Sheehan Jason P, Jane John A, Ray Dibyendu K, Goodkin Howard P
Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Neurosurg Focus. 2008;24(6):E6. doi: 10.3171/FOC/2008/24/6/E6.
Although it is uncommon, pediatric brain abscess remains a serious, life-threatening neurological problem. Those with congenital heart disease, an ongoing infection, or an immunocompromised state are particularly at risk. The symptoms on presentation may include those associated with a space-occupying lesion in the brain, and neuroimaging has made the diagnosis of brain abscess more reliable. Prompt diagnosis and treatment are required to lessen neurological morbidity and the risk of death. Treatment includes medical management with appropriate and specific antimicrobials. Although the effectiveness of medical management has improved and some children may be treated with antimicrobial therapy alone, surgical evaluation remains an important component of the treatment algorithm for most pediatric patients.
尽管小儿脑脓肿并不常见,但它仍然是一个严重的、危及生命的神经问题。患有先天性心脏病、正在感染或处于免疫功能低下状态的儿童尤其危险。临床表现的症状可能包括与脑内占位性病变相关的症状,神经影像学检查使脑脓肿的诊断更加可靠。需要及时诊断和治疗以降低神经功能障碍的发生率和死亡风险。治疗包括使用适当的特异性抗菌药物进行药物治疗。尽管药物治疗的效果有所改善,一些儿童可能仅接受抗菌治疗,但对于大多数儿科患者而言,手术评估仍然是治疗方案的重要组成部分。