
DeVries S. Metastatic epidural bacterial abscess in a 4-year-old boy. JAMA Neurol. 2013; 70: 648.
Voung DA, Rades D, Vo SQ, et al. Extracranial metastatic patterns on occurrence of brain metastases. J Neurooncol. 2011; 105: 83–90.