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[脑脓肿 - 概述]

[Brain abscess - overview].

作者信息

Sveinsson Olafur Arni, Asgeirsson Hilmir, Olafsson Ingvar H

机构信息

Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.

出版信息

Laeknabladid. 2013 Jan;99(1):25-31. doi: 10.17992/lbl.2013.01.478.

Abstract

Brain abscess is a life threatening illness, demanding rapid diagnosis and treatment. Its development requires seeding of an organism into the brain parenchyma, often in an area of damaged brain tissue or in a region with poor microcirculation. The lesion evolves from a cerebritis stage to capsule formation. Brain abscesses can be caused by contiguous or haematogenous spread of an infection, or by head trauma/ neurosurgical procedure. The most common presentation is that of headache and vomiting due to raised intracranial pressure. Seizures have been reported in up to 50% of cases. Focal neurological deficits may be present, depending on the location of the lesion. Treatment of a brain abscess involves aspiration or excision, along with parenteral antibiotic therapy. The outcome has improved dramatically in the last decades due to improvement in diagnostic techniques, neurosurgery, and broad-spectrum antibiotics. The authors provide an overview of the pathogenesis, diagnosis and management of brain abscesses.

摘要

脑脓肿是一种危及生命的疾病,需要快速诊断和治疗。其发展需要将病原体植入脑实质,通常是在受损脑组织区域或微循环不良的区域。病变从脑炎阶段发展到包膜形成。脑脓肿可由感染的邻近或血行播散引起,也可由头部外伤/神经外科手术引起。最常见的表现是由于颅内压升高导致的头痛和呕吐。据报道,高达50%的病例会出现癫痫发作。根据病变的位置,可能会出现局灶性神经功能缺损。脑脓肿的治疗包括穿刺抽吸或切除,以及胃肠外抗生素治疗。由于诊断技术、神经外科和广谱抗生素的改进,在过去几十年中,治疗效果有了显著改善。作者提供了脑脓肿的发病机制、诊断和管理的概述。

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