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[枕下结核:一例报告]

[Suboccipital tuberculosis: a case report].

作者信息

Ibahioin K, Ait Ben Ali A, Choukri M, Sami A, Achouri M, Ouboukhlik A, El Kamar A, El Azhari A

机构信息

Service de Neurochirurgie, CHU Ibn Rochd, 50, avenue Médecin-Général-Brown, Quartier des Hôpitaux, Casablanca, Maroc.

出版信息

Neurochirurgie. 2001 Feb;47(1):66-8.

Abstract

Suboccipital tuberculosis is an uncommon localization of Pott's disease. The gravity results from the neurological and life threatening risk. We report a case of suboccipital tuberculosis in a 22-year woman who survived. She was given an anti-tuberculosis antibiotic regimen due to pulmonary and pericardal involvement. The patient interrupted her treatment after four months and was admitted six months later for torticolis and spastic tetraplegia without sphincter disorders. Standard x-rays and MRI of the head confirmed suboccipital Pott's disease. Transcranial evacuation was performed and the patient was again given anti-tuberculosis antibiotics. The clinical course was favorable with definitive recovery 45 days later. The patient continued the antibiotic regimen for nine months. An orthopedic supporting device was worn for nine months. The diagnosis of suboccipital tuberculosis can be confirmed on MRI. Appropriate treatment is a subject of debate between exclusive orthopedic or combined orthopedic and surgical treatment. Prognosis depends on the neurological deficit, early diagnosis and prompt treatment.

摘要

枕下结核是波特病的一种罕见发病部位。其严重性源于神经方面以及危及生命的风险。我们报告一例22岁女性枕下结核患者存活的病例。由于肺部和心包受累,她接受了抗结核抗生素治疗方案。患者在四个月后中断治疗,六个月后因斜颈和痉挛性四肢瘫入院,无括约肌功能障碍。头部的标准X线和MRI检查确诊为枕下波特病。进行了经颅引流,患者再次接受抗结核抗生素治疗。临床过程顺利,45天后完全康复。患者继续使用抗生素治疗九个月。佩戴矫形支撑装置九个月。枕下结核的诊断可通过MRI确诊。适当的治疗是单纯矫形治疗还是矫形与手术联合治疗之间存在争议的话题。预后取决于神经功能缺损情况、早期诊断和及时治疗。

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