Lechowicz Miłosz, Dąbek Katarzyna, Majewska Urszula, Bekesińska-Figatowska Monika, Borszewska-Kornacka Maria K, Bokiniec Renata
Department of Neonatal and Intensive Care, Medical University of Warsaw, Warsaw, Poland.
Division of Gynaecology and Perinatology, Department of Neonatal, Medical University of Lublin, Lublin, Poland.
Pol J Radiol. 2017 Dec 15;82:837-841. doi: 10.12659/PJR.903276. eCollection 2017.
Brain abscesses are very rarely diagnosed in neonates, but if present, they are associated with a high risk of severe complications and mortality. In neonates, brain abscesses can be detected on transfontanelle ultrasonography, in which they appear as hyperechogenic lesions surrounded by a hypoechogenic border.
We present a female neonate, born in the 28 week of gestation, with birth weight of 950 grams, who was born in an ambulance by spontaneous vaginal vertex delivery. No signs of infection were present until the 35 day of hospitalization, when a sudden and serious deterioration in the patient's condition was observed due to late-onset sepsis. Cranial US, performed on the 40 day of life, revealed hyperechogenic lesions with a hypoechogenic halo in the right frontal lobe, which could correspond to brain abscesses. These lesions were caused by septicaemia, identified by transfontanelle ultrasonography, and confirmed on magnetic resonance imaging. The patient recovered and was discharged on the 91th day of life (39 PCA) with a recommendation of permanent neurological surveillance.
Ultrasonography of the central nervous system can reveal inflammatory changes and developing brain abscesses. In neonates, magnetic resonance imaging should be performed as the method of choice for confirming brain abscesses.
脑脓肿在新生儿中很少被诊断出来，但一旦出现，就会伴有严重并发症和死亡的高风险。在新生儿中，经囟门超声检查可以检测到脑脓肿，在超声图像上它们表现为高回声病变，周围有低回声边界。
我们报告一名女性新生儿，孕28周出生，出生体重950克，在救护车上经阴道自然分娩，头先露。住院第35天前无感染迹象，随后因迟发性败血症观察到患者病情突然严重恶化。出生后第40天进行的头颅超声检查显示右额叶有高回声病变，周围有低回声晕，可能为脑脓肿。这些病变由经囟门超声检查确定为败血症，并经磁共振成像证实。患儿康复，出生后第91天（纠正胎龄39周）出院，并建议进行长期神经监测。
中枢神经系统超声检查可发现炎症变化及正在形成的脑脓肿。在新生儿中，磁共振成像应作为确诊脑脓肿的首选方法。
