Revista Archivo Médico de Camagüey
versión ISSN 1025-0255
PEREIRA JIMENEZ, Katia. Acute confusional syndrome as way of presentation of a spinal abscess. AMC [online]. 2011, vol.15, n.1, pp. 1-7. ISSN 1025-0255.
Background:the alteration of the level of consciousness may be produced by multiple causes; it is a syndrome that requires an orderly, quick and effective performance; since it is a medical urgency in which time always goes against the patient. The approach to the geriatric patient with alteration of the level of consciousness should be guided to the treatment of its cause and to the prevention of their complications. Objective: to present an infrequent case with a spinal abscess that started with an acute confusional syndrome. Clinical case: a 62 years old patient begins with an acute change in his behavior, insomnia, abandonment of daily habits, forgot things and also very irritable. To the physical examination were found: perceptivity disorders and cognitive sphere, pain at percussion, mobilization of I and II dorsal spines (DI-DII). A nuclear magnetic resonance of dorsal region was practiced, which showed up a lesion in the epidural space that extended from the second to the sixth segment (DII to DVI). He was taken urgently to the surgical room; he was carried out a posterior approach to the dorsal rachis, through which an epidural abscess was evacuated. In twelve days, neuropsychiatry manifestations disappeared. Conclusions: acute confusional syndrome is a disease that may be found between 10-15% of patients with a medical-surgical disease, incidence that rises until 30% in the old men, and may be an infrequent form of presentation of an intrarrhachidian infection. The opportune diagnosis and effective treatment impeded the progression of neurological manifestations and the symptomatology was reverted.
Palabras llave : EPIDURAL ABSCESS; CONSCIOUSNESS DISORDERS; AGE; MAGNETIC RESONANCE SPECTROSCOPY; CASE STUDIES.