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颅内积脓:文献综述及猫的两例新病例

Intracranial empyema: literature review and two novel cases in cats.

作者信息

Barrs V R, Nicoll R G, Churcher R K, Beck J A, Beatty J A

机构信息

Valentine Charlton Cat Centre, Faculty of Veterinary Science, The University of Sydney, NSW 2006, Australia.

出版信息

J Small Anim Pract. 2007 Aug;48(8):449-54. doi: 10.1111/j.1748-5827.2006.00307.x. Epub 2007 Jun 2.

Abstract

OBJECTIVES

To review the literature on intracranial empyema and report two new cases in cats.

METHODS

Literature review and case reports.

RESULTS

Intracranial empyema has been rarely reported in small animals. In two novel cases in cats, the route of infection was postulated to be local extension from a retrobulbar abscess of odontogenic origin in one case and direct inoculation from a penetrating bite wound to the skull, confirmed at post-mortem examination, in the other. On magnetic resonance imaging of the first case, there was a contrast-enhancing large extra-axial fluid collection overlying the right cerebral hemisphere, consistent with subdural empyema. Infection was caused by an Actinomyces spp. This is the first report of successful treatment of intracranial empyema by craniotomy, drainage and antibiotics.

CLINICAL SIGNIFICANCE

Intracranial empyema is a neurosurgical emergency. Favourable outcomes may be achieved with surgical decompression, antimicrobial therapy and intensive care.

摘要

目的

回顾关于颅内积脓的文献,并报告猫的两例新病例。

方法

文献回顾及病例报告。

结果

颅内积脓在小动物中鲜有报道。在两例猫的新病例中,一例推测感染途径为牙源性眶后脓肿的局部蔓延,另一例经尸检证实为颅骨穿透性咬伤直接接种感染。在第一例病例的磁共振成像中,右侧大脑半球上方有一个增强造影的大轴外液体积聚,符合硬脑膜下积脓。感染由放线菌属引起。这是首例通过开颅手术、引流及抗生素成功治疗颅内积脓的报告。

临床意义

颅内积脓是一种神经外科急症。通过手术减压、抗菌治疗及重症监护可能取得良好疗效。

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