Commondoor Raghuram, Eisenhut Michael, Fowler Charlotte, Kirollos Ramirez W, Nathwani Nisha
Luton and Dunstable Hospital, NHS Foundation Trust, Luton, United Kingdom.
Pediatr Neurol. 2009 Jan;40(1):50-3. doi: 10.1016/j.pediatrneurol.2008.06.018.
Diagnosis of extradural abscesses can be difficult and is often delayed. The case is presented of a 13-year-old girl who was afebrile and had episodes of expressive aphasia, with maintenance of awareness and understanding, lasting for 2-3 minutes and with normal neurologic examination in between. She was found to have a left frontal extradural abscess overlying the region of Broca's area (Brodmann area 44/45) on magnetic resonance imaging. An electroencephalogram showed continuous delta activity in the left frontotemporal region. She made a full recovery after surgical evacuation of pus, which upon culture grew Streptococcus milleri. The possible cause of transient aphasia in this condition is pressure-induced or inflammatory mediator-induced ischemia, with or without associated focal seizures.
硬膜外脓肿的诊断可能具有挑战性，且常常被延误。本文报告了一例13岁女孩的病例，她无发热，出现表达性失语发作，意识和理解能力保持正常，发作持续2 - 3分钟，发作间期神经学检查正常。磁共振成像显示她左侧额叶硬膜外脓肿位于布洛卡区（布罗德曼44/45区）上方。脑电图显示左侧额颞区持续性δ活动。手术引流脓液后她完全康复，脓液培养结果显示为米勒链球菌生长。这种情况下短暂性失语的可能原因是压力诱导或炎症介质诱导的缺血，伴或不伴有相关的局灶性癫痫发作。
