Shimokawa S, Koga H, Nakashima S, Anegawa S, Hayashi T
Department of Neurosurgery, Institute of Neurosciences, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, Fukuoka 830-0047, Japan.
No To Shinkei. 2001 Aug;53(8):775-9.
Two cases of multiple brain abscesses associated with congenital pulmonary arteriovenous fistula are reported. A 57-year-old male with Rendu-Osler-Weber disease complicated by pulmonary arteriovenous fistula developed multiple brain abscesses in the right parietal region. He responded well to surgical drainage and antibiotic therapy, and the pulmonary arteriovenous fistula, located in the left lower lobe, was resected. A 26-year-old female with Rendu-Osler-Weber disease complicated by pulmonary arterivenous fistula developed recurrent multiple brain abscesses in both the frontal and right parietal regions. The brain abscesses were successfully treated with aspiration and antibiotic therapy. She had a history of two previous brain abscesses in the right parietal regions that were excised on separate occasions at 16 and 23 years of age. Although pulmonary arteriovenous fistula was confirmed by angiography, in this case surgical removal of the pulmonary lesions was not indicated due to multiple vascular shunting. The patient had no recurrence of brain abscess with oral antibiotic therapy.
报告了两例与先天性肺动静脉瘘相关的多发性脑脓肿病例。一名57岁男性,患有遗传性出血性毛细血管扩张症并伴有肺动静脉瘘,在右侧顶叶区域发生多发性脑脓肿。他对手术引流和抗生素治疗反应良好,位于左下叶的肺动静脉瘘被切除。一名26岁女性,患有遗传性出血性毛细血管扩张症并伴有肺动静脉瘘,在额叶和右侧顶叶区域反复出现多发性脑脓肿。脑脓肿通过穿刺抽吸和抗生素治疗成功治愈。她曾在16岁和23岁时分别在右侧顶叶区域有过两次脑脓肿切除病史。尽管血管造影证实存在肺动静脉瘘,但由于多处血管分流,该病例未行肺部病变手术切除。患者口服抗生素治疗后脑脓肿未复发。