颈椎 Halo 固定术后脑脓肿
Brain Abscess After Halo Fixation for the Cervical Spine.
作者信息
Lopes Arthur, Andrade Almir, Silva Igor, Paiva Wellingson, Brock Roger, Teixeira Manoel
机构信息
Hospital das Clínicas FMUSP, São Paulo, Brazil.
Hospital das Clínicas FMUSP, São Paulo, Brazil.
出版信息
World Neurosurg. 2017 Aug;104:1047.e7-1047.e11. doi: 10.1016/j.wneu.2017.05.033. Epub 2017 May 15.
BACKGROUND
Halo fixation is one of the possible treatments for cervical spine fractures. However, improper use of these devices may lead to many complications, such as pin loosening, halo dislocation, pin site infection, and intradural penetration.
CASE DESCRIPTION
We report the case of a 43-year-old man who first presented with a seizure and an altered level of consciousness 5 months after halo-vest placement for an odontoid fracture. Brain imaging showed a brain abscess, under the previous left parietal pin. The patient underwent abscess drainage and antibiotics were administered for 12 weeks. On hospital discharge, he presented with only mild impairments.
CONCLUSIONS
Misapplication of halo fixation devices may lead to serious complications, including intracranial pin penetration and brain abscesses. Proper use of the recommended technique may decrease the risk for complications related to the procedure.
背景
头环固定是颈椎骨折的一种可能治疗方法。然而，这些装置使用不当可能导致许多并发症，如螺钉松动、头环移位、钉道感染和硬膜内穿透。
病例描述
我们报告一例43岁男性病例，该患者在因齿状突骨折行头环背心固定5个月后首次出现癫痫发作和意识水平改变。脑部影像学检查显示在先前左侧顶骨螺钉下方有一个脑脓肿。患者接受了脓肿引流，并使用抗生素治疗12周。出院时，他仅表现出轻度功能障碍。
结论
头环固定装置应用不当可能导致严重并发症，包括颅内螺钉穿透和脑脓肿。正确使用推荐技术可能会降低与该手术相关的并发症风险。
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