Kocaeli Hasan, Hakyemez Bahattin, Bekar Ahmet, Yilmazlar Selçuk, Abas Faruk, Yilmaz Emel, Korfali Ender
Department of Neurosurgery, Uludağ University School of Medicine, Gorukle Campus, Bursa 16059, Turkey.
Surg Neurol. 2008 Apr;69(4):383-91; discussion 391. doi: 10.1016/j.surneu.2007.03.011. Epub 2007 Aug 17.
Complicating events and unusual presentations associated with intracranial abscess are rare but potentially fatal conditions. This study was undertaken to shed light on the unusual complications and presentations of intracranial abscess treated at a single institution.
We retrospectively reviewed 116 cases of intracranial abscesses that were treated at our institution over the last 10 years and identified 11 (9.4%) cases with unusual complications.
These complications consisted of (1) rupture within the abscess, (2) hemorrhage into the abscess, (3) hemispheric infarction due to ICA thrombosis, (4) acute visual loss due to pituitary abscess, (5) acute neurologic deterioration due to rapid gas formation within the abscess, (6) acute hydrocephalus, (7) trigeminal neuralgia, (8) fungal abscess developing secondary to intracranial extension of a temporal bone tumor, (9) Cryptococcus abscess with different morphology, (10) pontine infarction, and (11) sigmoid sinus thrombosis. Sinusitis accompanied 8 (72.7%) of the cases, and there were 5 (45.4%) mortalities. Culture results were unyielding in 4 patients, whereas Streptococcus species were identified in 4 and fungi in the rest.
Intracranial abscesses and their complications still continue to be challenging entities in the neurosurgical practice. Our experience may provide an informational source for those who are taking care of patients with intracranial abscess.
与颅内脓肿相关的复杂事件和异常表现较为罕见，但可能是致命性疾病。本研究旨在阐明在单一机构治疗的颅内脓肿的异常并发症和表现。
我们回顾性分析了过去10年在本机构治疗的116例颅内脓肿病例，确定了11例（9.4%）有异常并发症的病例。
这些并发症包括：（1）脓肿内破裂；（2）脓肿内出血；（3）颈内动脉血栓形成导致的半球梗死；（4）垂体脓肿导致的急性视力丧失；（5）脓肿内迅速形成气体导致的急性神经功能恶化；（6）急性脑积水；（7）三叉神经痛；（8）颞骨肿瘤颅内扩展继发真菌性脓肿；（9）形态不同的隐球菌脓肿；（10）脑桥梗死；（11）乙状窦血栓形成。8例（72.7%）病例伴有鼻窦炎，5例（45.4%）死亡。4例患者培养结果阴性，4例鉴定为链球菌属，其余鉴定为真菌。
颅内脓肿及其并发症在神经外科实践中仍然是具有挑战性的疾病。我们的经验可能为照顾颅内脓肿患者的人员提供信息来源。
