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儿童鼻窦感染继发硬脑膜下积脓

Subdural empyema secondary to sinus infection in children.

作者信息

Osman Farah Jibril, Kandasamy Jothy, May Paul, Buxton Neil, Mallucci Conor

机构信息

Neurosurgery, The Walton Centre for Neurology and Neurosurgery, Liverpool, UK.

出版信息

Childs Nerv Syst. 2009 Feb;25(2):199-205. doi: 10.1007/s00381-008-0665-x. Epub 2008 Jun 25.

Abstract

OBJECTIVE

To evaluate the impact, on morbidity and mortality, of aggressive surgical management of subdural empyema of sinus origin in children.

METHOD

The authors conducted a retrospective review of 20 children admitted between 2000-2007 to Alder Hay Children Hospital and The Walton centre for Neurology and Neurosurgery for subdural empyema secondary to sinus infection. Clinical presentation, duration of symptoms, radiological investigations, surgical treatment and post-operative outcome were evaluated.

RESULTS

Outcome was favourable in 19 cases. In four cases, there were re-accumulation requiring surgical evacuation, four patients experienced post-operative seizures but were seizure-free at follow-up. There was only one mortality in the series.

CONCLUSION

Subdural empyema secondary to sinus infection, although uncommon, it could be associated with a relative high morbidity and mortality rate. Early aggressive surgical and medical management with drainage of intracranial or sinus collections and antibiotics therapy lead to a low mortality or morbidity rate and good clinical outcome.

摘要

目的

评估积极手术治疗儿童鼻窦源性硬脑膜下积脓对发病率和死亡率的影响。

方法

作者对2000年至2007年间因鼻窦感染继发硬脑膜下积脓而入住奥尔德希儿童医院和沃尔顿神经外科中心的20名儿童进行了回顾性研究。评估了临床表现、症状持续时间、影像学检查、手术治疗及术后结果。

结果

19例预后良好。4例出现积液复发需再次手术引流,4例患者术后出现癫痫发作,但随访时无癫痫发作。该系列中仅1例死亡。

结论

鼻窦感染继发硬脑膜下积脓虽不常见,但可能伴有相对较高的发病率和死亡率。早期积极的手术及药物治疗,包括颅内或鼻窦积脓引流及抗生素治疗,可降低死亡率和发病率,并取得良好的临床效果。

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