Brain Abscess After Halo Fixation for the Cervical Spine

World Neurosurg. 2017 Aug:104:1047.e7-1047.e11. doi: 10.1016/j.wneu.2017.05.033. Epub 2017 May 15.

Abstract

Background: Halo fixation is one of the possible treatments for cervical spine fractures. However, improper use of these devices may lead to many complications, such as pin loosening, halo dislocation, pin site infection, and intradural penetration.

Case description: We report the case of a 43-year-old man who first presented with a seizure and an altered level of consciousness 5 months after halo-vest placement for an odontoid fracture. Brain imaging showed a brain abscess, under the previous left parietal pin. The patient underwent abscess drainage and antibiotics were administered for 12 weeks. On hospital discharge, he presented with only mild impairments.

Conclusions: Misapplication of halo fixation devices may lead to serious complications, including intracranial pin penetration and brain abscesses. Proper use of the recommended technique may decrease the risk for complications related to the procedure.

Keywords: Brain abscess; CNS infection; Cervical fracture; Halo fixation; Odontoid fracture.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Brain Abscess / diagnostic imaging
  • Brain Abscess / etiology
  • Brain Abscess / therapy*
  • Drainage*
  • External Fixators / adverse effects*
  • Fracture Fixation
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Odontoid Process / injuries*
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy*
  • Prosthesis-Related Infections / diagnostic imaging
  • Prosthesis-Related Infections / etiology
  • Prosthesis-Related Infections / therapy*
  • Seizures / etiology
  • Spinal Fractures / surgery*
  • Staphylococcal Infections / diagnostic imaging
  • Staphylococcal Infections / etiology
  • Staphylococcal Infections / therapy*
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents