Hakan Tayfun, Ceran Nurgül, Erdem Ilknur, Berkman Mehmet Zafer, Göktaş Paşa
Neurosurgery Department, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
J Infect. 2006 May;52(5):359-66. doi: 10.1016/j.jinf.2005.07.019. Epub 2005 Sep 23.
Although the decline of the morbidity and mortality in recent years, brain abscess is still one of the most important problems in Neurosurgery.
Ninety-six patients with brain abscess are analysed retrospectively, that treated between 1988 and 2001, according to age, the clinical symptoms, etiologic factors, infecting organisms, prognostic factors, localization, diagnostic and treatment methods and outcome.
Seventy-two patients treated with aspiration (streotactic aspiration in 12 cases), 14 patients with excision. Ten patients treated medically alone. Seven patients in the aspiration group and one patient in the excision group were died. Cure without any morbidity obtained in 55 patients. A significant correlation determined with initial neurologic grade, meningismus, high fever (>38.50), leucocytosis (>20.000/mm3) and mortality. There were no significant correlation the age groups and outcome, treatment groups and location of abscess, period of treatment, number of abscess, outcome according to GOS and factor, treatment period and received antibiotic.
In appropriate cases, medical treatment can be successful alone but surgery, aspiration, is gold standard for brain abscesses. In that way, definite diagnosis is obtained and pathogen is identified and cure is obtained in a short time.
尽管近年来发病率和死亡率有所下降，但脑脓肿仍是神经外科最重要的问题之一。
回顾性分析1988年至2001年间治疗的96例脑脓肿患者，根据年龄、临床症状、病因、感染病原体、预后因素、定位、诊断和治疗方法及结果进行分析。
72例患者接受穿刺抽吸治疗（12例为立体定向穿刺抽吸），14例患者接受切除术。10例患者仅接受药物治疗。穿刺抽吸组7例患者和切除组1例患者死亡。55例患者治愈且无任何并发症。初始神经功能分级、颈项强直、高热（>38.50）、白细胞增多（>20000/mm³）与死亡率之间存在显著相关性。年龄组与结果、治疗组与脓肿位置、治疗时间、脓肿数量、根据格拉斯哥预后评分的结果及因素、治疗时间和使用的抗生素之间无显著相关性。
在适当的病例中，单独药物治疗可能成功，但手术，即穿刺抽吸，是脑脓肿的金标准。通过这种方式，可以明确诊断、识别病原体并在短时间内治愈。
