Singh Ishwar, Rohilla Seema, Kumawat Manjulata
Department of Neurosurgery, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India.
Department of Radiodiagnosis, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India.
J Neurol Surg A Cent Eur Neurosurg. 2014 May;75(3):189-94. doi: 10.1055/s-0033-1342933. Epub 2013 May 20.
Intracranial abscesses remain a significant health care problem in developing countries. Though potentially curable, brain abscess remains a diagnostic and therapeutic challenge. The effective treatment of intracranial abscess remains controversial. Various surgical procedures like drainage, aspiration, and excision have been advocated for the management of brain abscess with variable results. Aspiration is a rapid and safe procedure, especially with use of stereotactic techniques, intraoperative ultrasound, or computed tomography (CT) scan guidance. However, these are not readily available everywhere.
To assess the outcome in pyogenic brain abscesses treated by twist drill aspiration (a bedside procedure) in which point of aspiration is marked with the help of three-dimensional (3D) reconstructed CT images.
From September 2007 to September 2011, a total of 103 cases of brain abscesses over 2.5 cm in size were treated by twist drill aspiration. The point of aspiration was marked with the help of 3D reconstructed CT images using fixed bony landmarks as reference, and exact measurement were taken with the help of biopsy software.
In the present study, 103 cases of superficial brain abscesses were treated via twist drill aspiration. Out of these, 98 patients had a single abscess and five had multiple abscesses. Out of the 103 patients, 86 (83.4%) showed good recovery, 9 (8.7%) had moderate disability, 3 (2.9%) had severe disability, and 5 (4.8%) expired.
Twist drill aspiration is a rapid, safe, and very effective lifesaving procedure in the underdeveloped world where stereotaxy is not readily available.
颅内脓肿在发展中国家仍然是一个重大的医疗保健问题。尽管脑脓肿有潜在的可治愈性，但它仍然是一个诊断和治疗上的挑战。颅内脓肿的有效治疗仍存在争议。各种外科手术，如引流、抽吸和切除，都被提倡用于脑脓肿的治疗，但效果各不相同。抽吸是一种快速且安全的手术，尤其是在使用立体定向技术、术中超声或计算机断层扫描（CT）扫描引导的情况下。然而，这些技术并非在所有地方都容易获得。
评估在三维（3D）重建CT图像的帮助下，通过钻颅抽吸术（一种床旁手术）治疗化脓性脑脓肿的效果，其中抽吸点借助3D重建CT图像进行标记。
从2007年9月至2011年9月，共有103例直径超过2.5厘米的脑脓肿患者接受了钻颅抽吸术治疗。抽吸点借助以固定骨性标志为参考的3D重建CT图像进行标记，并借助活检软件进行精确测量。
在本研究中，103例浅表性脑脓肿患者通过钻颅抽吸术进行治疗。其中，98例患者有单个脓肿，5例有多个脓肿。在这103例患者中，86例（83.4%）恢复良好，9例（8.7%）有中度残疾，3例（2.9%）有重度残疾，5例（4.8%）死亡。
在立体定向技术不易获得的欠发达地区，钻颅抽吸术是一种快速、安全且非常有效的挽救生命的手术。
