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[颅骨硬膜外脓肿:一例报告]

[Cranial epidural abscesses: a case report].

作者信息

Maj B, Kołodziej W, Łatka D

机构信息

Oddziału Neurochirurgii, Wojewódzkiego Centrum Medycznego w Opolu.

出版信息

Neurol Neurochir Pol. 2001 Mar-Apr;35(3):507-17.

Abstract

OBJECTIVE AND IMPORTANCE

Cranial epidural abscess mostly follows sinusitis or mastoiditis, also open cranial injury or cranial surgery with iatrogenic infection. In our case the abscess possibly evolved from epidural haematoma and the process invaded frontal sinus and subgaleal space in the frontal region.

CLINICAL PRESENTATION

A 22-year-old male after motorcycle accident 4 years ago, with signs of sinusitis frontalis and seizures, with CT confirmed epidural abscess.

INTERVENTION

Craniotomy was performed and the abscess totally removed. Homogeneous bone was replaced at the operation. Good result, after 2 months without pathologic signs and correct postoperative tomography.

CONCLUSION

We conclude on the basis of disease history and clinical evidence, that the most probable was transformation of the abscess from epidural haematoma end in long term period perforated through the frontal bone to the frontal sinus, and to the subgaleal space with signs of sinusitis at last.

摘要

目的与重要性

颅骨硬膜外脓肿大多继发于鼻窦炎或乳突炎,也可因开放性颅脑损伤或颅脑手术的医源性感染引起。在我们的病例中,脓肿可能由硬膜外血肿演变而来,且病变侵犯了额窦及额部帽状腱膜下间隙。

临床表现

一名22岁男性,4年前发生摩托车事故,有额窦炎体征及癫痫发作,CT确诊为硬膜外脓肿。

干预措施

行开颅手术,彻底清除脓肿。术中用同种异体骨进行修补。效果良好,术后2个月无病理体征,术后影像学检查正常。

结论

根据病史和临床证据,我们得出结论,最可能的情况是脓肿由硬膜外血肿长期演变而来,最终穿破额骨进入额窦,并蔓延至帽状腱膜下间隙,最终出现鼻窦炎体征。

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