% 0期刊文章% g·凯尔Harrold % Ahya Sajawal阿里%一个经济部Bhattacharyya阿隆·伯科威茨% % T脊髓髓内脓肿的临床特征和诊断成年人:系统回顾% D R 10.1212 / WNL 2023%。0000000000207515 % J半岛投注体育官网神经病学% P 10.1212 / WNL。0000000000207515 X %的背景和目标脊髓髓内脓肿(ISCA)描述了200年前但仍然知之甚少,往往误认为是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 - 58);70%的男性)。31%的人没有确定诱发条件的影响。最常见的症状是弱点(97%)和演讲是10天前症状持续时间中位数(四分位范围5 - 42)。MRI显示限制扩散在100%的8例和增强执行153年99%的情况下进行。 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 – 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. %U //www.ebmtp.com/content/neurology/early/2023/07/03/WNL.0000000000207515.full.pdf