Kobayashi Atsushi, Nagashima Goro, Noda Masayuki, Kato Akihito, Morishima Hiroyuki, Ishii Hiroaki, Kunishima Hiroyuki, Matsumoto Hiroshi
Department of Neurosurgery, St. Marianna University Kawasaki Municipal Hospital, Kawasaki, Kanagawa.
Department of Emergency and Disaster Medical Care Center, St. Marianna University Kawasaki Municipal Hospital, Kawasaki, Kanagawa.
NMC Case Rep J. 2015 Sep 8;3(2):25-27. doi: 10.2176/nmccrj.cr.2015-0066. eCollection 2016 Apr.
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is one of the major complications caused by prolonged bisphosphonate administration. We treated a case of BRONJ-related cerebral and intraventricular abscess. An 80-year-old woman was referred to our hospital for osteonecrosis of the maxilla. Removal of a decayed tooth followed by several oral antimicrobial administrations was performed, but the inflammation spread gradually into the orbit. Twenty-seven months after the initial treatment, she was referred to our hospital. A computed tomography (CT) scan revealed formation of an intraventricular abscess secondary to destruction of the maxillary and sphenoid sinuses. Reports of BRONJ associated with intracranial infection are rare. With prolonged life expectancy, BRONJ cases will increase with many comorbid diseases. Co-operation among physicians, dentists, and pharmacologists will be needed to treat these conditions appropriately.
双膦酸盐相关颌骨坏死（BRONJ）是长期使用双膦酸盐引起的主要并发症之一。我们治疗了一例与BRONJ相关的脑内和脑室内脓肿病例。一名80岁女性因上颌骨坏死被转诊至我院。拔除一颗龋齿后进行了多次口服抗菌药物治疗，但炎症逐渐蔓延至眼眶。初始治疗27个月后，她被转诊至我院。计算机断层扫描（CT）显示，上颌窦和蝶窦破坏继发脑室内脓肿形成。与颅内感染相关的BRONJ报道罕见。随着预期寿命延长，BRONJ病例将随着许多合并症的增加而增多。需要医生、牙医和药理学家之间的合作来妥善治疗这些病症。
