@article {Harrold10.1212 / WNL。={作者0000000000207515 G。凯尔·哈罗德Ahya Sajawal阿里和亚伦·l·伯科威茨经济部Bhattacharyya}, title ={脊髓髓内脓肿的临床特征和诊断成年人:系统回顾},elocation-id = {10.1212 / WNL。={2023}0000000000207515},年,doi = {10.1212 / WNL。出版商0000000000207515}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标髓内脊髓脓肿(ISCA)描述了200年前但仍然知之甚少,往往误认为是半岛投注体育官网免疫介导性或肿瘤进程。我们目前的系统回顾ISCA在成人中,描述的临床表现,诊断功能,治疗策略和结果。数据库搜索方法髓内脓肿进行2019年4月15日和2022年2月9日重复使用PubMed和EMBASE两个未公开的情况下也包括在内。出版物是由两位作者独立审查列入裁定紧随其后。数据抽象使用在线预测的形式分析了残疾。结果202例包括(中位年龄45(四分位范围31 {\ textendash} 58);70 \ %的男性)。 31\% of those affected had no identified predisposing condition. The most common symptom was weakness (97\%) and the median symptom duration prior to presentation was 10 days (interquartile range 5 {\textendash} 42). MRI showed restricted diffusion in 100\% of 8 cases where performed and enhancement in 99\% of 153 cases where performed. The most common organisms were Mycobacterium tuberculosis (29\%), Streptococcus (13\%), and Staphylococcus (10\%) species. All patients received antimicrobial therapy; surgical drainage was performed in 65\%. At follow up (median 6 months), 12\% had died, 69\% were ambulatory, and 77\% had improved compared to clinical nadir. Of those who underwent operative intervention, surgery within 24 hours of diagnosis was associated with increased likelihood of being ambulatory at follow-up compared to surgery after 24 hours (OR 4.44; 95\% CI 1.26 {\textendash} 15.61; p = 0.020).Discussion ISCA is important to consider in any patient presenting with acute-subacute, progressive myelopathy. Immunocompromise and typical signs of infection (e.g., fever) are often absent. Diffusion restriction and gadolinium enhancement on MRI appear to be sensitive. Antimicrobial therapy with surgical drainage is the most common therapeutic approach, but morbidity remains substantial. If performed, urgent surgery may be more beneficial.}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/early/2023/07/03/WNL.0000000000207515}, eprint = {//www.ebmtp.com/content/early/2023/07/03/WNL.0000000000207515.full.pdf}, journal = {Neurology} }