Blagoveshchenskaia N S, Mukhamedzhanov N Z
Vestn Otorinolaringol. 1989 Jul-Aug(4):37-42.
Analysis of observations of 49 patients with rhinosinusogenic brain abscesses revealed differences in their development between adults and children. This pathology occurs in adults more frequently than in children, particularly young children. In adults, brain abscesses usually develop as a result of chronic frontal- or polysinusitis, while in children they typically occur after maxillary sinusitis and in early age children also after acute suppuration in the nasal cavity. For adults, the contact pathway of infection is characteristic, whereas for children, the hematogenic-metastatic pathway is typical. Adults show single abscesses while children show both single, multiple and multichamber abscesses accompanied by separation of cranial sutures, thinning of calvaria, and protrusion and tension of the cranial fontanel. In children, abscesses may grow very large. In adults, the hypertensive syndrome is very distinct, while in children, the hydrocephalic-hypertensive syndrome comes to the foreground. In children, infectious-toxic symptoms are more significant. In adults, focal neurological symptoms become more serious than in children in whom they are also more labile.
对49例鼻源性脑脓肿患者的观察分析显示,成人和儿童在其发病过程中存在差异。这种病理情况在成人中比在儿童中更常见,尤其是幼儿。在成人中,脑脓肿通常由慢性额窦炎或多鼻窦炎引起,而在儿童中,它们通常发生在上颌窦炎之后,在幼儿中也可发生于鼻腔急性化脓之后。对于成人,感染的接触途径具有特征性,而对于儿童,血行转移途径则较为典型。成人表现为单个脓肿,而儿童则既有单个、多个和多房脓肿,同时伴有颅缝分离、颅骨变薄以及囟门突出和紧张。在儿童中,脓肿可能长得非常大。在成人中,高血压综合征非常明显,而在儿童中,脑积水 - 高血压综合征更为突出。在儿童中,感染中毒症状更为显著。在成人中,局灶性神经症状比儿童更严重,而儿童的此类症状也更不稳定。