Niklewski Franziska, Petridis Athanasios K, Al Hourani Jasmin, Blaeser Klaus, Ntoulias Georgios, Bitter Andrej, Rosenbaum Thorsten, Scholz Martin
Department of Neurosurgery, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany Department of Pediatrics, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany
Department of Neurosurgery, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany Department of Pediatrics, Academic Teaching Hospital of University Duisburg - Essen, Duisburg, Germany.
J Surg Case Rep. 2013 Aug 29;2013(8):rjt067. doi: 10.1093/jscr/rjt067.
Subdural intracranial empyemas and brain abscesses are a rare complication of bacterial sinusitis. Pediatric parafalcine abscesses are a rare entity with different treatment compared with other brain abscesses. We present two pediatric cases with falcine abscess as a sinusitis complication and introduce our department's treatment management. In addition a review of literature is performed. Surgical cases of our department and their management are compared with the current literature. In our cases, both of the children showed a recurrent empyema after the first surgical treatment and antibiotic therapy. A second surgical evacuation was necessary. The antibiotic therapy was given for 3 months. Short-time follow-up imaging is necessary irrespective of infection parameters in blood and patient's clinical condition. Especially in parafalcine abscesses a second look may be an option and surgical treatment with evacuation of pus is the treatment of choice if abscess remnants are visualized.
硬脑膜下颅内积脓和脑脓肿是细菌性鼻窦炎罕见的并发症。小儿大脑镰旁脓肿是一种罕见的病症,其治疗方法与其他脑脓肿不同。我们报告两例小儿大脑镰旁脓肿作为鼻窦炎并发症的病例,并介绍我们科室的治疗管理方法。此外,还进行了文献综述。将我们科室的手术病例及其管理方法与当前文献进行了比较。在我们的病例中,两名儿童在首次手术治疗和抗生素治疗后均出现复发性积脓。需要进行第二次手术引流。抗生素治疗持续了3个月。无论血液中的感染参数和患者的临床状况如何,都需要进行短期随访影像学检查。特别是对于大脑镰旁脓肿,如果脓肿残留可见,再次检查可能是一种选择,而手术引流脓液是首选的治疗方法。