Udoh DO
Department of Surgery, University of Benin Teaching Hospital, Benin, Nigeria.
J West Afr Coll Surg. 2012 Jan;2(1):75-83.
Intracranial abscess, though uncommon, have relatively higher occurrence in low socio-economic settings where previous antibiotic abuse and lack modern culture techniques makes isolation of organisms difficult. Diagnosis and treatment are further delayed by a poor referral system and low index for suspicion. Tuberculoma, cannabis abuse, ventriculo-peritoneal shunt catheters and cancer therapy are presented here as unusual causes of intracranial abscesses.
AIMS & OBJECTIVES: To highlight less commonly encountered causes of an uncommon, but dreaded, neurosurgical condition, their diagnosis and treatment approaches.
Five patients who had surgical evacuation of intracranial abscesses not due to pathology from the more familiar spread from sinusitis, mastoid, middle ear, post-meningitic or post -traumatic aetiology are presented. Contrast computerised tomography (CT) brain scan was essential in clinching the diagnosis and determining the management options.
Persistent headaches or features of intracranial involvement (in patients undergoing treatment for other conditions) should always warrant CT of the brain. However, there are several differential diagnoses of ring-enhancing lesions on CT which have to be excluded when considering an abscess.
颅内脓肿虽不常见，但在社会经济水平较低的地区发生率相对较高，在这些地区，既往抗生素滥用以及缺乏现代培养技术使得病原体分离困难。诊断和治疗因转诊系统不完善以及怀疑指数低而进一步延迟。本文介绍了结核瘤、大麻滥用、脑室 - 腹腔分流导管和癌症治疗作为颅内脓肿的不寻常病因。
强调一种不常见但可怕的神经外科疾病较少见的病因、其诊断和治疗方法。
介绍了5例接受颅内脓肿手术引流的患者，这些脓肿并非由鼻窦炎、乳突炎、中耳炎、脑膜炎后或创伤后等更常见的病因传播所致。对比计算机断层扫描（CT）脑部扫描对于确诊和确定治疗方案至关重要。
持续头痛或颅内受累症状（在接受其他疾病治疗的患者中）应始终进行脑部CT检查。然而，在考虑脓肿时，CT上有几种环形强化病变的鉴别诊断必须排除。
